Additional requirements for infant and toddler care

Additional requirements for infant and toddler care. (1) Applicability, qualifications and general requirements. (a) Family child care centers providing care and supervision to infants and toddlers shall comply with the additional requirements of this section. (c) General requirements. 1. A provider shall use information obtained on a department-provided form for children under 2 years of age to individualize the program of care for each child. The information shall be at the center before the child is left for care on the child’s first day of attendance. A provider and the child’s parents shall periodically discuss the child’s development and routines. 2. Cribs and playpens shall contain a tight-fitting mattress and a mattress covering that fits snugly over the mattress. 3. Sheets or blankets used to cover a child one year of age or older shall be kept away from the child’s mouth and nose, and if sleeping in a crib or playpen shall be tucked tightly under the mattress. 4. A child under one year of age may not sleep in a crib or playpen that contains soft or loose materials, such as sheepskins, pillows, blankets, flat sheets, bumper pads, bibs, pacifiers with attached soft objects, or stuffed animals. No blankets or other items may be hung on the sides of a crib or playpen. 4g. An audio monitoring device shall be used in any area or room where children under the age of one year are placed to sleep. 4r. Waterbeds may not be used by children under 2 years of age. 5. Safety gates shall be used at open stairways when children are awake. (2) Daily program. (a) Child care providers shall respond promptly to a crying child’s needs. (b) Each infant and toddler shall be allowed to form and follow his or her own patterns of sleeping and waking. (c) Each child under one year of age shall be placed to sleep on his or her back in a crib unless otherwise specified in writing by the child’s physician. The child shall be allowed to assume the position most comfortable to him or her when able to roll over unassisted. (d) Emphasis in activities shall be given to play as a learning and growth experience. (e) Throughout the day, each infant and toddler shall receive physical contact and attention such as being held, rocked, talked to, sung to and taken on walks inside and outside the center. (f) Routines related to activities such as taking a nap, eating, diapering and toileting shall be used as occasions for language development and other learning experiences. (g) When a non-mobile child is awake, a provider shall change the child’s body position and location in the room periodically. Non-mobile awake children shall be placed on their stomach occasionally throughout the day. (h) Each non-walking child who can creep or crawl shall be given opportunities each day to move freely in a safe, clean, open, warm and uncluttered area. (i) A provider shall encourage infants and toddlers to play with a wide variety of safe toys and objects. (3) Feeding. A provider shall do all of the following: (a) Feed each infant and toddler on the child’s own feeding schedule. (b) Ensure that food, breastmilk, and formula brought from home are labeled with the child’s name, dated, and refrigerated, if required. (bm) Ensure each infant and toddler is correctly fed the food, breastmilk, or formula labeled with the infant’s or toddler’s name. (c) Ensure that the food, breastmilk, or formula offered to infants and toddlers is consistent with the requirements of the U.S. department of agriculture child and adult care food program. (d) Provide formula or breast milk to all children under 12 months of age. (e) Provide another type of milk or milk substitute only on the written direction of the child’s physician. (f) Discard leftover milk or formula within 2 hours after each feeding and rinse bottles after use. (g) Refrain from heating breast milk or formula in a microwave oven. (h) Offer drinking water to infants over 6 months of age and toddlers several times daily. (i) Hold a child unable to hold a bottle whenever a bottle is given. Bottles may not be propped. (j) Hold or place a child too young to sit in a highchair or feeding table in an infant seat during feeding. Wide-based highchairs with safety straps or feeding tables with safety straps shall be provided for children who are not developmentally able to sit at tables and chairs. (k) Ensure that eating utensils and cups are scaled to the size and developmental level of the children. (L) Infant bottles and nipples may not be reused without first being cleaned and sanitized. (4) Diapering and toileting. A provider shall do all of the following: (a) Change wet or soiled diapers and clothing promptly. (b) Change the child on an easily cleanable surface that is cleaned with soap and water and a disinfectant solution after each use. The disinfectant solution used shall be one that is registered with the U.S. environmental protection agency as a disinfectant and has instructions for use as a disinfectant on the label. The disinfectant shall be used according to label instructions. (c) If the diapering surface is above floor level, use a strap, restraint, or other structural barrier to prevent falling. A child may not be left unattended on the diapering surface. (d) Place soiled cloth diapers in a plastic bag labeled with the name of the child and send them home daily. (e) Place soiled disposable diapers in a plastic-lined, covered container and dispose of them daily. (g) Apply lotions, powders or salves to the child during diapering only at the specific direction of a parent or the child’s physician. (h) Wash the child during diapering with a disposable towel used only once.