The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Adult" means any individual 18 years of age or older.

"Age and stage appropriate" means the curriculum, environment, equipment, and adult-child interactions are suitable for the ages of the children within a group and the individual needs of any child.

"Age groups":

1. "Infant" means children from birth to 16 months.

2. "Toddler" means children from 16 months up to two years.

3. "Preschool" means children from two years up to the age of eligibility to attend public school, five years by September 30.

4. "School age" means children eligible to attend public school, age five or older by September 30 of that same year. Four-year-old or five-year-old children included in a group of school age children may be considered school age during the summer months if the children will be entering kindergarten that year.

"Attendance" means the actual presence of an enrolled child.

"Balanced mixed-age grouping" means a program using a curriculum designed to meet the needs and interests of children in the group and is planned for children who enter the program at three through five years of age. The enrollment in the balance mixed-age grouping comprises a relatively even allocation of children in each of three ages (three to six years) and is designed for children and staff to remain together with turnover planned only for the replacement of exiting students with children of ages that maintain the class balance.

"Body fluids" means urine, feces, saliva, blood, nasal discharge, eye discharge, and injury or tissue discharge.

"Camp" means a child day camp that is a child day center for school age children that operates during the summer vacation months only. Four-year-old children who will be five by September 30 of the same year may be included in a camp for school age children.

"Center" means a child day center.

"Child" means any individual under 18 years of age.

"Child day center" means a child day program offered to (i) two or more children younger than 13 years of age in a facility that is not the residence of the provider or of any of the children in care or (ii) 13 or more children at any location.

"Child day program" means a regularly operating service arrangement for children where, during the absence of a parent or guardian, a person or organization has agreed to assume responsibility for the supervision, protection, and well-being of a child younger than 13 years of age for less than a 24-hour period. "Child day program" does not include programs such as drop-in playgrounds or clubs for children when there is no service arrangement with the child's parent.

"Children with special needs" means children with developmental disabilities, intellectual disabilities, emotional disturbance, sensory or motor impairment, or significant chronic illness who require special health surveillance or specialized programs, interventions, technologies, or facilities.

"Cleaned" means treated in such a way to reduce the amount of filth through the use of water with soap or detergent or the use of an abrasive cleaner on inanimate surfaces.

"Communicable disease" means a disease caused by a microorganism (bacterium, virus, fungus, or parasite) that can be transmitted from person to person via an infected body fluid or respiratory spray, with or without an intermediary agent (such as a louse or mosquito) or environmental object (such as a table surface). Some communicable diseases are reportable to the local health authority.

"Department" means the Virginia Department of Education.

"Department's representative" means an employee or designee of the Virginia Department of Education, acting as the authorized agent of the superintendent.

"Evening care" means care provided after 7 p.m. but not through the night.

"Good character and reputation" means knowledgeable and objective people agree that the individual (i) maintains business, professional, family, and community relationships which are characterized by honesty, fairness, and truthfulness and (ii) demonstrates a concern for the well-being of others to the extent that the individual is considered suitable to be entrusted with the care, guidance, and protection of children. Relatives by blood or marriage and people who are not knowledgeable of the individual, such as recent acquaintances, shall not be considered objective references.

"Group of children" means the children assigned to a staff member or team of staff members.

"Group size" means the number of children assigned to a staff member or team of staff members occupying an individual room or area.

"High school program completion or the equivalent" means an individual has earned a high school diploma, passed a high school equivalency examination approved by the Board of Education, or has completed a program of home instruction in accordance with § 22.1-254.1 of the Code of Virginia equivalent to high school completion.

"Homeless child" means a child who lacks a fixed, regular, and adequate nighttime residence and includes a child who is:

1. Living in a car, park, public space, abandoned building, substandard housing, bus or train station, or similar settings;

2. Sharing the housing of other persons due to loss of housing, economic hardship, or a similar reason; sometimes referred to as doubled-up;

3. Living in a motel, hotel, trailer park, or camping ground due to lack of alternative adequate accommodations;

4. Living in a congregate, temporary, emergency, or transitional shelter;

5. Awaiting or in foster care placement;

6. Abandoned in a hospital;

7. Living in a primary nighttime residence that is a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings; or

8. A migratory child as defined in 20 USC § 6399 who qualifies as homeless because the child is living in circumstances described in subdivisions 1 through 6 of this definition.

"Independent contractor" means an entity that enters into an agreement to provide specialized services or staff for a specified period of time.

"Individual service, education or treatment plan" means a plan identifying the child's strengths, needs, general functioning and plan for providing services to the child. The service plan includes specific goals and objectives for services, accommodations, and intervention strategies. The service, education or treatment plan clearly shows documentation and reassessment or evaluation strategies.

"Intervention strategies" means a plan for staff action that outlines methods, techniques, cues, programs, or tasks that enable the child to successfully complete a specific goal.

"Licensee" means any individual, corporation, partnership, association, limited liability company, local government, state agency, including any department institution, authority, instrumentality, board, other administrative agency of the Commonwealth, or other legal or commercial entity that operates or maintains a child day center to whom the license is issued.

"Lockdown" means a situation where children are isolated from a security threat and access within and to the facility is restricted.

"Minor injury" means a wound or other specific damage to the body such as abrasions, splinters, bites that do not break the skin, and bruises.

"Overnight care" means care provided after 7 p.m. and through the night.

"Parent" means the biological or adoptive parent or legal guardian of a child enrolled in or in the process of being admitted to a center.

"Physician" means an individual licensed to practice medicine in any of the 50 states or the District of Columbia.

"Physician's designee" means a physician, licensed nurse practitioner, licensed physician assistant, licensed nurse (R.N. or L.P.N.), or health assistant acting under the supervision of a physician.

"Primitive camp" means a camp where places of abode, water supply system, or permanent toilet and cooking facilities are not usually provided.

"Programmatic experience" means time spent working directly with children in a group that is located away from the child's home. Work time shall be computed on the basis of full-time work experience during the period prescribed or equivalent work time over a longer period. Experience settings may include a child day program, family day home, child day center, boys and girls club, field placement, elementary school, or a faith-based organization.

"Resilient surfacing" means:

1. For indoor and outdoor use underneath and surrounding equipment, impact absorbing surfacing materials that comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials' standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004.

2. Hard surfaces such as asphalt, concrete, dirt, grass, or flooring covered by carpet or gym mats do not qualify as resilient surfacing.

"Sanitized" means treated in such a way to remove bacteria and viruses from inanimate surfaces through using a disinfectant solution (i.e., bleach solution or commercial chemical disinfectant) or physical agent (e.g., heat). The surface of the item is sprayed or dipped into the disinfectant solution and allowed to air dry on the surface for a minimum of two minutes or according to the disinfectant solution instructions.

"Serious injury" means a wound or other specific damage to the body such as unconsciousness; broken bones; dislocation; deep cut requiring stitches; poisoning; concussion; or a foreign object lodged in eye, nose, ear, or other body orifice.

"Shaken baby syndrome" or "abusive head trauma" means a traumatic injury that is inflicted upon the brain of an infant or young child. The injury can occur during violent shaking, causing the child's head to whip back and forth, the brain to move about, and blood vessels in the skull to stretch and tear.

"Shelter-in-place" means the movement of occupants of the building to designated protected spaces within the building.

"Short-term program" means a child day center that operates less than 12 weeks a year.

"Special needs child day program" means a program exclusively serving children with special needs.

"Specialty camps" means those centers that have an educational or recreational focus on one subject such as dance, drama, music, or sports.

"Sponsor" means an individual, partnership, association, public agency, corporation, or other legal entity in whom the ultimate authority and legal responsibility is vested for the administration and operation of a center subject to licensure.

"Staff" means administrative, activity, and service personnel including the licensee when the licensee is an individual who works in the center, and any persons counted in the staff-to-children ratios or any persons working with a child without sight and sound supervision of a staff member.

"Staff positions" are defined as follows:

1. "Aide" means the individual designated to be responsible for helping the program leader in supervising children and in implementing the activities and services for children. Aides may also be referred to as assistant teachers or child care assistants.

2. "Program leader" means the individual designated to be responsible for the direct supervision of children and for implementation of the activities and services for a group of children. Program leaders may also be referred to as child care supervisors or teachers.

3. "Program director" means the primary, onsite director or coordinator designated to be responsible for developing and implementing the activities and services offered to children, including the supervision, orientation, training, and scheduling of staff who work directly with children, whether or not personally performing these functions.

4. "Administrator" means a manager or coordinator designated to be in charge of the total operation and management of one or more centers. The administrator may be responsible for supervising the program director or, if appropriately qualified, may concurrently serve as the program director. The administrator may perform staff orientation or training or program development functions if the administrator meets the qualifications of 8VAC20-780-190 and a written delegation of responsibility specifies the duties of the program director.

"Standard precautions" means an approach to infection control. According to the concept of standard precautions, all human blood and certain human body fluids are treated as if known to be infectious for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and other bloodborne pathogens.

"Superintendent" means Superintendent of Public Instruction.

"Therapeutic child day program" means a specialized program, including therapeutic recreation programs, exclusively serving children with special needs when an individual service, education, or treatment plan is developed and implemented with the goal of improving the functional abilities of the children in care.

"Volunteer" means a person who works at the center and:

1. Is not paid;

2. Is not counted in the staff-to-children ratios; and

3. Is in sight and sound supervision of a staff member when working with a child.

Any unpaid person not meeting this definition shall be considered "staff" and shall meet staff requirements.

A. Chapter 14.1, Article 3 (§ 22.1-289.010 et seq.) and Article 4 (§ 22.1-289.030 et seq.) of Title 22 of the Code of Virginia describes the responsibility of the Department of Education for the regulation of child day programs.

B. Section 22.1-16 of the Code of Virginia authorizes the State Board of Education to promulgate regulations to carry out its powers and duties. Pursuant to § 22.1-289.046 of the Code of Virginia, for child day programs that operate at a location that is currently approved by the Department of Education for school occupancy and that houses a public school during the school year, the public school building; vehicles that are owned by the public school and used to transport children attending the child day program; and meals served to children that are prepared by the public school are not subject to inspection or approval.

C. Nothing in this chapter shall be construed to contradict or to negate any provisions of the Code of Virginia which may apply to child day centers.

A. The purpose of these standards is to protect children under the age of 13 years who are separated from their parents during a part of the day by:

1. Ensuring that the activities, services, and facilities of centers are conducive to the well-being of children; and

2. Reducing risks in the environment.

B. The standards in this chapter apply to child day centers as defined in 8VAC20-780-10 that are required to be licensed by the department.

A. Applications for licensure shall conform with Article 3 (§ 22.1-289.010 et seq.) and Article 4 (§ 22.1-289.030 et seq.) of Chapter 14.1, of Title 22.1 of the Code of Virginia and the regulation entitled General Procedures and Information for Licensure, 8VAC20-820.

B. Pursuant to § 22.1-289.034 of the Code of Virginia and the regulation entitled Background Checks for Child Day Programs and Family Day Systems, 8VAC20-770, the applicant and any agent at the time of application who is or will be involved in the day-to-day operations of the center or who is or will be alone with, in control of, or supervising one or more of the children, shall be of good character and reputation; shall not have been convicted of a barrier crime as defined in § 19.2-392.02 of the Code of Virginia; and is not the subject of a founded complaint of child neglect or abuse within or outside the Commonwealth.

C. The sponsor shall afford the superintendent or his agents the right at all reasonable times to inspect facilities and to interview his agents, employees, and any child or other person within his custody or control, provided that no private interviews may be conducted with any child without prior notice to the parent of such child.

D. The license shall be posted in a place conspicuous to the public (§ 22.1-289.011 of the Code of Virginia).

E. The operational responsibilities of the licensee shall include ensuring that the center's activities, services, and facilities are maintained in compliance with these standards, the center's own policies and procedures that are required by these standards, and the terms of the current license issued by the department.

F. Every center shall ensure that advertising is not misleading or deceptive as required by § 22.1-289.027 of the Code of Virginia.

G. The center shall meet the proof of child identity and age requirements as stated in § 22.1-289.049 of the Code of Virginia.

H. The sponsor shall maintain public liability insurance for bodily injury for each center site with a minimum limit of at least $500,000 each occurrence and with a minimum limit of $500,000 aggregate.

1. A public sponsor may have equivalent self-insurance that is in compliance with the Code of Virginia.

2. Evidence of insurance coverage shall be made available to the department's representative upon request.

I. The center shall develop written procedures for injury prevention.

J. Injury prevention procedures shall be updated at least annually based on documentation of injuries and a review of the activities and services.

K. The center shall develop written procedures for prevention of shaken baby syndrome or abusive head trauma, including coping with crying babies, safe sleeping practices, and sudden infant death syndrome awareness.

L. The center shall inform all staff who work with children of children's allergies, sensitivities, and dietary restrictions.

M. The center shall maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions documented in the allergy plan required in 8VAC20-780-60 A 8. This list shall be dated and kept confidential in each room or area where children are present.

N. The center shall develop written playground safety procedures that shall include:

1. Provision for active supervision by staff to include positioning of staff in strategic locations, scanning play activities, and circulating among children; and

2. Method of maintaining resilient surface.

O. Hospital-operated centers may temporarily exceed their licensed capacity during a natural disaster or other catastrophe or emergency situation and shall develop a written plan for emergency operations, for submission to and approval by the Department of Education.

P. When children 13 years or older are enrolled in the program and receive supervision in the licensed program, they shall be counted in the number of children receiving care and the center shall comply with the standards for these children.

A. Staff and children's records shall be treated confidentially. Exception: Children's records shall be made available to parents on request, unless otherwise ordered by the court.

B. Records and reports on children and staff required by this chapter shall be maintained and made accessible for two years after termination of services or separation from employment unless specified otherwise.

C. Records may be kept at a central location except as stated otherwise in these standards.

A. Each center shall maintain and keep at the center a separate record for each child enrolled which shall contain the following information:

1. Name, nickname (if any), sex, and birth date of the child;

2. Name, home address, and home phone number of each parent who has custody;

3. When applicable, work phone number and place of employment of each parent who has custody;

4. Name and phone number of child's physician;

5. Name, address, and phone number of two designated people to call in an emergency if a parent cannot be reached;

6. Names of persons authorized to pick up the child. Appropriate legal paperwork shall be on file when the custodial parent requests the center not to release the child to the other parent;

7. Allergies and intolerance to medication or any other substances, and actions to take in an emergency situation;

8. A written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic and the steps to be taken in the event of a suspected or confirmed allergic reaction;

9. Chronic physical problems and pertinent developmental information and any special accommodations needed;

10. Written agreements between the parent and the center as required by 8VAC20-780-90;

11. Documentation of child updates and confirmation of up-to-date information in the child's record as required by 8VAC20-780-420 E 3;

12. Any blanket permission slips and opt out requests;

13. Previous child day care and schools attended by the child;

14. Name of any additional programs or schools that the child is concurrently attending and the grade or class level;

15. Documentation of viewing proof of the child's identity and age;

16. First and last dates of attendance;

17. Documentation of health information as required by 8VAC20-780-130, 8VAC20-780-140, and 8VAC20-780-150; and

18. Documentation of the enrollment of a homeless child enrolled under provision of 8VAC20-780-130 C or 8VAC20-780-140 A.

B. The requirements in subdivision A 17 of this section does not apply, and the center is not required to maintain duplicates of the school's health record if:

1. The center is located on the same premises where a child attends school;

2. The child's record has a statement verifying the school's possession of the health record; and

3. The school's records are accessible during the center's hours of operation.

C. The proof of identity, if reproduced or retained by the child day program or both, shall be destroyed upon the conclusion of the requisite period of retention. The procedures for the disposal, physical destruction or other disposition of the proof of identity containing social security numbers shall include all reasonable steps to destroy such documents by (i) shredding, (ii) erasing, or (iii) otherwise modifying the social security numbers in those records to make them unreadable or indecipherable by any means.

The following staff records shall be kept for each staff person:

1. Name, address, verification of age requirement, job title, and date of employment or volunteering; and name, address, and telephone number of a person to be notified in an emergency which shall be kept at the center.

2. For staff hired after March 1, 1996, documentation that two or more references as to character and reputation as well as competency were checked before employment or volunteering. If a reference check is taken over the phone, documentation shall include:

a. Dates of contact;

b. Names of persons contacted;

c. The firms contacted;

d. Results; and

e. Signature of person making call.

3. Background checks as required by the regulation entitled Background Checks for Licensed Child Day Programs and Family Day Systems (8VAC20-770).

4. Documentation to demonstrate that the individual possesses the education, certification, and experience required by the job position, and orientation and training as required in 8VAC20-780-240 and 8VAC20-780-245.

5. First aid, cardiopulmonary resuscitation, and other certifications as required by the responsibilities held by the staff member.

6. Health information as required by 8VAC20-780-160 and 8VAC20-780-170.

7. Information, to be kept at the center, about any health problems that may interfere with fulfilling the job responsibilities.

8. Date of separation from employment.

A. For each group of children, the center shall maintain a written record of daily attendance that documents the arrival and departure of each child in care as it occurs.

B. Reports shall be filed and maintained as follows:

1. The center shall inform the superintendent's representative as soon as practicable but not to exceed one business day of the circumstances surrounding the following incidents:

a. Death of a child while under the center's supervision;

b. Missing child when local authorities have been contacted for help; or

c. The suspension or termination of all child care services for more than 24 hours as a result of an emergency situation and any plans to resume child care.

2. The center shall inform the department's representative as soon as practicable, but not to exceed two business days, of any injury to a child that occurs while the child is under the supervision of the center and requires outside medical attention.

3. Any suspected incident of child abuse shall be reported in accordance with § 63.2-1509 of the Code of Virginia.

A written agreement between the parent and the center shall be in each child's record by the first day of the child's attendance. The agreement shall be signed by the parent and include:

1. An authorization for emergency medical care should an emergency occur when the parent cannot be located immediately unless the parent states in writing an objection to the provision of such care on religious or other grounds;

2. A statement that the center will notify the parent when the child becomes ill and that the parent will arrange to have the child picked up as soon as possible if so requested by the center; and

3. A statement that the parent will inform the center within 24 hours or the next business day after his child or any member of the immediate household has developed any reportable communicable disease, as defined by the State Board of Health, except for life threatening diseases which must be reported immediately.

Before the child's first day of attendance, there shall be personal communication between the director, or his designee, and the parent to determine:

1. The child's level of general functioning as related to physical, affective/emotional, cognitive and social skills required for participation; and

2. Any special medical procedures needed.

A. An individual assessment completed within six months before the child's attendance or 30 days after the first day of attendance shall be maintained for each child.

B. An individual assessment shall be reviewed and updated for each child no less than once every 12 months.

A. An individual service, education or treatment plan:

1. Shall be developed for each child by the director or his designee and primary staff responsible for plan implementation;

2. Shall be implemented within 60 days after the first day of the child's attendance.

B. The child's individual service, education or treatment plan shall be developed, reviewed, and revised every three months and rewritten annually by the director or his designee and primary staff responsible for plan implementation. This shall be done in partnership with the parent, residential care provider or advocate.

C. A copy of the initial plan and subsequent or amended service, education or treatment plans shall be maintained in the child's record and a copy given to the child's parent.

A. The center shall obtain documentation that each child has received the immunizations required by the State Board of Health before the child can attend the center.

B. The center may allow a child to attend contingent upon a conditional enrollment for a period of 90 days if the child received at least one dose of each of the required vaccines and the child possesses a plan from a physician or local health department for completing his immunization requirements within the ensuing 90 calendar days. If the child requires more than two doses of hepatitis B vaccine, the conditional enrollment period, for hepatitis B vaccine only, shall be 180 calendar days.

C. If a child is homeless and does not have documentation of the required immunizations, the center may allow the child to attend during a grace period of no more than 90 days to allow the parent or guardian time to obtain documentation of required immunizations.

D. Documentation related to the child's conditional enrollment shall be maintained in the child's record.

E. The center shall obtain documentation of additional immunizations once every six months for children under the age of two years.

F. The center shall obtain documentation of additional immunizations once between each child's fourth and sixth birthdays.

G. Pursuant to subsection C of § 22.1-271.2 of the Code of Virginia, documentation of immunizations is not required for any child whose:

1. Parent submits an affidavit to the center on the current form approved by the Virginia Department of Health stating that the administration of immunizing agents conflicts with the parent's or child's religious tenets or practices; or

2. Physician or a local health department states on a Department of Health-approved form that one or more of the required immunizations may be detrimental to the child's health, indicating the specific nature and probable duration of the medical condition or circumstance that contraindicates immunization.

A. Each child shall have a physical examination by or under the direction of a physician:

1. Before the child's attendance; or

2. Within 30 days after the first day of attendance.

If a child is homeless and does not have documentation of a physical examination, the center may allow the child to attend during a grace period of no more than 90 days to allow the parent or guardian time to obtain documentation of the required physical examination.

B. If the child has had a physical examination prior to attendance, it shall be within the time period prescribed in this subsection:

1. Within two months prior to attendance for children six months of age and younger;

2. Within three months prior to attendance for children aged seven months through 18 months;

3. Within six months prior to attendance for children aged 19 months through 24 months; and

4. Within 12 months prior to attendance for children two years of age through five years of age.

C. When a child transfers from a facility licensed by the Virginia Department of Education, approved by a licensed family day system, or voluntarily registered by the Virginia Department of Education, a new physical examination is not required if a copy of the physical examination from the originating program is maintained in the child's record.

D. Pursuant to subsection D of § 22.1-270 of the Code of Virginia, physical examinations are not required for any child whose parent objects on religious grounds. The parent must submit a signed statement noting that the parent objects on religious grounds and certifying that to the best of the parent's knowledge the child is in good health and free from communicable or contagious disease.

E. A new physical examination is not required for a school age child if a copy of the physical examination required for his entry into a Virginia public kindergarten or elementary school is kept in the child's record.

A. The current form required by the Virginia Department of Health or a physician's form shall be used to report immunizations received and the results of the required physical examination.

B. Each report shall include the date of the physical examination and dates immunizations were received and shall be signed by a physician, his designee, or an official of a local health department.

A. Each staff member and individual from an independent contractor shall submit documentation of a negative tuberculosis screening.

1. Documentation of the screening shall be submitted at the time of employment and prior to coming into contact with children.

2. The documentation shall have been completed within the last 30 calendar days of the date of employment and be signed by a physician, physician's designee, or an official of the local health department.

B. Acceptable forms of documentation of tuberculosis screening are:

1. A clearance statement signed by a physician, the physician's designee or an official of the local health department. This statement shall include language that the individual does not have any current symptoms of active tuberculosis, does not have either a risk factor for acquiring tuberculosis infection or a risk factor for progression to active tuberculosis disease as defined by the local health department, or has been treated for these conditions in the past, and is currently free of tuberculosis in a communicable form. Individuals who have a risk factor for progression to active tuberculosis disease as defined by the Virginia Department of Health shall submit documentation as stated in subdivision 2 or 3 of this subsection.

2. The results of a negative tuberculin skin test (TST). The documentation shall include the date the test was given and results of the test and be signed by a physician, physician's designee or an official of the local health department.

3. The results of a chest x-ray negative for active tuberculosis disease. The documentation shall include the date of the test and location where the examination was performed.

C. At least every two years from the date of the initial screening or testing, or more frequently if recommended by a licensed physician or the local health department, staff members and individuals from independent contractors shall obtain and submit the results of a follow-up tuberculosis screening as stated in subsection B of this section.

D. Any staff member or individual from an independent contractor who develops symptoms compatible with active tuberculosis disease, regardless of the date of the last tuberculosis screening or assessment, shall obtain and submit within 14 days a determination of noncontagiousness by a physician or local health department.

1. Until such determination is made, that staff member may not be permitted to work at the center.

2. Any staff member or individual from an independent contractor who comes in contact with a known active case of tuberculosis or who tests positive on a tuberculin skin test, regardless of the date of the last tuberculosis screening or assessment, shall submit within 30 days a statement indicating that all needed follow-up for the incident has been completed and that the individual is free of tuberculosis in a communicable form. This statement shall be signed by a physician, physician's designee or an official of the local health department.

A. When there is evidence that the safety of children may be jeopardized by contact with a staff member or volunteer because of the physical health or mental health of such staff member or volunteer, the licensee shall, at a minimum, prohibit the employee or volunteer from engaging in contact with the children or participation in the food service program until a physician or a clinical psychologist skilled in the diagnosis and treatment of mental illness confirms that any risk has been eliminated or can be reduced to an acceptable level by reasonable accommodations.

B. The requirement of subsection A of this section should not be construed as a mandatory precondition to any other employment action that an employer may otherwise take.

A. Staff shall be:

1. Of good character and reputation;

2. Capable of carrying out assigned responsibilities;

3. Capable of accepting training and supervision; and

4. Capable of communicating effectively both orally and in writing as applicable to the job responsibility.

B. Staff who work directly with children shall be capable of communicating with emergency personnel.

C. Staff who drive a vehicle transporting children shall disclose any moving traffic violation that occurred five years prior to or during employment or assignment as a driver.

D. For therapeutic child day programs and special needs child day programs, staff who work with children shall have knowledge of the groups being served and skills specific to the special needs of the children in care including functional abilities, accommodations, assessment techniques, behavior management, and medical and health concerns.

A. Program directors shall be at least 21 years of age and shall meet one of the following:

1. A graduate degree in a child-related field such as elementary education, nursing, or recreation from a college or university and six months of programmatic experience;

2. An endorsement or bachelor's degree in a child-related field such as elementary education, nursing, or recreation from a college or university and one year of programmatic experience;

3. Forty-eight semester hours or 72 quarter hours of college credit from a college or university of which 12 semester hours or 18 quarter hours are in child-related subjects and one year of programmatic experience;

4. Two years of programmatic experience with one year in a staff supervisory capacity and at least one of the following education backgrounds:

a. A one-year early childhood certificate from a college or university that consists of at least 30 semester hours;

b. A child development credential that requires:

(1) High school program completion or the equivalent;

(2) 480 hours working with children in a group which could include a supervised practicum;

(3) Determination of competency in promoting children's development, providing a safe and healthy environment, managing the classroom environment or childhood program, and promoting positive and productive relationships with parents or guardians; and

(4) At least 120 hours of child-related training taught by an individual or by an organization with expertise in early childhood teacher preparation provided that the training facilitator:

(a) Documents the student's mastery and competence;

(b) Observes the student's application of competence in a classroom setting;

(c) Has a combination of at least six years of education (leading to a degree or credential in a child-related field) or programmatic experience; and

(d) Has at least 12 semester hours or 180 hours in a child-related field, a child development credential or equivalent, and two years of programmatic experience with one year in a staff supervisory capacity; or

c. A certification of qualification from an internationally or nationally recognized Montessori organization.

B. Program directors without management experience shall have one college course in a business-related field, 10 hours of management training, or one child care management course that satisfactorily covers the management functions of:

1. Planning;

2. Budgeting;

3. Staffing; and

4. Monitoring.

Management experience is defined as at least six months of on-the-job training in an administrative position that requires supervising, orienting, training, and scheduling staff.

C. For program directors of therapeutic child day programs and special needs child day programs, education and programmatic experience shall be in the group care of children with special needs.

D. Notwithstanding subsection A of this section, a person between 19 and 21 years of age may serve as a program director at a short-term program serving only school age children if the program director has daily supervisory contact by a person at least 21 years of age who meets one of the program director qualification options.

E. A program director employed prior to October 13, 2021, who met the education and experience qualifications in effect immediately prior to October 13, 2021, and who has been continuously employed as a child day center director, is considered to have met the requirements of this section.

A. The center shall have a qualified program director or a qualified back-up program director who meets one of the director qualifications who shall regularly be on site at least 50% of the center's hours of operation.

B. For centers offering multiple shifts, a qualified program director or qualified back-up director shall regularly be on site at least 50% of the day shift and at least two hours during the evening shift and two hours during the night shift.

C. For centers employing one or more program leaders who are qualified under subsection C of 8VAC20-780-210 but not under subsection A of that section, the qualified program director or qualified back-up program director shall be on site at least 75% of the center's hours of operation.

A. Program leaders shall be at least 18 years of age, have fulfilled a high school program completion or the equivalent, and meet one of the following:

1. Have one of the program director qualifications in 8VAC20-780-190;

2. Have an endorsement or bachelor's degree in a child-related field such as, but not limited to, elementary education, nursing, or recreation, from a college or university;

3. Have three months of programmatic experience and at least one of the following education backgrounds:

a. A one year early childhood certificate from a college or university that consists of at least 30 semester hours;

b. A child development credential by an organization listed in § 22.1-289.048 of the Code of Virginia;

c. A teaching diploma from an internationally or nationally recognized Montessori organization; or

4. Have six months of supervised programmatic experience.

a. Within six months before being promoted or beginning work or one month after being promoted or beginning work, a minimum of 12 hours of training shall be received related to the care of children, including but not limited to:

(1) Child development;

(2) Playground safety;

(3) Health and safety issues; and

(4) Preventing and reporting child abuse and neglect.

b. Such training may take place on site while not supervising children. Such training hours shall increase according to the following:

B. For program leaders of therapeutic child day programs and special needs child day programs, at least three months of programmatic experience shall be in the group care of children with special needs.

C. Notwithstanding the experience requirements in subsection A of this section, program leaders at short-term programs may have only one season of programmatic experience, provided that this experience shall include at least 200 hours, of which up to 24 hours can be formal training, working directly with children in a group.

Aides shall be at least 16 years of age.

A. Individuals from independent contractors shall not be counted in the staff-to-children ratios unless they meet the qualifications for the applicable position.

B. Individuals from independent contractors who do not meet staff qualifications shall, when in the presence of children, be within sight and sound supervision of a staff member.

C. Volunteers who work with children shall be at least 13 years of age.

A. The Virginia Department of Education-sponsored orientation course shall be completed within 90 calendar days of employment.

B. Staff shall complete orientation training in subsection C of this section prior to the staff member working alone with children and no later than seven days of the date of assuming job responsibilities.

C. Orientation training shall be appropriate to the age of the children in care and include all of the following facility specific topics:

1. Job responsibilities and to whom they report;

2. The policies and procedures listed in subsection D of this section, 8VAC20-780-420 A, and the standards in this chapter that relate to the staff member's responsibilities;

3. The center's playground safety procedures unless the staff member will have no responsibility for playground activities or equipment;

4. Recognizing child abuse and neglect and the legal requirements for reporting suspected child abuse as required by § 63.2-1509 of the Code of Virginia;

5. Confidential treatment of personal information about children in care and their families;

6. The center's policies and procedures on the administration of medication;

7. Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event such as violence at a child care facility and the emergency preparedness plan as required by 8VAC20-780-550 A through K;

8. Prevention of sudden infant death syndrome and use of safe sleep practices;

9. Prevention of shaken baby syndrome and abusive head trauma, including procedures to cope with crying babies or distraught children;

10.Prevention of and response to emergencies due to food and other allergic reactions including:

a. Recognizing the symptoms of an allergic reaction;

b. Responding to allergic reactions;

c. Preventing exposure to the specific food and other substances to which the child is allergic; and

d. Preventing cross contamination; and

11. Prevention and control of disease.

D. Prior to working alone with children and within seven days of the first day of employment, staff shall be provided in writing with the center's information listed in 8VAC20-780-420 A and the following:

1. Procedures for supervising a child who may arrive after scheduled classes or activities including field trips have begun;

2. Procedures to confirm absence of a child when the child is scheduled to arrive from another program or from an agency responsible for transporting the child to the center;

3. Procedures for identifying where attending children are at all times, including procedures to ensure that all children are accounted for before leaving a field trip site and upon return to the center;

4. Procedures for action in case of lost or missing children, ill or injured children, medical emergencies, and general emergencies;

5. Policy for any administration of medication;

6. Emergency evacuation, relocation, shelter-in-place, and lockdown procedures; and

7. Precautions in transporting children, if applicable.

E. Within 30 days of the first day of employment, staff must complete orientation training in first aid and cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care.

F. Before assuming job responsibilities, staff who work with children in therapeutic child day programs and special needs child day programs shall receive training in:

1. Standard precautions procedures;

2. Activity adaptations;

3. Medication administration;

4. Disabilities precautions and health issues; and

5. Appropriate intervention strategies.

G. Volunteers who work more than six hours per week shall receive training on the center's emergency procedures within the first week of volunteering.

H. In a cooperative preschool center that is organized, administered, and maintained by parents of children in care, parent volunteers, or other persons who participate and volunteer in a cooperative preschool center on behalf of a child attending such cooperative preschool center, including such volunteers who are counted in the staff-to-child ratios required in 8VAC20-780-340, shall complete four hours of training per year, and shall be exempt from orientation requirements applicable to staff of child day programs. This orientation exemption shall not apply to any parent volunteer or other person as referred to in this subsection if the cooperative preschool center has entered into a contract with the department or a local department to provide child care services funded by the Child Care and Development Block Grant.

I. Documentation of orientation training shall be kept by the center in a manner that allows for identification by individual staff member, is considered part of the staff member's record, and shall include:

1. Name of staff;

2. Training topics;

3. Training delivery method;

4. The entity or individual providing training; and

5. The date of training.

A. Staff shall complete annually a minimum of 16 hours of training appropriate to the age of children in care.

B. Training completed to meet the requirements of this section shall be in addition to completing orientation requirements in 8VAC20-780-240.

C. Staff who do not work with a group of children at the center shall only be required to complete annual training on emergency preparedness and response, child abuse and neglect, and mandated reporter requirements.

D. Staff who work with a group of children at the center and are employed at a short-term program shall only be required to obtain a minimum of 10 hours of staff training per year.

E. In a cooperative preschool center that is organized, administered, and maintained by parents of children in care, parent volunteers, or other persons who participate and volunteer in a cooperative preschool center on behalf of a child attending such cooperative preschool center, including such volunteers who are counted in the staff-to-child ratios required in 8VAC20-780-340, shall complete four hours of training per year and shall be exempt from training requirements applicable to staff of child day programs. This training exemption shall not apply to any parent volunteer or other person as referred to in this subsection if the cooperative preschool center has entered into a contract with the department or a local department to provide child care services funded by the Child Care and Development Block Grant.

F. Volunteers who work more than six hours per week shall be required to complete annual training on the center's emergency procedures.

G. For therapeutic child day programs and special needs child day programs, staff who work directly with children shall annually complete four additional hours of training. At least eight hours of annual training shall be on topics related to the care of children with special needs.

H. Annual training shall be relevant to staff's job responsibilities and the care of children, and include topics such as:

1. Child development including physical, cognitive, social, and emotional development;

2. Behavior management and positive guidance techniques;

3. Prevention and control of infectious diseases;

4. Prevention of sudden infant death syndrome and use of safe sleep practices;

5. Prevention of and response to emergencies due to food and other allergic reactions including:

a. Recognizing the symptoms of an allergic reaction;

b. Responding to allergic reactions;

c. Preventing exposure to the specific food and other substances to which the child is allergic; and

d. Preventing cross contamination;

6. The center's policies and procedures on the administration of medication;

7. Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic;

8. Prevention of shaken baby syndrome and abusive head trauma including procedures to cope with crying babies or distraught children;

9. Signs and symptoms of child abuse and neglect and requirements for mandated reporters;

10. Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event such as violence at a child care facility and the center's specific emergency preparedness plan as required 8VAC20-780-550 A through K;

11. Handling and storage of hazardous materials and the appropriate disposal of diapers and other items contaminated by body fluids;

12. CPR and first aid;

13. Precautions in transporting children if applicable; and

14. If applicable, the recommended care requirements related to the care and development of children with special needs.

I. Training on the center's emergency preparedness plan shall be completed annually and each time the plan is updated.

J. Medication administration:

1. To safely perform medication administration practices listed in 8VAC20-780-510, whenever the center has agreed to administer prescribed medications, the administration shall be performed by a staff member or independent contractor who has satisfactorily completed a training program for this purpose approved by the Board of Nursing and taught by a registered nurse, licensed practical nurse, nurse practitioner, physician assistant, doctor of medicine or osteopathic medicine, or pharmacist pursuant to § 54.1-3408 of the Code of Virginia; or administration shall be performed by a staff member or independent contractor who is licensed by the Commonwealth of Virginia to administer medications.

a. The approved training curriculum and materials shall be reviewed by the department at least every three years and revised as necessary.

b. Staff required to have the training shall be retrained at three-year intervals.

2. To safely perform medication administration practices listed in 8VAC20-780-510, whenever the center has agreed to administer over-the-counter medications other than topical skin gel, cream, or ointment, the administration must be performed by a staff member or independent contractor who has satisfactorily completed a training course developed or approved by the Department of Education in consultation with the Department of Health and the Board of Nursing and taught by a registered nurse, licensed practical nurse, nurse practitioner, physician assistant, doctor of medicine or osteopathic medicine, or pharmacist; or administration shall be performed by a staff member or independent contractor who is licensed by the Commonwealth of Virginia to administer medications.

a. The course, which shall include competency guidelines, shall reflect currently accepted safe medication administration practices, including instruction and practice in topics such as reading and following manufacturer's instructions; observing relevant laws, policies, and regulations; and demonstrating knowledge of safe practices for medication storage and disposal, recording and reporting responsibilities, and side effects and emergency recognition and response.

b. The approved training curriculum and materials shall be reviewed by the department at least every three years and revised as necessary.

c. Staff required to have the training shall be retrained at three-year intervals.

3. Any child for whom emergency medications (such as albuterol, glucagon, and epinephrine auto injector) have been prescribed shall always be in the care of a staff member or independent contractor who meets the requirements in subdivision 1 of this subsection.

K. Daily health observation training shall include the following:

1. Components of daily health check for children;

2. Inclusion and exclusion of the child from the class when the child is exhibiting physical symptoms that indicate possible illness;

3. Descriptions of how diseases are spread and the procedures or methods for reducing the spread of disease;

4. Information concerning the Virginia Department of Health Notification of Reportable Diseases pursuant to 12VAC5-90-80 and 12VAC5-90-90, also available from the local health department and the website of the Virginia Department of Health; and

5. Staff occupational health and safety practices in accordance with Occupational Safety and Health Administration's bloodborne pathogens regulation (29 CFR 1910.1030).

L. There shall always be at least one staff member on duty who has obtained within the last three years instruction in performing the daily health observation of children.

M. Documentation of training shall be kept by the center in a manner that allows for identification by individual staff member, is considered part of the staff member's record, and shall include:

1. Name of staff;

2. Training topic;

3. Evidence that training on each topic required in this section has been completed;

4. Training delivery method;

5. The entity or individual providing training;

6. The number of training hours or credit hours received; and

7. The date of training.

N. Medication administration training required in subsection J of this section and daily health observation training required in subsection K of this section may count toward the annual training hours required in this section.

A. Before issuance of the first license and before use of newly constructed, renovated, remodeled, or altered buildings or sections of buildings, written documentation of the following shall be provided by the center to the licensing representative:

1. Approval by the authority having jurisdiction that each building meets building and fire codes or that a plan of correction has been approved; and

Exception: Any building which is currently approved for school occupancy and which houses a public or private school during the school year shall be considered to have met the requirements of subdivision 1 of this subsection when housing a center only serving children two and a half years of age or older.

2. Approval from the local health department, or approval of a plan of correction, for meeting requirements for:

a. Water supply;

b. Sewage disposal system; and

c. Food service, if applicable.

B. For buildings built before 1978, the following shall be submitted before the initial license is issued:

1. A written statement from a person licensed in Virginia as an asbestos inspector and management planner as required by § 22.1-289.052 of the Code of Virginia and the requirements of the Asbestos Hazard Emergency Response Act (15 USC § 2641 et seq.); and

2. A written statement that the response actions to abate any risk to human health have been or will be initiated in accordance with a specific schedule and plan as recommended by the asbestos management planner in accordance with § 22.1-289.052 of the Code of Virginia.

C. A notice regarding the presence and location of asbestos containing materials and advising that the asbestos inspection report and management plan are available for review shall be posted.

Exception: The provisions of subsections B and C of this section do not apply to centers located in buildings required to be inspected according to Article 5 (§ 2.2-1162 et seq.) of Chapter 11 of Title 2.2 of the Code of Virginia.

D. Before the first license is issued, camps shall notify the responsible fire department and the responsible emergency medical service of the camp location and hours of operation.

A. The center shall provide to the licensing representative an annual fire inspection report from the appropriate fire official having jurisdiction.

Exception: If a center is located in a building currently housing a public or private school, the school's annual fire inspection report shall be accepted.

B. After the first license, annual approval from the health department shall be provided, or approvals of a plan of correction, for meeting requirements for:

1. Water supply;

2. Sewage disposal system; and

3. Food service, if applicable.

C. For those buildings where asbestos containing materials are detected and not removed:

1. A signed, written statement that the center is following the recommendations of the management plan shall be submitted to the department before subsequent licenses are issued; and

2. The notice regarding the presence and location of asbestos containing materials and advising that the asbestos inspection report and management plan are available for review shall continue to be posted.

3. Exception: The provisions of this subsection do not apply to child day centers located in buildings required to be inspected according to Article 5 (§ 2.2-1162 et seq.) of Chapter 11 of Title 2.2 of the Code of Virginia.

A. Areas and equipment of the center, inside and outside, shall be maintained in a clean, safe and operable condition. Unsafe conditions shall include, but not be limited to, splintered, cracked or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting or breakage of any equipment; head entrapment hazards; and protruding nails, bolts or other components that could entangle clothing or snag skin.

B. Heat shall be supplied from a heating system approved in accordance with the Uniform Statewide Building Code (USBC, 13VAC5-62) except for camps. The heating system shall:

1. Be installed to prevent accessibility of children to the system; and

2. Have appropriate barriers to prevent children from being burned, shocked, or injured from heating equipment. In addition, proper supervision shall be available to prevent injury.

3. Exception: In case of emergency, portable heaters may be used in accordance with the manufacturer's instructions.

C. In inside areas occupied by children, the temperature shall be maintained no lower than 68°F.

D. Fans or other cooling systems shall be used when the temperature of inside areas occupied by children exceeds 80°F.

E. Drinking fountains or individual disposable cups with safe drinking water shall be accessible at all times.

F. Equipment shall include, but not be limited to, the following:

1. Outside lighting provided at entrances and exits used by children before sunrise or after sundown; and

2. An in-service, nonpay telephone.

A. No center shall be located where conditions exist that would be hazardous to the health and safety of children.

B. Hazardous substances such as cleaning materials, insecticides, and pesticides shall be kept in a locked place using a safe locking method that prevents access by children.

1. If a key is used, the key shall not be accessible to the children.

2. Exception: Cleaning supplies to clean and sanitize the diapering area or toilet chairs do not need to be kept locked during diapering or toilet training time as long as they are inaccessible to children.

C. Pesticides or insecticides shall not be stored in areas used by children or in areas used for food preparation or storage.

D. Cleaning and sanitizing materials shall not be located above food, food equipment, utensils or single-service articles and shall be stored in areas physically separate from food.

E. Cleaning materials (e.g., detergents, sanitizers and polishes) and insecticides/pesticides shall be stored in areas physically separate from each other.

F. Hazardous substances shall be stored in the original container unless this container is of such a large size that its use would be impractical.

G. If hazardous substances are not kept in original containers, the substitute containers shall clearly indicate their contents and shall not resemble food or beverage containers.

H. Cosmetics, medications, or other harmful agents shall not be stored in areas, purses or pockets that are accessible to children.

I. Hazardous art and craft materials shall not be used with children.

J. Smoking shall be prohibited in the interior of a center that is not used for residential purposes.

K. In residential areas of the center and outside the center, smoking shall be prohibited in the presence of children.

In areas used by children of preschool age or younger, the following shall apply:

1. Guardrails and handrails shall be provided in accordance with the USBC (13VAC5-62) in effect at time of first occupancy or construction.

2. Fans, when used, shall be out of reach of children and cords shall be secured so as not to create a tripping hazard.

3. Electrical outlets shall have protective covers that are of a size that cannot be swallowed by children.

A. Any building which is currently approved for school occupancy and which houses a school during the school year shall be considered to have met the building requirements in this chapter when housing a center only serving school age children.

B. Portable camping equipment for heating or cooking that is not required to be approved by the building official shall bear the label of a nationally recognized inspection agency and be used in accordance with the manufacturer's specifications, except for charcoal and wood burning cooking equipment.

C. No cooking or heating shall occur in tents except as provided by the USBC (13VAC5-62).

A. Indoor space shall be measured inside wall-to-wall excluding spaces not routinely used by children as referenced in subdivisions 1 and 2 of this subsection:

1. Areas not routinely used for children's activities shall not be calculated as available space.

2. Space not calculated shall include, but not be limited to, offices, hallways, restrooms, kitchens, storage rooms or closets.

B. There shall be 25 square feet of indoor space available per child until subdivisions 1 and 2 of this subsection take effect.

1. Effective June 1, 2008, applicants must have 35 square feet of indoor wall-to-wall space per child.

2. Current licensees and subsequent licensees at currently licensed facilities may continue to provide 25 square feet per child.

3. New additions shall have 35 square feet of indoor wall-to-wall space per child effective June 1, 2008.

C. Space in areas used by infants shall be calculated separately from space for older children. There shall be a minimum of 25 square feet of space per infant excluding space occupied by cribs and changing tables or a minimum of 35 square feet of available space per infant including space occupied by cribs and changing tables.

D. Camps for school age children are not required to meet this space requirement. However, when weather prevents outdoor activities, the required indoor space per child shall be provided either at the program site or at a predesignated, approved location off site.

E. When children are on the outdoor play area, at least 75 square feet of space per child shall be provided at any one time.

F. Centers licensed for the care of infants and toddlers shall provide a separate playground area for these children that has at least 25 square feet of unpaved surface per infant/toddler on the outdoor area at any one time. This space may be counted as part of the 75 square feet required in subsection B of this section.

G. A separate space shall be designated for children who are ill or injured.

A. Centers shall have at least two toilets and two sinks.

B. Each restroom area provided for children shall:

1. Be within a contained area, readily available and within the building used by the children (Restrooms used by school age children at camps are not required to be located within the building);

2. Have toilets that are flushable;

3. Have sinks located near the toilets and that are supplied with running warm water that does not exceed 120°F (Camps are exempt from the requirement that running water be warm); and

4. Be equipped with soap, toilet paper, and disposable towels or an air dryer within reach of children.

C. For restrooms available to males, urinals shall not be substituted for more than one-half the required number of toilets.

D. An adult size toilet with privacy shall be provided for staff use. Staff toilets may be counted in the number of required toilets for children only if children are allowed unrestricted access to them. Primitive camps are not required to have a toilet with privacy for staff.

E. Centers shall have at least one toilet and one sink per 20 preschool children and at least one standard size toilet and one sink per 30 school age children. When sharing restroom areas with other programs, the children in those programs shall be included in the toilet and sink ratio calculations. The toilet and sink ratio appropriate to the younger age group shall apply.

F. When child size toilets, urinals, and low sinks are not available in restrooms used by children of preschool age and younger, one or more platforms or sets of steps shall be provided.

G. A restroom used for school age children that contains more than one toilet shall have at least one toilet enclosed.

H. Restrooms used by school age children at primitive camps are not required to have:

1. Sinks, if adequate water, supplies, and equipment for hand washing are available; and

2. Flushable toilets, if the number of sanitary privies or portable toilets constructed and operated in accordance with the applicable law and regulations of the Virginia Department of Health meets the toilet ratio stated in subsection E of this section. No privy or outdoor toilet shall be located within 75 feet of other buildings or camp activities.

A. Playgrounds shall be located and designed to protect children from hazards.

B. Where playground equipment is provided, resilient surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Figures 2 (Compressed Loose Fill Synthetic Materials Depth Chart) and 3 (Use Zones for Equipment) on pages 6-7 of the National Program for Playground Safety's "Selecting Playground Surface Materials: Selecting the Best Surface Material for Your Playground," February 2004, and shall be under equipment with moving parts or climbing apparatus to create a fall zone free of hazardous obstacles. Fall zones are defined as the area underneath and surrounding equipment that requires a resilient surface. A fall zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Falls zones shall not include barriers for resilient surfacing. Where steps are used for accessibility, resilient surfacing is not required.

C. Ground supports shall be covered with materials that protect children from injury.

D. Swing seats shall be constructed with flexible material.

1. Exceptions: Nonflexible molded swing seats may be used only in a separate infant or toddler play area.

2. Swings made specifically for a child with a special need shall be permitted in any area as long as a staff member is positioned to see and protect other children who might walk into the path of the swing.

E. Sandboxes with bottoms which prevent drainage shall be covered when not in use.

F. A shady area shall be provided on playgrounds during the months of June, July, and August.

EXCEPTION: The requirements of this section shall not prohibit child day programs providing care for school-age children at a location that is currently approved by the Department of Education or recognized as a private school by the State Board of Education for school occupancy and that houses a public or private school during the school year from permitting school-age children to use outdoor play equipment and areas approved for use by students of the school during school hours.

A. When staff are supervising children, they shall always ensure their care, protection, and guidance.

B. During the center's hours of operation, one adult on the premises shall be in charge of the administration of the center. This person shall be either the administrator or an adult appointed by the licensee or designated by the administrator.

C. During the stated hours of operation, there always shall be on the premises and on field trips when one or more children are present one staff member who meets the qualifications of a program leader or program director and an immediately available staff member, volunteer or other employee who is at least 16 years of age, with direct means for communication between the two of them. The volunteer or other employee shall have received instruction in how to contact appropriate authorities if there is an emergency.

D. In each grouping of children at least one staff member who meets the qualifications of a program leader or program director shall be regularly present. Such a program leader shall supervise no more than two aides.

E. Exception: A program leader is not required in each grouping of children during the first and last hour of operation when a center operates more than six hours per day and during the designated rest period if the following are met: (i) there is a staff member in the group who is over 18 years of age and has at least three months of programmatic experience at the center; (ii) there is an additional staff person on site who meets program leader qualifications, is not counted in the staff-to-children ratios and is immediately available to help if needed; and (iii) there is a direct means for communicating between these two staff members.

F. Children under 10 years of age always shall be within actual sight and sound supervision of staff, except that staff need only be able to hear a child who is using the restroom provided that:

1. There is a system to assure that individuals who are not staff members or persons allowed to pick up a child in care do not enter the restroom area while in use by children; and

2. Staff check on a child who has not returned from the restroom after five minutes. Depending on the location and layout of the restroom, staff may need to provide intermittent sight supervision of the children in the restroom area during this five-minute period to assure the safety of children and to provide assistance to children as needed.

G. Children 10 years of age and older shall be within actual sight and sound supervision of staff except when the following requirements are met:

1. Staff can hear or see the children (video equipment, intercom systems, or other technological devices shall not substitute for staff being able to directly see or hear children);

2. Staff are nearby so they can provide immediate intervention if needed;

3. There is a system to ensure that staff know where the children are and what they are doing;

4. There is a system to ensure that individuals who are not staff members or persons allowed to pick up children in care do not enter the areas where children are not under sight supervision; and

5. Staff provide sight and sound supervision of the children at variable and unpredictable intervals not to exceed 15 minutes.

H. When the outdoor activity area is not adjacent to the center, there shall be at least two staff members on the outdoor activity area whenever one or more children are present.

I. Staff shall greet each child upon arrival at the center and oversee each child's departure from the center.

J. Staff shall not allow a child to leave the center unsupervised.

A. The maximum group size limitations specified in Table 1 shall be followed whenever children are in care.

B. The staff-to-children ratios specified in Table 2 are required whenever children are in care.

C. When children are in ongoing mixed age groups, the staff-to-children ratio and group size applicable to the youngest child in the group shall apply to the entire group.

D. Group size limitations shall not apply during:

1. Designated rest periods as described in this section;

2. Outdoor activity as described in 8VAC20-780-370, 8VAC20-780-380, and 8VAC20-780-390;

3. Transportation and field trips as described in 8VAC20-780-580;

4. Meals and snacks served as described in 8VAC20-780-560; or

5. Special group activities, or during the first and last hour of operation when the center operates more than six hours per day.

E. Group size requirements in subsection A of this section do not apply to children school age eligible through 12 years of age.

F. The center shall develop and implement a written policy and procedure that describes how the center will ensure that each group of children receives care by consistent staff or team of staff members.

G. Staff shall be counted in the required staff-to-children ratios only when they are directly supervising children.

H. A child volunteer 13 years of age or older not enrolled in the program shall not be counted as a child in the staff-to-children ratio requirements.

I. For children ages 16 months through preschool age, during the designated rest period, when children are resting or in an inactive state, the following rest period ratios are permitted if the requirements of subsections J through N of this section are met:

1. Children 16 through 24 months of age: one staff per 10 children.

2. Children two years of age: one staff per 16 children.

3. Children of preschool age: one staff per 20 children.

J. Staff required by rest period ratios shall be within sight and sound at all times in the same space as the resting or sleeping children.

K. In addition to the staff required by rest period ratios, an additional staff member shall always be available on-site to offer immediate assistance. The staff required by rest period ratios shall be able to summon the additional staff member without leaving the room or area of the sleeping or resting children.

L. Once at least half of the children in the resting room or area are awake and off their mats or cots, the staff-to-children ratio shall meet the ratios as required in subsection B of this section.

M. One staff member shall not supervise more than one room or area during rest time.

N. Centers providing evening and overnight care shall meet the requirements of subsections I through this subsection N of this section during sleep periods.

O. The ratio for balanced-mixed-age groupings of children shall be one staff member for every 14 children provided:

1. The center has additional staff who are readily accessible in the event of an emergency to maintain a ratio of one staff member for every 10 children when three-year-olds are included in the balanced-mixed-age group; and

2. The lead teacher has received at least eight hours of training in classroom management of balanced-mixed-age groupings.

P. A maximum group size of 28 shall be followed whenever children in care are in balanced-mixed-age groupings.

Q. With a parent's written permission and a written assessment by the program director and program leader, a center may choose to assign a child to a different age group if such age group is more appropriate for the child's developmental level and the staff-to-children ratio and group size shall be for the established age group.

1. If such developmental placement is made for a child with a special need, a written assessment by a recognized agency or professional shall be required at least annually. These assignments are intended to be a permanent new group and staff members for the child.

2. A center may temporarily reassign a child from his regular group and staff members for reasons of administrative necessity but not casually or repeatedly disrupt a child's schedule and attachment to his staff members and group.

A. For therapeutic child day programs, in each grouping of children of preschool age or younger, the following ratios of staff to children are required according to the special needs of the children in care:

1. For children with severe and profound disabilities, multiple special needs, serious medical need, or serious emotional disturbance: one staff member to three children.

2. For children diagnosed as having an intellectual disability with significant sub-average intellectual functioning and deficits in adaptive behavior, or with physical and sensory disabilities, or with autism: one staff member to four children.

3. For children diagnosed as having an intellectual disability in the mild range of development, children with a developmental delay, or children diagnosed with attention deficit/hyperactivity disorder (ADHD): one staff member to five children.

4. For children diagnosed with specific learning disabilities: one staff member to six children.

5. When children with varied special needs are included in a group, the staff-to-children ratio applicable to the child with the most significant special need in the group shall apply to the entire group.

6. Whenever 8VAC20-780-350 B requires more staff than 8VAC20-780-355 A because of the children's ages, 8VAC20-780-350 B shall take precedence over 8VAC20-780-355 A.

B. For therapeutic child day programs, in each grouping of school age children, the following ratios of staff to children are required according to the special needs of the children in care:

1. For children with severe and profound disabilities, autism, multiple special needs, serious medical need, or serious emotional disturbance: one staff member to four children.

2. For children diagnosed as having an intellectual disability with significant sub-average intellectual functioning and deficits in adaptive behavior, or with physical and sensory disabilities, ADHD, or other health impairments: one staff member to five children.

3. For children diagnosed as having an intellectual disability in the mild range of development, or developmentally delayed: one staff member to six children.

4. For children diagnosed with specific learning disabilities or speech or language impairments: one staff member to eight children.

5. When children with varied special needs are included in a group, the staff-to-children ratio applicable to the child with the most significant special need in the group shall apply to the entire group.

C. Group size requirements in 8VAC20-780-350 A do not apply to therapeutic child day programs.

A. The variety of daily activities for all age groups shall be age and stage appropriate and provide opportunities for teacher-directed, self-directed, and self-chosen tasks and activities; a balance of active and quiet activities; individual and group activities; and curiosity and exploration.

Exception: Specialty camps do not need to provide opportunities for self-chosen tasks and curiosity and exploration.

B. For a child who cannot move without help, staff shall offer to change the places and position of the child at least every 30 minutes or more frequently depending on the child's individual needs.

C. Children shall be allowed to sleep or rest as individually needed.

D. For a child in a therapeutic child day program, daily activities shall be in accordance with the program's individual plan for such child.

There shall be a flexible daily schedule for infants based on their individual needs. During the day, infants shall be provided with:

1. Sleep as needed.

a. When an infant is placed in his crib, he shall be placed on his back (supine).

b. When an infant is able to easily turn over from the back (supine) to the belly (prone) position and he is placed in his crib, he shall still be put on his back (supine) but allowed to adopt whatever position he prefers. This applies unless otherwise directed by the infant's physician in writing.

c. If the side position is used, caregivers shall bring the dependent arm forward to lessen the likelihood of the infant rolling into a belly (prone) position.

d. Resting or sleeping infants shall be individually checked every 15-20 minutes.

e. An infant who falls asleep in a play space specified in subdivision 5 a of this section may remain in that space if comfortable and safe.

2. Food as specified in 8VAC20-780-560 and 8VAC20-780-570.

3. Outdoor time if weather and air quality allow based upon the Air Quality Color Code Chart as provided by the Department of Environmental Quality.

4. Comfort as needed.

5. Play spaces.

a. Play spaces may include, but are not limited to, cribs, infant seats, play yards, exercise chairs or saucers (but not walkers), infant swings, high chairs, and floor space.

b. The variety of play spaces shall cumulatively offer:

(1) Room for extensive movement (rolling, crawling, or walking) and exploration;

(2) A diversity of sensory and perceptual experiences; and

(3) Equipment and toys that support large and small motor development.

c. Staff shall provide frequent opportunities for infants to creep, crawl, toddle and walk.

d. Infants shall be protected from older children.

e. Staff shall provide awake infants not playing on the floor or ground a change in play space at least every 30 minutes or more often as determined by the individual infant's needs.

f. Staff shall change the position of an awake infant playing on the floor or ground and the selection of toys available to the infant every 30 minutes or more often as determined by the individual infant's needs.

g. Infants, who cannot turn themselves over and are awake, shall be placed on their stomachs a total of 30 minutes each day to facilitate upper body strength and to address misshapen head concerns.

6. Stimulation and language development activities, including but not limited to staff reading, talking to, showing pictures to, naming objects for, playing with and engaging in positive interactions (such as smiling, cuddling, and making eye contact) with infants.

A. There shall be a posted daily schedule that allows for flexibility as children's needs require. The daily schedule need not apply on days occupied a majority of the time by a field trip or other special event. The daily schedule shall include opportunities for:

1. Outdoor activity, weather and air quality allowing, for at least:

a. Fifteen minutes per day or session if the center operates up to three hours per day or session;

b. Thirty minutes per day or session if the center operates between three and five hours per day or session; or

c. One hour per day or session if the center operates more than five hours per day or session.

2. Sleep or rest.

a. Centers operating five or more hours per day shall have a designated rest period for at least one hour but no more than two hours.

(1) Cribs, cots, beds, or mats shall be used.

(2) After the first 30 minutes, children not sleeping may engage in quiet activities.

b. A child who falls asleep in a place other than his designated sleeping location may remain in that space if comfortable and safe.

c. Sleeping toddlers shall be individually checked every 30 minutes.

3. Meals and snacks as specified in 8VAC20-780-560 and 8VAC20-780-570.

4. Small and large motor activities, language and communication experiences, sensory experiences, art or music activities, and play acting or social living.

B. Staff shall encourage language development by having conversations with children that give them time to initiate and respond, by labeling and describing objects and events, having storytelling time and by expanding the children's vocabulary.

A. Before or after school, the center shall provide an opportunity for children to do homework or projects or hobbies in a suitable area. In the afternoon, there shall be an opportunity for large motor activities at least 25% of the time.

B. On nonschool days, the daily activity shall include opportunities for large motor activities at least 25% of the time; small motor activities; projects, hobbies, or homework in a suitable place; art or music activities; outdoor activity in accordance with 8VAC20-780-380 A 1 and food as specified in 8vAC20-780-560 and 8VAC20-780-570.

Exception: Specialty camps are not required to meet the requirements of this subsection.

A. In order to promote the child's physical, intellectual, emotional, and social well-being and growth, staff shall interact with the child and one another to provide needed help, comfort, support and:

1. Respect personal privacy;

2. Respect differences in cultural, ethnic, and family backgrounds;

3. Encourage decision-making abilities;

4. Promote ways of getting along;

5. Encourage independence and self-direction; and

6. Use consistency in applying expectations.

B. Behavioral guidance shall be constructive in nature, age and stage appropriate, and shall be intended to redirect children to appropriate behavior and resolve conflicts.

C. When time out is used as a behavior guidance technique:

1. It shall be used sparingly and shall not exceed one minute for each year of the child's age;

2. It shall be appropriate to the child's developmental level and individual needs;

3. It shall not be used with infants or toddlers;

4. The child shall be in a safe, lighted, well-ventilated place, and within actual sight and sound of a staff member; and

5. The child shall not be left alone inside or outside the center.

The following actions or threats thereof are forbidden:

1. Physical punishment, striking a child, roughly handling or shaking a child, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, or exercise as punishment;

2. Enclosure in a small confined space or any space that the child cannot freely exit himself; however, this does not apply to the use of equipment such as cribs, play yards, high chairs, and safety gates when used with children preschool age or younger for their intended purpose;

3. Punishment by another child;

4. Separation from the group so that the child is away from the hearing and vision of a staff member;

5. Withholding or forcing of food or rest;

6. Verbal remarks which are demeaning to the child;

7. Punishment for toileting accidents; and

8. Punishment by applying unpleasant or harmful substances.

A. Before the child's first day of attending, parents shall be provided in writing the following:

1. The center's philosophy and any religious affiliation;

2. Operating information, including the hours and days of operation and holidays or other times closed, and the phone number where a message can be given to staff;

3. The center's transportation policy;

4. The center's policies for the arrival and departure of children, including procedures for verifying that only persons authorized by the parent are allowed to pick up the child, picking up children after closing, and when a child is not picked up for emergency situations including inclement weather or natural or man-made disasters;

5. The center's policy regarding any medication or medical procedures that will be given;

6. The center's policy regarding application of:

a. Sunscreen;

b. Diaper ointment or cream; and

c. Insect repellent.

7. Description of established lines of authority for staff;

8. Policy for reporting suspected child abuse as required by § 63.2-1509 of the Code of Virginia;

9. The custodial parent's right to be admitted to the center as required by § 22.1-289.054 of the Code of Virginia;

10. Policy for communicating an emergency situation with parents;

11. The appropriate general daily schedule for the age of the enrolling child;

12. Food policies;

13. Discipline policies including acceptable and unacceptable discipline measures; and

14. Termination policies.

B. Staff shall promptly inform parents when persistent behavioral problems are identified; such notification shall include any disciplinary steps taken in response.

C. A custodial parent shall be admitted to any child day program. Such right of admission shall apply only while the child is in the child day program (§ 22.1-289.054 of the Code of Virginia).

D. The center shall provide opportunities for parental involvement in center activities.

E. Communication.

1. For each infant, the center shall post a daily record which can be easily accessed by both the parent and the staff working with the child. The record shall contain the following information:

a. The amount of time the infant slept;

b. The amount of food consumed and the time;

c. A description and time of bowel movements;

d. Developmental milestones; and

e. For infants, who are awake and cannot turn over by themselves, the amount of time spent on their stomachs.

2. If asked by parents, staff shall provide feedback about daily activities, physical well-being, and developmental milestones.

3. Parents shall be provided at least semiannually in writing information on their child's development, behavior, adjustment, and needs.

a. Staff shall provide at least semiannual scheduled opportunities for parents to provide feedback on their children and the center's program.

b. Staff shall request at least annually parent confirmation that the required information in the child's record is up to date.

c. Such sharing of information shall be documented.

d. Short-term programs (as defined in 8VAC20-780-10) are exempt from this requirement.

4. Parents shall be informed of reasons for termination of services.

A. Furnishings, equipment, and materials shall be of an appropriate size for the child using it.

B. Materials and equipment available shall be age and stage appropriate for the children and shall include an adequate supply as appropriate for each age group of arts and crafts materials, texture materials, construction materials, music and sound materials, books, social living equipment, and manipulative equipment.

C. Play equipment used by children shall meet the following requirements:

1. Openings above the ground or floor which allow a 3-1/2 inch by 6-1/4 inch rectangle to fit through shall also allow a nine-inch circle to fit through;

2. S-hooks where provided may not be open more than the thickness of a penny; and

3. Have no protrusions, sharp points, shearing points, or pinch points.

D. The unenclosed climbing portion of slides and climbing equipment used by toddlers and preschool children shall not be more than seven feet high and must be located over resilient surfacing where outdoors, and shall not be more than five feet high where indoors.

E. Centers may not install after June 1, 2005, any slide or climbing equipment to be used by preschoolers or toddlers when the climbing portion of the equipment is more than six feet in height.

F. The climbing portions of indoor slides and climbing equipment over 18 inches shall not be over bare flooring.

G. The climbing portions of indoor slides and climbing equipment 36 inches or more shall be located over a resilient surface.

H. Trampolines may not be used.

EXCEPTION: The requirements of subsections A through H of this section shall not prohibit child day programs providing care for school-age children at a location that is currently approved by the Department of Education or recognized as a private school by the State Board of Education for school occupancy and that houses a public or private school during the school year from permitting school-age children to use outdoor play equipment and areas approved for use by students of the school during school hours.

I. If combs, toothbrushes, or other personal articles are used, they shall be individually assigned.

J. Disposable products shall be used once and discarded.

K. Provision shall be made for an individual place for each child's personal belongings.

L. Infant walkers shall not be used.

M. Play yards where used shall:

1. Meet the Juvenile Products Manufacturers Association (JPMA) and the American Society for Testing and Materials (ASTM) requirements and shall retain the manufacturer's label documenting product compliance with current safety standards at the time they were manufactured;

2. Not be used after recalled;

3. Not use any pillows or filled comforters;

4. Not be used for the designated sleeping areas;

5. Not be occupied by more than one child; and

6. Be sanitized each day of use or more often as needed.

N. Upon being informed that a product has been recalled, center staff shall remove the item from the center.

O. Where portable water coolers are used, they shall be of cleanable construction, maintained in a cleaned condition, kept securely closed and so designed that water may be withdrawn from the container only by water tap or faucet.

P. Drinking water which is transported to camp sites shall be in closed containers.

Q. Therapeutic child day programs and special needs child day programs serving children who use wheelchairs shall provide cushioned vinyl-covered floormats for use when activities require children to be out of their wheelchairs.

A. Cribs, cots, rest mats or beds shall be provided for children during the designated rest period and not be occupied by more than one child at a time.

B. Cribs, cots, rest mats, and beds shall be identified for use by a specific child.

C. Double decker cribs, cots, or beds, or other sleeping equipment when stacked shall not be permitted.

D. Occupied cribs, cots, rest mats, and beds shall be at least 2-1/2 feet from any heat producing appliance.

E. There shall be at least 12 inches of space between occupied cots, beds, and rest mats.

Exception: Twelve inches of space are not required where cots, beds, or rest mats are located adjacent to a wall or a divider as long as one side is open at all times to allow for passage.

F. If rest mats are used, they shall have cushioning and be sanitized on all sides weekly or before use by another child.

G. Cribs shall be used for children under 12 months of age and for children over 12 months of age who are not developmentally ready to sleep on a cot or mat.

H. Cribs shall meet the following requirements:

1. They shall meet the Consumer Product Safety Commission Standards at the time they were manufactured;

2. They shall not have been recalled;

3. There shall be no more than six centimeters or 2-3/8 inches of space between slats;

4. There shall be no more than one inch between the mattress and the crib; and

5. End panel cut-outs in cribs shall be of a size not to cause head entrapment.

I. Cribs shall be placed where objects outside the crib such as cords from blinds or curtains are not within reach of infants or toddlers.

J. There shall be at least:

1. Twelve inches of space between the sides and ends of occupied cribs except where they touch the wall; and

2. Thirty inches of space between service sides of occupied cribs and other furniture where that space is the walkway for staff to gain access to any occupied crib.

K. Crib sides shall be up and the fastenings secured when a child is in the crib, except when a staff member is giving the child immediate attention.

L. Pillows and filled comforters shall not be used by children under two years of age.

M. Use of crib bumper pads shall be prohibited.

N. Toys or objects hung over an infant in a crib and crib gyms that are strung across the crib may not be used for infants over five months of age or infants who are able to push up on their hands and knees.

A. Cribs, cots, mats and beds used by children other than infants during the designated rest period or during evening and overnight care shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges. Cribs when being used by infants shall have a bottom cover.

B. Linens shall be assigned for individual use.

C. Linens shall be clean and washed at least weekly.

1. Crib sheets shall be clean and washed daily.

2. When centers wash the linens, the water shall be above 140°F or the dryer shall heat the linens above 140°F as verified by the manufacturer or a sanitizer shall be used according to the manufacturer's instructions.

D. Pillows when used shall be assigned for individual use and covered with pillow cases.

E. Mattresses when used shall be covered with a waterproof material which can be cleaned and sanitized.

A. The staff-to-children ratios required by 8VAC20-780-350 B and 8VAC20-780-355 A and B shall be maintained while children are participating in swimming or wading activities.

1. Notwithstanding the staff-to-children ratios already indicated, at no time shall there be fewer than two staff members supervising the activity.

2. The designated certified lifeguard shall not be counted in the staff-to-children ratios.

B. If a pool, lake, or other swimming area has a water depth of more than two feet, a certified lifeguard holding a current certificate shall be on duty supervising the children participating in swimming or wading activities at all times when one or more children are in the water.

C. The lifeguard certification shall be obtained from an organization such as the American Red Cross, the YMCA, or the Boy Scouts.

A. When permanent swimming or wading pools are located on the premises of the center, the following shall apply:

1. The manufacturer's specifications for operating the pool shall be followed as well as any local ordinances and any Department of Health requirements for swimming pools;

2. Pools constructed, renovated, or remodeled after April 1, 1986, shall have a statement in writing of their inspection and approval from the local building official when such approval is required;

3. Outdoor swimming pools shall be enclosed by safety fences and gates which are in compliance with the applicable edition of the Virginia USBC (13VAC5-62) and shall be kept locked when the pool is not in use;

4. Entrances to indoor swimming pools shall be locked when the pool is not in use; and

5. A whistle or other audible signaling device, a buoy or a lemon line, a reach pole, and a backboard shall be available at the swimming or wading site.

B. If children are allowed to swim in a lake or other place other than a pool, safe swimming areas shall be clearly marked and there shall be appropriate water safety equipment.

C. Piers, floats, and platforms shall be in good repair and where used for diving, the minimum water depth shall be stated on the deck or planking.

D. If portable wading pools without integral filter systems are used, they shall be emptied after the use of each group of children, rinsed, and filled with clean water, or more frequently as necessary.

E. Children who are not toilet trained may not use portable wading pools.

F. After each day's use, portable wading pools shall be emptied, sanitized, and stored in a position to keep them clean and dry.

A. The center shall have emergency procedures and written safety rules for swimming or wading or follow the posted rules of public pools that are:

1. Posted in the swimming area when the pool is located on the premises of the center; and

2. Explained to children participating in swimming or wading activities.

B. The center shall maintain (i) written permission from the parent of each child who participates in swimming or wading and (ii) a statement from the parent advising of a child's swimming skills before the child is allowed in water above the child's shoulder height.

C. Staff shall have a system for accounting for all children in the water.

D. Outdoor swimming activities shall occur only during daylight hours unless underwater and deck lighting is provided.

A. A child shall not be allowed to attend the center for the day if he has:

1. A temperature over 101°F;

2. Recurrent vomiting or diarrhea; or

3. A communicable disease.

B. If a child needs to be excluded according to subsection A of this section, the following shall apply:

1. Arrangements shall be made for the child to leave the center as soon as possible after the signs or symptoms are noticed; and

2. The child shall remain in the designated quiet area until leaving the center.

C. When children at the center have been exposed to a communicable disease listed in the Department of Health's current communicable disease chart, the parents shall be notified within 24 hours or the next business day of the center's having been informed unless forbidden by law, except for life threatening diseases, which must be reported to parents immediately.

D. The center shall consult the local department of health if there is a question about the communicability of a disease.

E. When any surface has been contaminated with body fluids, it shall be cleaned and sanitized.

A. Hand washing.

1. Children's hands shall be washed with soap and running water or disposable wipes before and after eating meals or snacks.

2. Children's hands shall be washed with soap and running water after toileting and any contact with blood, feces, or urine.

3. Staff shall wash their hands with soap and running water:

a. Before and after helping a child use the toilet;

b. Before and after a diaper change;

c. After the staff member uses the toilet;

d. After any contact with body fluids;

e. Before feeding or helping children with feeding; and

f. Before preparing or serving food or beverages.

4. If running water is not available, a germicidal cleansing agent administered per manufacturer's instruction may be used.

B. Diapering; soiled clothing.

1. The diapering area shall be accessible and within the building used by children.

2. There shall be sight and sound supervision for all children when a child is being diapered.

3. The diapering area shall have the following:

a. A sink with running warm water not to exceed 120°F;

b. Soap, disposable towels, and single use gloves such as surgical or examination gloves;

c. A nonabsorbent surface for diapering or changing shall be used. For children younger than three years, this surface shall be a changing table or countertop designated for changing;

d. The appropriate disposal container as required by subdivision 6 of this subsection; and

e. A leakproof covered receptacle for soiled linens.

4. When a child's clothing or diaper becomes wet or soiled, the child shall be cleaned and changed immediately.

5. Disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal.

6. When cloth diapers are used, a separate leakproof storage system as specified in subdivision 5 of this subsection shall be used for each individual child.

7. The diapering surface shall be used only for diapering or cleaning children, and it shall be cleaned with soap and at least room temperature water and sanitized after each use. Tables used for children's activities or meals shall not be used for changing diapers.

8. Individual disposable barriers may be used between each diaper change. If the changing surface becomes soiled, the surface shall be cleaned and sanitized before another child is diapered.

9. Staff shall ensure the immediate safety of a child during diapering.

C. Toilet training. For every 10 children in the process of being toilet trained, there shall be at least one toilet chair or one child-sized toilet, or at least one adult sized toilet with a platform or steps and adapter seat.

1. The location of these items shall allow for sight and sound supervision of children in the classroom if necessary for the required staff-to-children ratios to be maintained.

2. Toilet chairs shall be emptied promptly and cleaned and sanitized after each use.

A. The decision to administer medicines at a facility may be limited by center policy to administer:

1. Prescribed medications;

2. Over-the-counter or nonprescription medications; or

3. No medications except those required for emergencies or by law.

B. Prescription and nonprescription medication shall be given to a child:

1. According to the center's written medication policies; and

2. Only with written authorization from the parent.

C. Medication shall be administered by a staff member who is 18 years of age or older.

D. Nonprescription medication shall be administered by a staff member or independent contractor who meets the requirements in 8VAC20-780-245 J 1 or J 2.

E. The center's procedures for administering medication shall:

1. Include any general restrictions of the center.

2. For nonprescription medication, be consistent with the manufacturer's instructions for age, duration, and dosage.

3. Include duration of the parent's authorization for medication, provided that it shall expire or be renewed after 10 work days. Long-term prescription drug use and over-the-counter medication may be allowed with written authorization from the child's physician and parent.

4. Include methods to prevent use of outdated medication.

F. The medication authorization shall be available to staff during the entire time it is effective.

G. Medication shall be labeled with the child's name, the name of the medication, the dosage amount, and the time or times to be given.

H. Nonprescription medication shall be in the original container with the direction label attached.

I. The center may administer prescription medication that would normally be administered by a parent or guardian to a child provided:

1. The medication is administered by a staff member or an independent contractor who meets the requirements in 8VAC20-780-245 J;

2. The center has obtained written authorization from a parent or guardian;

3. The center administers only those drugs that were dispensed from a pharmacy and maintained in the original, labeled container; and

4. The center administers drugs only to the child identified on the prescription label in accordance with the prescriber's instructions pertaining to dosage, frequency, and manner of administration.

J. When needed, medication shall be refrigerated.

K. When medication is stored in a refrigerator used for food, the medications shall be stored together in a container or in a clearly defined area away from food.

L. Medication, except for those prescriptions designated otherwise by written physician's order, including refrigerated medication and staff's personal medication, shall be kept in a locked place using a safe locking method that prevents access by children.

M. If a key is used, the key shall not be accessible to the children.

N. Centers shall keep a record of medication given children, which shall include the following:

1. Child to whom medication was administered;

2. Amount and type of medication administered to the child;

3. The day and time the medication was administered to the child;

4. Staff member administering the medication;

5. Any adverse reactions; and

6. Any medication error.

O. Staff shall inform parents immediately of any adverse reactions to medication administered and any medication error.

P. When an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet.

A. All nonprescription drugs and over-the-counter skin products shall be used in accordance with the manufacturer's recommendations. Nonprescription drugs and over-the-counter skin products shall not be kept or used beyond the expiration date of the product.

B. If sunscreen is used, the following requirements shall be met:

1. Written parent authorization noting any known adverse reactions shall be obtained;

2. Sunscreen shall be in the original container and labeled with the child's name;

3. Sunscreen does not need to be kept locked but shall be inaccessible to children under five years of age or those children in a therapeutic child day program or special needs child day program;

4. Any center-kept sunscreen shall be hypo-allergenic and have a minimum SPF of 15;

5. Staff members without medication administration training may apply sunscreen, unless it is prescription sunscreen, in which case the storing and application of sunscreen must meet medication-related requirements; and

6. Children nine years of age and older may administer their own sunscreen if supervised.

C. If diaper ointment or cream is used, the following requirements shall be met:

1. Written parent authorization noting any known adverse reactions shall be obtained;

2. These products shall be in the original container and labeled with the child's name;

3. These products do not need to be kept locked but shall be inaccessible to children;

4. A record shall be kept that includes the child's name, date of use, frequency of application and any adverse reactions; and

5. Staff members without medication administration training may apply diaper ointment, unless it is prescription diaper ointment, in which case the storing and application of diaper ointment must meet medication-related requirements.

D. If insect repellent is used, the following requirements shall be met:

1. Written parent authorization noting any known adverse reactions shall be obtained;

2. Insect repellent shall be in the original container and labeled with the child's name;

3. Insect repellent does not need to be kept locked but shall be inaccessible to children;

4. A record shall be kept that includes the child's name, date of use, frequency of application and any adverse reactions;

5. Manufacturer's instructions for age, duration and dosage shall be followed; and

6. Staff members without medication administration training may apply insect repellent, unless it is prescription insect repellent, in which case the storing and application of insect repellent must meet medication-related requirements.

A. At least one staff in each classroom or area where children are present shall have, within 90 days of October 13, 2021:

1. Current certification in cardiopulmonary resuscitation (CPR) as appropriate to the age of the children in care from an organization such as the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council. The training shall include an in-person competency demonstration; and

2. Current certification in first aid from an organization such as the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council.

B. CPR and first aid certification training may count toward the annual training hours required in 8VAC20-780-245.

C. There shall be at least two staff members who meet the requirements of subsection A of this section present on the premises during the center's hours of operation, on fieldtrips, and wherever children are in care.

D. Primitive camps shall have a staff member on the premises during the hours of operation who has at least current certification in first responder training.

E. Staff who is a registered nurse or licensed practical nurse with a current license from the Board of Nursing shall not be required to obtain first aid certification.

A. A first aid kit shall be:

1. On each floor of each building used by children;

2. Accessible to outdoor play areas;

3. On field trips; and

4. Wherever children are in care.

B. Each first aid kit shall be easily accessible to staff but not to children.

C. The required first aid kits shall include at a minimum:

1. Scissors;

2. Tweezers;

3. Gauze pads;

4. Adhesive tape;

5. Band-aids, assorted types;

6. An antiseptic cleansing solution /pads;

7. Thermometer;

8. Triangular bandages;

9. Single use gloves such as surgical or examination gloves; and

10. The first aid instructional manual.

D. The following emergency supplies shall be required at the center and be available on field trips:

1. Activated charcoal preparation (to be used only on the direction of a physician or the center's local poison control center); and

2. An ice pack or cooling agent.

E. The following nonmedical emergency supplies shall be required:

1. One working, battery-operated flashlight on each floor of each building that is used by children; and

2. One working, battery-operated radio in each building used by children and any camp location without a building.

A. The center shall have a written emergency preparedness plan that addresses staff responsibility and facility readiness with respect to emergency evacuation and relocation, shelter-in-place, and lockdown. The plan, which shall be developed in consultation with local or state authorities, shall include the most likely to occur emergency scenario or scenarios, including fire, severe storms, loss of utilities, natural disaster, chemical spills, intruder, violence at or near the center, terrorism specific to the locality, and other situations, including facility damage that requires evacuation, lockdown, or shelter-in-place.

B. The emergency preparedness plan shall contain procedural components for:

1. Sounding of alarms, such as intruder, evacuation, lockdown, and shelter-in-place for tornado or chemical hazards;

2. Emergency communication to include:

a. Establishment of center emergency officer and back-up officer to include 24-hour contact telephone number for each;

b. Notification of local authorities, such as fire and rescue, law enforcement, emergency medical services, poison control, health department, and parents and local media; and

c. Availability and primary use of communication tools;

3. Evacuation to include:

a. Assembly points, methods to account for all children at the assembly point and relocation site, primary and secondary means of egress, and complete evacuation of the buildings;

b. Securing of essential documents, including attendance records, parent contact information, emergency contact information, and information on allergies or food intolerances;

c. Methods to ensure any health care needs to include medications and care plans; emergency contact information for staff; and supplies are taken to the assembly point or relocation site;

d. Method of communication with parents and emergency responders;

e. Accommodations or special requirements for infants, toddlers, and children with special needs to ensure their safety during evacuation or relocation; and

f. Procedures to reunite children with a parent or authorized person designated by the parent to pick up the child;

4. Shelter-in-place to include:

a. Scenario applicability, such as tornado or chemical spill, inside assembly points, methods to account for all children at the safe locations, and primary and secondary means of access and egress;

b. Securing of essential documents, including attendance records, parent contact information, emergency contact information, and information on allergies;

c. Methods to ensure any health care needs to include medications and care plans; emergency contact information for staff; and supplies are taken to the assembly point or relocation site;

d. Method of communication with parents and emergency responders;

e. Accommodations or special requirements for infants, toddlers, and children with special needs to ensure their safety during shelter-in-place; and

f. Procedures to reunite children with a parent or authorized person designated by the parent to pick up the child;

5. Lockdown, to include:

a. Facility containment procedures, such as closing of fire doors or other barriers, scenario applicability, assembly points, and methods to account for all children at the safe locations;

b. Method of communication with parents and emergency responders;

c. Accommodations or special requirements for infants, toddlers, and children with special needs to ensure their safety during lockdown; and

d. Procedures to reunite children with a parent or authorized person designated by the parent to pick up the child;

6. Continuity of operations to ensure that essential functions are maintained during an emergency;

7. Staff training requirement, drill frequency, and plan review and update; and

8. Other special procedures developed with local authorities.

C. Emergency evacuation and shelter-in-place procedures or maps shall be posted in a location conspicuous to staff and children on each floor of each building.

D. The center shall implement a monthly practice evacuation drill.

E. Shelter in place procedures shall be practiced a minimum of twice per year.

F. Lockdown procedures shall be practiced at least annually.

G. Documentation shall be maintained of emergency evacuation, shelter-in-place, and lockdown drills that includes:

1. Identity of the person conducting the drill;

2. The date and time of the drill;

3. The method used for notification of the drill;

4. The number of staff participating;

5. The number of children participating;

6. Any special conditions simulated;

7. The time it took to complete the drill;

8. Problems encountered, if any; and

9. For emergency evacuation drills only, weather conditions.

H. The center shall maintain a record of the dates of the practice drills for one year. For centers offering multiple shifts, the simulated drills shall be divided evenly among the various shifts.

I. A 911 or local dial number for police, fire and emergency medical services and the number of the regional poison control center shall be posted in a visible place at each telephone.

J. Each camp location shall have an emergency preparedness plan and warning system.

K. The center shall prepare a document containing local emergency contact information, potential shelters, hospitals, evacuation routes, etc., that pertain to each site frequently visited or of routes frequently driven by center staff for center business such as field trips or pick up or drop off of children to or from schools etc. This document must be kept in vehicles that centers use to transport children to and from the center.

L. Parents shall be informed of the center's emergency preparedness plan.

M. Based on local authorities and documented normal ambulance operation, if an ambulance service is not readily accessible within 10 to 15 minutes, other transportation shall be available for use in case of emergency.

N. The center or other appropriate official shall notify the parent immediately if a child is lost, requires emergency medical treatment, or sustains a serious injury.

O. The center shall notify the parent by the end of the day of any known minor injuries.

P. The center shall maintain a written record of children's serious and minor injuries in which entries are made the day of occurrence. The record shall include the following:

1. Date and time of injury;

2. Name of injured child;

3. Type and circumstance of the injury;

4. Staff present and treatment;

5. Date and time when parents were notified;

6. Any future action to prevent recurrence of the injury;

7. Staff and parent signatures or two staff signatures; and

8. Documentation on how parent was notified.

Q. A parent shall be notified immediately of any confirmed or suspected allergic reaction and the ingestion of or contact with any food in the written care plan required in 8VAC20-780-60 A 8 even if a reaction did not occur.

A. Centers shall schedule appropriate times for snacks or meals, or both, based on the hours of operation and time of the day (e.g., a center open only for after school care shall schedule an afternoon snack; a center open from 7 a.m. to 1 p.m. shall schedule a morning snack and midday meal).

B. The center shall ensure that children arriving from a half-day, morning program who have not yet eaten lunch receive a lunch.

C. The center shall schedule snacks or meals so that there is a period of at least 1-1/2 hours but no more than three hours between each meal or snack unless there is a scheduled rest or sleep period for children between the meals and snacks.

D. Drinking water or other beverage not containing caffeine shall be offered at regular intervals to nonverbal children.

E. In environments of 80°F or above, attention shall be given to the fluid needs of children at regular intervals. Children in such environments shall be encouraged to drink fluids as outlined in subsection D of this section.

F. When centers choose to provide meals or snacks, the following shall apply:

1. Centers shall follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program of the United States Department of Agriculture (USDA).

2. Children shall be allowed second helpings of food listed in the USDA's child and adult care meal patterns.

3. Centers offering both meals and snacks shall serve a variety of nutritious foods and shall serve at least three sources of vitamin A and at least three sources of vitamin C on various days each week.

4. Children three years of age or younger may not be offered foods that are considered to be potential choking hazards.

5. A menu listing foods to be served for meals and snacks during the current one-week period shall:

a. Be dated;

b. Be posted in a location conspicuous to parents or given to parents;

c. List any substituted food; and

d. Be kept on file for one week at the center.

6. Powdered milk shall not be used except for cooking.

G. When food is brought from home, the following shall apply:

1. The food container shall be sealed and clearly dated and labeled in a way that identifies the owner;

2. The center shall have extra food or shall have provisions to obtain food to serve to children so they can have an appropriate snack or meal if they forget to bring food from home, bring an inadequate meal or snack, or bring perishable food; and

3. Unused portions of opened food shall be discarded by the end of the day or returned to the parent.

H. If a catering service is used, it shall be approved by the local health department.

I. Contaminated or spoiled food shall not be served to children.

J. Tables and high chair trays shall be:

1. Sanitized before and after each use for feeding; and

2. Cleaned at least daily.

K. Children shall be encouraged to feed themselves.

L. Staff shall sit with children during meal times.

M. No child shall be allowed to drink or eat while walking around.

N. Food shall be prepared, stored, and transported in a clean and sanitary manner.

O. When food is prepared to which a child in care is allergic, staff shall take steps to avoid cross contamination to prevent an allergic reaction.

P. A child with a diagnosed food allergy shall not be served any food identified in the written care plan required in 8VAC20-780-60 A 8.

A. High chairs, infant carrier seats, or feeding tables shall be used for children under 12 months who are not held while being fed.

1. Children using infant seats or high chairs shall be supervised during snacks and meals.

2. When a child is placed in an infant seat or high chair, the protective belt shall be fastened securely.

B. Bottle fed infants who cannot hold their own bottles shall be held when fed. Bottles shall not be propped or used while the child is in his designated sleeping location.

C. The record of each child on formula shall contain:

1. The brand of formula; and

2. The child's feeding schedule.

D. Infants shall be fed on demand or in accordance with parental instructions.

E. Prepared infant formula shall be refrigerated, dated and labeled with the child's name.

F. Heated formula and baby food shall be stirred or shaken and tested for temperature before serving to children.

G. Milk, formula or breast milk shall not be heated or warmed directly in a microwave. Note: Water for warming milk, formula, or breast milk may be heated in a microwave.

H. Prepared baby food not consumed during that feeding by an infant may be used by that same infant later in the same day, provided that the food is not served out of the baby jar and is dated and stored in the refrigerator; otherwise, it shall be discarded or returned to the parent at the end of the day. Formula or breast milk shall not remain unrefrigerated for more than two hours and may not be reheated.

I. A one-day's emergency supply of disposable bottles, nipples, and commercial formulas appropriate for the children in care shall be maintained at the center.

J. Breastfeeding shall be permitted.

K. Staff shall feed semisolid food with a spoon unless written instructions from a physician or physician's designee state differently.

L. For therapeutic child day programs and special needs child day programs, the consistency of food shall be appropriate to a child's special feeding needs. Necessary and adaptive feeding equipment and feeding techniques shall be used for children with special feeding needs.

A. If the center provides transportation, the center shall be responsible from the time the child boards the vehicle until returned to the parents or person designated by the parent.

B. Any vehicle used by the center for the transportation of children shall meet the following requirements:

1. The vehicle shall be manufactured for the purpose of transporting people seated in an enclosed area;

2. The vehicle's seats shall be attached to the floor;

3. The vehicle shall be insured with at least the minimum limits established by Virginia state statutes;

4. The vehicle shall meet the safety standards set by the Department of Motor Vehicles and shall be kept in satisfactory condition to assure the safety of children; and

5. If volunteers supply personal vehicles, the center is responsible for ensuring that the requirements of this subsection are met.

C. The center shall ensure that during transportation of children:

1. Virginia state statutes about safety belts and child restraints are followed as required by §§ 46.2-1095 through 46.2-1100 of the Code of Virginia, and stated maximum number of passengers in a given vehicle is not exceeded;

2. The children remain seated and each child's arms, legs, and head remain inside the vehicle;

3. Doors are closed properly and locked unless locks were not installed by the manufacturer of the vehicle;

4. At least one staff member or the driver always remains in the vehicle when children are present;

5. The following information is in transportation vehicles:

a. Emergency numbers as specified in 8VAC20-780-550 I and K;

b. The center's name, address, and phone number;

c. A list of the names of the children being transported; and

d. Allergy care plan and information as specified in 8VAC20-780-60 A 7 and A 8; and

6. Staff who transport children shall be 18 years of age or older.

D. When entering and leaving vehicles, children shall enter and leave the vehicle from the curb side of the vehicle or in a protected parking area or driveway.

E. Children shall cross streets at corners or crosswalks or other designated safe crossing point if no corner or crosswalk is available.

F. The staff-to-children ratios of 8VAC20-780-350 B and 8VAC20-780-355 shall be followed on all field trips. The staff-to-children ratios need not be followed during transportation of school age children to and from the center. One staff member or adult is necessary in addition to the driver when 16 or more preschool or younger children are being transported in the vehicle.

G. The center shall make provisions for providing children on field trips with adequate food and water.

H. If perishable food is taken on field trips, the food shall be stored in insulated containers with ice packs to keep the food cold.

I. Before leaving on a field trip, a schedule of the trip's events and locations shall be posted and visible at the center site.

J. There shall be a communication plan between center staff and staff who are transporting children or on a field trip.

K. Staff shall verify that all children have been removed from the vehicle at the conclusion of any trip.

L. Parental permission for transportation and field trips shall be secured before the scheduled activity.

M. If a blanket permission is used instead of a separate written permission, the following shall apply:

1. Parents shall be notified of the field trip; and

2. Parents shall be given the opportunity to withdraw their children from the field trip.

A. For therapeutic child day programs and special needs child day programs providing transportation, nonambulatory children shall be transported in a vehicle which is equipped with a ramp or hydraulic lift to allow entry and exit.

B. Wheelchairs shall be equipped with restraining devices and shall be securely fastened to the floor when used to seat children in a vehicle.

C. Arrangements of wheelchairs in a vehicle shall not impede access to exits.

D. For therapeutic child day programs and special needs child day programs, when the center is responsible for providing transportation, the center shall develop a plan based on the needs of the children in care to assure their safe supervision during on-loading, off-loading and transporting.

E. When 16 or more children are being transported, there shall be at least one center aide or adult besides the driver, for each group of 16.

F. For therapeutic child day programs and special needs child day programs, if a child has a known seizure disorder or neurological, genetic or physiological disability causing increased medical risk and that child is being transported, one center aide or adult who is not the driver and who is trained in CPR shall be present in the vehicle.

A. Animals that are kept on the premises of the center shall be vaccinated, if applicable, against diseases which present a hazard to the health or safety of children.

B. Animals which are, or are suspected of being, ill or infested with external lice, fleas and ticks or internal worms shall be removed from contact with children.

C. If a child is bitten by an animal, an attempt shall be made to confine the animal for observation or laboratory analysis for evidence of rabies.

D. The site of the bite shall be washed with soap and water immediately, and the child's physician or local health department shall be contacted as soon as possible for medical advice.

E. The center shall report the animal bite incident to the local health department.

F. Manure shall be removed from barns, stables and corrals at least once a day and stored and disposed of in a manner to prevent the breeding of flies.

A. For evening care, beds with mattresses or cots with at least one inch of dense padding shall be used by children who sleep longer than two hours and are not required to sleep in cribs.

Exception: Camps providing evening care on an occasional basis are not required to meet the requirements of this subsection if sleeping bags or cots are used.

B. For overnight care, beds with mattresses or cots with at least two inches of dense padding shall be used by children who are not required to sleep in cribs.

Exception: Camps providing overnight care on an occasional basis are not required to meet the requirements of this subsection if sleeping bags or cots are used.

C. For overnight care which occurs for a child on a weekly or more frequent basis, beds with mattresses shall be used.

D. In addition to 8VAC20-780-450 about linens, bedding appropriate to the temperature and other conditions of the rest area shall be provided.

E. For evening and overnight care, separate sleeping areas shall be provided for children of the opposite sex eight years of age or older.

F. If sleeping bags are used, 8VAC20-780-440 A through E about rest furnishings shall also apply to the use of sleeping bags.

G. Camps may use bunk beds if children are at least eight years of age.

H. In centers providing overnight care, an operational tub or shower with heated and cold water shall be provided.

Exception: Primitive camps are not required to have a tub or shower.

I. When bath towels are used, they shall be assigned for individual use.

J. Activities for children in evening or overnight care shall include, as time allows, age-appropriate activities as described in 8VAC20-780-360 through 8VAC20-780-390.

K. Quiet activities shall be available immediately before bedtime.

L. For children receiving evening or overnight care, the provider shall offer an evening snack.

Initial Application for a License to Operate a Child Day Center (eff. 7/1/21)

Renewal Application for a License to Operate a Child Day Center (eff. 7/1/21)

F406-02 ASTM Standard Consumer Safety Specification for Non-Full-Size Baby Cribs/Play Yards, October 2003.

F1292-99 ASTM Standard Specification for Impact Attenuation of Surface Systems Under and Around Playground Equipment, August 10, 1999.

"Selecting Playground Surface Materials: Guidelines for Selecting the Best Surface Material for Your Playground," National Program for Playground Safety, University of Northern Iowa, February 2004.

Air Quality Color Code Chart, Virginia Department of Environmental Quality, April 2004.

A. Each center shall maintain and keep on the premises a separate record for each child enrolled.

B. Each enrolled child's record shall contain the following information that is required upon enrollment unless otherwise stated:

1. Name, preferred name (if any), sex, birth date of the child, and address;

2. Name, home address, and phone number of each parent who has custody;

3. Name and phone number of two designated people to call in an emergency if a parent cannot be reached;

4. Names of persons to whom the child may be released, including any agencies the parent has a contract in place with to provide a specialized service to the child. Appropriate legal paperwork shall be on file when a custodial parent requests the center not to release the child to the other parent;

5. A list of health issues, including allergies; intolerances to medication, food, or other substances; chronic physical or medical conditions; special needs; dietary preferences; and pertinent behavioral or developmental information;

6. For items in subdivision 5 that are reasonably likely to result in a medical emergency, an emergency care plan that has been developed in consultation with a physician or physician’s designee;

7. Written agreements as required by 8VAC20-781-420;

8. Previous child day care and schools attended by the child, as well as any child day care or school concurrently attended by the child;

9. Documentation of viewing proof of the child's identity and age as outlined in § 22.1- 289.049 of the Code of Virginia;

10. Documentation of health information as required by 8VAC20-781-90. When a center assumes responsibility for the child directly from a school or the center transfers responsibility of the child directly to the school, the center is not required to maintain documentation required by subsections A and B of 8VAC20-781-90 of the school's records for that child;

11. Documentation of the enrollment of a child experiencing homelessness enrolled under provision of subsection C of 8VAC20-781-90; and

12. The date of initial attendance and the last day of attendance.

C. The center shall document annually that the parent has confirmed that information in the child’s record is accurate.

The following records shall be kept for each staff member:

1. Name, address, verification of age requirement, current job title, and dates of employment or volunteering;

2. Background check information shall be maintained in accordance with the requirements in 8VAC20-770;

3. Documentation that the individual meets the appropriate qualifications and training in Part III of this chapter. The documentation of training shall include (i) the name of the staff member; (ii) the date of the training; (iii) the training topic; (iv) evidence that the training has been completed; (v) the person providing the training; (vi) the number of training hours or credit hours received;

4. Health information as required by 8VAC20-781-90; and

5. Information, to be kept on the premises, about any health problems that may interfere with fulfilling the job responsibilities.

A. The center shall maintain a record of daily attendance that documents the arrival and departure times of each child as it occurs.

B. The licensee shall ensure that staff in each group of children maintain a list of children that accurately reflects the children in their care.

C. The center shall inform the superintendent as soon as practicable, but not to exceed one business day of the circumstances surrounding the following incidents:

1. Death of a child while under the center's supervision;

2. Missing child when local authorities have been contacted for help;

3. The suspension or termination of all child care services for more than 24 hours as a result of an emergency situation and any plans to resume child care; or

4. A situation in which a child's whereabouts was unknown, including a child left unattended or unsupervised.

D. The center shall inform the superintendent as soon as practicable but not to exceed two business days after learning about any incident while a child is under the supervision of the center that required medical attention.

E. If the center or any person employed by the center has reason to suspect that a child is an abused or neglected child, such person shall report the matter immediately in accordance with § 63.2-1509 of the Code of Virginia.

F. A center shall immediately report an outbreak of disease as defined by the Virginia Board of Health to the local health department, as required by § 32.1-37 of the Code of Virginia.

A. Immunizations. The center shall comply with the health provisions of § 22.1-271.2 of the Code of Virginia.

B. Physical examinations.

1. The center shall obtain documentation of a report from a qualified licensed physician, or a licensed nurse practitioner or licensed physician assistant acting under the supervision of a licensed physician, of a comprehensive physical examination performed within (i) the 12 months prior to the date a child first attends the center, or (ii) 30 days after the first day of attendance.

2. Such physical examination shall not be required of any child whose parent objects on religious grounds and who shows no visual evidence of sickness, provided that such parent shall state in writing that, to the best of his knowledge, such child is in good health and free from any communicable or contagious disease.

C. If a child is experiencing homelessness and does not have documentation of the required immunizations and physical examination, the center shall allow the child to attend during a grace period of no more than 90 days to allow the parent time to obtain documentation of the required documents.

D. Tuberculosis.

1. Prior to a staff member’s date of employment, such individual shall submit to the center the results of a screening assessment documenting the absence of tuberculosis in a communicable form. The documentation shall contain the elements of the current tuberculosis screening form published by the Virginia Department of Health and shall have been completed within 90 calendar days prior to coming in contact with children at the center.

2. Any staff member or volunteer who develops symptoms compatible with active tuberculosis disease, regardless of the date of the last tuberculosis screening or assessment, shall immediately obtain and submit a new tuberculosis screening form required in subdivision 1 of this subsection.

3. Any staff member or volunteer who comes into contact with a known case of infectious tuberculosis shall immediately obtain and submit to the center a new tuberculosis screening form required in subdivision 1 of this subsection. Until a new screening form is issued that documents the absence of tuberculosis in a communicable form, the staff member shall not have contact with children.

A. Directors shall be at least 21 years of age and shall have a high school diploma or the equivalent.

B. The director shall meet one of the following education and experience qualification options, as well as three months experience in a supervisory capacity:

1. A bachelor’s or graduate degree in a child-related degree such as child development, early childhood education, elementary education, recreation, or nursing; and three months programmatic experience;

2. Forty-eight college credits with 12 college credits in child related courses and six months of programmatic experience;

3. One-year community college certificate in a child-related field with a minimum of 30 total college credits and one year of programmatic experience; or

4. The requirement for a lead teacher in subsection B of 8VAC20-781-120 and two years of programmatic experience.

C. Directors without experience in a supervisory capacity shall complete, within ten business days of employment or promotion, ten hours of management training that includes information on supervising, orienting, training, and scheduling.

D. Notwithstanding subsection A of this section, an individual who is at least 19 years of age may serve as a director at a short-term program.

E. A director employed prior to [effective date of regulation] who met the education and experience qualifications in effect immediately prior to [effective date of regulation], and who has been continuously employed as a child day center director, is considered to have met the requirements of this section.

A. A center shall ensure that the director is on premises at least 50% of the center‘s hours of operation each week.

B. The director shall designate one or more staff to assume the director’s responsibilities in the director's absence. The designee shall meet the requirements of 8VAC20-781-100 and shall receive orientation and training on the director’s responsibilities prior to assuming such responsibilities.

C. The licensee shall ensure that, in the director’s absence, an adult designated to assume the director’s responsibilities is on the premises of the center to oversee the administration of the center during the center's hours of operation.

A. Lead teachers shall be at least 18 years of age and shall have a high school diploma or the equivalent.

B. Lead teachers shall meet a director qualification indicated in 8VAC20-781-100 or one of the following education and experience requirements:

1. Three months of programmatic experience and one of the following:

a. A one-year community college certificate in a child-related field with a minimum of 30 total college credits;

b. A career studies certificate in a child-related field with a minimum of 12 total college credits;

c. A teaching diploma from an internationally or nationally recognized Montessori organization; or

d. A credential in a child-related field by an organization listed in § 22.1-289.048 of the Code of Virginia or an equivalent credential recognized by the Department.

2. Six months of programmatic experience and:

a. A Virginia endorsement in a child-related field approved by the Department; or

b. 24 hours of training in the following topics: child development, behavior guidance, playground safety, and health and safety issues. This training shall be completed before being promoted or beginning work or within 60 days after being promoted or beginning work. Orientation training required by subsections B and C of 8VAC20-781-140 shall not be used to meet this qualification.

C. Lead teachers at short-term programs shall have a minimum of 200 hours of programmatic experience of which up to 24 hours can be formal training.

D. A lead teacher employed prior to [effective date of regulation], who met the education and experience qualifications in effect immediately prior to [effective date of regulation], and who has been continuously employed as a child day center lead teacher, is considered to have met the requirements of this section.

A. Any individual who drives a vehicle to transport children for a center shall (i) be at least 18 years of age; (ii) possess a valid driver’s license that authorizes the driver to operate the vehicle being driven; and (iii) provide, prior to transporting children, a driving record obtained from the state department of motor vehicles that issued the current license.

B. Centers that have obtained insurance for all individuals who transport children shall not be required to provide a driving record as required in subsection A of this section.

A. The licensee shall ensure that all staff who will work with children complete the preservice training sponsored by the Department within 90 calendar days of their date of employment. A staff member who has documentation of completing the preservice training shall not be required to retake the course.

B. The center shall provide orientation training to all staff who will work with children. The orientation training must be completed by such staff prior to working alone with a child and within seven days of the staff member’s date of employment. The orientation training shall include all the following facility specific topics:

1. Job responsibilities and to whom the staff member reports;

2. Recognizing child abuse and neglect and the legal requirements for reporting
suspected child abuse as required by § 63.2-1509 of the Code of Virginia;

3. All policies and procedures required by 8VAC20-781-40;

4. Introduction and orientation to each child assigned to staff, including health issues documented according to 8VAC20-781-60 B 5;

5. Child development; and

6. Classroom management.

C. The licensee shall ensure that all staff who work with children, within 30 days of the staff member’s date of employment, complete an overview of first aid and cardiopulmonary resuscitation (CPR) skills.

D. The licensee shall ensure that the director completes the prelicensure orientation sponsored by the Department within 60 days of the director’s date of employment or promotion. A director who has documentation of completing the prelicensure orientation shall not be required to retake the program.

E. Volunteers who regularly work with children more than eight hours per week shall receive training on the center's emergency procedures within the first week of volunteering. The center shall document and maintain a record that the volunteer received such training.

F. Parents or other persons who participate in a cooperative preschool center on behalf of a child attending such cooperative preschool center, including such parents and persons who are counted for the purpose of determining staff-to-child ratios, shall be exempt from orientation and training requirements applicable to staff of child day programs by this section. This orientation and training exemption shall not apply to any parent or other person who participates in a cooperative preschool center that has entered into a contract to provide child care services funded by the Child Care and Development Block Grant.

A. The licensee shall ensure that all staff complete annual training on emergency preparedness and response; child abuse and neglect; and mandated reporter requirements.

B. The licensee shall ensure that all staff who work with children complete at least 16 hours of ongoing training each year. Of these 16 hours, three hours shall include the Department’s health and safety update course. The ongoing training shall not include the training required by 8VAC20-781-140 B or C. The ongoing training shall be relevant to the staff member’s job responsibilities and appropriate to the age of children in care.

C. Notwithstanding the requirements of 8VAC20-781-150 B, a center that runs a short-term program shall ensure that all staff who work with children complete at least 10 hours of ongoing training each year.

D. Volunteers who regularly work with children more than eight hours per week shall be required to complete annual training on the center's emergency procedures. The center shall document and maintain a record that the volunteer received such training.

E. Parents or other persons who participate in a cooperative preschool center on behalf of a child attending such cooperative preschool center, including such parents and persons who are counted for the purpose of determining staff-to-child ratios, shall only be required to complete four hours of ongoing training each year. Any parent or other person who participates in a cooperative preschool center that has entered into a contract to provide child care services funded by the Child Care and Development Block Grant must complete the training requirements applicable to all centers by this section.

A. The licensee shall ensure that at least two staff members who have the following certifications are present on the premises whenever a child is in care:

1. Current certification in cardiopulmonary resuscitation (CPR) as appropriate to the age of the children in care from an individual or organization holding instructor certification. The training shall include an in-person competency demonstration; and

2. Current certification in first aid from an individual or organization holding instructor certification.

B. The licensee shall ensure that at least one staff in each classroom, area, or in each group of children on field trips where children are present meets the qualifications in subsection A.

C. A primitive camp shall have one staff member on the premises who has a current certification in emergency medical responder training whenever the primitive camp has assumed responsibility for supervising a child.

D. Medical professionals with a current license or certification shall not be required to obtain first aid certification.

A. The licensee shall ensure that there is at least one staff member on the premises who has obtained instruction within the last three years in performing daily health observations of children whenever the center has assumed responsibility for supervision of a child.

B. Daily health observation training shall include the following:

1. Components of daily health check for children;

2. Inclusion and exclusion of the child from the class when the child is exhibiting physical symptoms that indicate possible illness;

3. Descriptions of how diseases are spread and the procedures or methods for reducing the spread of disease;

4. Information concerning the Virginia Department of Health Notification of Reportable Diseases pursuant to 12VAC5-90-80 and 12VAC5-90-90, also available from the local health department and the website of the Virginia Department of Health; and

5. Staff occupational health and safety practices in accordance with Occupational Safety and Health Administration’s bloodborne pathogens regulation (29 CFR 1910.1030).

C. The licensee shall ensure that a trained staff member conducts a daily health observation of each child as close to arrival as possible and whenever staff responsible for the care of a child notes a change in behavior or appearance.

A. The licensee shall ensure that the administration of prescription medication is performed by a staff member who (i) is licensed by the Commonwealth of Virginia to administer such medications or (ii) is qualified under § 54.1-3408 O of the Code of Virginia to administer medication to a child in a child day program.

B. To safely perform medication administration practices listed in 8VAC20-781-540, whenever the center has agreed to administer over-the-counter medications other than topical skin gel, cream, or ointment, the administration must be performed by a staff member who has satisfactorily completed a training course developed or approved by the Department of Education in consultation with the Department of Health and the Board of Nursing and taught by a registered nurse, licensed practical nurse, nurse practitioner, physician assistant, doctor of medicine or osteopathic medicine, or pharmacist; or administration shall be performed by a staff member who is licensed by the Commonwealth of Virginia to administer medications.

C. Staff required to have medication administration training shall be retrained at three-year intervals.

The licensee shall ensure that any individual who drives a vehicle to transport children has received the following training prior to transporting any children under the supervision of the center:

1. Proper use of child safety restraints in accordance with Virginia state law;

2. Proper loading, unloading, and tracking of children per center policies;

3. Issues that may arise in transporting children with behavioral issues;

4. The location of first aid supplies;

5. The emergency procedures for the vehicle, including actions to be taken in the event of accidents, vehicle malfunction and medical emergencies; and

6. The center’s transportation policies required in subdivision 14 of 8VAC20-781-40 A.

A. Before issuance of an initial license, the center shall submit to the superintendent written documentation of the following:

1. Inspection by the authority having jurisdiction that each building is in compliance with applicable building and fire codes or that the authority has approved a plan of correction for any areas of noncompliance; and

2. Inspection from the local health department that each building is in compliance with applicable health codes with regard to water supply; sewage disposal system; and food service, if applicable; or a plan of correction approved by the local health department for any areas of noncompliance.

B. Any building which is currently approved for school occupancy, and which houses a public or private school during the school year shall be considered to have met the requirements of subdivision A1 of this section when housing a center only serving children two and a half years of age or older.

C. Asbestos.

1. For buildings built before 1978, the center shall submit the following before the initial license is issued:

a. A written statement from a person licensed in Virginia as an asbestos inspector and management planner as required by § 22.1-289.052 of the Code of Virginia and the requirements of the Asbestos Hazard Emergency Response Act (15 USC § 2641 et seq.); and

b. A written statement that the response actions to abate any risk to human health have been or will be initiated in accordance with a specific schedule and plan as recommended by the asbestos management planner in accordance with § 22.1-289.052 of the Code of Virginia.

2. If the asbestos inspector determines that there is asbestos on the premises, the center shall post a notice that (i) identifies the presence and location of asbestos containing materials and (ii) advises that the asbestos inspection report and management plan are available for review.

D. Lead.

1. For buildings built before 1978, the center shall submit the following before the initial license is issued:

a. A written statement from a person licensed in Virginia as a lead risk assessor who meets the requirements of § 54.1-500 of the Code of Virginia; and

b. A written lead risk assessment shall state that either (i) no lead was detected; (ii) lead was detected and response actions to abate any risk to human health have been completed; or (iii) lead was detected and response actions to abate any risk to human health have been recommended in accordance with a specified schedule.

2. A notice regarding the presence and location of lead containing materials advising that the lead inspection report and management plan are available for review shall be posted.

3. The provisions of this subsection do not apply to centers licensed before [the effective date of this chapter].

E. The provisions of subsections C and D of this section do not apply to centers located in buildings required to be inspected according to Article 5 (§ 2.2-1162 et seq.) of Chapter 11 of Title 2.2 of the Code of Virginia.

F. Before the first license is issued, primitive camps shall (i) notify the responsible fire department and emergency medical service of the primitive camp location and hours of operation, and (ii) maintain documentation of the notifications.

A. Before use of newly constructed, renovated, remodeled, or altered buildings or sections of buildings, the center shall submit to the superintendent written documentation of the following:

1. Inspection by the authority having jurisdiction that each building is in compliance with applicable building and fire codes or that the authority has approved a plan of correction for any areas of noncompliance; and

2. Inspection from the local health department that each building is in compliance with applicable health codes with regard to water supply; sewage disposal system; and food service, if applicable; or a plan of correction approved by the local health department for any areas of noncompliance.

B. Any building which is currently approved for school occupancy, and which houses a public or private school during the school year shall be considered to have met the requirements of subdivision 1 of subsection A when housing a center only serving children two and a half years of age or older.

C. The center shall provide to the superintendent an annual fire inspection report from the appropriate fire official having jurisdiction.

D. If a center is located in a building currently housing a public or private school, the center shall provide the school's annual fire inspection report.

E. The center shall provide to the superintendent an annual inspection from the local health department that each building is in compliance with applicable health codes with regard to water supply; sewage disposal system; and food service, if applicable; or a plan of correction approved by the local health department for any areas of noncompliance.

F. If a center is using a building where asbestos containing materials were detected and not removed, the center shall follow the recommendations of the management plan and ensure the following:

1. A signed, written statement that the center is following the recommendations of the management plan shall be submitted to the superintendent before subsequent licenses are issued; and

2. The notice regarding the presence and location of asbestos containing materials and advising that the asbestos inspection report and management plan are available for review shall continue to be posted.

3. The provisions of this subsection do not apply to child day centers located in buildings required to be inspected according to Article 5 (§ 2.2-1162 et seq.) of Chapter 11 of Title 2.2 of the Code of Virginia.

G. Primitive camps shall (i) notify the responsible fire department and the responsible emergency medical service of any changes in the primitive camp location and hours of operation, and (ii) maintain documentation of the notifications.

H. For those buildings built before 1978 where lead is detected and not removed:

1. A signed, written statement that the center is following the recommendations of the management plan shall be submitted to the Department before subsequent licenses are issued.

2. A notice regarding the presence and location of lead advising that the lead inspection report and management plan are available for review shall continue to be posted.

3. The provisions of this subsection do not apply to child day centers located in buildings required to be inspected according to Article 5 (§ 2.2-1162 et seq.) of Chapter 11 of Title 2.2 of the Code of Virginia.

4. The provisions of this subsection do not apply to centers licensed before the effective date of this chapter.

A. The center shall maintain the areas and equipment of the center, inside and outside, in a clean, safe, and operable condition. Unsafe conditions include splintered, cracked, or otherwise deteriorating wood; peeling paint; visible cracks, bending, warping, rusting, or breakage of any equipment; loose or unsecured cords within reach of children; unstable heavy equipment, furniture, or other items that a child could pull down.

B. The licensee shall ensure the following:

1. Hot water accessible to children does not exceed 120°F.

2. The heating system shall (i) be installed to prevent accessibility of children to the system and (ii) have appropriate barriers to prevent children from being burned, shocked, or injured from heating equipment. In addition, proper supervision shall be available to prevent injury.

3. Portable heaters may be used only to provide or supplement heat in the event of a power failure or similar emergency. The licensee shall ensure that portable heaters are inaccessible to children and have the seal of approval of a nationally recognized testing laboratory or are approved by the state or local fire official. Portable heaters shall not be used within three feet of combustible materials and shall be used in accordance with the manufacturer’s instructions.

4. Portable camping equipment for heating or cooking that is not required to be approved by the building official shall bear the label of a nationally recognized inspection agency and be used in accordance with the manufacturer's specifications, except for charcoal and wood burning cooking equipment.

5. Unvented fuel burning heaters are not used when children are in care.

6. Electrical outlets and surge protectors accessible to children who are preschool age and younger are tamper resistant or have protective covers.

7. Electrical cords are not spliced, deteriorated, or damaged, and unsecured electrical cords are inaccessible to children preschool age and younger.

8. Extension cords have the seal of a nationally recognized testing laboratory; shall not be overloaded, and shall not be placed through doorways, under carpeting, or across water- source areas.

9. When in use, fans shall be out of reach of children and cords shall be secured.

10. In inside areas occupied by children, the temperature shall be maintained no lower than 68°F.

11. When the temperature of indoor areas occupied by children exceeds 80°F, fans or other cooling systems are used.

12. Safe drinking water is available to children at all times.

13. Equipment shall include (i) outside lighting provided at entrances and exits used by children before sunrise or after sundown and (ii) an in-service telephone or cell phone that is operable and accessible to staff on premises during the center's hours of operation.

14. Hazardous mechanical or electrical equipment are inaccessible to children.

C. Pursuant to § 22.1-289.058 of the Code of Virginia, each building built before 2015 used to operate a licensed child day center must be equipped with one carbon monoxide detector.

A. The licensee shall ensure that hazardous substances and chemicals, including cleaning products, sanitizing agents, pesticides, flammable and explosive materials, and substances labeled as keep out of reach of children, toxic, danger, caution, warning, flammable, harmful if swallowed, causes burns, harmful vapor, or poison are considered hazardous to children are stored in the following manner:

1. Inaccessible to children in a location that is locked. If a key is used, the key shall be inaccessible to children;

2. In the original container or a substitute container with the contents clearly labeled;

3. Stored in areas physically separate from food and items used for food preparation or food service; and

4. Cleaning supplies to clean and sanitize the diapering area or toilet chairs do not need to be kept locked during diapering or toilet training time if they are inaccessible to children.

B. Items such as cosmetics, personal care items, and air fresheners that are used exclusively by staff or volunteers shall be inaccessible to children but are not required to be locked.

C. The licensee shall ensure that smoking and the use of electronic smoking devices are prohibited in the interior of a center while children are in care, in vehicles when children are being transported, or outdoors in the presence of children.

D. Hazardous items.

1. Empty plastic bags large enough for a child’s head to fit inside, disposable gloves, and rubber or latex balloons shall be inaccessible to children under three years of age;

2. Items with a diameter of less than 1-1/4 inch and a length of less than 2-1/4 inches shall be inaccessible to children under three years of age; and

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.

A. Indoor space shall be measured inside wall-to-wall excluding spaces not routinely used by children. Areas not routinely used for children's activities such as offices, hallways, restrooms, kitchens, storage rooms, or closets, shall not be calculated as available space.

B. Centers shall have 35 square feet of indoor space available for each child.

C. Licensees that operate in buildings approved prior to June 1, 2008, and were licensed prior to [the effective date of this regulation] shall have 25 square feet of indoor space available for each child 16 months and older.

D. The center shall designate a separate space for children who are ill or injured.

E. The licensee shall ensure that any space utilized for an outside play area has at least 75 square feet of space per child.

F. For centers licensed for the care of infants or toddlers, at least 25 square feet of the 75 square feet required in subsection E of this section must be an unpaved surface.

G. Infants, toddlers, and twos shall have a separate outdoor play area or shall not occupy the outdoor play area at the same time as preschool and school-age children.

A. Centers shall have at least two toilets and two sinks.

B. The licensee shall ensure the following for each toileting area provided for children:

1. Is within a contained area, readily available and within the building used by the children. Toilets used by children at primitive camps are not required to be located within the building;

2. Has flushable toilets;

3. Has sinks located near the toilets that are supplied with running water; and

4. Is equipped with a lined waste container, soap, toilet paper, and disposable towels or an air dryer within reach of children.

C. Centers shall have at least one toilet and one sink per 20 preschool children and at least one standard size toilet and one sink per 30 school age children. When sharing restroom areas with other programs, the children in those programs shall be included in the toilet and sink ratio calculations. The toilet and sink ratio appropriate to the younger age group shall apply. Urinals shall not count for more than 50% of the number of toilets in the toileting area.

D. When child size toilets, urinals, and low sinks are not available in restrooms used by children of preschool age and younger, one or more platforms or sets of steps shall be provided. Platform steps shall be anchored or broad based to prevent toppling and have a non-slip surface.

E. A toileting area used for school age children shall have at least one toileting area enclosed.

A. Outdoor play areas shall be located and designed to protect children from hazards including bodies of water and vehicular traffic.

B. Indoor and outdoor playground and climbing equipment shall be age appropriate for the children using it.

C. For child day centers licensed prior to [the effective date of this regulation], where playground equipment is provided, protective surfacing shall comply with minimum safety standards when tested in accordance with the procedures described in the American Society for Testing and Materials standard F1292-99 as shown in Table 1 (Compressed Loose Fill Synthetic Materials Depth Chart) and Table 2 (Use Zones for Equipment) below and shall be under equipment with moving parts or climbing apparatus to create a use zone free of hazardous obstacles. A use zone shall encompass sufficient area to include the child's trajectory in the event of a fall while the equipment is in use. Where steps are used for accessibility, protective surfacing is not required.

D. Depth requirements in this section are required unless the facility has received documentation of third-party laboratory testing verifying that the type, depth of protective surfacing, or installation process used at the facility complies with the most recent recommendations by the U.S. Consumer Product Safety Commission’s (CPSC) Public Playground Safety Handbook.

E. For child day centers licensed after [the effective date of this regulation] where playground equipment is provided, protective surfacing and use zones shall comply with protective surfacing requirements in the most current U.S. Consumer Product Safety Commission’s (CPSC) Public Playground Safety Handbook.

F. Use zones shall be free of obstacles, including any containment barriers for protective surfacing, and shall extend a minimum of six feet in all directions from the perimeter of the equipment.

G. Climbing equipment and swings shall not be installed over asphalt or concrete unless the asphalt or concrete is:

1. Covered with a properly installed unitary surfacing material; or

2. Covered with a loose-fill surfacing system (see Table 3). A loose-fill surfacing system shall include the following layers of protection:

a. Immediately over the hard surface there shall be a three- to six-inch base layer of loose-fill gravel for drainage;

b. The next layer shall be a geo-textile cloth;

c. On top of the geo-textile cloth there shall be a loose-fill layer meeting the requirements of section I of this subsection; and

d. Impact attenuating mats shall be embedded in the top loose-fill layer in high traffic areas. High traffic areas include underneath swings, at slide exits, and other places where displacement is likely.

H. Ground supports shall be covered with materials that protect children from injury.

I. Swing seats shall be constructed with flexible material such as rubber, canvas, or nylon.

1. Nonflexible molded swing seats may be used only in a separate infant or toddler play area.

2. Swings made specifically for a child with a special need shall be permitted in any area as long as a staff member is positioned to see and protect other children who might walk into the path of the swing.

3. Multi-axis swings including tire swings (i) shall not use steel belted tires, and (ii) the minimum clearance between the seating surface of the swing and the uprights of the supporting structure shall be 30 inches when the seat is in a position closest to the support structure.

J. Sandboxes shall be covered when not in use.

K. A shady area shall be provided in outdoor play areas during the months of May through September.

L. Play equipment used by children shall meet the following requirements:

1. Openings above the ground or floor which allow a 3 ½ inch by 6 ¼ inch rectangle to fit through shall also allow a nine-inch circle to fit through to prevent entrapment of a child’s body or body part.

2. All hooks, such as S-hooks and C-hooks, shall be properly closed and shall not be open more than 0.04 inches and less than the thickness of a dime; and

3. Have no protrusions, sharp points, shearing points, or pinch points.

M. The unenclosed climbing portion of slides and climbing equipment used by toddlers, twos, and preschool children shall not be more than seven feet high and must be located over protective surfacing where outdoors and shall not be more than five feet high where indoors.

N. The maximum fall height of slides and climbing equipment installed prior to June 1, 2005, and used by toddlers, twos, and preschool children, shall be seven feet high when outdoors, and five feet high when indoors.

O. Centers may not install any slide or climbing equipment to be used by toddlers, twos, and preschoolers when the climbing portion of the equipment is more than six feet in height.

P. The maximum fall height of slides and climbing equipment installed and used by toddlers, twos, and preschoolers shall be six feet high when outdoors, and five feet high when indoors.

Q. The climbing portions of indoor slides and climbing equipment over 18 inches shall not be over bare flooring.

R. The climbing portions of indoor slides and climbing equipment 36 inches or more shall be located over protective surfacing.

S. Slides shall not have any spaces or gaps that could trap strings, clothing, body parts, etc. between the platform and the start of the slide chute.

T. Trampolines shall not be used.

U. When inflatable equipment is used, the equipment shall be assembled, maintained, and used in accordance with the manufacturer’s instructions.

V. The requirements of this section shall not prohibit child day programs providing care for school-age children at a location that is currently approved by the Department of Education or recognized as a private school by the State Board of Education for school occupancy and that houses a public or private school during the school year from permitting preschool or school-age children to use outdoor play equipment and areas approved for use by students of the school during school hours.

A. The licensee shall ensure that staff provide for the safety of children under the supervision of the center.

B. The licensee shall ensure that staff remain alert to the needs of the children in the care of the center.

C. Whenever a child is in the care of the center, there shall be on the premises at least (i) a lead teacher and (ii) a staff member or volunteer who has received training on how to contact appropriate authorities in the event of an emergency.

D. There shall be at least one staff member who meets the qualifications of a lead teacher in each group of children.

E. A lead teacher is not required in each grouping of children during short breaks, special activities, and during the first and last 90 minutes of operation when a center operates more than eight hours per day and during the designated rest period if the following are met:

1. There is a staff member in the group who is over 18 years of age and has at least three months of programmatic experience;

2. There is an additional staff member on premises who meets lead teacher qualifications, is not counted in the staff-to-children ratios and is immediately available to help if needed; and

3. There is a direct means for communicating between these two staff members.

F. For children under 10 years of age, the licensee shall ensure sight and sound supervision by staff who are always physically present without separation by a physical barrier, except that staff need only be able to hear a child who is using the restroom provided that:

1. There is a system to assure that individuals who are not staff members or persons allowed to pick up a child in care are not present in the restroom area while in use by children;

2. Staff check on a child who has not returned from the restroom after five minutes. Depending on the location and layout of the restroom, staff may need to provide intermittent sight supervision of the children in the restroom area during this five-minute period to assure the safety of children and to provide assistance to children as needed; and

3. Staff can hear or see the children (video equipment, intercom systems, or other technological devices shall not substitute for staff being able to directly see or hear children).

G. Children 10 years of age and older shall be within sight and sound supervision of staff except when the following requirements are met:

1. Staff can hear or see the children (video equipment, intercom systems, or other technological devices shall not substitute for staff being able to directly see or hear children);

2. Staff are nearby so they can provide immediate intervention if needed;

3. There is a system to ensure that staff know where the children are and what they are doing;

4. There is a system to ensure that individuals who are not staff members or persons allowed to pick up children in care are not present in the areas where children are not under sight supervision; and

5. Staff provide sight and sound supervision of the children at variable and unpredictable intervals not to exceed 15 minutes.

H. When the outdoor activity area is not adjacent to the center, there shall be at least two staff members on the outdoor activity area whenever one or more children are present.

A. The maximum group size limitations specified in Table 1 shall be followed whenever children are in care.

B. The staff-to-children ratios specified in Table 2 are required whenever children are in care.

C. In accordance with Part V of 8VAC20-820 and with approval by the Superintendent, a center may temporarily alter the staff-to-child ratios (i) by one child for groups of children from birth up to school age eligibility, and (ii) by two children for groups of children school age eligible through age 12. Under this provision, group sizes three times the approved ratios may be implemented for children ages birth up to school age eligibility. Group size for school-age children must meet the requirements in subsection A of this section.

D. When a group includes children from different age groups, the age of the youngest child in the group shall be used to determine the staff-to-children ratio and group size that applies to that group.

E. Group size limitations shall not apply during the following:

1. Designated rest periods as described in 8VAC20-781-290 and 8VAC20-781-300;

2. Outdoor activity as described in 8VAC20-781-330, 8VAC20-781-350, and 8VAC20- 781-360;

3. Transportation and field trips as described in 8VAC20-781-640 and 8VAC20-781-650;

4. Meals and snacks served as described in 8VAC20-781-620; or

5. Special group activities, or during the first and last hour of operation when the center operates more than six hours per day.

F. Staff shall be counted in the required staff-to-children ratios only when they are directly supervising children.

G. A child volunteer 13 years of age or older not enrolled in the program shall not be counted as a child in the staff-to-children ratio requirements.

H. With a parent's written permission and a written assessment by the director and lead teacher, a center may choose to assign a child to a different age group if such age group is more appropriate for the child's developmental level and the staff-to-children ratio and group size shall be for the established age group.

I. If a child with a special need is assigned to a more appropriate age group for the child’s developmental level, a written assessment by a recognized agency or professional shall be required at least annually. These assignments are intended to be a permanent new group and staff members for the child.

A. The ratio for balanced-mixed-age groupings of children shall be one staff member for every 14 children provided:

1. The center has additional staff who are readily accessible in the event of an emergency to maintain a ratio of one staff member for every 10 children when three- year-olds are included in the balanced-mixed-age group; and

2. The lead teacher has received at least eight hours of training in classroom management of balanced-mixed-age groupings.

B. The staff-to-child ratio for balanced-mixed-age groupings during rest time shall be one staff member for every 28 children and the requirements subsection B through D of 8VAC20-781-300 shall be met.

C. A maximum group size of 28 shall be followed whenever children in care are in balanced- mixed-age groupings.

A. For children ages 16 months through preschool age, during the designated rest period, when children are resting or in an inactive state, the following rest period ratios are permitted if the requirements of subsections B through D of this section are met:

1. Children 16 up to 24 months of age: one staff per 10 children.

2. Children two years of age: one staff per 16 children.

3. Children of preschool age: one staff per 20 children.

B. In addition to the staff required by rest period ratios, an additional staff member shall always be available on-site to offer immediate assistance. The staff required by rest period ratios shall be able to summon the additional staff member without leaving the room or area of the sleeping or resting children.

C. Once at least half of the children in the resting room or area are awake and off their mats or cots, the staff-to-children ratio shall meet the ratios as required in 8VAC20-781-280 and 8VAC20-781-290.

D. The licensee shall ensure that one staff member shall not supervise more than one room or area during rest time.

E. Centers providing evening and overnight care shall meet the requirements of subsections A through D of this section during sleep periods.

A. The staff-to-children ratios of 8VAC20-781-280 and 8VAC20-781-290 A shall be followed on all field trips.

B. The staff-to-children ratio need not apply during transportation of school age children to and from the center.

C. One staff member or adult is necessary in addition to the driver when 16 or more preschool or younger children are being transported in the vehicle.

A. The center shall provide a variety of daily activities for all age groups that are age and stage appropriate and based on the physical, social, emotional, and intellectual needs of the children.

B. The center shall provide opportunities for staff-directed and self-directed activities; a balance of active and quiet activities; active outdoor play; and individual and group activities.

C. If the center uses visual media such as television, videos, video games, software, and computers, the following shall apply:

1. For infants, the use of visual media is prohibited.

2. For toddlers, media use up to two hours per day is permitted if the center operates more than six hours per day.

3. For children two and older, not more than a total of two hours per day, when content is not based on curriculum or educational content.

4. All media provided by the center shall be limited to age appropriate programs and meet all the requirements in subsection A of this section.

D. Requirements in subdivision 3 of subsection C of this section do not apply to school-age children who attend educational programming that incorporates technology into curriculum learning activities.

E. Children shall be allowed to sleep or rest as individually needed.

A. The center shall post a flexible daily schedule for infants based on their individual needs and the requirements of 8VAC20-781-320-B.

B. During the day, the licensee shall ensure that infants are provided with the following:

1. Food as specified in 8VAC20-781-620 and 8VAC20-781-630.

2. Outdoor time, unless weather and air quality allow based upon the Air Quality Color Code Chart as provided by the Department of Environmental Quality indicates that outdoor conditions are hazardous.

3. Comfort as needed.

4. Stimulation and language development activities, including but not limited to staff reading, talking to, showing pictures to, naming objects for, playing with and engaging in positive interactions (such as smiling, cuddling, and making eye contact) with infants.

5. A variety of play spaces that offer:

a. Room for extensive movement (rolling, crawling, or walking) and exploration;

b. A diversity of sensory and perceptual experiences; and

c. Equipment and toys that support large and small motor development.

6. Frequent opportunities for infants to creep, crawl, toddle and walk.

7. Protection from older children.

C. The licensee shall ensure that staff respond promptly to infants who are crying or distraught.

D. The licensee shall ensure that, for an infant playing on the floor or ground who cannot move without help, staff ensure that the infant’s position and the selection of toys accessible to the infant changes every 30 minutes or more based on the infant's needs.

E. The licensee shall ensure that staff shall not confine infants who are awake and not actively eating in one piece of equipment including: swings, highchairs, cribs, play pens, or other similar pieces of equipment for more than 30 consecutive minutes. Except when eating, the intervening time between confinements shall be at least one hour.

F. The licensee shall ensure that for infants who are awake and unable to turn over alone, staff shall make three attempts at supervised tummy time for approximately three to four minutes at a time.

G. The licensee shall ensure that infant car seats are only used for child transportation.

H. The licensee shall ensure that cribs are only used for rest and sleep.

A. The licensee shall ensure that staff allow infants to follow individual patterns of sleeping and eating.

B. The licensee shall ensure that staff place infants in cribs on their backs (supine) rather than on their stomachs (prone) unless otherwise ordered by a written, signed statement signed by the child's physician or physician’s designee.

C. The licensee shall ensure that when an infant is able to turn supine to the prone, staff shall place the infant supine but allow the infant to adopt the infant’s preferred position unless otherwise directed in a written, signed statement by the child’s physician or physician’s designee.

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.

E. The licensee shall ensure that each resting or sleeping infant is individually checked for breathing, the color of the infant’s skin, signs of distress, and to ensure safe sleep conditions are still met every 15-20 minutes.

F. The licensee shall ensure that staff shall move an infant who falls asleep outside of their crib to the infant's assigned crib.

G. The licensee shall ensure that staff ensure sleeping infants do not wear items that could restrict their breathing or have items cover their head or face.

A. The center shall develop, follow, and post a daily schedule that allows for flexibility as children's needs require and that meets the requirements of 8VAC20-781-320 B. The daily schedule need not apply on days occupied a majority of the time by a field trip or other special event. The daily schedule shall include opportunities for:

1. Outdoor activity, weather and air quality allowing, for at least:

a. Fifteen minutes per day or session if the center operates up to three hours per day or session;

b. Thirty minutes per day or session if the center operates between three and five hours per day or session; or

c. One hour per day or session if the center operates more than five hours per day or session.

2. Sleep or rest. Centers operating five or more hours per day shall have a designated rest period for at least one hour but no more than two hours.

3. Meals and snacks as specified in 8VAC20-781-620.

4. Small and large motor activities, language and communication experiences, sensory experiences, art or music activities, and play acting or social living.

B. After the first 30 minutes, children not sleeping shall be permitted to engage in quiet activities.

C. A child who falls asleep in a place other than his designated sleeping location may remain in that space if comfortable and safe.

D. The licensee shall ensure that each sleeping toddler is individually checked for breathing, the color of the toddler’s skin, signs of distress, and to ensure safe sleep conditions are still met every 30 minutes.

E. The licensee shall ensure that staff shall not confine children who are awake and not actively eating in one piece of equipment including: swings, highchairs, cribs, play pens, or other similar pieces of equipment for more than 30 consecutive minutes. Except when eating, the intervening time between confinements shall be at least one hour.

A. The center shall develop, follow, and have available for review, a daily schedule for school- age children that allows for flexibility based on their individual needs and the requirements of 8VAC20-781-320-B. This schedule need not apply on field trip days or special events.

B. Before or after school, the center shall provide an opportunity for children to do homework, projects, hobbies, small motor activities, art activities, or music activities in a suitable area. In the afternoon, there shall be an opportunity for large motor activities at least 25% of the time.

C. On non-school days, the center shall provide opportunities for large motor activities at least 25% of the time; small motor activities; projects, hobbies, or homework in a suitable place; art or music activities; outdoor activity except in hazardous conditions for at least one hour per day; and food as specified in 8VAC20-781-620.

A. The center shall work with the parent and the staff assigned to the child to ensure that children with special needs receive care and activity opportunities appropriate to their individual needs, including specific care and activities recommended by a professional. The care and activities recommended by the professional shall be documented and maintained in the child's record, and updated annually, or more frequently, as necessary.

B. For a child who cannot move without assistance, staff shall change the place and position of the child at least every 30 minutes or according to the child's needs.

A. The center shall use positive methods of guiding behavior.

B. When a child is in the care of the center, the licensee shall ensure that staff interact with children and one another to provide needed help, comfort, support and:

1. Respect personal privacy;

2. Respect differences in cultural, ethnic, religious, and family backgrounds;

3. Encourage decision-making abilities;

4. Promote ways of getting along;

5. Encourage independence and self-direction; and

6. Use consistency in applying expectations.

C. The licensee shall ensure that behavioral guidance is constructive in nature, age, and stage appropriate, and shall be intended to redirect children to appropriate behavior and resolve conflicts.

D. If time out is used as a behavior guidance technique:

1. It shall be used sparingly and shall not exceed one minute for each year of the child's age;

2. It shall be appropriate to the child's developmental level and individual needs;

3. It shall not be used with infants or toddlers;

4. The child shall be in a safe, lighted, well-ventilated place, and within sight and sound of a staff member; and

5. The child shall not be left alone inside or outside the center.

The following actions or threats thereof are prohibited:

1. Physical punishment;

2. Striking a child, roughly handling, or shaking a child, biting, pinching, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, forced exercise, or any action taken to cause pain or discomfort;

3. Enclosure in a small, confined space or any space that the child cannot freely exit himself; however, this does not apply to the use of equipment such as cribs, play yards, highchairs, and safety gates when used with children preschool age or younger for their intended purpose;

4. Permitting a child to discipline or punish other children;

5. Punitive separation from the group so that the child is away from the hearing and vision of a staff member.

6. Withholding or forcing of food, water, or rest;

7. Verbal remarks which are demeaning to the child or psychological punishment of any kind, including ridicule or humiliation;

8. Punishment for toileting accidents or withholding opportunities for toileting;

9. Punishment by applying unpleasant or harmful substances; and

10. Withholding outside activity time as punishment.

Before the child's first day of attending parents shall be notified about how to access the following:

1. The center's philosophy and any religious affiliation;

2. Operating information, including the hours and days of operation and holidays or other times closed, and the contact information to communicate with staff;

3. Description of established lines of authority for staff;

4. A custodial parent's right to be admitted to the center as required by § 22.1-289.054 of the Code of Virginia;

5. The appropriate general daily schedule for the age of the enrolling child;

6. How the center will send parent communication and notifications as required by 8VAC20- 781-410; and

7. The following information from the center’s emergency procedures:

a. The relocation site;

b. Method of communication with parents and emergency responders; and

c. Procedure to reunite children with a parent or authorized person designated by the parent.

A. The center shall inform parents in writing when a pattern of behavioral problems emerges or persists. Such notification shall include any actions taken in response.

B. The center shall maintain a written record and provide parents with a written report of each incident involving their child on the day of occurrence. The written report shall protect the confidentiality of other children involved, and shall include:

1. Date and time of incident or injury;

2. Child’s name;

3. Type and circumstance of incident or injury;

4. Staff present, and actions taken, or treatment offered;

5. Date, time, and method used to notify parents; and

6. Staff and parent signatures or two staff signatures.

C. The center shall notify the parent immediately when:

1. The child sustains any injury that may reasonably require medical or dental treatment.

2. The child has an adverse reaction to an administered medication or topical skin product, a medication error has occurred, or the center has administered an emergency medication.

3. The child has a confirmed or suspected allergic reaction; or has ingested any food identified in the written care plan required in subdivision 6 of 8VAC20-781-60 B even if a reaction did not occur.

4. A situation in which the child’s whereabouts is or was unknown, including a lost or missing child; a child left unattended in a vehicle or on the playground; or a child who wandered away unattended from the facility or assigned group.

D. When a child has been exposed to a communicable disease listed in the Department of Health's current communicable disease chart, the parents shall be notified within 24 hours or the next business day of the center's having been informed unless forbidden by law, except for life threatening diseases, which must be reported to parents immediately.

E. Parents shall be informed in writing of any change to the center’s relocation site, the communication plan, and the reunification plan.

F. If an emergency evacuation or relocation is necessary, the parent shall be informed of the child’s whereabouts as soon as possible as stated in the center’s emergency preparedness and response plan.

G. For each infant, the center shall maintain a daily record which can be easily accessed by both the parent and the staff working with the child. The record shall contain the following information:

1. The amount of time the infant slept;

2. The amount of food consumed and the time;

3. Record of diaper changes and any application of diaper ointment;

4. A description and time of bowel movements;

5. Developmental milestones; and

6. For infants, who are awake and cannot turn over by themselves, (i) the number of attempts at tummy time, and (ii) the amount of time spent on their stomachs.

H. The licensee shall ensure staff maintain daily records required by subsection G of this section for 60 calendar days from the date of report.

I. Parents shall be informed of reasons for termination of services.

J. The center shall provide to parents of children, at least semiannually or more frequently if needed:

1. Written information about their child's development, behavior, adjustment, and needs; and

2. Scheduled opportunities for parents to provide feedback on their children. This opportunity to provide feedback shall be documented.

K. Information on a child required by subsection J of this section shared between the child’s parents and the center shall be documented in the child’s record.

L. Requirements in subsection J of this section shall not apply to school age children and children participating in short-term programs as defined in 8VAC20-781-10.

A written agreement between the parent and the center shall be in each child's record by the first day of the child's attendance. The agreement shall be signed by the parent and include:

1. An authorization for emergency medical care should an emergency occur when the parent cannot be located immediately unless the parent states in writing an objection to the provision of such care on religious or other grounds;

2. A statement that the center will notify the parent when the child becomes ill and that the parent will arrange to have the child picked up as soon as possible if requested by the center;

3. A statement that the parent will inform the center within 24 hours or the next business day after his child or any member of the immediate household has developed any reportable communicable disease, as defined by the State Board of Health, except for life threatening diseases which must be reported immediately; and

4. Authorization for the center to transport the child in the event of an emergency including needing medical care or facility relocation.

A. Furnishings, equipment, and materials shall be (i) of an appropriate size for the child using it and (ii) used in accordance with the manufacturer's instructions.

B. Materials and equipment shall be available and shall be age and stage appropriate for the children and shall include an adequate supply, as appropriate for each age group, of arts and crafts materials, texture materials, construction materials, music and sound materials, books, social living equipment, and manipulative equipment.

C. Washable toys and materials used by infants shall be cleaned and sanitized daily, or more often if necessary.

D. The following cloth items shall be washable: stuffed animals, cloth dolls, and dress-up clothes; floor pillows shall be washable or have removable covers that are machine washable. The center shall wash stuffed animals, cloth dolls, dress-up clothes, and pillows or removable covers at least once a week or when soiled.

E. If water play tables or tubs are used, they shall be cleaned and sanitized daily.

F. If combs, toothbrushes, or other personal articles are used, they shall be individually assigned.

G. Disposable products shall be used once and discarded.

H. Provision shall be made for an individual place for each child's personal belongings.

I. Infant walkers shall not be used.

J. Play yards where used shall:

1. Meet the current Juvenile Products Manufacturers Association (JPMA) and the American Society for Testing and Materials (ASTM) requirements and shall retain the manufacturer's label documenting product compliance with current safety standards at the time they were manufactured;

2. Not use any pillows or filled comforters;

3. Not be used for the designated sleeping areas;

4. Not be occupied by more than one child; and

5. Be sanitized each day of use or more often as needed.

K. The licensee shall register to receive free recall alerts from the U.S. Consumer Product Safety Commission and shall remove all recalled items from the center.

L. Portable water coolers shall be cleaned daily when in use, kept securely closed and so designed that water may be withdrawn from the container only by tap.

A. Cribs, cots, rest mats or beds shall be provided for children during the designated rest period and not be occupied by more than one child at a time.

B. Cribs shall not be used as a play space.

C. Cribs, cots, rest mats, and beds shall be identified for use by a specific child.

D. Double decker cribs, cots, or beds, or other sleeping equipment when stacked shall not be permitted to be used for children.

E. Occupied cribs, cots, rest mats, and beds shall be at least 2-1/2 feet from any heat producing appliance.

F. There shall be at least 12 inches of space between occupied cots, beds, and rest mats.

G. Twelve inches of space are not required where cots, beds, or rest mats are located adjacent to a wall or a divider if one side is open at all times to allow for passage.

H. Mattresses, cots, or rest mats shall be (i) nonabsorbent or covered with a waterproof material, and (ii) sanitized on all sides weekly or before use by another child.

I. Rest mats shall have at least one inch of cushioning.

J. Cribs shall be used for children under 12 months of age.

K. Cribs shall meet the following requirements:

1. They shall meet the current Consumer Product Safety Commission Standards at the time they were manufactured;

2. There shall be no more than one inch between the mattress and the crib; and

3. Not have mesh sides.

L. Cribs shall be placed where objects outside the crib such as cords from blinds or curtains are not within reach of children in cribs.

M. There shall be at least:

1. Twelve inches of space between the sides and ends of occupied cribs except where they touch the wall or solid barrier; and

2. Thirty inches of space between service sides of unoccupied cribs and other furniture where that space is the walkway for staff to gain access to any occupied crib.

N. If cribs with a swing down safety gate on one side for easy access to a child are used, the hinged safety gates shall be up and the fastenings secured when a child is in the crib, except when a staff member is giving the child immediate attention.

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.

P. Toys or objects hung over an infant in a crib and crib gyms that are strung across the crib shall be out of reach of the infant and may not be used for infants over five months of age or infants who are able to push up on their hands and knees.

A. Cribs when being used by infants shall only have a tight fitted bottom cover that does not make the mattress buckle or bend.

B. Cribs, cots, mats, and beds used by children other than infants during the designated rest period or during evening and overnight care shall have linens consisting of a top cover and a bottom cover or a one-piece covering which is open on three edges.

C. Linens and pillows used by children shall be (i) assigned for individual use, and (ii) stored separately from those of other children.

D. Linens and pillows shall be (i) changed when wet, soiled, or dirty, and (ii) linens shall be washed at least weekly.

E. Pillows when used shall be covered with pillowcases.

A. The center shall post written safety rules for swimming or wading in the swimming area when the pool is located on the premises of the center.

B. The center shall follow posted rules of public swimming areas when swimming activities are located off site.

C. Safety rules for swimming or wading shall be explained to children participating in swimming or wading activities.

D. Prior to a child being able to participate in swimming or wading activities, and annually thereafter, the center shall obtain (i) written permission from the parent of each child who participates in swimming or wading including a statement advising of the child's swimming skills, and (ii) a written assessment from a certified lifeguard or an adult who is familiar with basic swimming strokes to determine if the child is a swimmer or nonswimmer before the child is allowed in water with a depth of more than two feet.

E. The licensee shall ensure that staff maintain active supervision when any child is in or around water by staff designated to supervise children in the water. Notwithstanding ratio requirements in 8VAC20-781-280 and 8VAC20-781-290 A, these staff shall only be responsible for the supervision of children participating in the water activity and additional staff shall be available to supervise children not participating.

F. The licensee shall ensure that staff have a system for accounting at all times for all children in the water and in the aquatic area.

G. The staff-to-children ratios required by 8VAC20-781-280 and 8VAC20-781-290 A shall be maintained while children are participating in swimming or wading activities. Notwithstanding the staff-to-children ratios already indicated, at no time shall there be fewer than two staff members supervising the activity.

H. If a pool, lake, or other swimming area has a water depth of more than two feet, a certified lifeguard holding a current certification shall be on duty supervising whenever a child is participating in swimming or wading activities.

1. One lifeguard for every 25 children in the water shall be on duty and supervising the children.

2. The designated certified lifeguard shall not be counted in the staff-to-children ratios.

3. The lifeguard certification shall (i) include an in-person competency demonstration, and (ii) be obtained from an individual or organization holding instructor certification from an organization such as the American Red Cross.

I. Outdoor swimming activities shall occur only during daylight hours unless underwater and deck lighting is provided.

A. When permanent swimming or wading pools are located on the premises of the center, the following shall apply:

1. The manufacturer's specifications for operating the pool shall be followed as well as any local ordinances and any Department of Health requirements for swimming pools;

2. Pools constructed, renovated, or remodeled after April 1, 1986, shall have a statement in writing of their inspection and approval from the local building official when such approval is required;

3. Outdoor swimming pools shall be enclosed by safety fences and gates which are in compliance with the applicable edition of the Virginia USBC (13VAC5-62) and shall be kept locked when the pool is not in use;

4. Entrances to indoor swimming pools shall be locked when the pool is not in use; and

5. A whistle or other audible signaling device, a buoy or a lemon line, a reach pole, and a backboard shall be available at the swimming or wading site.

B. If children are allowed to swim in a lake or other place other than a pool, safe swimming areas shall be clearly marked and there shall be appropriate water safety equipment.

C. Piers, floats, and platforms shall be in good repair and where used for diving, the minimum water depth shall be stated on the deck or planking.

D. After use by a group of children, or more frequently as necessary, portable wading pools without an integrated filtration system shall be emptied, rinsed, and filled with fresh water.

E. After each day's use, portable wading pools shall be emptied, sanitized, and stored in a position to keep them clean and dry.

F. Children who are not toilet trained may not use portable wading pools without an integrated filtration system.

A. Unless otherwise approved by a child's health care professional, a child shall be excluded from the center if the child has:

1. A fever, which means an oral or axillary temperature at or above 100.4°F;

2. Recurring vomiting or diarrhea not associated with diet change or medication; or

3. Symptoms of a communicable disease listed in the Virginia Department of Health's current communicable disease chart.

B. If a child needs to be excluded according to subsection A of this section, the following shall apply:

1. The center shall contact the parents or designated emergency contact immediately so that arrangements can be made to remove the child from the center as soon as possible; and

2. The child shall remain in a designated area as required by 8VAC-781-240-D. The licensee shall ensure that the child is within sight and sound of a staff member at all times and shall ensure that staff respond to the needs of the child.

C. When any surface has been contaminated with body fluids, it shall be cleaned and sanitized immediately or restricted from use until cleaned and sanitized.

D. When any child’s clothing has been contaminated with body fluids, it shall be separated and stored in leakproof storage system until returned to the child’s parent.

A. The licensee shall ensure that staff ensure children's hands are washed with liquid soap and running water:

1. After diapering or toileting;

2. After contact with any body fluids;

3. After coming in from outdoors;

4. After handling or caring for animals;

5. Before and after playing with water used by more than one child;

6. When their hands are visibly dirty; and

7. Before eating.

B. The licensee shall ensure that children's hands are washed with liquid soap and running water or disposable wipes after eating.

C. Until an infant is old enough to be safely raised to the sink and reach for the water, the infant's hands may be washed using disposable wipes.

D. The licensee shall ensure that staff wash their hands with liquid soap and running water:

1. Before and after:

a. Helping a child use the toilet;

b. A diaper change;

c. Feeding or helping children with feeding;

d. Preparing or serving food or beverages; and

e. Administering medication or over-the-counter skin products.

2. After:

a. Using the toilet;

b. Contact with any body fluids;

c. Eating;

d. Handling garbage or cleaning materials;

e. Coming in from outdoors; and

f. Handling or caring for animals.

E. The licensee shall ensure that staff wash their hands with liquid soap and running water when their hands are visibly dirty and when entering the classroom before working with children.

F. If running water is not available, a germicidal cleansing agent administered per manufacturer's instruction may be used.

A. The diapering area shall be accessible and within the building used by children.

B. There shall be sight and sound supervision for all children when a child is being diapered.

C. The licensee shall ensure that staff do not leave a child unattended on the diapering surface.

D. The diapering area shall have the following:

1. A sink with running water not to exceed 120°F;

2. Liquid soap, disposable towels, and single use gloves such as surgical or examination gloves;

3. A nonabsorbent surface for diapering or changing shall be used. For children younger than three years, this surface shall be a changing table or countertop designated for changing unless otherwise specified in this section; and

4. The appropriate disposal containers as required by this section.

E. When a child's clothing, diaper, or disposable training pants becomes wet or soiled, the child shall be wiped clean and changed immediately.

F. Staff shall check diapers and disposable training pants at least once every two hours.

G. Disposable diapers and disposable training pants shall be disposed in a covered leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal.

H. When cloth diapers are used, a separate covered leakproof storage system as specified in subsection G of this section shall be used for each individual child.

I. Diapers or disposable training pants of children who are toilet training may be changed in the bathroom, and not on the diapering surface required in subdivision 3 of subsection D of this section, but the required procedures for handwashing in 8VAC20-781-490 and disposal of diapers or disposable training pants in subsections G and H of this section shall be followed.

J. The storage system required in subsections G and H of this section shall be cleaned and sanitized daily.

K. The diapering surface shall (i) not be used for storage, (ii) be used only for diapering or wiping children clean, and (iii) be cleaned and sanitized after each use. Tables used for children's activities or meals shall not be used for changing diapers.

L. Staff shall ensure the immediate safety of a child during diapering.

Toilet training. For every 10 children in the process of being toilet trained, there shall be at least one toilet chair or one child-sized toilet, or at least one adult sized toilet with a platform or steps and adapter seat.

1. The location of these items shall allow for sight and sound supervision of children in the classroom if necessary for the required staff-to-children ratios to be maintained.

2. Toilet chairs shall be emptied promptly and cleaned and sanitized after each use and located on non-carpeted areas when used.

A. The decision to administer medicines at a facility may be limited by center policy to administer: (i) prescribed medications, (ii) nonprescription medications, or (iii) only those medications required for emergencies or by law.

B. Written parental authorization for medication shall be obtained prior to a medication being accepted, maintained, or stored at the center.

C. Medications accepted, maintained, or stored at the center shall (i) be labeled with the child’s name, and (ii) not be kept or used beyond the date of expiration.

D. For any child for whom emergency medication (such as albuterol, glucagon, or epinephrine auto-injector) has been provided to the center by the parent, there shall always be a staff member who is immediately accessible and available and meets the requirements listed in 8VAC20-781-180.

E. Prescription and nonprescription medication shall be given to a child:

1. According to the center's written medication policies; and

2. Only with written authorization from the parent that has not expired.

F. Medication shall be administered by a staff member who is 18 years of age or older.

G. The licensee shall ensure that written authorization from the child’s parent for medication is only valid for 10 business days unless written authorization from the child’s physician is on file.

H. Long-term prescription and nonprescription drug administration may be allowed with written authorization from the child's physician and parent and shall be renewed based on the child's physician instructions.

I. Medication authorization shall be available to staff during the entire time it is effective.

J. When an authorization for medication expires, the center shall notify the parent with the intent to safely return the medication to the parent or receive an updated authorization form. If a parent has been non-responsive and has not retrieved the medication, the center shall safely dispose of the medication according to the center’s policy for medication disposal, but no later than 30 calendar days after the expiration date of the authorization. The expired medication authorization form shall be kept with the medication until the center can safely return the medication to the parent or dispose of the medication.

The center may administer prescription medication provided that:

1. The medication is administered by a staff member who meets the requirements in 8VAC20- 781-180;

2. The center administers only those drugs that are dispensed from a pharmacy or health care provider and maintained in the original, labeled container; and

3. The center administers medications only to the child identified on the prescription label in accordance with the prescriber's instructions pertaining to dosage, frequency, and route of administration.

The center may administer nonprescription medication provided the medication is:

1. Administered by a staff member who meets the requirements in 8VAC20-781-180;

2. Labeled with the child's name; the name of the medication, the dosage amount, and the time or times to be given;

3. In the original container with the manufacturer's direction label attached; and

4. Given only as specified on the manufacturer's label unless otherwise designated by written physician’s order.

A. Unless designated otherwise by a written physician’s order, medications, including refrigerated and staff’s personal medications, shall be kept in a locked place, using a safe locking method, that prevents access by children.

B. If a key is used, the key shall be inaccessible to the children.

C. When needed, medication shall be refrigerated.

D. When medication is stored in a refrigerator used for food, the medications shall be stored together in a container or in a clearly defined area away from food.

The center shall keep a record of prescription and nonprescription medication given to children, which shall include the following:

1. Name of the child to whom medication was administered;

2. The dose, the route, and the name of the medication administered to the child;

3. The date and time the medication was administered to the child;

4. Name of the staff member administering the medication;

5. Any adverse reactions; and

6. Any medication administration error and action taken.

A. When a school-age child self-administers medication while in care, the center shall:

1. Establish written safety procedures for self-administration of medication for school- age children that include direct supervision of during the administration of the medication; and

2. Obtain: (i) documentation of written authorization from the child’s physician; (ii) a written request from the child’s parent for the child’s self-administration of medication; and (iii) written authorization from the parent to administer the medication in the event that the child is unable to self-administer.

B. The center shall document any medication self-administered by a child to include:

1. The child’s name;

2. The dose, the route, and name of the medication self-administered;

3. The date and time the medication was self-administered;

4. Any adverse reactions or side effects; and

5. Any medication administration error and action taken.

C. If the written safety procedures required in this section are not followed, the center shall:

1. Notify the child’s parent;

2. Assume responsibility for administration of the medication while the child is in care; and

3. Document in the child’s record, the discontinuation of the authorization to self- administer and the notification to the child’s parent.

A. When topical skin products such as lip balm, hand lotion, sunscreen, diaper ointment and lotion, and insect repellent are administered by the center, the following requirements shall be met:

1. Written parent authorization noting any known adverse reactions shall be obtained at least annually;

2. The product shall be in the original container and, if provided by the parent, labeled with the child's name;

3. Manufacturer's instructions for application shall be followed; and

4. A record shall be kept that includes the child’s name, the name of the product, date and time of use, any adverse reactions, and any application errors and action taken.

B. Caregivers without medication administration training may apply topical skin products unless the product is a prescription medication, in which case the requirements in 8VAC20-781-530 shall be met.

C. Children five years of age and older may have access to and may apply their own hand sanitizers, liquid hand soaps, sunscreens, lip balms and hand lotions labeled "Keep out of reach of children" provided that the label does not contain any other warnings listed in 8VAC20-781-230 A and is used under adult supervision.

D. Sunscreen provided by the center shall have a minimum sunburn protection factor (SPF) of 15.

E. The product shall not be kept or used beyond the expiration date.

F. Topical skin products except those referenced in subsection B of this section, do not need to be kept locked, but shall be inaccessible to children under five years of age.

A. The center shall have a minimum of one working flashlight that does not require electricity on each floor of each building that is used by children.

B. The center shall have a minimum of one working radio that does not require electricity in each building used by children and any primitive camp location without a building.

C. The center shall have first aid supplies on each floor of the building, accessible from outdoor play areas, while on field trips, in vehicles when transporting children, and wherever children are in care. The first aid supplies shall be readily accessible to staff, inaccessible to children, and include the following:

1. An ice pack or instant cold pack;

2. Scissors;

3. Tweezers;

4. Gauze pads;

5. Adhesive tape;

6. Adhesive bandages, assorted sizes;

7. An antiseptic cleansing solution or pads;

8. Operable digital thermometer;

9. A minimum of two triangular bandages;

10. Single use gloves such as surgical or examination gloves; and

11. A first aid instructional manual.

A. The center shall have a written emergency preparedness and response plan developed in consultation with the local emergency manager, or the state or local fire official. The plan shall include:

1. Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event such as violence at a or near the child care facility; and

2. Emergency evacuation, relocation, shelter-in-place, and lockdown procedures to include;

a. Scenario applicability: the most likely emergency scenarios including fire, severe storms, flooding, tornadoes, earthquakes, pandemic, loss of utilities, and other situations including facility damage that requires evacuation, lockdown, or shelter-in-place;

b. Emergency communication to alert staff and emergency responders;

c. Methods to account for all children and to ensure continued supervision of children;

d. Method of communication with staff, parents, and emergency responders;

e. Accommodations or special requirements for infants, toddlers, children with special needs and children with chronic physical or medical conditions to ensure their safety during evacuation or relocation;

f. Procedure to reunite children with a parent or authorized person designated by the parent; and

g. Staff and volunteer training requirements and drill frequency.

B. The center’s emergency preparedness and response plan shall also include the following additional requirements:

1. Evacuation and relocation procedures shall include:

a. Designated primary and secondary routes out of the building;

b. Designated assembly point away from the building;

c. Designated relocation site;

d. Methods to ensure essential documents, including attendance records; parent contact information; emergency contact information; information on allergies, and intolerance to food or medication are taken to the assembly point or relocation site; and

e. Methods to ensure any special healthcare needs to include medications and care plans; and supplies are taken to the assembly point or relocation site.

2. Shelter-in-place procedures shall include:

a. Designated shelter-in-place areas within the center;

b. Designated primary and secondary routes to the shelter-in-place areas;

c. Methods to ensure essential documents, including attendance records; parent contact information; emergency contact information; information on allergies, and intolerance to food or medication are taken to the assembly point or relocation site; and

d. Methods to ensure any special healthcare needs to include medications and care plans; and supplies are taken to the assembly point or relocation site.

3. Lockdown procedures shall include designated safe areas that the facility can contain using procedures such as closing or locking of doors or other barriers.

C. The center shall review the emergency preparedness and response plan at least annually and update as needed. Center shall document each review and update made to the emergency preparedness and response plan.

D. Emergency evacuation and shelter-in-place diagrams, and a 911 or local dial number for police, fire, and emergency medical services, and the number of the national poison control center hotline shall be posted in conspicuous locations in each room used by children or staff.

E. Continuity of operations shall be established to ensure that essential functions are maintained during an emergency.

A. All emergency response drills shall be practiced:

1. In each building used by children;

2. With all staff and children present at the time of the drill;

3. At varying times during the center’s hours of operation; and

4. For centers offering evening and overnight care, a separate drill must be completed during the evening and overnight hours according to the same schedules specified in subsections B through D of this section.

B. Emergency evacuation procedures shall be practiced monthly.

C. Shelter-in-place procedures shall be practiced a minimum of twice per year.

D. Lockdown procedures shall be practiced a minimum of twice per year.

E. Documentation shall be maintained for one year of emergency evacuation, shelter-in-place and lockdown drills that include:

1. The date and time of the drill;

2. The number of staff and children participating; and

3. The time it took to complete the drill.

A. Centers shall schedule appropriate times for snacks or meals, or both, based on the hours of operation and time of the day (e.g., a center open only for after school care shall schedule an afternoon snack; a center open from 7 a.m. to 1 p.m. shall schedule a morning snack and midday meal).

B. The licensee shall ensure that children arriving from a half-day, morning program who have not yet eaten lunch receive a lunch.

C. The center shall schedule snacks or meals so that there is a period of at least 1-1/2 hours but no more than three hours between each meal or snack unless there is a scheduled rest or sleep period for children between the meals and snacks.

D. Drinking water or other beverage not containing caffeine shall be offered at regular intervals to children.

E. In environments of 80°F or above, attention shall be given to the fluid needs of children at regular intervals. Children in such environments shall be encouraged to drink fluids as outlined in subsection D of this section.

F. When centers choose to provide meals or snacks, the following shall apply:

1. Centers shall follow the most recent, age-appropriate nutritional requirements of the Child and Adult Care Food Program administered by the United States Department of Agriculture (USDA).

2. Children shall be allowed second helpings of food listed in the Child and Adult Care Food Program.

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.

4. A menu listing foods to be served for meals and snacks during the current one-week period shall:

a. Be dated;

b. Be posted in a location conspicuous to parents or given to parents;

c. Be kept on file for one week at the center; and

d. List any substituted food by the end of the business day.

5. Powdered milk shall not be used except for cooking.

G. When food or beverage is brought from home, the following shall apply:

1. The food and beverage container shall be sealed and labeled in a way that identifies the owner by first and last name.

2. The center shall have extra food or shall have provisions to obtain food to serve to children so they can have an appropriate snack or meal if they forget to bring food from home, bring an inadequate meal or snack, or bring perishable food.

3. Unused portions of opened food shall be discarded by the end of the day or returned to the parent.

H. If a catering service is used, it shall be approved by the local health department.

I. Contaminated or spoiled food shall not be served to children.

J. Tables and high chair trays shall be cleaned and sanitized before and after each use for feeding;

K. Staff shall be present in the feeding area with children anytime children are eating.

L. Children shall not be allowed to eat or drink while walking, running, playing, lying down, or riding in vehicles.

M. Food and beverages shall be prepared, served, stored, and transported in a sanitary manner.

N. When food is prepared to which a child in care is allergic, staff shall take steps to avoid cross contamination to prevent an allergic reaction.

O. A child with a diagnosed food allergy shall not be served any food identified in the emergency care plan required in 8VAC20-781-60 B 6.

A. High chairs, infant seats, or feeding tables shall be used for children under 12 months who are not held while being fed.

1. Children shall be supervised during snacks and meals.

2. When a child is placed in a feeding table with protective belts, a high chair, or an infant seat, the protective belt shall be fastened securely.

B. Bottle fed infants who cannot hold their own bottles shall be held when fed. Bottles shall not be propped or used while the child is in his designated sleeping location.

C. Each bottle fed infant shall have a written feeding schedule on file that is updated as needed and contains:

1. Whether the child receives breast milk, formula, or milk; and

2. The brand name of formula, if applicable.

D. Infants shall be fed on demand or in accordance with parental instructions.

E. All prepared bottles or breast milk stored in other containers provided by parents shall be labeled with the child’s name and date of receipt.

F. Breast milk shall be stored according to center’s policy for the storage of breast milk.

G. Infant formula prepared by the center shall be prepared according to manufacturer’s instructions and prepared infant formula or milk shall be (i) refrigerated; and (ii) dated and labeled with the child's name.

H. Heated breast milk, formula, milk, and baby food shall be stirred or shaken and tested for temperature before serving to children.

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.

J. When a bottle warmer or slow-cooking device, such as a crock-pot, is used for warming breast milk, formula, milk or bottles of infant food, the device (and cord) shall be out of children’s reach and used according to manufacturer’s instructions.

K. Breast milk, formula and milk shall not remain unrefrigerated at the center for more than two hours and may not be reheated.

L. Prepared bottles shall be discarded or returned to the parent at the end of the day.

M. Prepared baby food not consumed during that feeding by an infant may be used by that same infant later in the same day, provided that the food is not served out of the baby jar and is dated and stored in the refrigerator; otherwise, it shall be discarded or returned to the parent at the end of the day.

N. A one-day's emergency supply of disposable bottles, nipples, and commercial formulas appropriate for the children in care shall be maintained on premises. The center shall consult parents on any special feeding needs such as specific formula, breast milk, or other special accommodations.

O. The center shall not prohibit breastfeeding.

P. When bottles with breast milk, formula or milk are prepared by the center, they shall not be mixed with cereal unless a physician or physician's designee provides written documentation stating otherwise.

Q. When feeding semisolid food to a child, staff shall use a spoon unless written instructions from a physician or physician's designee state differently.

A. Written parental permission for field trips shall be secured before the scheduled activity.

B. If a blanket permission is used instead of a separate written permission, the following shall apply:

1. Parents shall be notified in advance of the field trip; and

2. Parents shall be given the opportunity to withdraw their child from the field trip.

C. Children shall cross streets at corners or crosswalks or other designated safe crossing point if no corner or crosswalk is available.

D. Before leaving on a field trip, a schedule of the trip's events and locations shall be posted and visible on the premises.

E. The licensee shall ensure a method of communication for emergencies during field trips.

F. The center shall make provisions for providing children on field trips with adequate food and water.

A. Written parental permission for transportation shall be secured before transportation is provided.

B. Any vehicle used by the center for the transportation of children shall meet the following requirements:

1. The vehicle shall meet the safety standards set by the Department of Motor Vehicles and shall be kept in satisfactory condition to assure the safety of children.

2. The vehicle shall be manufactured for the purpose of transporting people.

3. The vehicle shall be insured with at least the minimum limits established by Virginia state statutes.

4. If staff or volunteers supply personal vehicles, the center is responsible for ensuring that the requirements of this subsection are met.

C. The licensee shall ensure that during transportation of children:

1. Virginia state statutes about safety belts and child restraints are followed as required by §§ 46.2-1095 through 46.2-1100 of the Code of Virginia, and stated maximum number of passengers in a given vehicle is not exceeded;

2. The children remain seated, and each child's arms, legs, and head remain inside the vehicle;

3. Doors are closed and locked;

4. At least one staff member or the driver always remains in the vehicle when one or more children are present; and

5. The following information is in transportation vehicles:

a. Emergency numbers as specified in 8VAC20-781-600 D;

b. The center's name, address, and phone number;

c. A list of the names of the children being transported and each child's emergency contact information as required in subdivisions 2 and 3 of 8VAC20-781-60 B;

d. Emergency care plan and information as specified in 8VAC20-781-60 B 5 and B 6; and

e. A document containing local emergency contact information, potential shelters, hospitals, evacuation routes, etc., that pertain to each site frequently visited or of routes frequently driven by center staff for center business, such as field trips, pick-up, and drop-off of children to or from home and local schools.

D. When entering and leaving vehicles, children shall enter and leave the vehicle from the curb side of the vehicle or in a protected parking area or driveway and cross streets at corners or crosswalks or other designated safe crossing point if no corner or crosswalk is available.

E. The licensee shall ensure a method of communication for emergencies during transportation.

F. The licensee shall ensure that any driver verifies that all children have been removed from the vehicle at the conclusion of any trip by checking every seat.

A. Animals that are kept on the premises of the center or that interact with children at the center shall be vaccinated if applicable.

B. Animals which are, or are suspected of being, ill or infested with external lice, fleas and ticks or internal worms shall be removed from contact with children.

C. Monkeys, bats, ferrets, poisonous animals, reptiles, psittacine birds (birds of the parrot family), stray animals, or wild or dangerous animals shall not be in areas accessible to children during the hours children are in care.

D. Animals that have shown aggressive behavior shall not be kept in the center or on the grounds.

E. All animal excrement shall be removed promptly, disposed of properly, and, if indoors, the soiled area cleaned and sanitized.

F. If a child is bitten by an animal while in care, the following procedures shall be followed:

1. The site of the bite shall be washed with soap and water immediately;

2. Appropriate first aid shall be administered immediately including appropriate medical attention if necessary;

3. The child's parent and the local health department shall be notified immediately to report the animal bite incident; and

4. The incident shall be documented in the child’s record as required by 8VAC20-781-60 and a written report shall be given to the parent as required by 8VAC20-781-410.

G. Manure shall be removed from barns, stables, and corrals at least once a day and stored and disposed of in a manner to prevent the breeding of flies.

A. For evening care, beds with mattresses or cots with at least one inch of dense padding shall be used by children who sleep longer than two hours and are not required to sleep in cribs.

B. For overnight care, beds with mattresses or cots with at least two inches of dense padding shall be used by children who are not required to sleep in cribs.

C. In addition to 8VAC20-781-450 about linens, bedding appropriate to the temperature and other conditions of the rest area shall be provided.

D. Centers providing evening care or overnight care on an occasional basis are not required to meet the requirements subsection A and B of this section if sleeping bags or cots are used.

E. If sleeping bags are used, 8VAC20-781-440 A through H about cribs, cots, rest mats and beds shall also apply to the use of sleeping bags.

F. In centers providing overnight care, an operational tub or shower with heated and cold water shall be provided.

G. Activities for children in evening or overnight care shall include, as time allows, age- appropriate activities as described in 8VAC20-781-320 through 8VAC20-781-360.

H. Quiet activities shall be available immediately before bedtime.

I. School age children may use bunk beds for sleeping.

J. Primitive camps are not required to have a tub or shower.

A child day center that meets the definition of a therapeutic child day program or special needs child day program shall also comply with all requirements of Parts I through XI of this chapter.

Therapeutic child day programs shall ensure that an individual assessment is:

1. Completed within six months before the child's attendance or 30 days after the first day of attendance and shall be maintained for each child.

2. Reviewed and updated for each child no less than once every 12 months.

Therapeutic child day programs shall ensure that an individual service, recreation, education, or treatment plan is:

1. Developed for each child by the director or his designee in consultation with primary staff responsible for plan implementation.

2. Implemented within 60 days after the first day of the child's attendance.

3. Reviewed every three months and revised if needed by the director or his designee in consultation with primary staff responsible for plan implementation. The review and revisions shall be done in partnership with the child’s parent.

4. Maintained in the child's record and a copy given to the child's parent.

Notwithstanding 8VAC20-781-100 and 8VAC20-781-120, therapeutic child day programs and special needs programs shall ensure that:

1. Directors have education and programmatic experience in the group care of children with special needs.

2. Lead teachers have at least three months of programmatic experience in the group care of children with special needs.

Therapeutic child day programs and special needs child day programs shall ensure that staff who work with children:

1. Receive training before assuming job responsibilities in:

a. Staff occupational health and safety practices in accordance with Occupational Safety and Health Administration’s bloodborne pathogens regulation (29 CFR 1910.1030);

b. Activity adaptations;

c. Medication administration;

d. The special needs of the children in care including functional abilities and accommodations;

e. Disabilities and health issues; and

f. Appropriate precautions and intervention strategies.

2. Annually complete eight additional hours of training on topics related to the care of children with special needs.

A. For therapeutic child day programs and special needs child day programs, in each grouping of children of preschool age or younger, the following ratios of staff to children are required according to the special needs of the children in care:

1. For children with severe and profound disabilities, multiple special needs, serious medical need, or serious emotional disturbance: one staff member to three children.

2. For children diagnosed as having an intellectual disability with significant sub-average intellectual functioning and deficits in adaptive behavior, or with physical and sensory disabilities, or with autism: one staff member to four children.

3. For children diagnosed as having an intellectual disability in the mild range of development, children with a developmental delay, or children diagnosed with attention deficit/hyperactivity disorder (ADHD): one staff member to five children.

4. For children diagnosed with specific learning disabilities: one staff member to six children.

5. When children with varied special needs are included in a group, the staff-to-children ratio applicable to the child with the most significant special need in the group shall apply to the entire group.

6. Whenever 8VAC20-781-280 B requires more staff than 8VAC20-781-730 A because of the children's ages, 8VAC20-781-280 B shall take precedence over 8VAC20-781-730 A.

B. For therapeutic child day programs and special needs child day programs, in each grouping of school age children, the following ratios of staff to children are required according to the special needs of the children in care:

1. For children with severe and profound disabilities, autism, multiple special needs, serious medical need, or serious emotional disturbance: one staff member to four children.

2. For children diagnosed as having an intellectual disability with significant sub-average intellectual functioning and deficits in adaptive behavior, or with physical and sensory disabilities, ADHD, or other health impairments: one staff member to five children.

3. For children diagnosed as having an intellectual disability in the mild range of development, or developmentally delayed: one staff member to six children.

4. For children diagnosed with specific learning disabilities or speech or language impairments: one staff member to eight children.

5. When children with varied special needs are included in a group, the staff-to-children ratio applicable to the child with the most significant special need in the group shall apply to the entire group.

C. Group size requirements in 8VAC20-781-280 A do not apply to therapeutic child day programs and special needs child day programs.

Therapeutic child day programs and special needs child day programs serving children who use wheelchairs, shall provide appropriate positioning equipment and cushioned vinyl-covered floor mats for use when activities require children to be out of their wheelchairs.

A. For therapeutic child day programs and special needs child day programs, the consistency of food shall be appropriate to a child's special feeding needs.

B. Necessary and adaptive feeding equipment and feeding techniques shall be used for children with special feeding needs according to the information on file pursuant to 8VAC-781-60-B 5.

A. Therapeutic child day programs and special needs child day programs providing transportation to non-ambulatory children shall ensure children are transported in a vehicle which is equipped with a ramp or hydraulic lift to allow entry and exit.

B. Wheelchairs shall be equipped with restraining devices and shall be securely fastened to the floor when used to seat children in a vehicle.

C. Arrangements of wheelchairs in a vehicle shall not impede access to exits.

D. For therapeutic child day programs and special needs child day programs, when the center is responsible for providing transportation, the center shall develop a plan based on the needs of the children in care to assure their safe supervision during on-loading, off-loading, and transporting.

E. When 16 or more children are being transported, there shall be at least one staff member or adult besides the driver, for each group of 16.

F. For therapeutic child day programs and special needs child day programs, if a child has a known seizure disorder or neurological, genetic, or physiological disability causing increased medical risk and that child is being transported, one staff member or adult who is not the driver and who is trained in first aid and CPR shall be present in the vehicle.