Specific Rules for Basic Care Agencies Providing Care for Infant, Toddler, or Preschool Age Children (Birth Through Age Six (6))

PURPOSE: This rule sets forth the requirements for personnel, indoor and outdoor space, and equipment. (1) Physical Requirements. (A) General Requirements. 1. Stairways shall be well-lighted and free of obstructions. Stairways having more than three (3) steps shall have a handrail the children can reach. 2. Porches, decks, stairwells, or other areas having a significant drop-off from which children might fall and be injured shall have an approved railing or approved barrier. The railing or barrier shall be constructed to prevent the child from crawling or falling through or becoming entrapped. 3. Approved safety gates at stairways and doors shall be provided and used as needed. 4. Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children. 5. Heaters, floor furnaces, radiators, hot water heaters, or other equipment which pose a threat to children shall be separated from areas used by children by partitions, screens, or other approved barriers. 6. Smoking shall be prohibited in child care, food preparation, and food service areas. (B) Indoor Space. 1. General requirements. A. Open windows and doors shall be securely screened. Barriers to prevent children from falling against windows or falling from windows shall be provided when windows are less than twenty-four inches (24") from the floor and not constructed of safety glass or other unbreakable material. B. Walls, ceilings, and floors shall be finished with material which can be cleaned easily and shall be free of splinters, cracks, and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces. C. Concrete floors in areas utilized for child care shall be covered with carpet, tile, linoleum, or other floor covering. D. Floor surfaces under indoor equipment from which children might fall and be injured, shall be protected with pads or mats which will effectively cushion the fall of a child. Carpeting alone is not an acceptable resilient surface under indoor equipment. E. Toilet and handwashing facilities shall be in working order and convenient for the children’s use. F. Paper towels, soap, and toilet paper shall be provided and easily accessible so the children can reach them without assistance. G. Locks or latches shall not be used on bathroom or bathroom stall doors. H. One (1) potty chair, junior commode, or toilet with an adaptor seat shall be provided for every four (4) children being toilet trained. Potty chairs shall be located in the bathroom and shall be emptied, cleaned, and disinfected after each use. (C) Diapering Area. 1. A safe diapering table with a waterproof washable surface shall be used for changing diapers. The diapering table shall be located within or adjacent to the group space so staff using the diapering table can maintain supervision of his/her group of children at all times. 2. Operating sites shall have one (1) diapering table for every group of eight (8) infant/toddlers. 3. Diapering supplies, and a properly equipped hand washing sink with warm running water, soap, and a towel or other Department of Health and Senior Services approved hand sanitizing method shall be adjacent to the diapering area. (D) Outdoor Space. 1. General requirements. A. An outdoor play area shall be available on, or adjoining, the agency’s property. The area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water, or other hazards. B. The play area shall be safe for children’s activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks, or other debris and shall have good drainage. C. The fall-zone area under and around outdoor equipment where children might fall and be injured shall be covered with impact-absorbing materials which will effectively cushion the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting, or other approved resilient material. (E) Swimming and Wading Pools. 1. Swimming and wading pools used by children shall be constructed, maintained, and used in a manner which safeguards the lives and health of children. 2. Swimming and wading pools shall be fenced to prevent access by children. The fence shall be at least forty-eight inches (48") high with a self-closing, self-latching door that must be unlatched from the inside and should be constructed so that a four-inch (4") sphere could not be passed through the fence. 3. Children using swimming or wading pools shall be instructed in water safety and supervised by an adult at all times. 4. An adult with a current lifeguard training certificate, including infant/child cardio pulmonary resuscitation training, shall be on duty at all times when a swimming pool or other bodies of water containing a water depth of twenty-four inches (24") or more is being used. 5. An adult who has completed a course in basic water safety, which includes infant/child cardio pulmonary resuscitation, shall be on duty when a swimming pool containing less than twenty-four inches (24") of water is being used. (F) Sleeping Equipment. 1. An individually assigned crib, portable crib, or playpen shall be provided for each infant and toddler. Stack cribs shall not be used. 2. Cribs and playpens shall have side rail spokes which conform to current United States Consumer Product Safety Commission standards. 3. The crib mattress or playpen pad shall be correctly sized to the crib or playpen, in good condition, waterproof, and kept clean and dry. Sheets and covers shall be changed immediately when soiled or wet. (G) Tables and Seating Equipment. 1. Individual chairs and table space for the licensed capacity of the operating site shall be available for children twelve (12) months of age and older. Chairs shall be proportioned so children sit comfortably and securely. 2. Infants and toddlers who are unable to sit at a table shall have one (1) piece of mealtime feeding equipment for every four (4) infant/toddlers which may include feeding tables, high chairs, infant seats, or other safely designed infant seating equipment. Equipment shall be provided which will allow the child to sit comfortably and securely while being fed. Appropriate safety restraints shall be used according to manufacturer’s instructions. (H) Indoor Play Equipment and Materials. 1. General requirements. A. Play equipment and materials shall be clean, in good condition with all parts intact and accessible to children. B. Play equipment and materials shall be replaced as needed to maintain the number of items required for the licensed capacity of the operating site. 2. Preschool and school-age children. A. Children twenty-four (24) months of age and older shall have an ample variety of age-appropriate toys, books, creative materials and activities which provide fun, stimulation, development, and opportunities for individual choices. B. The following shall be required: (I) Blocks, construction, and transportation toys; (II) Manipulatives; (III) Creative arts; (IV) Gross motor activities; (V) Library and language activities; (VI) Music and rhythm activities; (VII) Dramatic and housekeeping play; and (VIII) Science activities or sensory experiences. C. Infants and toddlers. (I) Infants and toddlers shall have safe toys which shall be washed or sanitized at least weekly or when soiled. Toys, parts of toys, or other materials shall not be small enough to be swallowed. Toys and materials shall include, but not be limited to, each of the following: (a) Push-pull toys; (b) Balls or other gross motor equipment; (c) Blocks, stacking toys, or other manipulatives; and (d) Cloth or plastic-coated books. 3. Outdoor equipment. A. All outdoor equipment shall be safely constructed, in good condition and free of sharp, loose, or pointed parts. Only lead-free paint shall be used. B. Outdoor equipment shall be provided for the ages and number of children in care to meet their physical and developmental needs. C. Children shall be instructed in the safe use of outdoor equipment. D. Stationary equipment such as swings, slides, and climbers shall be securely anchored, have no exposed footings, and be placed to avoid accidents or collisions. E. Any hanging apparatus that might entrap, close, or tighten upon a child shall not be used. F. Trampolines shall not be used. Mini-trampolines, aerobic bouncers, or other similar small jumping equipment may be used with close supervision. AUTHORITY: sections 210.481, 210.486, and 210.506, RSMo 2000.* This rule originally filed as 13 CSR 40-71.100. Emergency rule filed Nov. 1, 1993, effective Nov. 12, 1993, expired March 11, 1994. Emergency rule filed March 2, 1994, effective March 12, 1994, expired July 9, 1994. Original rule filed Nov. 1, 1993, effective June 6, 1994. Moved to 13 CSR 35-71.100, effective Oct. 30, 2008. Amended: Filed Dec. 16, 2013, effective June 30, 2014. *Original authority: 210.481, RSMo (1982), amended 1985 and 210.486 and 210.506, RSMo (1982), amended 1993.