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Virginia Regulatory Town Hall

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Licensed Family Day Systems Regulation Comprehensive Review
Stage: Proposed
7/18/11  12:42 PM
 

CHAPTER 120
MINIMUM STANDARDS FOR LICENSED FAMILY DAY-CARE SYSTEMS (REPEALED)

22VAC40-120-10. Introduction. (Repealed.)

A. Legal Base. Chapter 10 (§ 63.1-195 et seq.) of Title 63.1 of the Code of Virginia sets forth the responsibility of the Department of Social Services for licensure of family day-care systems, including the authority and responsibility of the State Board of Social Services for the development of regulations containing minimum standards and requirements.

It is a misdemeanor to operate a family day-care system without a license. (§ 63.1-215 of the Code of Virginia.)

B. Definitions. The following words and terms, when used in this chapter, shall have the following meaning unless the context clearly indicates otherwise:

"Family Day Care System" means any person who approves family day-care homes as members of its system; who refers children to available day-care homes in that system; and who through contractual arrangement may provide central administrative functions including, but not limited to, training of operators of family day-care homes; technical assistance and consultation to operators of family day-care homes; inspection, supervision, monitoring, and evaluation of family day-care homes; and referral of children to available health and social services. (§ 63.1-195 of the Code of Virginia.)

"Family Day-Care System Home" means any private family home, which is an approved member of a family day-care system and receives nine or fewer children for care, protection and guidance during any part of the 24 hour day except children who are related by blood or marriage to the person who maintains the home. (Family day-care homes that are members of a licensed day-care system and are approved by that system to care for six or more children are not subject to direct licensure by the department.) by law; see § 63.1-196.001B of the Code of Virginia.

"Abused or Neglected Child" (See § 63.1-248.2) of the Code of Virginia) means any child less than 18 years of age whose parents or other persons responsible for his or her care:

a. Create or inflict, threaten to create or inflict, or allow to be create or inflicted a physical or mental injury by other than accidental means, or creates a substantial risk of death, disfigurement, impairment of bodily or mental functions;

b. Neglect or refuse to provide care necessary for the child's health, unless the child is, in good faith, under treatment solely by spiritual means through prayer, according to the practice of a recognized church or denomination;

c. Abandon the child;

d. Commit or allow to be committed any sexual act upon a child in violation of the law.

"Child" means any person less than 18 years of age.

"Commissioner" means the Commissioner of Social Services also known as the Director of the Virginia Department of Social Services. (§ 63.1-2 of the Code of Virginia)

"Complaint" means an accusation received either orally or in writing that:

a. A licensed family day-care system is not in compliance with one or more of these standards or one or more statutory requirements; or

b. A family day-care system home is not in compliance with one or more applicable requirements of these standards or one or more requirements as established by the family day-care system; or

c. A child or children in the care of a family day-care home, which is a member of a licensed family day-care system is or are being abused or neglected.

"Day-Care" means care, protection and guidance provided to a child or group of children separated from their parents or guardian for less than 24 hours per day at a location other than the home of the parents or guardian.

"Day-Care Provider" means an individual who, by contract with a family day-care system, provides day-care in his or her home.

"Department" means the Virginia Department of Social Services.

"Department Representative" means an employee of the Virginia Department of Social Services, acting as the authorized agent of the Commissioner in carrying out the responsibilities and duties specified in Chapter 10 (§ 63.1-195 et seq.) of Title 63.1 of the Code of Virginia.

"Director" means the licensee or a person designated by the licensee who oversees the day-to-day operation of the system including compliance with all minimum standards for licensed family day-care systems.

"Licensee" means any person, association, partnership or corporation to whom the license is issued.

"Person" means any natural person or any association, partnership or corporation. For the purpose of these standards public agencies are not included in this definition.

"Referral" means any activity by the family day-care system which provides assistance in locating or arranging day-care for children in homes that have been accepted or approved as members of the system, or in locating or arranging for health or social services from other sources based upon identified needs.

"Sponsor" means an individual, association, partnership or corporation having the responsibility for planning and operating a family day-care system subject to licensure. The licensee is the sponsor of a family day-care system. (The sponsor may not, in all cases, be the owner of the physical plant including buildings or real estate, or both, in or on which the family day-care system office is located. In these instances the term "sponsor" as defined here and used in this chapter is considered to be the person, partnership, association or corporation that owns the enterprise rather than the physical plant or real estate, or both,.)

C. The license.

1. A license to operate a family day-care system is issued to a specific person, partnership, association, or corporation for an exact location which will be indicated on the license.

2. The family day-care system shall be operated and conducted in the name of the sponsor or in such name as shall be designated on the application and as indicated on the license.

3. The license expires automatically and is not transferable when there is a change of sponsorship.

4. [Deleted effective February 1, 1984.]

5. The current license shall be posted at all times at a place that is conspicuous to the public in the building housing the system office. If the system has more than one office, copies of the current license shall be posted in a place that is conspicuous to the public in each office.

6. An annual license is one issued to a family day-care system when the activities, services and facilities meet substantially the minimum standards and requirements for a license that are set forth in this chapter and any additional requirements that may be specified in Chapter 10 (§ 63.1-195 et seq.) of Title 63.1 of the Code of Virginia. The annual license is effective for 12 months unless it is sooner revoked or surrendered.

7. When an annual license expires, a provisional license may be issued for any period not to exceed six months, if the applicant is temporarily unable to comply with all of the requirements; however, no facility may operate under any such provisional license and renewals of that license for a longer period than six successive months.

8. At the discretion of the Commissioner, a conditional license may be issued to operate a new facility in order to permit the applicant to demonstrate compliance with all requirements. A conditional license and any renewable of that shall be for no longer a period than six successive months.

9. Terms of the license.

a. The terms of any license issued include:

(1) The operating name of the family day-care system;

(2) The name of the individual, the partnership, the association, or the corporation to whom the license is issued;

(3) The physical location;

(4) The number of homes that may be under contract to the system;

(5) The period of time for which the license is effective; and

(6) The total number of children who may be referred by the system and be receiving care at any given time in all homes that are members of the system.

b. The terms of the license may include other limitations which the Commissioner may prescribe within the context of this chapter.

c. The provisional license cites the standards with which the licensee is not in compliance.

D. The licensing process.

1. Pre-application consultation. Upon request, the department's representative will provide consultation to any person seeking information about obtaining a license for a family day-care system. The purpose of such consultation is:

a. To explain standards;

b. To help the potential applicant to explore the operational demands of a licensed family day-care system;

c. To provide assistance in locating sources of information and technical assistance;

d. To alert the potential applicant of the need to determine whether local ordinances will affect the proposed operation (e.g. zoning, business license, etc.)

e. To provide an on-site visit to a proposed family day-care system office, upon request.

2. The application.

a. The application for a license to operate a family day-care system shall be obtained form the Virginia Department of Social Services.

b. The application, together with all required information, shall be submitted to the Department at least two months in advance of the planned opening date.

This is required in order that a determination of compliance with the provisions of Chapter 10 (§ 63.1-195 et seq.) of Title 63.1 of the Code of Virginia, and with the Standards for Licensed Family Day-Care Systems as set forth here may be made.

Among other things, the information submitted shall be sufficient to enable the department's representative to determine, during the subsequent investigation, the specific services to be offered, the adequacy of staff to provide these services, the financial capability of the applicant, the character and reputation of the applicant, including the officers and agents of any association, partnership or corporation as mandated by § 63. 1-198 of the Code of Virginia.

c. The application shall be signed by the individual responsible for the operation of the family day-care system. The application for a family day-care system to be operated by a board shall be signed by an officer of the board, preferably the chairman.

3. The investigation.

a. Following receipt of the application, the department's representative will make an on-site inspection of the proposed office and an investigation of the proposed services, as well as an investigation of the character, reputation and financial responsibility of the applicant.

b. "The applicant shall afford representatives of the commissioner required to make the investigation reasonable opportunity to inspect all of the applicant's facilities, books and records, and to interview his or its agents and employees and any child or other person within his or its custody or control." (§ 63.1-198 of the Code of Virginia)

4. Notice to the applicant of commissioner's action. Upon completion of the investigation of the application for a license, the applicant will be notified in writing of the commissioner's decision.

If the license is issued, an accompanying letter will cite any areas of non-compliance with standards. This letter will also include any limitations on the license and may contain recommendations.

If a license is to be denied, the letter will state the reasons for the intent to deny and will set forth the applicant's right to an administrative hearing.

5. Procedures for renewal of annual, provisional or conditional license. In order to renew an annual, provisional or conditional license, the licensee must complete the renewal application and return it, together with any required attachments, to the department. In order to assure timely processing, the renewal application should be completed and returned within 10 days after it is received from the department.

The procedure for investigation and issuance or denial of the license as set forth in subdivisions D 3 and D 4 will be followed.

6. Early compliance (replacement of a provisional or conditional license with an annual license).

a. A provisional or conditional license may be voided and an annual license issued when all of the following conditions exist:

(1) The facility complies with all standards listed on the face of the provisional or conditional license well in advance of the expiration date of the provisional or conditional license, and no additional areas of non-compliance exist;

(2) Compliance has been verified by an on-site observation by the department representative or by written evidence provided by the licensee; and

(3) All other terms of the license remain the same.

b. A request to void a provisional or conditional license and to issue an annual license must be made in writing by the licensee to the regional office of the Virginia Department of Social Services from which the family day-care system's license to operate was issued.

c. If the request is approved by the department, the effective date of the new annual license will be the same as the beginning date of the provisional or conditional license.

7. Situation requiring a new application. A new application must be filed when sponsorship of the family day-care system changes.

8. Modification.

a. The conditions of the license may be modified during the effective dates of the license with respect to increasing or decreasing the number of homes that may be placed under contract, the number of children who may be referred by the system and be receiving care at a given time, changing the name of the system when there is no change in sponsorship, change in location of the system office, or because of other conditions caused by changes in staff, program, or facilities.

b. The licensee shall report to the department any contemplated changes in operation which would affect with either the terms of the license or the continuing eligibility for a license. (This does not mean the department has to approve changes in staff or program unless they affect the terms of the license or continuing eligibility.)

c. This information shall be submitted in writing by the licensee to the regional office of the Virginia Department of Social Services from which the system's license to operate was issued.

d. The department will then determine whether such changes may be approved and the license modified accordingly or whether a new application must be filed.

9. Determination of continued compliance. In order to determine continued compliance with standards during the effective dates of the license, the department's representative will make announced and unannounced visits to the offices or offices of the system and may make such visits to homes that are members of the system.

10. Complaint investigation.

a. The department has the responsibility to investigate any complaints regarding alleged violations of minimum standards for licensed family day-care systems and provisions of Chapter 10 (§ 63.1-195 et seq.) of Title 63.1 of the Code of Virginia, or both.

b. The licensee has the responsibility to investigate any complaints regarding any family day-care home which is approved as a member of its system. (See 22VAC40-120-50 C.) At its discretion the department may also investigate complaints against individual homes.

11. Revocation. Any license may be revoked for failure to maintain these standards or for violation of the provisions of Chapter 10 (§ 63.1-195 et seq.) of Title 63.1 of the Code of Virginia.

12. Appeals. The applicant or licensee has the right to request an administrative hearing regarding any denial or revocation of a license, in accordance with the provisions of the Administrative Process Act, Chapter 1.1:1 (§§ 9-6.14:11 through 9-6.14:14) of Title 9 of the Code of Virginia.

Following the receipt of the final order which transmits the department's decision after the administrative hearing, the applicant/licensee has the right to appeal to a court of record in accordance with § 63.1-213 of the Code of Virginia.

22VAC40-120-20. Organization and Administration. (Repealed.)

A. Sponsorship.

1. A family day-care system may be sponsored by a single individual, a partnership, association or a corporation.

2. A corporation sponsoring a family day-care system shall maintain its corporation sponsoring a family day-care system shall maintain its corporate status in accordance with Virginia law.

3. Such corporation shall be organized and empowered for the purpose of operating and maintaining a family day-care system. Corporations not organized and empowered solely to operate a family day-care system shall provide for such operations in their charters.

4. A family day-care sponsored by an association or corporation shall be controlled by a governing board that shall fulfill the duties of the licensee.

5. If a family day-care system is sponsored by an individual or a partnership, the individual or partnership shall be the licensee and shall comply with the responsibilities specified for the governing board. (See subdivision B 3 of this section.)

B. Governing board.

1. Composition of the Governing Board.

a. The membership of the governing board shall be based on the size and purpose of the family day-care system as well as the services to be offered by the system.

b. It shall be large enough and of a composition to:

(1) Be representative of the variety of interests served by the system;

(2) Contain experience appropriate to the services offered by the system; and

(3) Be representative of the geographical area served by the system.

c. At minimum, the governing board shall be composed of three members unless there are fewer than three shareholders, at which time the number of members can equal the number of shareholders. This membership shall include a president, secretary-treasurer and member-at-large. When there are fewer than three members, this membership shall consist of a president and secretary-treasurer.

d. The method of selecting board members shall be made known to the department's representative and shall be consistent with the by-laws.

2. Meetings of the governing board.

a. The governing board shall meet not less than quarterly.

b. Minutes of all meetings shall be recorded and retained in a permanent file at the office of the family day-care system.

c. Copies of minutes shall be made available to the department's representative upon request.

3. The responsibilities of the governing board shall include, but shall not be limited to:

a. Establishing written by-laws for the association or corporation; (not applicable to an individual or partnership);

b. Establishing written goals and policies under which the family day-care system is to operate (See subsection C of this section);

c. Ensuring the family day-care system functions according to its defined purpose and within the scope of services to be offered;

d. Ensuring that compliance with minimum standards for licensed family day-care systems;

e. Maintaining a budgetary and financial system which assures that a sound financial structure is maintained;

f. Appointing a qualified director to whom it delegates, in writing, the authority and responsibility for administrative direction and management of the family day-care system in accordance with established policies (optional for an individual or partnership);

g. Establishing written policies which govern the board's or licensee's relationship to the director to include, at minimum:

(1) Evaluation of the performance of the director not less than annually;

(2) Provision for the director to meet with the board periodically to review the services being provided, the personnel needs and the fiscal management of the family day-care system.

h. Providing a written organizational chart which indicates the organizational elements of the system the personnel positions within each organizational element and the lines of authority and communication within the family day-care system. This chart shall be kept current.

i. Reviewing, at least annually, the program of the family day-care system. This review shall include an examination of:

(1) The number, size, capabilities and quality of service offered by homes that are members of the system;

(2) The needs of homes that are members of the system and the services offered to these homes by the system;

(3) The needs of children and families served by the system and the services offered to them;

(4) Problems encountered n the operation of the system;

(5) Consistency of services provided within the framework of the stated purpose and objectives of the system;

(6) Changes required in the focus of the system's program;

(7) The adequacy of the record keeping system.

j. Determining, based on the annual review required by subdivision B 3 i of this section, the following:

(1) Requirements for additional staff training;

(2) Requirements for changes in staffing;

(3) Requirements for changes in the focus of the program and services offered by the system.

k. Developing and implementing plans to respond to the needs identified in subdivision B 3 j of this section.

l. Maintaining accurate and appropriate inventories regarding all real property and equipment belonging to the system.

m. Ensuring that member homes comply with local child care ordinances where such ordinances exist. (NOTE: A note of approval from the administrator of the local ordinances will constitute evidence of compliance.)

C. Goals, policies and procedures.

1. Goals.

a. Written goals shall be developed for the family day-care system.

b. These goals shall clearly describe the philosophy and objectives of the system.

c. At minimum, they shall address:

(1) The purpose of the family day-care system;

(2) The population to be served;

(3) The recruitment of homes;

(4) The program to be offered by the system in terms of:

(a) Services to be provided to the homes that are members of the system;

(b) Services to be provided to families and children who use the system.

2. Policies and procedures. Written policies and procedures shall be prepared for the operation of the family day-care system. These policies and procedures shall relate to:

a. Personnel policies (seeVAC40-120-30 B)

b. Services to member homes including:

(1) Criteria for approving family day-care homes as members of system.

(2) Training of home operators;

(3) Technical assistance and consultation to home operators; and

(4) Inspection, supervision, monitoring and evaluation system homes.

c. Services to children and their families including:

(1) Referral of children to homes that are members of the system; and

(2) Referral of children to available health and social services.

3. A copy of the goals and all policies and procedures shall be made available to the department representative upon request.

D. Finances.

1. Fiscal accountability.

a. The family day-care system shall have a plan of financing which assures sufficient funds to operate in accordance with its stated purpose, objectives and the services to be provided.

b. The department, at any time, may request an audit of the financial records of the system by a certified public accountant. When requested, systems shall obtain such an audit and the cost of the audit report shall be borne by the system. (This does not mean that the department will routinely require such a report as part of the process of application for licensure.)

c. A new system shall as part of its initial application for licensure:

(1) Submit a plan of financing (working budget) for the first year of operation;

(2) Document funds or credit available for the first year of operation;

(3) Provide a financial report reflecting the current fiscal condition of the facility. This report shall be in the form of a current balance sheet showing a statement of assets and liabilities;

(4) Submit fee and payment schedules as required by subdivision D 3 of this section.

d. The application for license renewal shall include evidence of financial responsibility. At minimum, this evidence shall consist of:

(1) A current balance sheet showing a statement of current assets and current liabilities;

(2) A budget for the next year of operation;

(3) A copy of the current audit report required by subdivision D 1 b of this section if such a report is requested by the department;

(4) Current fee and payment schedules as required by subdivision D 3 of this section.

2. Internal financial procedures.

a. There shall be a system of financial record keeping that is consistent with generally accepted accounting principles, showing separation of the system's accounts from all other records.

b. There shall be a written policy for the collection and disbursement of funds.

c. Those members of the governing board or body and staff who have been granted authorized responsibility for funds of the system shall be bonded.

3. Fee and payment schedules.

a. The family day-care system shall maintain a current written schedule of fees charged for the services provided. The applicable schedule or schedules shall be made available to families who seek or use the services of the system, to home that apply for membership in the system and to the department as part of the application for licensure.

b. The family day-care system shall establish and maintain a current written schedule of payments to be made to homes that are members of the system. This schedule shall specify the amount of payment, conditions of payment and frequency of payment. It shall be provided to all homes that are members of the system and also to the department as part of the application for licensure. When applicable, this schedule shall also be made available to families who seek or use the services of the system.

E. Relationship to the licensing authority.

1. The family day-care system shall submit to the department such reasonable reports and information as it may require. (See § 63.1-203 of the Code of Virginia)

2. The system's books and records shall be made available for inspection by the department's representative, upon request. (See § 63.1-198 of the Code of Virginia)

3. The licensee, governing board or its official representative shall notify the department when any major change is anticipated in the program, services provided or administrative structure. When such a change occurs, which was not anticipate, this notification shall be provided no later than 10 days following the change. The department shall also be notified within five working days whenever a new director is employed by the family day-care system.

F. Family day-care system setting.

1. The family day-care system shall have an office which shall serve as the headquarters of the system.

2. This office shall have:

a. Sufficient space for administration of the system, including all clerical functions;

b. Sufficient space to maintain privacy and confidentiality for conferences with parents who seek or use the services of the system and family day-care home operators who are members of the system; and

c. At least one working telephone, other than a pay phone, with a listed number which is available for system business. An emergency phone number shall be provided for the use of the homes in the system during any hours that children are in care if the system's telephone is not manned during those hours.

G. Determination of the number of homes that may be under contract to the system. In order to ensure timely and adequate service delivery, the maximum number of homes that may be under contract of the system shall be based on the following factors:

1. The number of system's office staff (NOTE: Persons who are approved as day-care providers and their assistants are not considered to be system's office staff.);

2. The geographical dispersion of homes with relation to the system office;

3. The type or types and needs of children served by the system;

4. The financial capabilities of the system; and

5. They types of program or programs and services offered by the system.

22VAC40-120-30. Personnel.* (Repealed.)

A. General Requirements.

1. No person convicted of a crime involving child abuse, child neglect or moral turpitude shall be a family day-care system owner, operator or employee.

2. The family day-care system owner, director, and all system employees shall be:

a. At least 18 years of age (EXCEPTION: Secretarial and custodial help may be younger than 18 years of age.);

b. Of good moral character and reputation;

c. Physically and mentally capable of carrying out assigned duties and responsibilities;

d. Emotionally stable with an understanding of problems and needs of children and their families; and

e. Qualified in accordance with the applicable educational training and experience requirements contained in these standards.

B. Personnel policies.

1. There shall be a written description for each staff position. This job description shall include:

a. The job title;

b. The functions assigned to the position, including authority and responsibility; and

c. Educational or experience, or both, requirements for the position.

2. A copy of the job description shall be made available to each person assigned to the position at the time of employment.

3. When a system has more than three employees, within the system's office, the system shall have written personnel policies outlining personnel practices as they affect both the employer and employee. A copy of these policies shall be readily accessible to each staff member and shall include at minimum:

a. Conditions of employment;

b. Conditions under which employment may be suspended or terminated;

c. Procedures for resignation;

d. Salary scales;

e. Provisions for paid vacation, sick leave, compensatory leave and holidays, if any;

f. Provisions for recurring evaluation of work performance of each employee at least annually;

g. A description of employee benefits;

h. Provisions for staff development and training through in-service training, attendance at conferences and workshops and educational leave; and

i. Grievance procedures.

C. The system staff.

1. Composition and size.

a. Composition and number of staff employed by the system shall be sufficient to assure:

(1) Compliance with these standards;

(2) The uninterrupted and timely provision of all services included in the system program to children, parents and homes that are members of the system.

b. In order to ensure timely and adequate service delivery, the number and composition of staff shall be determined by:

(1) The scope of the program and services offered by the system;

(2) The number of homes that are members of the system and their geographical location in relation to the system office;

(3) The number of children in care in homes that are members of the system;

(4) The capabilities and experience of the staff; and

(5) The total responsibilities assigned to each staff member and the time required to effectively carry out these responsibilities. Total responsibilities are those relating to inspection, supervision, monitoring, evaluation of member homes; providing training and technical assistance to operators and staff of member homes; providing referral services to parents and children; as well as administrative tasks and supervisory responsibilities.

c. Qualified staff members, who meet the applicable qualifications established by subdivision C 2 of this section shall be designated to perform each of the following functions:

(1) Day-to-day management, administration and supervision of system operations;

(2) Referral services to parents and children;

(3) Training, technical assistance and consultation to the staff of homes that are members of the system;

(4) Home visitation and approval which includes at minimum those functions and services relating to inspection, supervision, monitoring and evaluation of homes that are members of the system; and

(5) Clerical functions.

d. Multiple functions may be assigned to an individual staff member provided:

(1) The staff member meets the qualifications for each function as established by subdivision C 2 of this section; and

(2) The multiple assignment is consistent with the requirements of subdivision C 1 a of this section regarding the timely and uninterrupted delivery of services, and subdivision C 1 b of this section which provides for a determination of the required number and composition of staff.

2. Staff qualifications.

a. The director.

(1) There shall be one full-time staff member designated as the director of the system who shall be responsible for the overall day-to-day management, administration and supervision of system operations. In the case of an individual proprietorship or partnership the director may be the licensee.

(2) An individual assuming the duties of a director on or after the effective date of these standards shall have:

(a) A master's degree in early childhood education, child development, social work, education or psychology from an accredited college or university, or the equivalent as determined and approved by the department, plus three years of experience in any one or more of these fields, including two years experience in a supervisory, administrative or management capacity; or

(b) A bachelor's degree in early childhood education, child development, social work psychology or education from an accredited four year college or university, or the equivalent as determined and approved by the department, plus four years of experience in any of these fields, including two years experience in a supervisory, administrative or management capacity.

b. Referral, training and home visitation services.

(1) Responsibilities for referral, training and home visitation services shall be assigned to a permanent staff member or members. These services and responsibilities shall consist of:

(a) Referral services—Interviewing of parents and children and the referral of children to family day-care homes that are members of the system or to available health or social services as special needs are identified.

(b) Training services—Developing and providing training, technical assistance and consultation to the operators and staff of family day-care homes that are members of the system.

(c) Home visitation services—Visiting family day-care homes, for the purpose of approving homes in accordance with requirements established in 22VAC40-120-40 and any additional requirements established by the system and assuring continued compliance with these requirements. A full-time home visitation staff member shall be responsible for no more than 25 family day-care homes.

(2) Staff members designated to perform referral, training or home visitation services on or after the effective date of these standards shall have:

(a) A bachelor's degree in early childhood education, child development, social work, psychology or education from an accredited four year college or university or the equivalent as determined and approved by the department, or

(b) An associate degree, or equivalent, in human services, community and social service, or educational services or their equivalent as determined and approved by the department, from an accredited community college or four year college or university and two years supervised experience working in a child care center, residential children's facility, nursery school, family day-care home, or similar program providing care to children.

c. Clerical staff.

(1) The system shall employ sufficient clerical staff to keep correspondence, required records, accounts and files current and in good order.

(2) Clerical staff shall be qualified by both education and experience to perform assigned tasks.

d. Documentation of qualifications.

(1) The professional qualifications of staff members, established by subdivision C 2 of this section, shall be individually documented.

(2) The personal qualifications including those established by subdivision A 1 of this section shall be verified through character references.

(a) At least three references shall be obtained for each applicant.

(b) These references shall not be obtained from relatives of applicants.

(c) These references shall be in writing or there shall be a written notation of verbal references.

3. Staff development.

a. Provision shall be made for orientation for all staff. This shall be documented and recorded in the employee's record.

b. Prior to assuming their duties, new employees shall be given orientation and training in at least the following areas:

(1) The objectives and philosophy of the system;

(2) The services offered by the system;

(3) Confidential treatment of personal information;

(4) The policies and procedures that are applicable to their specific position and assigned duties and responsibilities; and

(5) The standards as they apply to the individual position.

c. A written plan of in-service training with specific well-defined objectives shall be prepared and implemented annually for each employee. A copy of this plan shall be filed in the employee's record and shall be made available to the department's representative upon request. (EXCEPTION: Clerical and custodial employees are exempt from this requirement.)

d. Attendance at conferences, seminars, workshops, institutes and academic courses related to the employee's assigned duties and responsibilities shall be encouraged.

D. Volunteers.

1. Any volunteers used shall:

a. Have qualifications appropriate to the services they render;

b. Be subject to laws and regulations governing the confidential treatment of personal information; and

c. Be selected on the basis of their ability to make a positive contribution to the program.

2. The system shall establish written requirements for the screening and selection of volunteers.

3. Duties and responsibilities of all volunteers shall be clearly defined in writing and differentiated from those persons regularly filling staff positions.

4. At least one staff member shall be assigned the responsibility for selection, orientation, training, scheduling, supervision and evaluation of volunteers.

5. The system shall not be dependent on the use of volunteers to ensure the basic provision of services on a continuous basis.

*The minimum personnel requirements and qualifications for family day-care providers and their staff are addressed in 22VAC40-120-40 B 1.

22VAC40-120-40. Services to system homes. (Repealed.)

A. Policies and agreements.

1. Policies. The system shall establish and maintain written policies regarding:

a. The roles, rights and responsibilities of the system in the supervision and approval of member homes and referral of children to those homes;

b. The roles, rights and responsibilities of homes that are members of the system;

c. The roles, rights and responsibilities of parents of children who are cared for in homes that are members of the system;

d. Procedures for consultation to prospective providers to include alerting them to zoning and other local ordinances;

e. Procedures for evaluation, selection and initial approval of homes as members of the system;

f. Orientation and training of operators and staff of homes that are members of the system;

g. The annual renewal of approval of homes as members of the system; and

h. Procedures to be followed to assure that all areas of non-compliance with approval requirements have been corrected.

2. Agreements.

a. The system shall have a written agreement with each member home which specifies at least the following:

(1) The home's agreement with the system's policies in the areas identified in subdivision A 1 of this section;

(2) The financial agreement between the system and the member home;

(3) The system's role in assisting the home in developing a plan to meet the needs of each child accepted for care;

(4) They system's role in planning for regular conferences between the home and parents of children in care;

(5) The system's responsibility for supervision of children's care and adjustment;

(6) The rights and responsibilities of the system to monitor, inspect, evaluate and approve member homes;

(7) The system's right to remove a child from the home and the conditions under which a child may be removed;

(8) That the home shall accept a child from any source other than the system responsible for the home without the prior approval of the system;

(9) Conditions under which the provider may take children away from the member home on a routine basis (In an unusual situation, the provider shall notify the system by telephone and secure system approval before taking a child out of the home.); and

(10) That the home shall release a child only to the persons specified in the child care agreement required by 22VAC40-120-50 A 5.

b. This agreement shall be signed prior to referral of children to the home.

B. Approval, monitoring and termination.

1. Approval, criteria and requirements. The system shall develop criteria and requirements that family day-care homes must meet to be approved as members of the system. At minimum these criteria and requirements shall address the following areas:

a. Qualifications of day-care providers and their staff that include establishing specific educational or experience requirements, or both, to assure that both providers and their staff are capable of providing acceptable care to children placed in the member home. At minimum the following basic qualifications must be met:

(1) A family day-care provider must be at least 18 years of age;

(2) A family day-care provider must be able to read and write;

(3) A family day-care assistant must be at least 14 years of age;

(4) Family day-care providers and any assistant or assistants must have the following personal attributes:

(a) An understanding of children and their problems together with an ability to relate to children with courtesy, respect, patience and affection, and understanding and respect for the child's family;

(b) An ability to handle emergencies with dependability and good judgment; and

(c) A motivation to contribute to children's wholesome development;

(5) Family day-care providers and any assistant or assistants shall be responsible, wholesome, emotionally stable people of good character and reputation;

(6) No person convicted of a crime involving child abuse, child neglect or moral turpitude shall be a family day-care provider or assistant.

b. Ratio of adults to children in care. Ratios shall be based at minimum on the number, ages and needs of children in care. The system shall require at least one adult for every eight children in care, and infants below the age of two years shall be counted as two children in determining staff requirements.

c. The physical environment which includes:

(1) Physical plant requirements (building and grounds) and requirements for maintenance and cleanliness;

(2) Furnishing and equipment appropriate to the ages of children in care;

(3) Toileting and bathing facilities;

(4) Lighting requirements;

(5) Absence of safety hazard; and

(6) Adequate space requirements for play activities and napping.

d. The water supply and sanitary disposal system shall be approved by the health officer, unless water is obtained from a municipal supply and the member home is connected to a municipal sewer line.

e. Care of children including at minimum supervision of children in care and the planning and providing of varied daily activities which are appropriate to the ages, needs, and capabilities of children in care. Children must be supervised at all times by an adult and shall not be left alone in the care of an assistant under the age of 18 years.

f. Methods of dealing with unacceptable behavior which prohibit harsh and unreasonable punishment.

g. Nutrition to assure that nutritious and adequate meals and snacks, in terms of quality and quantity, are provided each child.

h. Health information shall be maintained for the family day-care provider, assistant and assistants and for those household members who come in contact with children or handle food served to children, as described below:

(1) Initial tuberculosis examination and report.

(a) Prior to approval or contact with children, each individual shall obtain an evaluation indicating the absence of tuberculosis in a communicable form.

(b) Each individual shall submit a statement that he or she is free of tuberculosis in a communicable form, including the type or types of test or tests used and the result or results.

(c) The statement shall be signed by a licensed physician, the physician's designee, or an official of a local health department.

(d) The statement shall be filed in the individual's record.

(2) Subsequent evaluations.

(a) An individual who had a significant (positive) reaction to a tuberculin skin test and whose physician certifies the absence of communicable tuberculosis must obtain chest x-rays on an annual basis for the following two years.

(i) The individual shall submit statements documenting the chest x-rays and certifying freedom from tuberculosis in a communicable form.

(ii) The statements shall be signed by a licensed physician, the physician's designee, or an official of a local health department.

(iii) The statement shall be filed in the individual's record.

(iv) Screening beyond two years is not required unless there is known contact with a case of tuberculosis or development of chronic respiratory symptoms.

(b) Additional screening is not required for an individual who had a non-significant (negative) reaction to an initial tuberculin skin test.

(c) Any individual who comes in contact with a known case of tuberculosis or who develops chronic respiratory symptoms shall, within 30 days or exposure or development, receive an evaluation in accordance with subdivision B 1 h (1) of this section.

(3) At the request of the licensed system or the Department of Social Services, a report of examination by a licensed physician shall be obtained when there are indications that the safety of children in care my be jeopardized by the physical or mental health of a specific individual.

(4) Any individual who, upon examination or as a result of tests, shows indication of a physical or mental condition which may jeopardize the safety of children in care:

(a) Shall immediately be removed from contact with children;

(b) Shall immediately be removed from contact with food served to children; and

(c) Shall not be allowed contact with children or food served to children until the conditions cleared to the satisfaction of the examining physician as evidenced by a signed statement from the physician.

i. Fire safety to include appropriate emergency plans for evacuation of the home. The member home shall comply with any limitations which may be placed by the Virginia Fire Safety Regulations on the maximum number of children who may be in care.

j. Record keeping to include the records to be maintained in the home on each child and the content and format of each record.

k. Each member home shall have a working telephone on the premises with a listed number. The phone number for a doctor who may be called in an emergency, an ambulance service or rescue squad, the fire department and the police shall be posted near the phone.

2. Approval determination.

a. Prior to approval of any home, as a member of the system, the system shall determine that the home complies with the written criteria and requirements established by the system in accordance with subdivision B 1 of this section.

b. This determination of compliance shall be documented by a compliance investigation addressing, at minimum, the areas identified under subdivision B 1 of this section and an evaluation of all information provided as part of the application process.

c. The study shall also contain the following documentation:

(1) Health reports required by subdivision B 1 h of this section;

(2) Reports of at least three character references for the day-care provider and each member of the staff (These references shall be in writing or there shall be a written notation of verbal references.);

(3) A written record of previous training and experience of the day-care provider, if any; and

(4) Information to show how capacity was determined, including evaluation of any unusual conditions.

d. This study shall include interviews with all adult members of the household and at least two interviews with the day-care applicant or provider, one of which shall take place in the home where care will be provided to children.

3. Approval notification.

a. Within 30 days following the completion of the interviews required by subdivision B 2 d of this section, the system shall provide written notification to the applicant home of the results of the study, to include corrective action required.

b. If the home is approved, the notification to the provider shall include the capacity of the home. In no case shall the capacity exceed nine children, including children under six who are related by blood or marriage to the day-care provider.

c. If the day-care provider has responsibility for a handicapped person who requires special attention or services, this factor shall be considered in determining the approved capacity of the member home and the record of the home shall contain documentation of this evaluation.

d. If the home is approved, this notification shall be accompanied by an approval certificate which shall be posted in a place that is conspicuous to the public in each approved home.

4. Termination.

a. The system shall have written policies for suspension or termination of a member home.

b. The system shall notify the provider in writing of the reasons for suspension or termination within two weeks of such suspension or termination.

5. Annual approval. Each member home shall be approved annually. The same approval process shall be used as described in subdivisions B 1 through 3.

6. Monitoring.

a. Each member home shall be visited at least quarterly in order to assure that the home continues to comply with the system's standards.

(1) At least two of these visits shall be unannounced;

(2) The results of these visits shall be documented in the home's record.

b. The department, at any time, may make an announced or unannounced visit to a home that is a member of the system in order to assure continued compliance with the applicable provisions of this chapter. The results of such visits shall be provided to the system.

7. Annually the system shall provide the regional office of the Virginia Department of Social Services, from which the system's license to operate is issued, a current directory of approved homes that are members of the system.

a. The initial directory shall be provided 30 days after the system's initial license to operate is issued.

b. An updated directory shall be provided with the system's application for license renewal.

c. The directory shall contain at minimum the following information:

(1) The name of the day-care provider;

(2) The address of the member home;

(3) The telephone number of the member home; and

(4) The approved capacity of the member home.

8. Copies of the notification of member home approval and termination, required by subdivisions B 3 a and B 4 b of this section, shall also be provided by the system to the regional office of the Virginia Department of Social Services from which the system's license to operate was issued.

C. Training.

1. The licensee shall have on file at the system office separate written plans describing initial and on-going training of each provider. Each plan shall describe such training in detail and shall include a description of training topic covered, training materials used, frequency and duration of training sessions, persons and resources utilized within the system and from the community to implement training, names of trainers, training methodology, and the process used to evaluate the training program by both staff and providers.

2. Initial training.

a. Prior to acceptance or within the first six months after acceptance as a member home, the system shall provide initial training for each day-care provider.

b. Such training shall include at minimum a two-hour training session on each of the following areas, unless the system develops a method to certify equivalent competency in these subject areas. Such methods shall be subject to review and approval by the department.

(1) An orientation to the system;

(2) Organizing for family day-care;

(3) Child growth and development;

(4) Health care;

(5) First aid, home safety and fire safety;

(6) Nutrition;

(7) Child abuse and protection;

(8) Appropriate activities and toys for mixed age groups of children;

(9) Dealing with unacceptable behavior;

(10) Community resources;

(11) Parent and day-care provider relationships.

c. The licensee shall describe and document the content and hours of training received by each provider or the equivalent competency, or both. This documentation shall be kept on file at the system office as part of the day-care provider required by 22VAC40-120-60 C 2.

3. On-going training.

a. Within each succeeding year, following the completion of initial training, the licensee shall provide at least two hours of on-going, in-service training to providers each quarter.

b. The content of this training shall be determined by the system and shall be based on the needs of approved day-care providers. At minimum, it shall reinforce or expand on the areas identified in subdivision C 2 b of this section.

c. The licensee shall describe and document the content and hours of training received by each provider and shall keep this documentation on file at the system office as part of the day-care provider record required by 22VAC40-120-60 C 2.

4. A provider who refuses to participate in training shall be terminated as a member home.

D. Technical assistance and consultation.

1. The system has the responsibility to provide technical assistance and consultation to member homes.

2. Technical assistance and consultation include, but shall not be limited to, the following areas:

a. Provision of information and advice on child development, methods of dealing with unacceptable behavior, fire safety, working with exceptional children, dealing with stress or crisis, etc.;

b. Loans of toys and equipment, if available;

c. Provision of information on training resources available in the community on an on-going basis and as appropriate; and

d. Nutrition and menu planning on an on-going basis.

3. Technical assistance and consultation provided to member homes shall be recorded in the day-care provider record required by 22VAC40-120-60 C 2 e (5).

22VAC40-120-50. Services to children and families. (Repealed.)

A. Referral to system homes.

1. Children shall be referred only to homes which have been approved as required in subsection B of this section.

2. No child shall be referred to a home which has reached its approved capacity.

3. Referrals shall be made only after a personal interview between a representative of the system and the parent or parents and child. Prior to acceptance of a child for care, the parent and child or children shall visit the home where care will be provided.

4. When a child is accepted for care and payment will be made by a local department of public welfare or social services, the system shall seek approval from that department prior to referral of the child for care.

5. When a child is accepted for care and a referral is made to a home that is a member of the system, there shall be a written agreement between the system and parent or parents or guardian or guardians of the child. A copy of the signed agreement shall be given to the parent or parents or guardian or guardians and a copy shall also be retained and filed by the system at the system office. Additionally, the requirements of subdivisions A 6 and 7 also apply.

6. The child care agreement shall address the following items:

a. Child's name, birth date, home address, and home telephone number;

b. Names and addresses of parent or parents or guardian or guardians and telephone number at which they can be reached during hours the child is in care;

c. A statement that a child brought to the home shall be left with a staff member and released only to the parent or parents or other specified person or persons;

d. The hours the child will be in care;

e. The name, address, and telephone number of the child's physician;

f. Emergency medical authorization;

g. Transportation arrangements;

h. Notes of any special problems or needs of a child;

i. Granting or denying permission for field trips;

j. Granting or denying permission for participation in water activities, such as swimming and wading;

k. Any other referral information;

l. Agreement regarding the home in which the child will be placed;

m. Financial arrangements for care;

n. A statement that staff members of both the system and member home in which the child receives care shall be available for parent conferences;

o. Information regarding the means by which care will be provided in the event the primary day-care provider is ill, on vacation or other wise unavailable due to an emergency; and

p. Information regarding the role of the system in referral of children in care in a home that is terminated as a member of the system.

7. The child care agreement may be a one or two part agreement at the option of the system.

a. When a one part agreement is used it shall:

(1) Be signed by the parent or parents of the child, a representative of the system and the day-care provider in whose home the child will receive care.

(2) A copy of this agreement shall be provided by the system to the member home in which the child will receive care.

b. When the system elects to use to two part agreement the following standards apply:

(1) Part one:

(a) Shall contain all items specified in subdivision A 6 except financial arrangements for care (See subdivision A 6 m);

(b) Be signed by the parent or parents of the child, a representative of the system and the day-care provider in whose home the child will receive care; and

(c) A copy shall be provided by the system to the member home in which the child will receive care.

(2) Part two:

(a) Shall contain the financial information required by subdivision A 6 m and any other information that the system deems appropriate;

(b) Shall be signed by the parent or parents of the child and a representative of the system.

8. Health requirements for children.

a. Timing and frequency of medical reports:

(1) Each child accepted for care shall obtain a physical examination by or under the direction of a licensed physician prior to admission (as outlined below) or within 30 days after admission:

(a) Within 60 days prior to admission for children six months of age and younger;

(b) Within 90 days prior to admission for children seven months through 18 months of age;

(c) Within six months prior to admission for children 19 months through 24 months of age;

(d) Within 12 months prior to admission for children two years of age through five years of age;

(e) Within 24 months prior to admission for children six years of age and above.

EXCEPTIONS:

(i) Children transferring from one facility licensed by the Virginia Department of Social Services, certified by a local department of public welfare or social services, or approved by a licensed family day care system:

If the initial report of physical examination and immunizations is submitted to the new home, no additional examination is require. If the initial report is not available, a report of physical examination and immunizations is required.

(ii) Physical examinations are not required for any child whose parent or guardian objects on religious ground. The parent or guardian must submit a statement noting that the parents or guardian objects on religious grounds and certifying that, to the best of the parent's or guardian's knowledge, the child is in good health and free from communicable and contagious disease.

(2) Medical reports after admission:

(a) Updated information on immunizations received shall be obtained once every six months for children under the age of two years.

(b) Updated information on immunizations received shall be obtained once between each child's fourth and fifth birthdays.

b. Form and content of medical reports:

(1) The current form approved by the Virginia Department of Health, or any other form which provides all of the same information shall be used to record immunizations received and the results of the required physical examination.

(2) Each report shall include the date of the physical examination or the dates immunizations were received, or both.

(3) Each report shall be signed by a licensed physician, the physician's designee, or an official of a local department of health.

EXCEPTION: Documentation of immunizations received is not required for any child whose parent or guardian submits an affidavit to the center stating that the administration of immunizing agents conflicts with the parent's or child's religious tenets or practices.

9. An emergency medical authorization form shall be provided the home at the time the child enters care. (NOTE: At the discretion of the system this form may be part of the child care agreement required by subdivision A 6.)

a. The emergency medical authorization form shall be signed by the parent or parents, the provider, and a representative of the system.

b. A copy of the signed emergency medical authorization form shall also be filed in the child's record that is maintained in the system's office.

10. The system shall make arrangements for substitute or back-up care when a day-care provider in a member home needs assistance in any emergency or during illness or vacation. Such care may be provided by a staff person approved as a system assistant or another member provider with available enrollment capacity.

11. They system shall confer with the parent of each child at least twice a year concerning the child's progress and the parents' view of the adequacy of care being provided. This contact may be by telephone or in person at the discretion of the parent or parents involved.

B. Referral to health and social services.

1. The licensee shall have on file a written plan describing how the need for medical and social services is determined and how social services are made available, either within the system or by arrangement with specific public or private community agencies, or both. This written plan shall include the system's policy and procedures for referral of children and their parents to appropriate social, mental health, welfare and medical services.

2. The licensee shall maintain a written record of all referrals of children and their families to social, mental health, welfare, and medical services which shall include the results of such referrals, when reports of such results are provided to the system.

C. Complaint investigation. The family day-care system shall be responsible for investigation of any complaint received on any home that is a member of its system. When a system receives such a complaint, the following Standards apply:

1. The complaint shall be recorded on a complaint record which shall include at minimum the information required by 22VAC40-120-60 C 5 b.

2. A copy of this completed record shall be placed in the file of the home against which the complaint was made and a copy shall be provided the regional office of the Virginia Department of Social Services from which the family day-care system's license to operate is issued. This copy shall be provided within 10 days of the date the complaint investigation is completed.

3. When the complaint concerns a specific child, a copy of the completed record shall be placed in the file of the child.

4. A complete investigation shall be made, by the licensee, of each complaint received. This investigation shall:

a. Be initiated within five working days following the receipt of the complaint:

b. Completed within 14 days following receipt of the complaint; and

c. Include at least one visit to the family day-care home on which the complaint was received.

5. If the complaint is found to be valid, corrective action shall be initiated immediately.

6. When the complaint includes an accusation of child abuse or neglect, the following Standards also apply:

a. The complainant shall be referred to the protective services unit of the local department of public welfare or social services in the locality where the home is located.

b. The family day-care system shall notify the local department of public welfare or social services child protective services' staff member immediately and provide all information regarding the complaint. The oral notification shall be confirmed in writing within 72 hours and a copy placed in the file of the home against which the complaint was made. Simultaneously, a copy of this written notification shall also be provided the regional office of the Virginia Department of Social Services from which the family day-care system's license to operate is issued.

c. The system shall make its own investigation within 24 hours. A joint investigation by the protective services worker of the local department of public welfare or social services and a representative of the system is encouraged to the maximum extent possible.

22VAC40-120-60. Records. (Repealed.)

A. General requirements.

1. Any forms used for record keeping shall contain at minimum the information specified in these Standards. Model forms, which may be copied, will be supplied by the department upon request.

2. If any model form developed by the department is not used, the substitute form shall be approved by the department.

3. All records shall be kept in a locked area.

4. The licensee shall have the responsibility for assuring that all records are treated confidentially and that information shall be made available only when needed for proper care of the children referred to homes who are members of the system. (EXCEPTION: All records shall be made available for inspection by the department's representative. See 22VAC40-120-10 D 3 b.)

B. Written policies and procedures. The following written policies and procedures shall be developed by the system. Copies shall be maintained in a permanent file within the system office. Those so identified shall also be permanently filed in homes that are members of the system.

1. Policies and procedures pertaining to operation and management of the system:

a. Written goals which clearly describe the philosophy and objectives of the family day-care system and address those areas specified in 22VAC40-120-20 C 1. A copy of these written goals shall be provided to each home that is a member of the system.

b. Written policies and procedures which address system services to be provided to member homes and services to be provided to children and their families. (See 22VAC40-120-20 C 2.) Copies of these policies and procedures which relate to services to be provided to member homes and to children and their families shall be provided to each home that is a member of the system.

c. Written by-laws, when the family day-care system is sponsored by an association or corporation.

2. Policies and procedures pertaining to staff employed in the system office.

a. A written job description for each staff position which exists in the system office. Each job description shall address the areas identified in 22VAC40-120-30 B 1.

b. Written policies which outline personnel practices as they affect both the employer and employee. These policies shall include the areas identified in 22VAC40-120-30 B 3.

c. Written requirements for the screening and selection of volunteers, if volunteers are used. (See 22VAC40-120-30 D 2.)

d. Written definition of the duties and responsibilities of volunteers. (See 22VAC40-120-30 D 3.)

3. Policies and procedures pertaining to member homes.

a. Policies and procedures which describe the selection, evaluation, approval and general management of homes which are members of the system and cover at minimum those areas specified in 22VAC40-120-40 A 1.

b. Specific criteria and requirements which family day-care homes must meet to be approved as members of the system. At minimum these criteria and requirements shall address the areas specified in 22VAC40-120-40 B 1.

c. Policies for suspension or termination of a home that is a member of the system. (See 22VAC40-120-40 B 1.)

d. Copies of the policies and procedures, required by subdivisions B 3 a, b, and c shall be provided to each home that is a member of the system.

C. System records. The following records shall be maintained by the system in a permanent file within the system office. Those so identified shall also be provided to each home that is a member of the system.

1. Records on the system.

a. An organization chart (See 22VAC40-120-20 B 3 h.)

b. Financial records which are consistent with generally accepted accounting principles and reflect a separation of system accounts form all other records. (See 22VAC40-120-20 D 2.)

c. An inventory of all real property and equipment belonging to the system. (See 22VAC40-120-20 B 3 1.)

d. A schedule of fees charged for services provided. (See 22VAC40-120-20 D 3 a.)

e. A schedule of payments to be made to homes that are members of the system which contains the items required by 22VAC40-120-20 D 3 b. A copy of this schedule shall be provided to each home who is a member of the system.

f. Minutes of all meetings of the corporate or association governing board. (See 22VAC40-120-20 B 2 b.)

2. Records on homes who are members of the system.

a. An individual record shall be maintained on each home that is approved as a member of the system.

b. This record shall be established when the home applies for membership in the system and shall be maintained in the system office.

c. The record shall be kept current.

d. The complete record shall be retained until two years after the home withdraws or is terminated as a member of the system.

e. It shall contain at minimum the following information and documentation:

(1) A copy of the agreement with the member home as required by 22VAC40-120-40 A 2 a. A copy of this agreement shall be on file in the member home.

(2) A copy of each compliance study completed on the home and required by 22VAC40-120-40 B 2 b.

(3) The report of each quarterly visit to the home as required by 22VAC40-120-40 B 6 a (2).

(4) A record containing the name of each child who has been referred to the home for care, the date of referral and in those cases where care has been terminated, the date and reason for termination.

(5) A notation of all technical assistance and consultation provided to the home as required by 22VAC40-120-40 D 3.

(6) The following personal and social data on each day-care provider.

(a) Name;

(b) Birthdate;

(c) Current address and telephone number;

(d) Last previous employment;

(e) For providers who are accepted as members of the system after the effective date of these Standards, copies of at least three references or notations of verbal references reflecting the date of the reference, the source and the content;

(f) A statement signed by the day-care provider reporting any convictions of law violations excluding traffic violations and offenses committed before his or her eighteenth birthday which were finally adjudicated in a juvenile court or under a youth offender law;

(g) Previous experience or training, or both;

(h) Social Security number;

(i) Name and telephone number of person to contact in an emergency; and

(j) Date and reason for termination as a member of the system.

(7) The following personal and social data for each person employed by the provider as a staff member in the home:

(a) Name;

(b) Birthdate;

(c) Current address and telephone number;

(d) Position and date employed;

(e) Last previous employment;

(f) For persons who are employed after the effective date of this chapter, copies of at least two character references or notations of verbal references reflecting the date of the reference, the source and the content;

(g) A statement signed by the staff member reporting any convictions of law violations excluding traffic violations and offenses committed before his or her eighteenth birthday which were finally adjudicated in a juvenile court or under a youth offender law;

(h) Previous experience or training, or both;

(i) Social Security number;

(j) Name and telephone number of person to contact in an emergency;

(k) Notations of formal training received following employment; and

(l) Date and reason for termination of employment.

(8) The health related statements required by 22VAC40-120-40 B 1 h.

(9) The provider training plan, the record of initial provider training and the record of on-going provider training required by 22VAC40-120-40 C 1, 2, c, and 3 c.

(10) A copy of the record of each complaint received on the home as required by 22VAC40-120-50 C 2. (See subdivision C 5 for content of this record.)

3. Records of persons employed in the system office.

a. An individual record shall be maintained on each staff member employed in the system office.

b. This record shall be established when the individual is employed and shall not be destroyed until two years after employment is terminated.

c. The record shall be kept current.

d. It shall contain at minimum the following:

(1) Personal and social data:

(a) Name;

(b) Birthdate;

(c) Current address and telephone number;

(d) Position and date employed;

(e) Last previous employment;

(f) For persons employed after the effective date of this chapter, copies of at least three references or notations of verbal references reflecting the date of the reference, the source and the content;

(g) A statement signed by the employee reporting any convictions of law violations excluding traffic violations and offenses committed before his or her eighteenth birthday which were finally adjudicated in a juvenile court or under a youth offender law;

(h) Previous experience or training, or both;

(i) Social Security number;

(j) Name and telephone number of person to contact in an emergency;

(k) Notations of formal training received following employment; and

(l) Date and reason for termination of employment.

(2) The record of staff orientation required by 22VAC40-120-30 C 3 a.

(3) The annual plan for in-service training required by 22VAC40-120-30 C 3 c.

4. Records on children referred for care.

a. An individual record shall be maintained on each child accepted by the system and referred to a member home for care.

b. This record shall be established when the child is accepted for care.

c. The record shall be kept current.

d. It shall contain at a minimum the following:

(1) A copy of the child care agreement required by 22VAC40-120-50 A 5, 6, and 7;

(2) A record of placement which contains the name of each home in which the child has received care, the date referred for care and the date and reason care was terminated;

(3) A copy of the medical information required by 22VAC40-120-50 A 8;

(4) A copy of the emergency medical authorization form required by 22VAC40-120-50 A 9;

(5) A record or each referral of the child and/or the family to social, mental health, welfare and medical services as required by 22VAC40-120-50 B 2.

e. A copy of the records required by subdivisions C 4 d (3) and (4), shall be on file in the member home in which the child is provided care.

5. Complaint records.

a. Each complaint shall be recorded on a complaint record. (See 22VAC40-120-50 C 1.)

b. The complaint record shall include at minimum the following information:

(1) Name and address of the family day-care home;

(2) Name, address and telephone number of the complainant;

(3) Method by which the complaint was made, including the date and time received;

(4) Person receiving the complaint;

(5) A description of the complaint, including dates and times, where applicable;

(6) Findings and action taken to include whether the complaint was found to be valid, invalid or validity not clearly determined;

(7) The name of the person or persons who investigated the complaint and the date the investigation was completed; and

(8) The date the complainant was notified of the results of the investigation.

c. When the complaint includes an accusation of child abuse or neglect, a copy of the written notification required by 22VAC40-120-50 C 6 shall be attached to the complaint record and filed as a permanent part of that record.

d. Release of information regarding the identity of the complainant shall be governed by the provisions of the Privacy Protection Act, Chapter 26 (§ 2.1-377 et seq.) of Title 2.1 of the Code of Virginia.

CHAPTER 121

STANDARDS FOR LICENSED FAMILY DAY SYSTEMS

Part I

General Provisions

22VAC40-121-10. Definitions.

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

"Accessible" means capable of being entered, reached, or used.

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

"Age-appropriate" means suitable to the chronological age and individual needs of a child.

"Assistant" means an individual who helps the provider or substitute provider in the care, protection, supervision, and guidance to children in the member home.

"Body fluids" means urine, feces, vomit, blood, saliva, nasal discharge, and tissue discharge.

"Caregiver" means an individual who provides care, protection, supervision, and guidance to children in the home and includes the provider, substitute provider, and assistant.

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

"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 under the age of 13 for less than a 24-hour period.

"Child with special needs" means a child with developmental disabilities, mental retardation, emotional disturbance, sensory or motor impairment, or significant chronic illness who requires special health surveillance or specialized programs, interventions, technologies, or facilities.

"Cleaned" means treated in such a way as to remove dirt and debris by scrubbing and washing with soap and water or detergent solution and rinsing with water.

"Commissioner" means the Commissioner of the Virginia Department of Social Services.

"Complaint" means an accusation received either orally or in writing that (i) a licensed family day system is not in compliance with one or more of these standards or one or more statutory requirements; (ii) a family day system home is not in compliance with one or more applicable requirements of these standards or one or more requirements established by the family day system; or (iii) a child in care of a family day home that is a member of a licensed family day system is being abused or neglected as defined by § 63.2-100 of the Code of Virginia.

"Department" means the Virginia Department of Social Services.

"Department's representative" means an employee or designee of the Virginia Department of Social Services, acting as the authorized agent of the commissioner.

"Director" means the licensee or a person designated by the licensee who oversees the day-to-day operation of the system including compliance with all standards for licensed family day systems.

"Evacuation" means movement of occupants out of the building to a safe area near the building.

"Family day system" or "system" means any person who approves family day homes as members of its system; who refers children to available family day homes in that system; and who, through contractual arrangement may provide central administrative functions including, but not limited to, training of operators of member homes; technical assistance and consultation to operators of member homes; inspection, supervision, monitoring, and evaluation of member homes; and referral of children to available health and social services.

"Good character and reputation" means knowledgeable and objective people agree that the individual (i) maintains business, professional, family, and community relationships that 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.

"Inaccessible" means not capable of being entered, reached, or used.

"Infant" means a child from birth up to 16 months of age.

"Licensee" means the person or persons to whom the family day system license is issued.

"Licensing office" means the office of the Virginia Department of Social Services from which the family day system's license to operate was issued.

"Member home" means any family day home that is an approved member of a family day system where care is provided for one to 12 children under the age of 13 exclusive of the provider's own children and any children who reside in the home. Family day homes that are members of a licensed family day system and are approved by that system to care for six to 12 children are, by law, not subject to direct licensure by the department.

"Nighttime care" means care provided between 7 p.m. and 6 a.m.

"Parent" means the biological, foster or adoptive parent, legal guardian, or any individual with responsibility for, or custody of a child enrolled or in the process of being admitted to a family day system home.

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

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

"Provider" means an individual who is approved by the family day system and who has primary responsibility for providing care, protection, supervision and guidance for children in the family day system home.

"Referral" means any activity by the family day system that provides assistance in locating or arranging day care for children in homes that have been accepted or approved as members of the system, or in locating or arranging for health or social services from other sources based upon identified needs.

"Relocation" means movement of occupants of the building to a safe location away from the vicinity of the building.

"Residence" means principal legal dwelling or abode that is occupied for living purposes by the provider and contains the facilities necessary for sleeping, eating, cooking, and family living.

"Sanitized" means treated in such a way as to remove bacteria and viruses from inanimate surfaces through first cleaning and secondly using a solution of one tablespoon of bleach mixed with one gallon of water and prepared fresh daily or using a sanitizing solution approved by the U.S. Environmental Protection Agency.  The surface of the item is sprayed or dipped into the sanitizing solution and then allowed to air dry.

"School age" means eligible to attend public school, age five or older by September 30 of that same year.

"Serious injury" means a wound or other specific damage to the body such as, but not limited to, unconsciousness; broken bones; dislocation; deep cut requiring stitches; poisoning; concussion; foreign object lodged in eye, nose, ear, or other body orifice.

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

"Staff" or "staff person" means a person working for the licensee who is compensated or has a financial interest in the business of the licensee, regardless of role, service, age, function or duration of employment with the licensee. Staff or staff person also includes persons hired through a contract to provide services for the licensee.

"Substitute provider" means an individual who meets the qualifications for a provider, is designated by the provider and approved by the system, and who is readily available to provide substitute child care in the member home.

"Time out" means a discipline technique in which a child is moved for a brief time away from the stimulation and reinforcement of ongoing activities and other children in the group to allow the child who is losing self-control to regain composure.

"Toddler" means a child from 16 months of age up to 24 months of age.

Part II

System Administration

22VAC40-121-20. Operational responsibilities.

The licensee shall:

1. Ensure compliance with these standards; the terms of the current license issued by the department; relevant federal, state or local laws, and other relevant regulations; and the system's own policies and procedures;

2. Give evidence of financial responsibility;

3. Meet the requirements specified in 22VAC40-191, Background Checks for Child Welfare Agencies;

4. Meet the requirements specified in 22VAC40-80, General Procedures and Information for Licensure;

5. Ensure that the system's and member homes' activities, services, and facilities are conducive to the welfare of children in care;

6. Develop and maintain an operating budget that is sufficient to ensure adequate funds in all aspects of operation;

7. Maintain financial records that show separation of the system's accounts from all other accounts;

8. Ensure that the system keeps such records, makes such reports and maintains such plans, schedules, and other information as required by this chapter for licensed family day systems. The system shall submit, or make available, to the department's representative, records, reports, plans, schedules, and other information necessary to establish compliance with this chapter and applicable law. Such records, reports, plans, schedules, and other information shall be maintained at the system and may be inspected at any reasonable time by the department's representative;

9. Develop a written program description for the system that shall be available to prospective member homes, parents and the general public and that shall include the following elements:

a. The mission of the system;

b. The system's organizational structure;

c. Population to be served;

d. Geographical area to be served;

e. Services to be provided to member homes; and

f. Services to be provided to families and children who use the system;

10. Develop written policies and procedures for the operation of the system that include:

a. The roles, rights, and responsibilities of the system in the supervision and approval of member homes and referral of children to those homes;

b. Criteria for approving, suspending, and terminating member homes;

c. The roles, rights and responsibilities of member homes;

d. The roles, rights and responsibilities of parents of children who are cared for in member homes;

e. Orientation and training of providers;

f. Procedures for technical assistance and consultation to providers, to include providing information on zoning and other pertinent local ordinances;

g. Procedures for selection, evaluation, inspection, supervision, and monitoring of member homes;

h. Policies and procedures for referral of children to member homes;

i. Policies and procedures for referral of children to available health and social services;

j. Procedures for the annual re-approval of member homes including procedures to be followed to ensure that member homes correct all areas of noncompliance prior to re-approval;

k. Procedures for investigations of complaints about member homes; and

l. Procedures for notifying parents when a member home closes or when a member home's approval has been suspended or terminated;

11. Meet the qualifications of the requirements for the director if he serves as the director of the system;

12. At all times allow the department's representative reasonable opportunities to conduct announced and unannounced inspections of member homes;

13. Ensure that any advertising is not misleading or deceptive as required by § 63.2-1713 of the Code of Virginia; and

14. Ensure that information, brochures, and materials distributed or available to the public contain accurate and updated information.

22VAC40-121-30. Fees and payments.

The family day system shall:

1. Maintain a current written schedule of fees charged to parents for services provided;

2. Make applicable fee schedules available to parents who seek to use or use the services of the system, homes that apply for membership in the system, and the department as part of the application for licensure;

3. Establish and maintain a current written schedule of payments to be made to member homes that specifies the amount of payment, conditions of payment and frequency of payment;

4. Provide the schedule of payments to member homes, to the department as part of the application for licensure and when requested by the department, and, when applicable, to parents who seek to use or use the services of the system; and

5. Develop and implement a written policy for collection of fees from parents and disbursement of payments to member homes.

22VAC40-121-40. Family day system setting.

A. The family day system shall have an office in Virginia that shall serve as the headquarters of the system.

B. The system office shall have:

1. Sufficient space for administration of the system, including all clerical functions;

2. Sufficient space to maintain privacy and confidentiality for conferences with parents who seek or use the services of the system and with home providers;

3. At least one working telephone, other than a pay phone, with a listed number that is available for system business; and

4. An emergency telephone number for use during hours that the system's telephone is not manned and the number shall be provided to member homes to use during any hours that children are in care.

22VAC40-121-50. Determination of number of member homes.

In order to ensure timely and adequate service delivery, the maximum number of family day homes that may be member homes of the system shall be based on the following factors:

1. The number of the system's office staff. Persons who are approved as day care providers and their assistants shall not be considered as office staff;

2. The geographical dispersion of homes with relation to the system office;

3. The financial capabilities of the system;

4. The types and needs of children served by the system; and

5. The types of programs and services offered by the system.

22VAC40-121-60. Reporting requirements.

A. The system shall notify the department‘s representative prior to implementation of any major change in the program, services provided, or administrative structure. 

B. The system shall notify the department‘s representative no later than 10 days following any change in the director of the system.

C. The system shall, as specified in § 63.2-1509 of the Code of Virginia, notify the local department of social services or the toll-free Child Abuse and Neglect Hotline whenever there is reason to suspect that a child has been subjected to abuse or neglect by a provider or any other person.

D. The system shall notify the department‘s representative of any of the following by the next working day after the system learns of their occurrence:

1. Serious injury to a child while in the care of a provider;

2. Lost or missing child while in the care of a provider;

3. Death of a child while in the care of a provider;

4.Imminent danger or hazard that threatens the health and safety of children in a member home.

5. Damage to the system's office that affects the operation of the system; and

6. Unanticipated permanent or temporary cessation of the operation of the system.

E. The system shall send a current directory of member homes to the department's representative no later than 30 days following the licensee's receipt of the initial system's license and shall provide a current directory to the department's representative quarterly thereafter. The directory shall contain the following information for each member home:

1. Name of the member home provider;

2. Street address of the member home;

3. Telephone number of the member home; and

4. Approved capacity of the member home.

22VAC40-121-70. General requirements for records.

A. Any forms used for record keeping shall contain at minimum the information specified in these standards.

B. All records when not in use shall be kept in a locked area.

C. All records required by this regulation shall be kept current.

22VAC40-121-80. Public access to records.

A. The family day system shall make the following information available for public review:

1. Confirmation that a family day home is a member of the system;

2. Evaluation and monitoring reports, reflecting the results of the system's evaluation and monitoring of the member home;

3. Enforcement letters or other notification or written notices from the system to the member home requiring correction of violations of sections 22VAC40-121-510 through 22VAC40-121-1370 of this regulation; and

4. Correspondence to the system from the department regarding the systems' enforcement actions taken against the member home.

B. Documents, materials, and correspondence required by this chapter, including records and reports on children and caregivers of the member homes, shall be maintained and made accessible to the department's representative for two years from the date of termination of a member home and, in the case of a child, two years from the date of termination of services for the child.

C. If the system provides copies of information to individuals who have requested written information, the system shall not charge more than the actual cost incurred in assessing, duplicating, supplying, or searching for the information requested. All charges for supplying the requested records shall be estimated in advance at the request of the requestor.

22VAC40-121-90. Confidentiality.

The system shall keep confidential and not part of the public record the following:

1. Records, reports, and correspondence that pertain to child abuse or neglect investigations involving enrolled children;

2. Names of enrolled children and their parents;

3. Confidential information with regard to specific system personnel;

4. Any information on reports of inspection or complaint investigations that are still in progress; and

5. Other material required by state law to be confidential.

PART III.

System Personnel

22VAC40-121-100. General staff qualifications.

A. The staff persons, volunteers, and any other persons who are alone with, in control of, or supervising one or more children, or involved in the day-to-day operations of the system shall comply with requirements for background checks in 22VAC40-191, Background Checks for Child Welfare Agencies.

B. Each staff person and volunteer of a system shall be:

1. 18 years of age or older;

2. Of good character and reputation;

3. Physically and mentally capable of carrying out assigned duties and responsibilities;

4. Emotionally stable with an understanding of problems and needs of children and their families; and

5. Qualified in accordance with the applicable educational training and experience requirements contained in these standards.

22VAC40-121-110. Position descriptions.

A. There shall be a written description for each staff position that includes the following:

1. Job title;

2. Functions assigned to the position, including authority and responsibility; and

3. Education or experience, or both, required for the position.

B. A copy of the position description shall be made available to each person assigned to the position at the time of employment and a copy retained in the staff person's record.

22VAC40-121-120. Qualifications of the director.

A. Each system shall have one full-time staff person designated as the director.

B. The director shall have:

1. A master's degree in early childhood education, child development, social work, psychology, human services, or a child-related field from an accredited college or university, or the equivalent as determined and approved by the department, plus three years of experience in any one or more of these fields, including two years experience in a supervisory or management capacity; or

2. A bachelor's degree in early childhood education, child development, social work, psychology, human services, or a child-related field from an accredited college or university, or the equivalent as determined and approved by the department, plus four years of experience in any of these fields, including two years experience in a supervisory or management capacity.

C. The professional qualifications of the director shall be documented in the director's record.

22VAC40-121-130. Responsibilities of the director.

A. The director shall be responsible for the overall day-to-day management, administration and supervision of systems operations.

B. The director shall ensure assignment of sufficient qualified staff to operate the system.

C. The director shall designate a staff person to serve in the director's absence.

22VAC40-121-140. Qualifications of referral and home visitation staff.

A. Staff persons designated to perform referral or home visitation services shall have:

1. A bachelor's degree in early childhood education, child development, social work, psychology, human services, or a child-related field from an accredited college or university or the equivalent as determined and approved by the department; or

2. An associate degree, or equivalent, in a child-related field, human services, community and social services, or educational services from an accredited college or university or the equivalent as determined and approved by the department, and two years supervised experience working in a child day center, children's residential facility, family day home, or similar program providing care to children.

B. The professional qualifications of referral and home visitation staff shall be documented in the staff person's record.

22VAC40-121-150. Qualifications of trainers.

A. All trainers used, including those under contract, shall have an associate of arts, bachelor of arts, bachelor of science, or advanced degree in early childhood education, child development, home economics, psychology, nursing, social work, special education or related field from an accredited college or university.  The degree shall directly relate to the area of training.

B. Alternatives to the education requirements in subsection A of this section shall only be considered on an individual basis for specialized subject matter that is relevant for child care providers but that does not require academic preparation in early childhood education.  The trainer shall provide the following documentation to the system in order for the system to consider accepting any alternative education requirements:

1. Written description of education related to the field of expertise under consideration; and

2. Brief explanation of how the area of expertise relates to early childhood care.

C. The professional qualifications of trainers shall be documented in the trainer's record.

22VAC40-121-160. Responsibilities of referral, training, and home visitation staff.

A. Responsibilities for referral, training and home visitation services shall be assigned to qualified system staff.

1. Referral services and responsibilities include interviewing parents and children and referring children to member homes, available health or social services as appropriate and as needs are identified.

2. Training services and responsibilities include developing and providing training, technical assistance and consultation to providers and staff of family day member homes.

3. Home visitation services and responsibilities include visiting providers interested in being approved as a system home and visiting approved member homes, for the purpose of inspecting, evaluating, approving, supervising and monitoring member homes in accordance with the requirements of these standards.

B. A full-time home visitation staff person shall be responsible for no more than 30 member homes. Two years after the effective date of the regulation, a full-time staff person shall be responsible for no more than 35 member homes. Four years after the effective date of the regulation, a full-time home visitation staff person shall be responsible for no more than 40 member homes.

22VAC40-121-170. Clerical or support staff.

A. The system shall employ sufficient clerical or support staff to keep correspondence, required records, accounts and files current and in good order.

B. Clerical or support staff shall be qualified by both education and experience to perform assigned tasks.

22VAC40-121-180. Volunteers.

A. A system that uses volunteers shall have a written plan for their selection, orientation, training, supervision and assignment.

B. At least one staff person shall be assigned the responsibility for selection, orientation, training, scheduling, supervision and evaluation of volunteers.

C. A volunteer who is used to perform any staff function or responsibility shall meet the qualifications of the position and the general staff qualifications as required by 22VAC40-121-100.

D. The system shall not be dependent on the use of volunteers to ensure the basic provision of services on a continuous basis.

22VAC40-121-190. Staff orientation and training.

A. Prior to assuming their duties, staff persons, including a newly employed director, shall be given orientation in the following areas:

1. The system's program description;

2. Services offered by the system;

3. Confidential treatment of personal information;

4. Recognizing and reporting child abuse or neglect;

5. System's policies and procedures; and

6. Standards in this chapter that relate to the individual's job description.

B. Staff, except custodial staff, shall annually obtain a minimum of eight clock hours of training through in-service training programs or institutes, workshops, classes or conferences.

1. The training shall be in areas related to the staff person's assigned duties and responsibilities and shall include an update to the topics covered during orientation.

2. Training shall be conducted by trainers who meet the qualifications in 22VAC40-121-150.

C. Documentation of orientation and training, including the date and total hours of training received, the content of the training, and the name of the organization or person who sponsored the training shall be filed in the staff person's record.

22VAC40-121-200. Records for system staff and volunteers.

A. The system shall maintain a record on each staff person and volunteer.

B. The record shall contain at minimum the following:

1. Personal and social data.

a. Name;

b. Verification of age;

c. Current address and telephone number;

d. Position description and date employed or date volunteer service began;

e. Last previous employment;

f. For director and for referral, training and home visitation staff, professional qualifications;

g. Copies of at least three references or notations of verbal references reflecting the date of the reference, the source and the content;

h. Background checks, including criminal record checks, child abuse and neglect central registry checks and sworn disclosure statements, as required in 22VAC40-191, Background Checks for Child Welfare Agencies;

i. Previous experience and training;

j. Name and telephone number of a person to contact in an emergency; and

k. Date and reason for termination of employment.

2. Documentation of orientation and annual training received following employment as required in 22VAC40-121-190.

C. The records for staff and volunteers shall be retained by the system until two years after employment or volunteer service is terminated.

Part IV

Services to Member Homes

22VAC40-121-210. Member home approval determination.

A. The system shall obtain a written application from each provider seeking approval as a member home.

B. The system's investigation of the applicant member home shall include interviews with all adult members of the household and at least two interviews with the provider, one of which shall take place in the home where care will be provided to the children.

C. Prior to approving a provider to operate a member home, the system shall determine that the provider complies with the requirements of sections 22VAC40-121-510 through 22VAC40-121-1370 of this regulation.

D. The system shall evaluate and consider the following when determining the capacity of the member home:

1. The availability of adequate space to allow each child free movement and active play indoors and outdoors as required by 22VAC40-121-740; and

 2. The provider's responsibility to care for another individual who may require special attention or care, including but not limited to an elderly resident or a child with a serious physical, emotional, or behavioral condition.

E. The capacity of the member home shall not exceed 12 children, excluding the member home provider's own children and any children who reside in the member home.

F. The compliance investigation, including documentation of how capacity was determined, shall be maintained in the record of the member home.

22VAC40-121-220. Member home approval notification.

A. Within 30 days following completion of the system's investigation required in 22VAC40-121-210, the system shall provide written notification to the provider of the results of the investigation, to include any corrective action required.  The corrective action plan will briefly describe any standard, system policy or procedure not met, the action to be taken to meet it, the date by which it will be completed and the signature of the provider.

B. Upon determination that the corrective action plan submitted by the provider is acceptable, the system shall issue to the provider a written certificate documenting that the provider has been approved as a member home.  The approval certificate shall include the capacity of the home.

C. Upon determination that the corrective action plan submitted by the provider is unacceptable, the system shall inform the provider in writing that the application for approval as a member home has been denied.

22VAC40-121-230. Agreements with member homes.

A. The system shall have a written agreement with each member home that specifies the following:

1. The member home's agreement with the system's policies and procedures in the areas identified in subdivision 22VAC40-121-20 10.

2. A financial agreement between the system and the member home;

3. The system's role in assisting the member home in developing a plan to meet the needs of each child accepted for care;

4. The system's role in planning for regular conferences between the member home and parents of children in care;

5. The rights and responsibilities of the system to evaluate, approve, monitor, inspect, supervise, suspend or terminate approval, and provide technical assistance and consultation to member homes;

6. The system's responsibility to refer children to available health and social services;

7. The system's right to remove a child from the home and the conditions under which a child may be moved; and

8. The member home's agreement not to accept a child from any source other than the system responsible for the member home without the prior approval of the system; and

B. The written agreement shall be signed prior to referral of children to the member home.

C. The system shall maintain a copy of the agreement in the member home's record and shall provide a copy to the member home.

22VAC40-121-240. Records on member homes.

The family day system shall maintain a record on each member home. The record shall contain the following:

1. Provider's application for approval as a member home;

2. The results of the initial compliance investigation

3. Documentation on determination of capacity;

4. Written agreement with the system;

5. Content and hours of provider's orientation;

6. Documentation of provider's initial training;

7. Documentation of technical assistance and consultation;

8. Results of monitoring inspections;

9. Documentation of complaints investigations;

10. Corrective action plans;

11. Children's records; and

12. Caregiver's records.

22VAC40-121-250. Caregiver records.

A. The system shall maintain a record for each caregiver.

B. Caregivers' records shall contain the following:

1. Name;

2. Address;

3. Verification of age;

4. Job title;

5. Date of employment or volunteering;

6. Name address and telephone number of a person to be notified in an emergency;

7. For assistants and substitute providers who are not the spouse, parent, sibling, or child of the provider, documentation that two or more references as to character and reputation as well as competency were checked before employment. If a reference check is taken over the telephone, documentation shall include:

a. Dates of contact,

b. Names of persons contacted,

c. Firms contacted,

d. Results, and

e. Signature of person making call;

8. Background checks as required by 22VAC40-121-510;

9. Documentation of tuberculosis screening as required by 22VAC40-121-260 and 22VAC40-121-270 A; and

10. Documentation of the education, training, and mentoring as required by 22VAC40-121-320.

22VAC40-121-260. Initial tuberculosis screening for caregivers and household members.

A. The system shall obtain from each caregiver at the time of hire and each adult household member prior to coming into contact with children a current Report of Tuberculosis Screening form published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form.

B. The form shall have been completed within the last 30 days and be signed by a physician, physicians' designee, or an official of the local health department.

22VAC40-121-270. Subsequent tuberculosis screening for caregivers and household members.

A. The system shall obtain for each caregiver and adult household member a current Report of Tuberculosis Screening form, in accordance with the requirements in 22VAC40-121-260, every two years from the date of the first screening or more frequently as recommended by a physician or the local health department.

B. Within 30 days of a caregiver's or adult household member's coming into contact with a known case of infectious tuberculosis, the system shall obtain for the individual a new Report of Tuberculosis Screening form in accordance with the requirements in 22VAC40-121-260. Until a new screening form is issued that documents the absence of tuberculosis in a communicable form, the caregiver or adult household member shall not have contact with children.

C. The system shall immediately obtain a new Report of Tuberculosis Screening form in accordance with the requirements in 22VAC40-121-260 for any caregiver or adult household member who develops chronic respiratory symptoms of three weeks duration. Until a new screening form is issued that documents the absence of tuberculosis in a communicable form, the caregiver or adult household member shall not have contact with children.

22VAC40-121-280. Physical and mental health examinations for caregivers and household members.

A. The system or the department's representative may require a report of examination by a licensed physician or mental health professional when there are indications that a caregiver's or household member's physical or mental health may endanger the health, safety, or well-being of children in care.

B. A caregiver or household member who is determined by a licensed physician or mental health professional to show an indication of a physical or mental condition that may endanger the health, safety, or well-being of children in care or that would prevent the performance of duties shall be removed immediately from contact with children and food served to children until the condition is cleared as evidenced by a signed statement from the physician or mental health professional.

22VAC40-121-290. Initial provider training and mentoring.

A. Prior to referring a child to a member home, the system shall provide a minimum of 18 hours of training to each provider. 

B.  The training shall cover the following areas:

1. Orientation to the system's mission, organizational structure, services to be provided to member homes and families and children who use the system, and the system's expectations for member homes;

2. Requirements for member homes in 22VAC40-121-510 through 22VAC40-121-1370 of this chapter;

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

4. Organizing for family day care;

5. Child growth and development;

6. Nutrition;

7. Developmentally appropriate activities;

8. Behavior management and discipline techniques;

9. Parent-provider relationships; and

10. Appropriate toys for mixed age groups of children.

C. Prior to referring a child to a member home, the system shall ensure the provision of 40 hours of mentoring to each provider by an experienced system-approved provider.  

22VAC40-121-300. Orientation of substitute providers and assistants.

A. The system shall orient the substitute provider and assistant by the end of their first week of assuming job responsibilities.

B. The orientation shall cover the following topics:

1. Job responsibilities;

2. Requirements for parental notifications listed in 22VAC40-121-1010;

3. Standards in this chapter that relate to the substitute provider's or assistant's responsibilities;

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

5. Location of emergency numbers, first aid kit, and emergency supplies;

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

7. Requirement for reporting suspected child abuse and neglect.

22VAC40-121-310. Annual training.

A. In addition to applicable first aid training and CPR training, the system shall provide a minimum of twelve clock hours of training annually to caregivers in areas relevant to their job responsibilities.

1. Effective July 1, 2012, caregivers shall obtain 14 clock hours of training annually.

2. Effective July 1, 2013, caregivers shall obtain 16 clock hours of training annually.

B. The annual training shall cover areas such as, but not limited to:

1. Physical, intellectual, social, and emotional child development;

2. Behavior management and discipline techniques;

3. Health and safety in the family day home environment;

4. Art and music activities for children;

5. Child nutrition;

6. Recognition and prevention of child abuse and neglect;

7. Emergency preparedness as required by 22VAC40-121-1160 C; or 

8.  Recognition and prevention of the spread of communicable diseases.

22VAC40-121-320. Documentation of training and mentoring.

A. The system shall maintain written documentation of each provider's initial training and mentoring, and each caregiver's applicable first aid and CPR certification, orientation, annual training, and applicable medication administration training.

B. Written documentation of initial and annual training shall include:

1. Name of the caregiver;

2. Name of the training session;

3. Date and total hours of the session; and

4. Name of the trainer.

C.  Written documentation of mentoring shall include:

 1. Name of the provider;

 2. Name of the mentor;

 3. Information covered during the mentoring sessions: and

 4. Dates and total hours of mentoring sessions.

22VAC40-121-330. Technical assistance and consultation.

A. The system shall provide technical assistance and consultation to member homes including, but not limited to, the following:

1. Information and guidance on child development, discipline, safety, children with special needs, nutrition, and provider support services;

2. Information on training resources;

3. Information on community resources; and

4. Toys and equipment.

B. Technical assistance and consultation provided to member homes shall be recorded in the member home's record.

22VAC40-121-340. Monitoring.

A. The system shall inspect each member home at least quarterly in order to ensure that the home continues to comply the requirements of sections 22VAC40-121-510 through 22VAC40-121-1370 of this regulation.

B. At least two of the monitoring inspections shall be unannounced.

C. The results of the monitoring inspections shall be documented in the member home's record.

D. The department, at any time, may make an announced or unannounced inspection of a member home in order to ensure continued compliance with the applicable provisions of these standards.  The results of such inspections shall be provided to the system.

22VAC40-121-350.  Annual re-approval.

The system shall evaluate each member home for re-approval annually.  The same approval process shall be used as described in 22VAC40-121-210 and 22VAC40-121-220.

22VAC40-121-360. Child abuse or neglect complaint.

A. The system shall:

1. Immediately notify the local department of social services' child protective services unit or the Child Abuse and Neglect Hotline whenever there is reason to suspect that a child has been or is being subjected to any kind of child abuse or neglect by any person.  The system shall also immediately thereafter call the department's representative to report the suspected abuse or neglect complaint.

2. Cooperate with the local department of social services in the investigation of the child abuse or neglect complaint.

3. Forward written notification of the complaint within 72 hours to the local department of social services child protective services unit and to the assigned licensing office.

4. Place copies of the written notifications to the local department of social services and the department's representative in the file of the member home against which the complaint was made.

B. If the complaint suggests that the suspected abuse or neglect occurred while the child was in care, the system staff shall immediately consult with the local department of social services child protective services unit or the police, if necessary, to plan the system's investigation of the member home and to determine the safety of other children in care.

22VAC40-121-370. Complaint records.

Each complaint on a member home that is received by the system shall be recorded on a complaint record that includes, but is not limited to, the following:

1. Name and address of member home;

2. Name, address and telephone number of complainant;

3. Method by which the complaint was made, including the date and time received;

4. Name of person receiving the complaint;

5. Description of the complaint, including dates and times, where applicable;

6. Findings and action taken to include whether the complaint was found to be valid, invalid or its validity was not clearly determined;

7. Name of the person or persons who investigated the complaint and the date the investigation was completed; and

8. Date the complainant was notified of the results of the investigation.

22VAC40-121-380. Complaint investigation.

A. The system shall investigate any complaints regarding alleged violations of this chapter by any member home.  At his discretion the department's representative may also investigate complaints regarding alleged violations of this chapter by member homes or other pertinent requirements.

B. A thorough investigation shall be made, by the system, of each complaint received.  This investigation shall:

1. Be initiated immediately following the receipt of the complaint when the complaint circumstances are related to ensuring the health and safety of the children in care or, initiated no later than five working days following the receipt of the complaint when circumstances do not warrant immediate investigation initiation;

2. Be completed within 14 days following receipt of the complaint;

3. Include at least one inspection to the member home on which the complaint was received; and

4. Be unannounced and without prior notification of the complaint to the provider unless, the circumstances of the complaint clearly warrant that announcement and notification be made.

C. A copy of the complaint record shall be placed in the record of the member home against which the complaint was made.  If the complaint investigation was not conducted unannounced and without notification, reason shall be documented in the record.

D. The system shall provide a copy of the complaint record to the department's representative within 10 days of the date the complaint investigation is completed.

E. When the complaint concerns a specific child, a copy of the completed complaint record shall be placed in the child's record maintained by the system. 

22VAC40-121-390. Corrective action plans.

A. If a complaint against a member home is found to be valid or if the system's monitoring visit reveals violations of this chapter or the system's policies and procedures, a written corrective action plan shall be developed, unless the system elects to terminate its approval of the home.  This plan shall be signed by the provider and the system representative, and initiated immediately.

B. The corrective action plan shall specify the standard or system's policy or procedure with which the member home does not comply and specify a date by which the violation shall be corrected.

C. The licensee shall ensure that violations are corrected by the date on the corrective action plan.

D. The licensee shall make a follow-up inspection to the member home to ensure the violations listed on the corrective action plan are corrected.

E. A copy of the corrective action plan shall be maintained in the record of the member home and on file at the member home.

22VAC40-121-400. Suspensions and terminations.

A. The system may suspend or terminate approval of a member home for cause, including, but not limited to:

1. Failure to comply with the standards set forth in this chapter or the system's policies and procedures;

2. Use of fraud or misrepresentation in obtaining approval or in the subsequent operation of the member home.

B. When a member home is found to be in violation of any of the provisions of subsection A of this section, the system shall notify the provider of the violation or violations first orally and then in writing, and, as appropriate, shall afford the provider an opportunity to abate the violation or violations within a time frame agreed upon by the system and the provider in the corrective action plan.

C.The system shall ensure that the member home provider immediately abates any violation that places children at risk of abuse, neglect or serious harm or injury.

D. The system shall suspend or terminate approval of the member home if the member home provider fails to abate the violation or violations within the agreed upon time frame or commits a subsequent violation.

E. Within five calendar days of the suspension or termination, the system shall give written notice to the provider, specifying the reason for suspension or termination.  The notice shall be delivered either by hand or by certified mail with return receipt requested.

F. Within five calendar days of the suspension or termination, the system shall provide copies of the notification of member home suspension or termination required by subsection E of this section to the department's  representative at the assigned licensing office.

PART V.

SERVICES TO CHILDREN.

22VAC40-121-410. Referral to member homes.

 The system shall:

1. Refer children only to approved member homes;

2. Not knowingly refer a child to a member home that has reached its approved capacity;

3. Ensure that a qualified system staff person interviews the parent or parents and child prior to referral; and

4. Ensure that the parent and child or children visit the member home where care will be provided prior to acceptance into care.

22VAC40-121-420. Agreements with parents.

A. A written agreement shall be made between the system and the parent when a referral is made to a member home.

B. The written agreement shall contain the following:

1. An authorization for emergency medical care should an emergency occur and the parent cannot be located immediately unless the parent presents a written objection to provision of medical treatment on religious or other grounds;

2. Information on any special services to be provided by the member home;

3. Information on the hours of care per day, week, or month; cost of care per day, week, or month; frequency and amount of payment per day, week or month;

4. Notice of any special problems or needs of a child;

5. Granting or denying permission for field trips;

6. Granting or denying permission for participation in swimming activities;

7. Any other referral information;

8. Agreement regarding the home in which the child will be placed;

9. Name and address of the provider;

10. Information regarding the means by which care will be provided in the event the primary day care provider is ill, on vacation or otherwise unavailable due to an emergency;

11. Statement that system staff persons and caregivers in the member home in which the child receives care will be available for parent conferences; and

12. Information regarding the role of the system in referring children when the approval of a member home is terminated or suspended.

C. A signed copy shall be maintained in the child's record at the system's office, a signed copy given to the parent, and a signed copy maintained in the child's record at the member home.

22VAC40-121-430. Records on children referred for care.

A. The family day system shall maintain a record on each child accepted by the system and referred to a member home for care.  The record shall be kept up-to-date and contain the following:

1. A copy of the agreement with the parent agreement required by 22VAC40-121-420;

2. A record of placement that contains the name of each member home in which the child has received care, the date referred for care and the date and reason care was terminated;

3. A record of each referral of the child or the family to health and social services;

4. A copy of each complaint investigation as required by 22VAC40-121-380 C.

5. Child's full name, nickname (if any), sex, address, and birth date;

6. Emergency contact information including:

a. Name, home address, and telephone number of each parent who has custody;

b. Name, address and telephone number of each custodial parent's place of employment;

c. Name, office address and telephone number of the child's physician;

d. Name, address and telephone number of two designated persons to contact in case of an emergency if the parent cannot be reached;

e. Information on allergies and intolerance to food, medication, or any other substances, and actions to take in an emergency situation;

f. Name and policy number of the child's medical insurance, if applicable;

g. Names of persons other than the custodial parents who are authorized to pick up the child;

h. Appropriate legal paperwork when a custodial parent does not authorize the provider to release the child to the other parent; and

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

7. First and last dates of attendance;

8. Parent's signed acknowledgement of the receipt of the information required by 22VAC40-121-440;

9. Proof of the child's age and identity and the names and addresses of previously attended child day care and schools as required by 22VAC40-121-550;

10. Immunization records for the child as required by 22VAC40-121-560;

11  Results of the physical examination for the child as required by 22VAC40-121-570;

12. Written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately unless the parent presents a written objection to provision of medical treatment on religious or other grounds;

13. Special instructions to the provider including, but not limited to, exception to an infant's sleeping position as required in 22VAC40-12-950 A, recommendations for the care and activities of a child with special needs as required in 22VAC40-121-980 A, and exception to an infant's being fed on demand as required in 22VAC40-121-1320 A;

14. Record of any accidents or injuries sustained by the child while at the member home as required by 22VAC40-121-1200; and

15. Documentation of the review of the child's emergency contact information as required subsection C of this section.

B. Annually, the system shall:

1. Review with the parent the emergency contact information required in subdivision B 2 of this section to ensure the information is correct, and

2. Obtain the parent's signed acknowledgment of the review.

C. The system shall provide an up-to-date record to the member home for each enrolled child that contains the following information:

1. Child's full name, nickname (if any), sex, address, and birth date;

2. Emergency contact information required by subdivision A 6 of this section:

3. Written authorization for emergency medical care required by subdivision A 12 of this section; and

4. Special instructions to the provider  required by subdivision A 13 of this section.

D. The licensed family day system shall retain children's records for two years from the date the system terminated the services to the child.

22VAC40-121-440. Written information for parents.

A. Before the child's first day of attendance, the system shall provide parents in writing the following information:

1. Operating information for the system and member home including the hours and days of operation, holidays or other times closed, and the telephone number where a message can be left;

2. The system's role in assisting the member home in developing a plan to meet the needs of each child accepted for care;

3. The system's role in planning for regular conferences between the member home and parents of children in care;

4. The system's responsibility for supervision of children's care and adjustment;

5. The rights and responsibilities of the system to evaluate, approve, monitor, inspect, supervise, suspend or terminate approval, and provide technical assistance and consultation to member homes;

6. The system's responsibility to refer children to available health and social services;

7. Schedule of fees and payment plans;

8. The home's check in and check out procedures;

9. The home's policies for the administration of medications;

10. Whether or not there is liability insurance of at least $100,000 per occurrence and $300,000 aggregate in force on the member home operation as required by § 63.2-1809.1 of the Code of Virginia;

11. Requirement for the member home to notify the parent when the child becomes ill and for the parent to arrange to have the child picked up as soon as possible if so requested by the home;

12. Requirement for the parent to inform the member home 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;

13. Requirement for the child to be adequately immunized  as required by 22VAC-40-121-460;

14. Requirement for paid caregivers to report suspected child abuse or neglect according to § 63.2-1509 of the Code of Virginia;

15. Custodial parent's right to be admitted to the member home any time the child is in care as required by § 63.2-1813 of the Code of Virginia;

16. General daily schedule of the home that is appropriate for the age of the enrolling child;

17. The home's policies for the provision of food;

18. Presence of a pet or animal in the home;

19. Discipline policies including acceptable and unacceptable discipline measures;

20. Amount of time per week that an adult assistant or substitute provider instead of the provider is scheduled to care for the child and the name of the adult assistant or substitute provider;

21. Provisions of the member home's emergency preparedness and response plan;

22. Parental notifications required in 22VAC40-121-490 and 22VAC40-121-1010; and

23. Policies for termination of care.

B. The system shall obtain the parent's written acknowledgement of the receipt of the information in this section.

22VAC40-121-450. Proof of age and identity; record of child care and schools.

A. Within seven business days of the child's first day of attendance at the member home, the system shall obtain from the parent:

1. Verification of the identity and age of the child; and

2. Name and location of previous day care programs and schools the child has attended.

B. The system shall verify the identity and age of a child by viewing one of the following:

1. Certified birth certificate;

2. Birth registration card;

3. Notification of birth, i.e., hospital, physician, or midwife record;

4. Passport;

5. Copy of the placement agreement or other proof of the child's identity from a child placing agency;

6. Original or copy of a record or report card from a public school in Virginia;

7. Signed statement on letterhead stationery from a public school principal or other designated official that assures the child is or was enrolled in the school, or

8. Child identification card issued by the Virginia Department of Motor Vehicles. 

C. The system shall document in the child's record:

1. The method of verification of the child's age and identity; and

2. The names and locations of the previous child care programs and schools the child has attended.

D. The system shall notify the local law-enforcement agency if the parent does not provide the information required in subdivision A of this section within seven business days of the child's first day of attendance at the member home.

E. The proof of identity, if reproduced or retained by the system, shall be destroyed two years after termination of services to the child. 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:

1. Shredding;

2. Erasing; or

3. Otherwise modifying the social security numbers in those records to make them unreadable or indecipherable by any means.

22VAC40-121-460. Immunizations for children.

A. Before a child may attend the member home, the system shall obtain documentation that the child has been adequately immunized according to the requirements of § 32.1-46 A of the Code of Virginia and applicable State Board of Health regulations.

B. 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 system 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.

C.  The system shall obtain documentation of additional immunizations for a child who is not exempt from the immunization requirements according to subsection B of this section:

1. Once every six months for children under the age of two years; and

2. Once between each child's fourth and sixth birthdays.

22VAC40-121-470. Physical examinations for children.

A. The system shall obtain documentation of a physical examination by or under the direction of a physician prior to a child's attendance at a member home or within 30 days after the first day of attendance.

B. The physical examination prior to attendance shall have been conducted  within:

1 Two months prior to attendance for children six months of age or younger;

2. Three months prior to attendance for children age seven months through 18 months;

3. Six months prior to attendance for children age 19 months through 24 months;

4. Twelve months prior to attendance for children two years of age through five years of age; or

5. Twenty-four months prior to attendance for children six years of age and above.

EXCEPTIONS:

1. A new physical examination is not required if a copy of the physical examination is available to the system for a child transferring from a facility licensed by the Virginia Department of Social Services, approved by a licensed family day system, voluntarily registered by the Virginia Department of Social Services or by a contract agency of the Virginia Department of Social Services, or transferring from a Virginia Department of Education-approved child care program;

2. 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;

3. For a school age child, a copy of the physical examination required for his entry into a Virginia public kindergarten or elementary school is acceptable documentation. 

22VAC40-121-480. Form and content of immunization and physical examination reports for children.

A. The current form approved by the Virginia Department of Health or a physician's form shall be used to record 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 licensed physician, the physician's designee, or an official of a local health department.

22VAC40-121-490. Notification of no liability insurance on member home.

The system shall provide written notification to the parent within 10 business days after the effective date of the change when there is no longer liability insurance in force on the member home operation;

1. The system shall obtain the parent's written acknowledgement of the receipt of this notification, and

2. A copy of the parent's written acknowledgement of the receipt of this notification shall be maintained in the child's record.

22VAC40-121-500.  Referral to health and social services.

A. The system shall maintain a current listing of health and social services available in the community and shall refer providers and parents of enrolled children upon request.

B. The system shall record in the child's record all referrals of the child and his family to health and social services agencies as required by 22VAC40-121-430.

PART VI.

 Requirements for Member Homes

22VAC40-121-510. General qualifications for caregivers.

Caregivers shall:

1. Be of good character and reputation;

2. Be physically and mentally capable of carrying out assigned responsibilities;

3. Be courteous, respectful, patient, and affectionate toward the children in care;

4. Be able to speak, read, and write in English as necessary to:

a. Carry out assigned job responsibilities, and

b. Communicate effectively with emergency responders; and

5. Meet the requirements specified in 22VAC40-191, Background Checks for Child Welfare Agencies.

22VAC40-121-520. Qualifications and requirements for providers and substitute providers.

A. Providers and substitute providers shall be 18 years of age or older.

B. Providers shall have:

1. Current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care, from the American Red Cross, American Heart Association, American Safety and Health Institute, the National Safety Council, or current CPR certification issued within the past two years by a community college, a hospital, a rescue squad, or a fire department; and

2. Current certification in first aid from the American Red Cross, American Heart Association, American Safety and Health Institute, the National Safety Council, current first aid certification issued within the past three years by a community college, a hospital, a rescue squad, or a fire department.

EXCEPTION: A provider or substitute provider 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.

22VAC40-121-530. Qualifications and requirements for assistants.

A. Assistants shall  be 16 years of age or older:

B. An assistant under the age of 18 years of age shall always work under the direct supervision of the provider or substitute provider. Direct supervision means being able to hear or see the assistant and children at all times.

C. An assistant 18 years of age or older shall not be left alone with children in care for more than two hours per day.

D. An assistant 18 years of age or older who is left alone with children in care shall have:

1. Current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care, from the American Red Cross, American Heart Association, American Safety and Health Institute, National Safety Council, or current CPR certification issued within the past two years by a community college, a hospital, a rescue squad, or a fire department; and

2. Current certification in first aid from the American Red Cross, American Heart Association, American Safety and Health Institute, National Safety Council, or current first aid certification issued within the past three years by a community college, a hospital, a rescue squad, or a fire department.

EXCEPTION: An assistant 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. 

E. An assistant 18 years of age or older who meets the requirements for a substitute provider may act as the substitute provider when the provider is absent from the home for more than two hours.

22VAC40-121-540. Attributes for household members.

Individuals 14 years of age and older who reside in the member home shall:

1. Display behavior that demonstrates emotional stability;

2. Be of good character and reputation; and

3. Meet the requirements specified in 22VAC40-191, Background Checks for Child Welfare Agencies.

22VAC40-121-550. Posting approval certificate. 

The provider shall post the member home's approval certificate in a place that is conspicuous to the public.  

22VAC40-121-560. Medication administration training.

A. To safely perform medication administration practices listed in 22VAC40-121-1070 and 22VAC40-121-1080 whenever the member home has agreed to administer prescription medications or non-prescription medications, the administration shall be performed by a caregiver who:

1. Has satisfactorily completed a training program for this purpose developed or approved by the Board of Nursing and taught by a registered nurse, licensed practical nurse, doctor of medicine or osteopathic medicine, or pharmacist; or

2. Is licensed by the Commonwealth of Virginia to administer medications.

B. Caregivers required to have the training in subdivision A 1 of this section shall be retrained at three-year intervals.

22VAC40-121-570. Written information for parents.

A. Before the child's first day of attendance, the provider shall give parents the following information in writing :

1. Operating information for the member home including the hours and days of operation, holidays or other times closed, and the telephone number where a message can be left for a caregiver;

2. The home's check in and check out procedures;

3. The home's policies for the administration of medications;

4. General daily schedule of the home that is appropriate for the age of the enrolling child;

5. Presence of a pet or animal in the home;

6. Amount of time per week that an adult assistant or substitute provider instead of the provider is scheduled to care for the child and the name of the adult assistant or substitute provider; and

7. Provisions of the member home's emergency preparedness and response plan.

B. The provider shall obtain the parent's written acknowledgement of the receipt of the information in this section.

22VAC40-121-580. Written permissions.

A. The provider shall obtain general written permission from the parent of each child for the provider to take the child off the premises of the member home. The general written permission shall be on a form that lists regularly scheduled trips (e.g., library, store, playground) and the driver, if the child is to be transported.

B. The provider shall obtain special written permission from the parent of each child for the provider to take the child on special field trips (those not regularly scheduled). The written special permission shall specify destination, duration of trip, and driver, if the child is to be transported.

C. The provider shall annually obtain:

1. Written permission from the parent of each child who participates in swimming or wading activities, and

2. A written statement from the parent advising of a child's swimming skills before the child is allowed in water above the child's shoulder height.

22VAC40-121-590. Children's records.

The provider shall maintain for each enrolled child the:

     1. Up-to-date record on the child provided by the system as required by for 22VAC40-121-430 C;

2. Parent's signed acknowledgement of the receipt of the information required by 22VAC40-121-570;

3. Written permissions and statement as required by 22VAC40-121-580;

4. Written authorization if a caregiver is to administer prescription or nonprescription medication to the child as required by 22VAC40-121-1060 A 2; and

5. Injury records as required by 22VAC40-121-1200.

22VAC40-121-600. Home maintenance.

A. Areas and furnishings of the member home, inside and outside, shall be maintained in a clean, safe, and operable condition. Unsafe conditions shall include, but not be limited to,  the presence of poisonous plants; tripping hazards; unstable heavy equipment, furniture, or other items that a child could pull down on himself;  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 or could snag skin.

B. No equipment, materials, or furnishings shall be used if recalled or identified by the U.S. Consumer Product Safety Commission as being hazardous.

22VAC40-121-610. Hanging, suffocation, and strangulation hazards.

A. Hanging items including, but not limited to, window blind or curtain cords, appliance cords, and ropes shall be out of reach of children under five years of age.

B. Children shall be protected from materials that could be swallowed or present a choking hazard. Toys or objects less than 1-1/4 inches in diameter and less than two inches in length shall be kept out of reach of children under the age of three years.

C. Items tied across the top or corner of a crib or playpen or toys hung from the sides with strings or cords shall be removed when the child begins to push up on hands and knees or is five months of age, whichever occurs first.

D. Hood or neck drawstrings shall be removed from a child's clothing prior to a child's using climbing play equipment.

E. Latex gloves, balloons, and empty plastic bags large enough for a child's head to fit inside shall be inaccessible to children under five years of age. 

22VAC40-121-620. Drowning hazards.

A. Access to the water in aboveground swimming pools shall be prevented by locking and securing the ladder in place or storing the ladder in a place inaccessible to children.

B. A non-climbable barrier at least four feet high such as, but not limited to, a fence or impenetrable hedge shall surround outdoor play areas located within 30 feet of drowning hazards such as, but not limited to, in-ground swimming or wading pools, ponds, or fountains not enclosed by safety fences. Member homes approved prior to [insert the effective date of this regulation] must comply fully with the requirement of this subsection [within one year of insert the effective date of this regulation].

C. Portable wading pools without integral filter systems shall:

1. Be emptied after use by each group of children, rinsed, and filled with clean water, or more frequently as necessary; and

2. When not in use during the member home's hours of operation, be emptied, sanitized, and stored in a position to keep them clean and dry.

D. Portable wading pools shall not be used by children who are not potty trained.

E. Bathtubs, buckets, and other containers of liquid accessible to children shall be emptied immediately after use.

F. Hot tubs, spas, and whirlpools shall:

1. Not be used by children in care, and

2. Covered with safety covers while children are in care.

22VAC40-121-630. Firearms and ammunition.

A. Firearms of every type and purpose shall be stored unloaded in a locked container, compartment, or cabinet, and apart from ammunition.

B. Ammunition shall be stored in a locked container, compartment, or cabinet during the member home's hours of operation.

C. If a key is used to lock the container, compartment, or cabinet, the key shall be inaccessible to children.

22VAC40-121-640. Poisonous materials.

Potentially poisonous substances, materials and supplies such as, but not limited to, cleaning agents, disinfectants, deodorizers, plant care chemicals, pesticides, and petroleum distillates shall be stored away from food in areas inaccessible to children. 

22VAC40-121-650. Sharp objects.

Sharp kitchen utensils and other sharp objects shall be inaccessible to children unless being used by the caregiver or with children under close supervision.

22VAC40-121-660. Body fluids contamination.

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

22VAC40-121-670. Machinery.

Machinery in operation such as lawnmowers and power tools shall be inaccessible to the children in care.

22VAC40-121-680. Fire safety and shock prevention.

A. Small electrical appliances such as, but not limited to, curling irons, toasters, blenders, can openers, and irons shall be unplugged unless being used by the caregiver or with children under close supervision.

B. Electrical outlets and surge protectors  accessible to children under five years of age shall be tamper-resistant or have child-resistant protective covers larger than 1-1/4 inches in diameter.

 C. No electrical device accessible to children shall be placed so that it could be plugged into an electrical outlet while in contact with a water source, such as a sink, tub, shower area, toilet, or swimming or wading pool.

D. Electrical cords and electrical appliances and equipment with cords that are frayed and have exposed wires shall not be used.

E. Radiators, oil and wood burning stoves, floor furnaces, fireplaces, portable electric heaters, and similar heating devices located in areas accessible to children shall have barriers or screens and be located at least three feet from combustible materials.

F. Unvented fuel burning heaters shall not be used when children are in care. Unvented fuel burning heaters include, but are not limited to, portable oil-burning (kerosene) heaters; portable, unvented liquid or gas fueled heaters; and unvented fireplaces.

G. Wood-burning stoves and wood-burning fireplaces and associated chimneys shall be inspected annually by a knowledgeable inspector to verify that the devices are properly installed, maintained, and cleaned as needed. Documentation of the inspection and cleaning shall be maintained by the provider.

H. All flammable and combustible materials such as, but not limited to, matches, lighters, lighter fluid, kerosene, turpentine, oil and grease products, aerosol cans, and alcohol shall be stored in an area inaccessible to children.

I. If there are open and obvious fire hazards, including the absence of fire extinguishers or smoke detectors as required by the Uniform Statewide Building Code and the Statewide Fire Prevention Code, the local fire prevention or building officials, or the State Fire Marshal's office shall be contacted by the system. The provider shall comply with the requirements or recommendations made by the fire prevention or building officials to eliminate fire hazards.

22VAC40-121-690. Telephones.

A. A landline telephone, excluding a cordless or cell phone, shall be available, operable, and accessible during the member home's hours of operation. An operable landline telephone is one that does not require electricity to operate. Cordless or cell phones may be used in addition to the landline telephone.

B. If the telephone number is unlisted, the provider shall ensure that parents and the system have been given the unlisted number in writing.

C. The provider shall inform the system within 48 hours and parents within 24 hours of a change of the telephone number.

22VAC40-121-700. Bathrooms.

A. The home shall have an indoor bathroom.

B. The bathroom shall be easily accessible to children two years of age and older.

C. The bathroom shall be kept clean and contain a working toilet and sink, toilet tissue, liquid soap, and paper towels.

22VAC40-121-710. Water supply.

A. The member home shall have indoor running water.

B. When water is not obtained from a municipal supply, and the house is not connected to a municipal sewer line, the water supply and septic system of the member home shall be inspected and approved by the local health official or a private laboratory if there are open and obvious symptoms of water or sewage system problems, such as evidence of cloudy, murky, or muddy water, or sewage back up.

C. Member homes connected to a municipal water supply and sewer line that have open and obvious symptoms of water or sewage system problems shall have the problems corrected within a time frame established by the local public utility department.

D. There shall be an ample supply of hot and cold water available to children and caregivers for hand washing.

E. Hot water at taps available to children shall be maintained within a range of 105°F to 120°F.

22VAC40-121-720. Garbage.

A. Garbage shall be removed on a daily basis from rooms occupied by children and removed from the premises at least once weekly or more often as needed.

B. There shall be a sufficient number of garbage and diaper containers.

C. Children shall not be allowed access to garbage storage areas.

D. Garbage storage areas shall be free of litter, odor, and uncontained trash.

22VAC40-121-730. Rodents and insects.

A. The member home shall be kept free from rodents and insect infestation.

B. No member home shall maintain any receptacle or pool, whether natural or artificial, containing water in such condition that insects breeding therein may become a menace to public health.

22VAC40-121-740. Space.

The member home shall provide each child with adequate space to allow free movement and active play indoors and out.

22VAC40-121-750. Individual location.

A. Each child who is two years of age and older shall have access to an individual location in which to keep clothing, toys, and belongings.

B. Each child who is under the age of two shall have an individual location in which to keep clothing, toys, and belongings that is accessible to the caregiver and parent.

22VAC40-121-760. Heating and cooling.

A. The temperature in all inside areas occupied by children shall be maintained no lower than 65°F.

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

22VAC40-121-770. Electric fans.

Portable electric fans shall be securely mounted out of the reach of children and shall be equipped with a mesh guard.

22VAC40-121-780. Lighting.

A. Rooms, halls, and stairways used by children in care shall be lighted with natural or electric lighting for the children's safety and comfort.

B. Entrance and exit ways shall be unobstructed and be lighted with natural or electric lighting.

22VAC40-121-790. Stairs.

A. Children under two years of age and children over two years of age who are not developmentally ready to climb or descend stairs without supervision shall not have access to stairs.

B. Accordion expansion gates and pressure mounted gates shall not be used as protective barriers at stair openings.

C. Children over the age of two shall not have access to stairs with three or more risers that do not have protective barriers or guardrails on each side.

D. Protective barriers or guardrails on sides of stairs shall be constructed to prevent a child from climbing over, crawling or falling through, or becoming entrapped.

22VAC40-121-800. Decks and porches.

A. Children shall not have access to decks, porches, lofts, or balconies more than 15½ inches above the floor or grade below that do not have protective barriers or guardrails.

B. Protective barriers or guardrails shall be constructed to prevent a child from climbing over, crawling or falling through, or becoming entrapped.

22VAC40-121-810. Doors and windows.

A. Doors with clear glass panels that reach within 18 inches of the floor shall be clearly marked with decorative objects such as pictures, art work, or decals at the eye level of children in care.

B. Closet doors that have latches shall be such that children can open the door from inside the closet.

C. Bathroom doors with locks shall have locks designed to permit opening of the locked door from the outside with a readily accessible opening device.

D. Windows and doors used for ventilation shall be securely screened.

22VAC40-121-820. Animals.

A. Family pets shall not be allowed on any surfaces where food is prepared or served.

B. A pet or animal present at the member home, indoors or outdoors, shall be in good health and show no evidence of carrying any disease.

C. Dogs or cats, where allowed, shall be vaccinated for rabies and shall be treated for fleas, ticks, or worms as needed.

D. The provider shall maintain documentation of the current rabies vaccination.

E. Caregivers shall closely supervise children when children are exposed to animals.

F. Children shall be instructed on safe procedures to follow when in close proximity to animals, e.g., not to provoke or startle them or remove their food.

G. Animals that have shown aggressive behavior shall not be kept in the member home or on the grounds.

H. Monkeys, ferrets, amphibians, reptiles, psittacine birds (birds of the parrot family), or wild or dangerous animals shall not be in areas accessible to children during the hours children are in care.

I. Animal litter boxes, toys, food dishes, and water dishes shall be inaccessible to children.

J. All animal excrement shall be removed promptly, disposed of properly, and, if indoors, the soiled area cleaned.

22VAC40-121-830. Smoking and prohibited substances.

The provider shall ensure that:

1. No person smokes:

a. Indoors while children are in care,

b. In a vehicle when children are transported, or

c. Outdoors in an area occupied by children.

2. No caregiver is under the effects of medication that impairs functioning, alcohol, or illegal drugs. 

22VAC40-121-840. Play equipment and materials.

A. The member home shall provide a sufficient quantity and variety of play materials and equipment that shall be readily accessible to children.

B. Equipment and materials used by a child shall be appropriate to the age, size, ability, and interest of the child.

C. Materials and equipment available shall include, but not be limited to, arts and crafts materials, texture materials, construction materials, music and sound materials, books, social living equipment, and manipulative equipment.

D. Equipment used by children shall be assembled, maintained, and used in accordance with the manufacturer's instructions.

E. Equipment and materials used by children shall be clean, nontoxic, and free from hazards such as lead paint, sharp edges or points, loose parts, and rust.

F. Toys mouthed by children shall be cleaned and sanitized daily.

22VAC40-121-850. Indoor slides and climbing equipment.

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

22VAC40-121-860. Outdoor play area and equipment.

. A non-climbable barrier at least four feet high such as, but not limited to, a fence or impenetrable hedge shall surround outdoor play areas located within 30 feet of hazards such as, but not limited to, streets with speed limits in excess of 25 miles per hour or with heavy traffic, or railroad tracks.

B. The highest climbing rung or platform on outdoor climbing equipment or top of a slide shall not exceed six feet for school age children and four feet for preschool children.

C. Stationary outdoor playground equipment shall:

1. Not be installed over concrete, asphalt, or any other hard surface;

2. Be placed at least six feet from the perimeter of other play structures or obstacles; and

3. Be firmly anchored with ground supports that are covered with materials to protect children from injury.

D. Outdoor play equipment shall meet the following requirements:

1. "S" hooks shall be tightly closed;

2. Swings shall have flexible seats of rubber, canvas, or nylon;

3. Nonflexible-molded seats shall be used only when a caregiver stays within arm's length of any hard-molded swing in use and is positioned to see and protect other children who might walk into the path of the swing;

4. Openings above the ground that are closed on all sides shall be smaller than 3-1/2 inches or larger than nine inches to prevent head entrapment hazards;

5. Ropes, loops, or any hanging apparatus that might entrap, close, or tighten upon a child shall not be used;

6. Equipment with moving parts that might pinch or crush children's hands or fingers shall not be used unless they have guards or covers; and

7. Equipment with platforms and ramps over 30 inches high shall have been designed with guardrails or barriers to prevent falls.

E. Sandboxes shall be covered when not in use.

F. Trampolines shall not be used during the hours children are in care.

22VAC40-121-870. Rest areas.

A. A child shall be provided with an individual crib, cot, rest mat, or bed for resting or napping.

B. Upper levels of double-deck beds shall not be used.

C. Occupied cribs, cots, rest mats, and beds shall be:

1. At least three feet from any heat-producing appliance; and

2. At least 12 inches from each other.

D. Rest mats that are used must have at least an inch of cushioning.

E. Rest mats shall be cleaned and sanitized on all sides at least weekly and as needed.

22VAC40-121-880. Cribs.

A. Cribs shall be provided for children from birth through 12 months of age and for children over 12 months of age who are not developmentally ready to sleep on a cot, rest mat, or bed.

B. Cribs shall not be used as a play space for infants.

C. Cribs shall:

1. Meet the U.S. Consumer Product Safety Commission standards; and

2. Have mattresses that fit snugly next to the crib so that no more than two fingers can be inserted between the mattress and the crib.

D. Double-deck cribs shall not be used.

E. Crib bumper pads shall not be used. 

22VAC40-121-890. Linens.

A. Cribs, cots, rest mats, and beds when being used for sleeping or napping by children other than infants shall have linens consisting of a top cover and a bottom cover or a one-piece covering that is open on three edges.

B. Cribs when being used by infants shall have a tight-fitting bottom cover.

C. Linens shall be assigned for individual use.

D. Linens shall be clean and washed at least weekly or when soiled.

E. Clean linens shall be used each time a child rests on the bed of a family member.

F. No soft bedding of any kind shall be used under or around sleeping infants including, but not limited to, pillows, quilts, comforters, sheepskins, or stuffed toys.

G. Children under two years of age shall not use pillows or filled comforters when sleeping.

H. Pillows, when used for children over two years of age, shall be assigned for individual use and covered with pillowcases.

I. Mattresses, when used, shall be covered with a waterproof material that can be cleaned and sanitized.

22VAC40-121-900. Infant and toddler equipment.

A. Infant carrier seats, swings, strollers, feeding or activity tables, and high chairs shall be used according to the manufacturer's instructions and when occupied by a child, a safety strap shall be used and securely fastened.

B. Infant walkers shall not be used. 

22VAC40-121-910. Play pens.

A play pen where used shall:

1. Have either mesh netting with mesh holes smaller than 1/4 inch or slats no more than 2-3/8 inches apart;

2. Have a firm floor with a secured, waterproof pad that is not more than one-inch thick;

3. Have the sides up and the fastenings secured when a child is in the play pen, except when the caregiver is giving the child immediate attention;

4. Be cleaned and sanitized each day of use or more often as needed;

5. Not be occupied by more than one child;

6. Not be used for the designated sleeping area;

7. Not have torn mesh sides or vinyl-covered or fabric-covered rails, protruding rivets on the rails, or broken hinges;

8. Not contain any pillows or filled comforters;

9. Not contain large toys and other objects that can serve as a stepping stool for climbing out when a child can pull to a standing position;

10. Not be used by children who weigh 30 pounds or more; and

11. Not be used by children who are 35 inches tall or taller.

22VAC40-121-920. Supervision.

A. A caregiver shall be physically present on site and provide direct care and supervision of each child at all times. Direct care and supervision of each child includes:

1. Awareness of and responsibility for each child in care, including being near enough to intervene if needed; and

2. Monitoring of each sleeping infant in one of the following ways:

a. By placing each infant for sleep in a location where the infant is within sight and hearing of a caregiver;

b. By in-person observation of each sleeping infant at least once every 15 minutes; or

c. By using a baby monitor.

B. Caregivers shall actively supervise each child during outdoor play to minimize the risk of injury to a child.

C. A caregiver may allow only school age children to play outdoors while the caregiver is indoors if the caregiver can hear the children playing outdoors. 

D. Infants shall be protected from injury by older children.

E.  No child under five years of age or a child older than five who lacks the motor skills and strength to avoid accidental drowning, scalding, or falling while bathing shall be left unattended while in the bathtub.

22VAC40-121-930. Determining need for additional caregiver.

A. To ensure adequate supervision of children, the provider shall use the following point system to determine if an additional caregiver is needed:

1. Children from birth through 15 months of age count as four points each;

2. Children from 16 months through 23 months of age count as three points each;

3. Children from two through four years of age count as two points each;

4. Children from five years through nine years of age count as one point each; and

5. Children who are 10 years of age and older count as zero points.

B. A caregiver shall not supervise a group of children who count more than 16 points.

C.A caregiver's own children and resident children under eight years of age count in point maximums.

22VAC40-121-940. General requirements for programs.

A. In order to promote the child's physical, intellectual, emotional, and social well-being and growth, caregivers shall:

1. Talk to the child;

2. Provide needed help, comfort, and  support;

3. Respect personal privacy;

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

5. Encourage decision-making abilities;

6. Promote ways of getting along;

7. Encourage independence and self-direction; and

8. Use consistency in applying expectations.

B. Caregivers shall provide age-appropriate activities for children in care throughout the day that:

1. Are based on the physical, social, emotional, and intellectual needs of the children;

2. Reflect the diversity of enrolled children's families, culture, and ethnic backgrounds; and

3. Enhance the total development of children.

C. Daily age-appropriate activities shall include:

1. Opportunities for alternating periods of indoor active and quiet play depending on the ages of the children;

2. Opportunities for vigorous outdoor play daily, depending upon the weather, the ages, and the health of the children;

3. Opportunities for one or more regularly scheduled rest or nap periods. Children unable to sleep shall be provided time and space for quiet play;

4. Opportunities for children to learn about themselves, others, and the world around them;

5. Opportunities for children to exercise initiative and develop independence in accordance with their ages; and

6. Opportunities for structured and unstructured play time and provider-directed and child-initiated learning activities.

22VAC40-121-950. Requirements for sleeping and resting.

A. Infants shall be placed on their backs when sleeping or napping unless otherwise ordered by a written statement signed by the child's physician.

B. An infant, toddler, or preschool child who falls asleep in a play space other than his own crib, cot, mat, or bed shall be moved promptly to his designated sleeping space if the safety or comfort of the infant, toddler, or preschool child is in question.

C. School age children shall be allowed to nap if needed, but not forced to do so. 

22VAC40-121-960. Daily activities for infants and toddlers.

A. Infants and toddlers shall be provided with opportunities to:

1. Interact with caregivers and other children in the home in order to stimulate language development;

2. Play with a wide variety of safe, age-appropriate toys;

3. Receive individual attention from caregivers including, but not limited to, holding, cuddling, talking, and reading; and

4. Reach, grasp, pull up, creep, crawl, and walk to develop motor skills.

B. Infants and toddlers shall spend no more than 30 minutes of consecutive time during waking hours, with the exception of mealtimes, confined in a crib, play pen, high chair or other confining piece of equipment. The intervening time period between confinements shall be at least one hour. 

22VAC40-121-970. Television, computers, videos, and video games.

A. Use of media such as, but not limited to, television, videos, video games, and computers shall be:

1. Limited to not more than a total of two hours per day; and

2. Limited to programs, tapes, websites, and software that are produced for children or are suitable for children.

B. Other activities shall be available to children during television or video viewing.

22VAC40-121-980. Care of a child with special needs.

A. Caregivers shall provide a child with special needs with the care and activities recommended in writing by a physician, psychologist, or other professional who has evaluated or treated the child.

B. The written recommendation shall:

1. Include instructions for any special treatment, diet, or restrictions in activities that are necessary for the health of the child; and

2. Be maintained in the child's record.

C. The provider shall ensure the environment is appropriate for the child based on the plan of care and shall instruct other caregivers in the proper techniques of care.

D. A caregiver shall perform only those procedures and treatments for which he has the necessary training, experience, credentials, or license to perform.

E. Staffing shall be appropriate and adequate to meet the specific physical and developmental needs of a child with special needs in care.

F. The provider and the parent of the child with special needs shall mutually determine a recommendation for the level of staffing necessary to care for and supervise the child based on the child's chronological and functional age and degree of disability.

G. Within 30 days of the child's enrollment, the system shall provide the department's representative a written recommendation for the level of staffing necessary to care for and supervise the child.

H. The department shall make the final decision regarding level of staffing or any capacity limitations necessary to care for, supervise, and protect all children in care when a child with special needs is receiving care.

I. The parent, system, and department's representative shall review the staffing requirements annually.

J. A separate area shall be provided for the purpose of privacy for diapering, dressing, and other personal care procedures for a child above age three with special needs who requires assistance in these activities.

22VAC40-121-990. Behavioral guidance.

A. Caregivers shall use positive methods of discipline. Discipline shall be constructive in nature and include techniques such as:

1. Using limits that are fair, consistently applied, appropriate, and understandable for the child's level of development;

2. Providing children with reasons for limits;

3. Giving positively worded direction;

4. Modeling and redirecting children to acceptable behavior;

5. Helping children to constructively express their feelings and frustration to resolve conflict; and

6. Arranging equipment, materials, activities, and schedules in a way that promotes desirable behavior.

B. When time out is used as a discipline 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 circumstances;

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 caregiver; and

5. The child shall not be left alone inside or outside the home while separated from the group.

22VAC40-121-1000. Forbidden actions.

The following acts or threats thereof are forbidden:

1. Physical punishment including, but not limited to, 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, 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 pens, high chairs, and safety gates when used for their intended purpose with children preschool age or younger;

3. Punishment by another child;

4. Withholding or forcing of food, water, or rest;

5. Verbal remarks that are demeaning to the child;

6. Punishment for toileting accidents; and

7. Punishment by applying unpleasant or harmful substances.

22VAC40-121-1010. Parent notifications.

A. Caregivers shall provide information daily to parents about the child's health, development, behavior, adjustment, or needs.

C. The provider shall give parents prior notice when a substitute provider will be caring for the children.

D. Caregivers shall notify parents and the system when persistent behavioral problems are identified and such notification shall include any disciplinary steps taken in response.

E. The provider shall notify the parent immediately and the system as soon as practicable, but no later than 12 hours after the incident when the child:

1. Has a head injury or any serious injury that requires emergency medical or dental treatment;

2. Has an adverse reaction to medication administered;

3. Has been administered medication incorrectly;

4. Is lost or missing; or

5. Has died.

F. The provider shall notify a parent and the system the same day whenever first aid is administered to the child.

G. When a child has been exposed to a communicable disease listed in the Department of Health's current communicable disease chart, the provider shall notify the parent and the system within 24 hours or the next business day of the home's having been informed, unless forbidden by law, except for life-threatening diseases, which must be reported to parents immediately. The provider shall consult the local health department if there is a question about the communicability of a disease.

H. Parents shall be informed of any changes in the home's emergency preparedness and response plan.

I. Except in emergency evacuation or relocation situations, the provider shall inform the parent and the system and have written permission as required by 22VAC40-111-580 whenever the child will be taken off the premises of the member home, before such occasion.

J. If an emergency evacuation or relocation is necessary, the parent shall be informed of the child's whereabouts as soon as possible. 

22VAC40-121-1020. Swimming and wading activities.

A. The level of supervision by caregivers required in 22VAC40-121-920 and the point system as outlined in 22VAC40-121-930 shall be maintained while the children are participating in swimming or wading activities.

B. Caregivers shall have a system for accounting for all children in the water.

C. Outdoor swimming activities shall occur only during daylight hours.

D. When one or more children are in water that is more than two feet deep in a pool, lake, or other swimming area on or off the premises of the member home:

1. A minimum of least two caregivers shall be present and able to supervise the children; and

2. An individual currently certified in basic water rescue, Water Safety Today, water safety instruction, or lifeguarding shall be on duty supervising the children participating in swimming or wading activities at all times. The certification shall be obtained from an organization such as, but not limited to, the American Red Cross, the YMCA, or the Boy Scouts.

22VAC40-121-1030. Exclusion of sick children.

A. Unless otherwise approved by a child's health care professional, a child shall be excluded from the member home if he has:

1. Both fever and behavior change. A fever means oral temperature over 101°F or armpit temperature over 100°F;

2. Diarrhea (more watery, less formed, more frequent stools not associated with a diet change or medication). Children in diapers who develop diarrhea shall be excluded, and children who have learned to use the toilet, but cannot make it to the toilet in time, shall also be excluded;

3. Recurrent vomiting (vomiting two or more times in 24 hours); or

4. 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 parents or designated emergency contact shall be contacted immediately so that arrangements can be made to remove the child from the member home as soon as possible; and

2. The child shall remain in a quiet, designated area and the caregiver shall respond immediately to the child until the child leaves the member home.

22VAC40-121-1040. Hand washing.

A. Caregivers shall wash their hands with liquid soap and warm running water:

1. When their hands are dirty;

2. After toileting;

3. Before preparing and serving food;

4. Before feeding or helping children with feeding;

5. After contact with any body fluids;

6. After handling or caring for animals;

7. After handling raw eggs or meat; and

8. After diapering a child or assisting a child with toileting.

B. Caregivers shall ensure that children's hands are washed with liquid soap and warm running water:

1. When their hands are dirty;

2. Before eating;

3. After toileting or diapering;

4. After handling or caring for animals; and

5. After contact with any body fluids.

22VAC40-121-1050. Diapering and toileting.

A. A child shall not be left unattended on a changing table during diapering.

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

C. During each diaper change or after toileting accidents, the child's genital area shall be thoroughly cleaned with a moist disposable wipe or a moist, clean individually assigned cloth, if the child is allergic to disposable wipes.

D. The diapering surface shall be:

1. Separate from the kitchen, food preparation areas, or surfaces used for children's activities;

2. Nonabsorbent and washable; and

3. Cleaned and sanitized after each use.

E. Soiled disposable diapers and wipes shall be disposed of in a leak-proof or plastic-lined storage system that is either foot operated or used in such a way that neither the caregiver's hand nor the soiled diaper or wipe touches the exterior surface of the storage system during disposal.

F. When cloth diapers are used, a separate leak-proof storage system as specified in subsection E of this section shall be used.

G. Children five years of age and older shall be permitted privacy when toileting.

H. Caregivers shall respond promptly to a child's request for toileting assistance.

I. The provider shall consult with the parent before toilet training is initiated.

J. Toilet training shall be relaxed and pressure free.

K. There shall be a toilet chair or an adult-sized toilet with a platform or steps and adapter seat available to a child being toilet trained.

L. Toilet chairs, when used, shall be emptied promptly, cleaned and sanitized after each use.

22VAC40-121-1060. General requirements for medication administration.

A. Prescription and nonprescription medications shall be given to a child:

1. According to the member home's written medication policies, and

2. Only with written authorization from the parent.

B. The parent's written authorization for medication shall expire or be renewed after 10 working days.

EXCEPTION: Long-term prescription and nonprescription drug use may be allowed with written authorization from the child's physician and parent.

C. 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 shall be taken to a pharmacy for proper disposal

22VAC40-121-1070. Prescription medication.

The member home 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 caregiver who meets the requirements in 22VAC40-121-560;

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

3. The caregiver 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.

22VAC40-121-1080. Nonprescription medication.

A. The member home may administer nonprescription medication provided the medication is:

1. Administered by a caregiver 18 years of age or older who meets the requirements in 22VAC40-121-560;

2. Labeled with the child's name;

3. In the original container with the manufacturer's direction label attached; and

4. Given only at the dose, duration, and method of administration specified on the manufacturer's label for the age or weight of the child needing the medication.

B. Nonprescription medication shall not be used beyond the expiration date of the product.

22VAC40-121-1090. Storage of medication.

A. Medications for children in care shall be stored separately from medications for household members and caregivers.

B. When needed, medication shall be refrigerated.

C. 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.

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

E. If a key is used, the key shall be inaccessible to the children.

22VAC40-121-1100. Medication records.

The provider shall keep a record of prescription and nonprescription medication given children, which shall include the following:

1. Name of the 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. Name of the caregiver administering the medication;

5. Any adverse reactions; and

6. Any medication administration error.

22VAC40-121-1110. Topical skin products.

A. When topical skin products such as sunscreen, diaper ointment and lotion, oral teething medicine, and insect repellent are used, 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. Parents shall be informed immediately of any adverse reaction.

B. The product does not need to be kept locked, but shall be inaccessible to children.

C. Caregivers without medication administration training may apply the product unless it is a prescription medication, in which case the storing and administration must meet prescription medication requirements of this chapter.

D. The product shall not be used beyond the expiration date of the product.

E. Sunscreen shall have a minimum sunburn protection factor (SPF) of 15. 

22VAC40-121-1120. First aid and emergency medical supplies.

A. The following emergency supplies shall be in the member home, accessible to outdoor play areas, on field trips, in vehicles used for transportation and wherever children are in care:

1. A first aid kit that contains at a minimum:

a. Scissors;

b. Tweezers;

c. Gauze pads;

d. Adhesive tape;

e. Adhesive bandages, assorted sizes;

f. Antiseptic cleaning solution or pads;

g. Digital thermometer;

h. Triangular bandages;

i. Single use gloves such as surgical or examination gloves;

j. In member homes located more than one hour's travel time from a healthcare facility, activated charcoal preparation (to be used only on the direction of a physician or the member home's local poison control center); and

k. First aid instructional manual.

2. An ice pack or cooling agent.

B. The first aid kit shall be readily accessible to caregivers and inaccessible to children.

22VAC40-121-1130. Emergency information.

A working battery-operated flashlight, a working portable battery-operated weather band radio, and extra batteries shall be kept in a designated area and be available to caregivers at all times.

22VAC40-121-1140. Emergency information.

The emergency contact information required by 22VAC40-121-430 C 2 and the parent's written authorization for emergency medical care as required by 22VAC40-121-430 C 3 shall be made available to a physician, hospital, or emergency responders in the event of a child's illness or injury.

22VAC40-121-1150. Posted telephone numbers.

The following telephone numbers shall be posted in a visible area close to the telephone:

1. A 911 or local dial number for police, fire, and emergency medical responders;

2. The responsible person for emergency backup care as required in 22VAC40-121-1160 A 3; and

3. The regional poison control center.

22VAC40-121-1160. Emergency preparedness and response plan.

A. The member home shall have a written emergency preparedness and response plan that:

1. Includes emergency evacuation, emergency relocation, and shelter-in-place procedures;

2. Addresses the most likely to occur scenarios including, but not limited to fire, severe storms, flooding, tornadoes, and loss of utilities; and

3. Includes provisions for a responsible person who is 18 years of age or older and is able to arrive at the member home within 10 minutes for emergency backup care until the children can be picked up by their parents.

B. The provider shall review the emergency plan at least annually and update the plan as needed. The provider shall document in writing each review and update to the emergency plan.

C. The provider shall ensure that each substitute provider and assistant receives training regarding the emergency evacuation, emergency relocation, and shelter-in-place procedures by the end of his first week of assuming job responsibilities, on an annual basis, and at the time of each plan update.

22VAC40-121-1170. Evacuation and relocation procedures.

Evacuation procedures shall include:

1. Methods to alert caregivers and emergency responders;

2. Designated primary and secondary routes out of the building;

3. Designated assembly point away from the building;

4. Designated relocation site;

5. Methods to ensure all children are evacuated from the building and, if necessary, moved to a relocation site;

6. Methods to account for all children at the assembly point and relocation site;

7. Methods to ensure essential documents, including emergency contact information, medications, and supplies are taken to the assembly point and relocation site;

8. Method of communication with parents and emergency responders after the evacuation; and

9. Method of communication with parents after the relocation.

22VAC40-121-1180. Shelter-in-place procedures.

Shelter-in-place procedures shall include:

1. Methods to alert caregivers and emergency responders;

2. Designated safe location within the home;

3. Designated primary and secondary routes to the safe location;

4. Methods to ensure all children are moved to the safe location;

5. Methods to account for all children at the safe location;

6. Methods to ensure essential documents, including emergency contact information, and supplies are taken to the safe location; and

7. Method of communication with parents and emergency responders.

22VAC40-121-1190. Emergency response drills.

A. The emergency evacuation procedures shall be practiced monthly with all caregivers and children in care during all shifts that children are in care.

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

C. Documentation shall be maintained of emergency evacuation and shelter-in-place drills that include:

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 caregivers 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. 

D. Records of emergency evacuation and shelter-in-place drills shall be maintained for one year.

22VAC40-121-1200. Injury records.

A. The provider shall record in the child's record an injury or accident sustained by a child while at the member home that requires first aid or emergency medical or dental treatment.

B. The information recorded shall include the following:

1. Date and time of injury;

2. Name of injured child;

3. Type and circumstance of the injury;

4. Caregiver present and action taken;

5. Date and time when parents were notified;

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

7. Caregiver and parent signatures or two caregiver signatures; and

8. Documentation on how the parent was notified.

22VAC40-121-1210. Reports to system.

A. The provider shall report to the system within 24 hours of the circumstances surrounding the following incidents:

1. Lost or missing child when local authorities have been contacted for help,

2. Serious injury to a child while under the member home's supervision, and

3. Death of a child while under the member home's supervision.

B. A written report shall be completed and submitted to the system within five working days of the date the incident occurred.

22VAC40-121-1220. Reports of suspected child abuse or neglect and disease outbreaks.

A. A caregiver shall immediately call the local department of social services or call the toll free number of the Child Abuse and Neglect Hotline (1-800-552-7096/TDD) whenever there is reason to suspect that a child has been or is being subjected to any kind of child abuse or neglect by any person.

B. The provider shall immediately make or cause to be made a report of an outbreak of disease as defined by the Virginia Board of Health.  Such report shall be made by rapid means to the local health department or to the Commissioner of the Virginia Department of Health.

C.  The provider shall notify the system as soon as practicable, but no later than 24 hours after reporting suspected child abuse or neglect or after reporting a disease outbreak.

22VAC40-121-1230. General requirements for meals and snacks.

A. Meals and snacks shall be served in accordance with the times children are in care, which include:

1. For member homes operating less than four consecutive hours, at least one snack  shall be served.

2. For member homes operating four to seven consecutive hours, at least one meal and one  snack shall be served.

3. For member homes operating seven to 12 consecutive hours, at least one meal and two snacks, or two meals and one snack shall be served.

4. For member homes operating 12 to 16 consecutive hours, at least two meals and two snacks or three meals and one snack shall be served. 

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

C. The member home shall schedule snacks or meals so 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. Children shall be served small-sized portions.

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

F. Leftover food shall be discarded from individual plates following a meal or snack.

G. Tables and high chair trays shall be cleaned after each use and at least daily.

22VAC40-121-1240. Meals and snacks provided by member home.

When member homes provide meals or snacks, the following shall apply:

1. Member homes shall follow the most recent, age-appropriate nutritional requirements of a recognized authority such as the Child and Adult Care Food Program of the United States Department of Agriculture (UDSA).

2. Children shall be allowed second helpings of food listed in the child care food program meal patterns.

22VAC40-121-1250. Meals and snacks brought from the child's home.

When food is brought from a child's home, the following shall apply:

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

2. The member home shall have extra food or shall have provisions to obtain food to serve to a child so the child can have an appropriate snack or meal as required in 22VAC40-121-1230 if the child forgets to bring food from home or brings an inadequate meal or snack; and

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

22VAC40-121-1260. Preventing choking.

A. To assist in preventing choking, food that is hard, round, small, thick and sticky, or smooth and slippery such as whole hot dogs sliced into rounds, nuts, seeds, raisins, uncut grapes, uncut raw carrots, peanuts, chunks of peanut butter, hard candy, and popcorn shall not be served to children under four years of age, unless the food is prepared before being served in a manner that will reduce the risk of choking, i.e., hot dogs cut lengthwise, grapes cut in small pieces, and carrots cooked or cut lengthwise.

B. Children shall not be allowed to eat or drink while walking, running, playing, lying down, or riding in vehicles.

22VAC40-121-1270. Drinking water and fluids.

A. Water shall be available for drinking and shall be offered on a regular basis to all children in care.

B. In environments of 80ºF 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.

C. Clean individual drinking cups shall be provided daily. Children shall not be allowed to share common drinking cups.

22VAC40-121-1280. Menus.

When meals or snacks are provided by the member home, the menu for the current one-week period shall:

1. Be dated;

2. Be given to parents or posted or placed in an area accessible to parents;

3. List any substituted food; and

4. Be kept on file one week at the member home.

22VAC40-121-1290. Eating utensils and dishes.

A. Eating utensils shall be appropriate in size for children to handle.

B. Chipped or cracked dishes shall not be used.

C. Eating utensils and dishes shall be properly cleaned by prerinsing, washing, and air drying, or using a dishwasher.

D. Eating utensils and dishes shall be stored in a clean dry place, and protected from contamination.

E. If disposable eating utensils and dishes are used, they shall be sturdy enough to prevent spillage or other health and safety hazards.

F. Disposable utensils and dishes shall be used once and discarded.

22VAC40-121-1300. Food storage.

A. Temperatures shall be maintained at or below 40°F in refrigerator compartments and at or below 0°F in the freezer compartments.

B. The provider shall have an operable thermometer available to monitor refrigerator and freezer compartment temperatures.

C. All perishable foods and drinks used for children in care, except when being prepared and served, shall be kept in the refrigerator.

22VAC40-121-1310. Milk.

A. All milk and milk products shall be pasteurized.

B. Powdered milk shall be used only for cooking.

22VAC40-121-1320. Feeding infants.

A. Infants shall be fed on demand unless the parent provides other written instructions.

B. Infants who cannot hold their own bottles shall be picked up and held for bottle feeding. Bottles shall not be propped.

C. High chairs, infant carrier seats, or feeding tables with safety waist and crotch straps fastened according to the manufacturer's instructions shall be used for children under 12 months of age who are not held while being fed.

D. Infant formula shall be prepared according to the manufacturer's or physician's instructions.

E. Bottles shall be refrigerated and labeled with the child's full name and the date, if more than one infant is in care.

F. Refrigerated bottles of prepared formula and breast milk shall be discarded after 48 hours if not used.

G. Bottles shall not be heated in a microwave oven.

H. To avoid burns, heated formula and baby food shall be stirred or shaken and tested for temperature before being served to children.

I. A child's mother shall be granted access to a private area of the member home to facilitate breast feeding.

J. Solid foods shall:

1. Not be fed to infants less than four months of age without parental consent, and

2. Be fed with a spoon, with the exception of finger foods.

K. Baby food shall be served from a dish and not from the container.

L. Baby food remaining in:

1. A serving dish shall be discarded;

2. Opened containers, from which a portion has been removed, shall be refrigerated and labeled with the child's full name and the date, if more than one infant is in care; and

3. Opened containers stored in the refrigerator shall be discarded if not consumed within 24 hours of storage.

22VAC40-121-1330. Special feeding needs.

A. The consistency of food provided for a child with special needs shall be appropriate to any special feeding needs of the child.

B. Necessary and adaptive feeding equipment and feeding techniques shall be used for a child with special feeding needs.

22VAC40-121-1340. Requirements for drivers .

A. Drivers must be 18 years of age or older.

B. The provider shall ensure that during transportation of children the driver has:

1. A valid driver's license;

2. The name, address, and telephone number of the member home;

3. A copy of the parent's written permission to transport the child;

4. A copy of each child's emergency contact information as required in 22VAC40-121-430 A 6;

5. Emergency medical supplies as required in 22VAC40-121-1120; and

6. A mechanism for making telephone calls to emergency responders and parents (e.g., change, calling card, cellular phone).

22VAC40-121-1350. Requirements for vehicles.

The provider shall ensure that the vehicle used for transportation:

1. Meets the safety standards set by the Virginia Department of Motor Vehicles;

2. Is kept in satisfactory condition to assure the safety of children;

3. Is licensed and insured according to state law;

4. Was manufactured for the purpose of transporting people seated in an enclosed area; and

5. Has seats that are attached to the floor.

22VAC40-121-1360. Requirements for transportation.

The provider shall ensure that during transportation of children:

1. Each child is in an individual car seat or individual and appropriate restraint in accordance with Virginia law;

2. 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. No child is left unattended inside or outside a vehicle; and

5. Each child boards and leaves the vehicle from the curb side of the street.

22VAC40-121-1370. Nighttime care.

A. For nighttime care during which a child sleeps more than two hours, the following is required:

1. A child shall have a rest area that meets the requirements of 22VAC40-121-870,

2. An infant shall have an individual crib that meets the requirements of 22VAC40-121-880, and

3. Linens shall be provided that meet the requirements in 22VAC40-111-890.

B. For children in nighttime care, quiet activities and experiences shall be available immediately before bedtime.

C. Providers shall establish a bedtime schedule for a child in consultation with the child's parent.

D. Separate sleeping and dressing areas shall be provided for children of the opposite sex over six years of age.

E. Each child shall have a toothbrush, and a comb or hair brush assigned for individual use.

F. Each child nine months of age or older shall have flame-resistant or snug-fitting sleepwear.

G. Bath towels and washcloths, when used, shall be assigned for individual use and laundered as needed, but at least weekly.

H. A child shall have a routine that encourages good personal hygiene practices including bathing (if needed) and teeth brushing.

I. Caregivers shall remain awake until all children are asleep and shall sleep on the same floor level as the children in care.

J. A baby monitor shall be used if the caregiver is not sleeping in the room with the child or in a room adjacent to the room where the child is sleeping.