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(a) Approved corrective action plan required. A corrective action plan shall be submitted by the permittee to the Department within five business days for review and approval by the Department:
(1) Prior to the permittee hiring, retaining or utilizing the services of persons listed in subdivision (a) of 24 RCNY Health Code § 47.19 when such persons are reported as having:
(A) A criminal conviction as specified in 24 RCNY Health Code § 47.19(h); or
(B) Pending criminal charges as specified in 24 RCNY Health Code § 47.19(h); or
(C) SCR reported incidents of child abuse or maltreatment which have been indicated or which are under investigation.
(2) When a death or serious injury of a child or an incident involving a lost child has occurred while under the care or supervision of an applicant for a permit or a permittee, or of any owner, director, employee, or volunteer of the applicant or permittee or of any agent of the permittee, or if a related criminal or civil action has been already adjudicated or adjudication is pending in any jurisdiction with respect to such death or serious injury or incident involving a lost child.
(3) When required by the Department, including but not limited to after the permittee has been cited for violations or conditions deemed imminent health hazards, or when the Department determines that the permittee has been operating with serious or uncorrected violations over a period of time, to demonstrate the permittee's willingness and ability to continue in operation in accordance with applicable law.
(b) Contents of corrective action plan. A corrective action plan shall assess the risk to children in the program, and shall clearly and convincingly demonstrate that such person presents no danger to any child, or other persons. The plan shall include, but not be limited to, consideration of the following factors:
(1) Seriousness of the incident(s) or crimes cited in the report(s);
(2) Seriousness and extent of injuries, if any, sustained by the child(ren) named or referred to in the indicated report(s) or disclosed upon investigation of the criminal charge;
(3) Any detrimental or harmful effect on child(ren) as a result of the person's actions or inactions and relevant events and circumstances surrounding these actions and inactions as these relate to any report(s);
(4) The age of the person and child at the time of the incident(s);
(5) Time elapsed since the most recent incident(s);
(6) Number of indicated incident(s) or crimes; where more than one incident or crime, an evaluation of each separately, and an assessment of the total effect of all indicated incidents on risks to children currently under care or supervision;
(7) Duties of the person under consideration; degree of supervision, interaction, opportunity to be with children on regular, substantial basis and if position may involve being alone with children or will always involve presence of other adults;
(8) Information provided by person, re: rehabilitation, i.e., showing positive, successful efforts to correct the problems resulting in the indicated child abuse or criminal report so that children in the program will not be in danger, demonstrated by no repeated incidents or showing that the person has undergone successful professional treatment;
(9) Employment or practice in a child care field without incident involving injuries to children;
(10) Extra weight and scrutiny shall be accorded child abuse and maltreatment reports involving fatality, sexual abuse, subdural hematoma, internal injuries, extensive lacerations, bruises, welts, burns, scalding, malnutrition or failure to thrive; and crimes involving homicides, sexual offenses (misconduct, rape, sodomy, abuse); kidnapping; felony possession or sale of a controlled substance; felony promotion of prostitution; obscenity offenses; disseminating indecent material involving, or to, minors; incest; abandonment of a child; endangering welfare of a child; promoting sexual performance by a child; felony weapon possession; assault; reckless endangerment; coercion; burglary; arson and robbery; driving while intoxicated or under the influence of alcohol if the person will have responsibilities for unsupervised contact or driving motor vehicles at the program.
(c) Contents of corrective action plan for imminent health hazards or serious repeat violations. When the Department requires a corrective action plan to show that imminent health hazards or patterns of serious repeat violations are being corrected, the permittee must:
(1) Address each hazard, condition or violation;
(2) Identify their causes; and
(3) Provide a plan satisfactory to the Department showing that the causes have been addressed, and that the conditions or violations have been corrected and will not recur.
(d) Implementing the plan. If the Department determines that such plan adequately safeguards the health and safety of children, the permittee shall be responsible for implementation of the plan, subject to periodic monitoring by the Department.
(e) Rejection of plan. If the Department determines that such plan fails to provide adequate safeguards, a permittee that intends to hire or retain the employee shall resubmit the plan until it is acceptable to Department and shall not allow such employee to have unsupervised contact with any children until the plan is approved by the Department.
(Amended City Record 9/20/2016, eff. 10/20/2016; amended City Record 9/20/2017, eff. 10/10/2017; amended City Record 6/12/2018, eff. 7/12/2018)
(a) Constant competent supervision required. Staff included in the staff/child ratios set forth below shall maintain direct line of sight, constant competent supervision of all of the children in the program at all times. Children in a child care program shall be competently supervised by a qualified group teacher or education director at all times in each type of child care program for which a permit is issued, with the sole exception that in the event of breaks or lunch periods, absence of no more than three days, the required staff/child ratio in a child care program may be maintained with assistant teachers and teacher aides, so long as at least one assistant teacher is included for each group of children in attendance. Children in a family shelter-based drop-off child supervision program shall be competently supervised by shelter child supervision staff at all times.
(1) When any program is in operation, the number of qualified staff required by this Code shall be assigned and on duty to protect the health and safety of the children on the program's premises, and in the case of trips off-site the required number of staff shall accompany the children at all times wherever the children travel.
(2) Each program shall maintain a daily log, to be kept on site and provided to the Department upon request, reflecting the arrival and departure time of each member of the teaching staff or shelter child supervision staff.
(b) Group teacher. Except in a night child care program, a group teacher in a child care program shall be in charge of each group of children ages two to five years.
(c) Infant/toddler child care program supervision. An education director or a group teacher with equivalent qualifications shall be present at all times of a child care program's operation to supervise an infant/toddler child care program.
(d) Infant/Toddler teacher. An infant/toddler teacher in a child care program, under the supervision of the education director, may be in charge of individual groups of infants and toddlers, or children in a night child care program.
(e) CPR and first aid certifications. The permittee shall ensure that at least one staff member certified in CPR and first aid is on the premises of the program during all hours when children are present. Upon application for a new permit or for renewal of an existing permit, such certifications must be in pediatric CPR and pediatric first aid, and must be based on successful completion of appropriate training that includes hands-on skill tests.
(f) Minimum staff/child ratios.
(1) The staff of a child care program for purposes of staff/child ratios must include only the teaching staff. The minimum ratios of staff to children in a child care program must be as follows:
AGE OF CHILDREN | MINIMUM STAFF/CHILD RATIO | MAXIMUM GROUP SIZE per room/area separated from other rooms/areas by a physical barrier |
under 12 months | 1:4 or 1:3 | 8 |
12 to 24 months | 1:5 | 10 |
2 years to under 3 | 1:6 | 12 |
3 years to under 4 | 1:10 | 15 |
4 years to under 5 | 1:12 | 20 |
5 years to under 6 | 1:15 | 25 |
(2) The staff of a family shelter based child supervision program for purposes of staff/child ratios shall include only shelter child supervision staff. Volunteers may count as staff for these purposes only if they meet all of the requirements to qualify as shelter child supervisors. The minimum ratios of staff to children in a family shelter-based drop-off child supervision program shall be as follows:
AGE OF CHILDREN | MINIMUM STAFF/CHILD RATIO | MAXIMUM GROUP SIZE |
under 3 years | 1:4 or 1:3 | 10 per room/area separated from other rooms/areas by a physical barrier |
3 years to under 6 | 1:8 | 16 |
(3) When children 12 months of age and older are in a group of mixed but contiguous ages, the minimum staff/child ratio and group size shall be based on the predominant age of the children in the group.
(4) Programs that maintain a staff/child ratio of 1:4 for children under 12 months of age shall demonstrate through their Written Safety Plan that they have sufficient staff in the program at all times to provide a staff/child ratio of 1:3 for the safe evacuation of children younger than 12 months of age during emergency situations.
(g) Mixed groups. Infants shall not be placed in older age groups.
(h) Night child care program supervision.
(1) Staff included in the staff/child ratios set forth above shall be awake at all times, and shall maintain direct line of sight, visual supervision of children.
(2) An education director or a group teacher with equivalent qualifications, or a member of the child supervision staff, shall be present at all times to supervise the night child care program and may not have a specific classroom assignment if more than 40 children are receiving night care or nighttime supervision.
(3) If a family shelter-based child drop-off child supervision program requires more than one shelter child supervisor to be present at any time to attain the required child/staff ratio, the permittee must designate one shelter child supervisor to be the lead shelter child supervisor, responsible for directing the supervision of children during that time period.
(Amended City Record 9/20/2017, eff. 10/10/2017; amended City Record 6/12/2018, eff. 7/12/2018; amended City Record 12/26/2019, eff. 1/25/2020)
(a) Required examinations, screening and immunizations.
(1) Physical examinations and screening. Prior to admission all children must receive a complete age appropriate medical examination, including but not limited to a history, physical examination, developmental assessment, nutritional evaluation, lead poisoning screening, and, if indicated, screening tests for dental health, tuberculosis, vision, and anemia.
(2) Immunizations.
(A) (i) All children must be immunized against diphtheria, tetanus, pertussis, poliomyelitis, measles, mumps, rubella, varicella, hepatitis B, pneumococcal disease and haemophilus influenzae type b (Hib), in accordance with New York State Public Health Law § 2164, or successor law. Exemption from specific immunizations may be permitted if the immunization may be detrimental to the child's health, in accordance with New York State Public Health Law § 2164. Documentation of immunizations and exemptions must be kept on site and made available to the Department immediately upon request. If such records are maintained electronically, Department staff must be allowed to access such records while on-site.
(ii) No permittee shall permit any child to attend such program without appropriate documentation of the immunizations required pursuant to clause (i) of this subparagraph, except as provided for in this subdivision or pursuant to New York State Public Health Law § 2164 or successor law.
(B) (i) Children aged from 6 months to 59 months must be immunized each year before December 31 against influenza with a vaccine approved by the U.S. Food and Drug Administration as likely to prevent infection for the influenza season that begins following July 1 that calendar year, unless the vaccine may be detrimental to the child's health, as certified by a physician licensed to practice medicine in this state or the state in which the child resides. The permittee may require additional information supporting such request for exemption.
(ii) The permittee may refuse to allow any child to attend a program without acceptable evidence of the child meeting the requirements of clause (i) of this subparagraph. A parent, guardian, or other person in parental relationship to a child denied attendance by a permittee may appeal by petition to the commissioner. A child who first enrolls in a program after June 30 of any year is not required to meet the requirements of clause (i) of this paragraph for the flu season that ends before July 1 of that calendar year.
(C) A permittee that fails to maintain documentation showing that each child in attendance has received each vaccination required by this subdivision or is exempt from such a requirement, pursuant to paragraph A or B of this subdivision will be subject to fines for each child not meeting such requirements as provided for under this Code. Documentation required by A of this subdivision must be kept on site and made available to the Department upon request.
(D) All children shall have any additional immunizations required by the Department.
(E) All children must have such additional immunizations as the Department may require.
(F) The permittee must report to the Department all requests for exemption made pursuant to subparagraphs (A) or (B) of paragraph (2) of this subdivision in a manner and form prescribed by the Department. Upon submission of an exemption request and pending Department determination, the child may attend the child care program. If upon review of the documents submitted and any additional documentation provided to the Department, the Department determines that the exemption request is not valid insofar as it is not in accordance with the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) guidelines or other nationally recognized evidence-based guidelines, the permittee or person in charge of a child care program must not allow the child to attend the program without documentation that such child has received the immunizations required pursuant to clause (i) of subparagraph (A) of paragraph (2) of this subdivision.
(b) Form with results of examination. Health care providers examining children, pursuant to this section shall furnish permittees with a signed statement, in a form provided or approved by the Department, containing a summary of the results of examination, past medical history, and, if a disease or condition which affects the child's ability to participate in program activities is found, a summary of the evaluation and findings associated with that condition. The examination form shall include the health care provider's recommendations for exclusion or treatment of the child, modifications of activities, and plans for any necessary health supervision.
(c) Periodic examinations. Each child shall have periodic medical examinations at 2, 4, 6, 9, 12, 15, 18 and 24 months and 3, 4, 5 and 6 years of age.
(d) Medical records to be maintained. A permittee shall maintain an individual paper or electronic medical record file for each child on the premises of the program and make the file available for review by the Department upon request. This file shall include:
(1) A cumulative record consisting of a form provided or approved by the department, including: child's name, address, date of admission and date of birth: parents' names, home and business addresses and telephone numbers; names and telephone contact information of person(s) to contact in case of emergency, including name, address and telephone number of the child's primary health care provider; pertinent family medical history, and child's history of allergies, medical illnesses, special health problems and medications, immunization records; and parental consent for emergency treatment.
(2) Copies of all individual health records required by this Code, including new admission and periodic medical examination forms, parents' and health care provider notes regarding episodic illnesses, and a history of all illnesses, accidents, and other health data.
(e) Records to be confidential. All records required by this section shall be maintained as confidential records and shall not be made available for inspection or copying by any persons other than parents, other persons who present a written authorization from a parent, or authorized staff of the Department.
(Amended City Record 9/20/2017, eff. 10/10/2017; amended City Record 6/12/2018, eff. 7/12/2018; amended City Record 12/26/2019, eff. 1/25/2020)
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