Responsibilities of Caregivers

PURPOSE: This rule establishes the responsibilities of caregivers in license-exempt facilities. (1) The responsibilities of caregivers are— (A) Children shall not be left without adult supervision. 1. A caregiver shall personally admit each child upon arrival and personally dismiss each child upon departure. Children shall be dismissed only to a parent, guardian, legal custodian, or to individuals approved by a parent, guardian or legal custodian. 2. A caregiver shall remain in the room with infants, preschool and school-age children while the children are napping and shall be able to see and hear the children if they have difficulty during napping or when they awaken. 3. Caregivers shall be alert to various needs of each child such as thirst, hunger, diaper change, aggression by other children and need for attention; (B) Facility directors, with the exception of directors in facilities operated by religious organizations, shall establish a written discipline plan that includes simple, understandable rules for children’s behavior. 1. Expectations for a child’s behavior shall be appropriate for the developmental level of the child and explained to the child. 2. Only constructive, age-appropriate methods of discipline that help children develop self-control and assume responsibility for their own actions shall be used. 3. Physical punishment including, but not limited to, spanking, slapping, shaking, biting or pulling hair is prohibited. 4. Any discipline technique that is humiliating, threatening or frightening to children is prohibited. Children shall not be shamed, ridiculed or spoken to harshly, abusively or with profanity. 5. Punishment or threat of punishment shall not be associated with food, rest, toileting accidents or toilet training. 6. Children shall not be placed in a closet, a locked or unlighted room, or any other frightening place. 7. Children shall not be permitted to intimidate or harm others, harm themselves or destroy property; (C) Facility directors, with the exception of directors in facilities operated by religious organizations, shall establish a daily schedule of activities for all children in care. The schedule shall include the following: 1. A total of at least one (1) hour of outdoor play for children in full-day attendance, unless prevented by weather extremes or medical reasons; 2. Toileting and handwashing times; 3. Regular snack and meal times, with infants being fed according to the individualized feeding schedule established by a parent; and 4. A supervised nap or rest period for preschool children after the noon meal, with infants allowed to remain in bed a maximum of thirty (30) minutes after awakening. Toddlers shall be taken out of bed for other activities when they awaken; (D) Facility directors shall not allow animals which may pose a threat to the health or safety of children on the premises or the animals shall be penned securely in an area that is inaccessible to children; (E) A caregiver shall supervise children in the bathroom; (F) Caregivers shall meet the following requirements regarding diapering areas: 1. A safe, waterproof and washable diapering surface shall be used for changing diapers. The diapering area shall be located within or adjacent to the infant/toddler group so the caregiver using the diapering surface can maintain supervision of his/her group of children at all times; 2. One (1) diapering surface shall be provided for every group of eight (8) infants/toddlers and one (1) diapering surface shall be provided for every group of sixteen (16) two (2)-year-old children in the infant/toddler unit; 3. A diapering surface shall be available in the preschool unit if children who are not toilet trained are accepted; 4. Children shall be attended at all times while on the diapering surface; 5. No effort shall be made to toilet train a child until the parent and caregiver agree on when to begin; and 6. Extra clothing shall be available for children in case they accidentally soil themselves; (G) If meals are served, the facility director is responsible for assuring that the children’s diets are planned according to recognized nutrition standards; (H) In facilities providing care for less than four (4) hours per day or less than twenty (20) hours per week, children may bring sack lunches; and (I) Caregivers shall meet the following requirements for kitchens: 1. Kitchens shall not be used for children’s play activities unless the activities are part of a learning program and the children are supervised by adults; 2. Kitchens shall not be used for napping or as passageways for children; 3. Kitchens shall be separated from all other areas by walls or partitions at least thirty-six inches (36") high; and 4. Animals which may pose a threat to children shall not be permitted on the premises or shall be located in an area that is inaccessible to the children. Animals shall not be permitted in food preparation and storage areas. AUTHORITY: sections 210.221.1(3) and 210.252.5, RSMo Supp. 1999.* This rule was previously filed as 19 CSR 40-60.070. Original rule filed Dec. 1, 1994, effective July 30, 1995. Changed to 19 CSR 30-60.070 July 30, 1998. Emergency amendment filed March 1, 2000, effective March 11, 2000, expired Sept. 6, 2000. Amended: Filed March 1, 2000, effective Aug. 30, 2000. Moved to 5 CSR 25-300.060, effective Aug. 30, 2021. *Original authority: 210.221, RSMo 1949, amended 1955, 1987, 1993, 1995, 1999; 210.252, RSMo 1993, amended 1999.