These regulations sadly miss an opportunity to clarify expectations and best practices. The lack of readability reduces clarity and decreased compliance. The length makes the process seem overwhelming and increases the barrier to licensure. We can do better. This regulation update also fails to deal with multiple other sections of regulations that need modernizing.

22VAC40-185-240 B - DSS Orientation Course

• It is unlikely that this course will provide any value to teachers, there is no research to indicate courses of this nature are effective at teaching material or impacting behavior.

• Any course implemented should reflect best practices for adult education.

22VAC40-185-245 G Medication administration and daily health observation

• It's unclear why one would group these two things together and this decreases clarity of the following sections. This is EXTREMELY confusing.

• These two things MUST be separated.  Sections 1-4 would be under medication administration and section 5 would be its own daily health observation section.

• Further, the Medication administration sections 1-4 are poorly organized and written.

  • Section 1 and 3 say the same thing, they should be combined. I see absolutely no reason to separate them. Once rewritten this section should go first.

  • 1a and 3b Addressed the department rather than the licensed program which is not done in other areas. I just found that confusing.

22VAC40-185-245 G 4 Emergency Medications

• The “in the care of” wording concerns me.

• How would that work practically for children in the program? Is this expecting all staff to get MAT training?

• If there is an administrator not included in ratio of any other classroom immediately on call and MAT trained that would actually in my opinion be better because the person would be available and the other children supervised but that would likely not meet 'in the care of'.

• Perhaps it could state, “A plan shall be in place to ensure any child for whom emergency medications have been prescribed will have immediate access to a trained staff member.”

22VAC40-185-80 2 - Reporting of Injuries

• While it is very valuable to have injuries reported for data collections however this has already caused some questions.

• These reports are being used by DSS to target programs for citation which is eroding the relationships between licensing agents and the programs, not to mention adding additional work to already over stretched agents.

• Will these reports trigger a licensing visit? If so, how will the licensing agent’s caseload be adjusted to accommodate?

22VAC40-185-240 D - Orientation Period

• It seems this is implying though it is unclear that a program could not have an orientation period longer than 7 days even if the staff member is not supervising children during the period.

• Many programs have longer orientation periods, I don’t know why that would be a problem.

• It seems it could say “within seven days of assuming supervising responsibilities”

22VAC40-185-40 M - List of Allergies

• This seems confusing and to add unnecessary complication. I'm not sure why it would be confidential vs. just posted. Does all children mean other classrooms need a list of children not in their classroom? Does all areas mean also outside?

22VAC4-185-350 A Group Size

• The proposed group size for toddlers is 15, based on a 1:5 ratio which is understandable. Our program operates at a lower 1:4 ratio with a group size of 16 and I think that should be acceptable, it is only one more child and would be an additional teacher.

22VAC40-185-80 B 1 C

• This is unclear and I'm not sure why it would be necessary or even helpful.

• For example if we have two snow days would we need to notify?

• What if our power was out and we closed early one day then it wasn’t repaired the next so we closed?

22VAC40-185-240 C

• C would be unnecessary if you just add the word all to D between 'completed on ALL the following'

• Remember brevity and clarity for readers increases compliance.

22VAC40-185-245 B1 Exemptions to Training Requirements

• It is completely unclear who “staff who do not work with a group of children” would be.

• Administrators, directors, floaters, substitutes.

• Perhaps something about “regularly supervising children” would be clearer.

22VAC40-185-245 E (1-12)

• This has been repeated three times it seems that it would be clearer to write it once and refer to it.

• Perhaps a section on training topics”The following are acceptable training topics” Then with some listed as required for orientation and ongoing, orientation only, ongoing only.

NOTES ON EXISTING REGULATIONS

22VAC40-185-140 B Physical Exam

• This elaborate requirement is completely unnecessary just a simple regulation based on the lowest requirement there would be fine.

22VAC40-185-500 A3 a and b Hand Washing

• I have no idea why you would wash your hands before giving a child a diaper change or helping them use the potty. That seems really unnecessary. No one washes their hands prior to changing a diaper.

22VAC40-185-500 B 5 States Diapering

• It is best practice to allow cloth diapering if the program can do it in accordance with the other regulations

22VAC40-185-500 C Toileting

• This is burdensome and unnecessary.

• A classroom with 15 toddlers would not likely need two toilets and a changing table.

• How is it determined who is toilet training and who is not?

• Best practice would be to call it toilet learning rather than training in my opinion and for it to be a slow child guided process of introduction. But if we are following that process than ‘more than 10 children in the process of being toilet trained’.

• It is best practice to have bathrooms in the classroom of the children but this would encourage children have a communal bathroom.

22VAC40-185-510

This section is so poorly organized it is very unclear when the regulation is talking about prescription and non-prescription medication. It would be much clearer is it was a section for all medication (Rx and non) then a section for prescription medications in addition.