(a) Cleanliness.  Staff shall attend promptly to children's personal hygiene needs.

• (1) Caregivers shall thoroughly wash their hands with soap and warm, running water:
  • (A) before handling food;
  • (B) before feeding children or eating;
  • (C) after diapering or toileting;
  • (D) after touching or cleaning up body fluids including wiping noses; and
  • (E) after handling or feeding pets.
• (2) Children shall be encouraged to wash their hands with soap and water before eating, after toileting, after handling pets and after playing outdoors or in sand or water.
• (3) When a child over three years of age in diapers is cared for in a room without a diaper-changing area, arrangements shall be made for sanitary diaper-changing, hand-washing and privacy.
• (4) A child's wet or soiled clothing shall be changed immediately, and a supply of clean clothing shall be available.
• (5) Toys and items that are in contact with children's mouths shall be washed and sanitized after each child's use or as needed.  If contaminated by other body fluids, toys and equipment shall be set aside to be washed and sanitized.
• (6) Any toilet article, e.g., wash cloths, towels, combs, toothbrushes, shall be individually assigned and stored.  Such articles shall not be used jointly by or on children.

(b) Health records.  Upon admission of their child to a part-day program, parents shall be required to submit the child's immunization record, a listing of special health needs and the name of the child's physician.

(c) Immunizations.  The program shall comply with the requirements pertaining to immunizations contained in this subsection.

• (1) Children shall have or be in the process of obtaining all required immunizations at the medically appropriate time.  However, if a program chooses to accept a child for whom an exemption is claimed, documentation of the exemption shall be kept on file at the facility.
• (2) As a general rule, healthy children between the ages of fifteen months and five years of age require at least:
  • (A) three doses of polio vaccine;
  • (B) four doses of DTP vaccine;
  • (C) one to four doses of HbCV (HIB) (depending on the child's first dose of HbCV); and
  • (D) one dose each of measles, mumps and rubella vaccines administered on or after the first birthdate.

(d) Disease control.  At the time of enrollment, each program shall inform parents of the policy regarding ill children.

• (1) Each child shall be carefully observed by staff members for symptoms of illness or infestation.
• (2) Any child showing symptoms of illness or infestation shall be separated from the group.  Parents or the child's physician shall be notified as needed.
• (3) The local or state health department shall be notified upon discovery of any case of hepatitis, meningitis, Shigellosis, Giardiasis, measles, rubella, whooping cough, tuberculosis or any Hemophilus influenza invasive disease in any person associated with the program.  If a program has concerns about the health of a child, the local or state health department may be contacted.
• (4) Any cot or crib, bedding and play equipment shall be cleaned and sanitized following use by an ill child.
• (5) Staff shall use disposable, nonporous gloves when cleaning up blood, vomit or body fluids that may contain blood.  Disposable gloves shall be discarded immediately after use, and hands shall be washed.
• (6) A commercial disinfectant or a bleach solution of two teaspoons of bleach to one gallon of water, made fresh daily, shall be used to disinfect surfaces whenever needed. For diaper changing the solution shall be two teaspoons of bleach to one‑half gallon of water or one teaspoon bleach to one quart of water or one-half teaspoon of bleach to one pint of water.
• (7) Parents shall be notified as soon as possible if their children have been exposed to a contagious illness.
• (8) Staff persons with symptoms of a communicable disease or illness shall not be present in the program.

(e) Medication.  The program shall comply with the requirements pertaining to medication contained in (1)-(8) of this subsection.

• (1) When a child needs medication, the parent shall sign an authorization for the program to administer each medication.  Directions for the proper amount (dosage), and time and days medication is to be administered shall be recorded.
• (2) If a child has a chronic medical problem, the parent may sign a medication authorization for up to a six-month period for prescribed medication to be given when symptoms occur.  However, parents shall be notified whenever medication is administered.
• (3) No prescription medication shall be given unless the medication being administered is a part of a prescribed therapeutic treatment.
• (4) Medication shall be provided by the parent in the original container and labeled with the child's full name.
• (5) Staff shall administer medication according to the label directions and only to the child for whom it is intended.
• (6) To avoid duplication, each dosage administered shall be recorded by designated staff and the records readily available to parents.
• (7) All medications shall be inaccessible to children and stored in a manner which prevents contamination of food.
• (8) When medication is out-of-date or the child has withdrawn from the program, the medication shall be returned to the parent or disposed of properly.

(f) Injuries.  The program shall:

• (1) contact poison control with any suspected child poisonings;
• (2) Notify parents as soon as possible of any known cuts, burns, animal bites or injuries that may need evaluation by a physician; and
• (3) maintain a log or report of all injuries that occur at the program.

(g) Emergency procedure.   Emergency procedure for severe injury or acute illness shall be written and prominently displayed in the facility.  The emergency procedure shall contain the steps to be taken in case of emergency, including:

• (1) administration of first aid and location of the first aid kit;
• (2) name and telephone number of the emergency service, physician and/or clinic;
• (3) notification of parent; and
• (4) notification of Licensing Services regarding any incident addressed in the requirement contained in 340:110-3-39 (d)(3)(F)-(H).

(h) First aid kits.  Readily available first aid kits shall be maintained in the program as well as on each field trip away from the facility.

• (1) Each kit shall be a closed container for storing first aid supplies, accessible to staff at all times but inaccessible to children.
• (2) First aid kits shall be restocked as needed.
• (3) The first aid kit shall contain at least:
  • (A) disposable nonporous gloves;
  • (B) scissors, blunt-tipped;
  • (C) tweezers;
  • (D) thermometer;
  • (E) bandage tape;
  • (F) sterile gauze pads;
  • (G) rolled flexible or stretch gauze;
  • (H) non-medicated adhesive strips;
  • (I) current standard first aid text or equivalent first aid guide; and
• (4) First aid kits taken on field trips shall also include:
  • (A) liquid soap and water or individually packaged towelettes;
  • (B) pen/pencil and note pad;
  • (C) cold pack;
  • (D) coins for use in pay phone; and
  • (E) poison control center telephone number.