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(a) Corrective action plan required. A corrective action plan shall be prepared by the person in charge of a school that is subject to this Article in the following instances:
(1) Prior to the person in charge of a school hiring, retaining or utilizing the services of persons listed in subdivision (a) of 24 RCNY Health Code § 43.13 when such persons are reported as having:
(A) A criminal conviction, as specified in 24 RCNY Health Code § 43.13(g); or
(B) Pending criminal charges, as specified in 24 RCNY Health Code § 43.13(g); 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 has occurred while in the care of a person in charge of a school, or in the care of any owner, director, employee, or volunteer of the person in charge of a school or while in the care of any agent of the person in charge of a school, or if a related criminal or civil action has already been adjudicated or adjudication is pending in any jurisdiction with respect to such death or serious injury.
(3) When required by the Department, if the person in charge of a school has been cited for violations or conditions deemed imminent or public health hazards, or if there has been a history of failure to comply with applicable provisions of this Code, to demonstrate that the person in charge of a school is able and willing to correct such violations or conditions.
(b) Contents of corrective action plan. A corrective action plan must assess the risk to children in the school, and must clearly and convincingly demonstrate that such person or condition presents no danger to any child, or other persons. The plan must include, but need 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;
(7) Duties of the person under consideration; degree of supervision, interaction, opportunity to be with children on a regular, substantial basis and whether the position may involve being alone with children or will always involve the presence of other adults;
(8) Information provided by the 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 care 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 school.
(c) Available for Department inspection. Corrective action plans must be maintained on-site by the person in charge of a school and submitted to the Department within 5 business days of discovery of the condition to be corrected.
(Amended City Record 12/26/2019, eff. 1/25/2020)
(a) School programs that prepare and/or process food for service to children in their care must maintain a food service establishment permit issued in accordance with 24 RCNY Health Code § 81.05.
(b) All food must be stored, prepared and served to children in accordance with the requirements of 24 RCNY Health Code Article 81.
(c) The school must designate as a supervisor of food service operations a person who has a certificate in food protection in accordance with 24 RCNY Health Code § 81.15(a). Such food protection certificate holder must be on-site to supervise all food storage, preparation, cooking, holding and cleaning activities, whenever such activities are in progress.
(d) Food supplied to children must be wholesome, of good quality, properly prepared, age-appropriate in portion size and variety and served at regular hours at appropriate intervals.
(e) Unless the program has a pending waiver application or has been issued a waiver, single-use expanded polystyrene (foam) food containers, such as cups and plates, are prohibited.
(Added City Record 12/26/2019, eff. 1/25/2020)
(a) Required examinations, screening and immunizations.
(1) Physical examinations and screening. Prior to initial admission to a school, or within 90 days after admission for children who are either homeless, as defined by section 11434a of chapter 119 of title 42 of the United States code, or in foster care, all children shall 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 principal, teacher, owner, or person in charge of a school shall permit any child to attend such school 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 of that calendar year, unless the vaccine may be detrimental to the child's health, as certified by a physician licensed in the State of New York. The principal or person in charge of a school may require additional information supporting the exemption request.
(ii) Except where prohibited by law, the principal or person in charge of a school may after December 31 refuse to allow any child to attend such school 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 principal or person in charge of a school may appeal by petition to the commissioner. A child who first enrolls in a school 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) All children must have such additional immunizations as the Department may require.
(D) The principal, owner, or person in charge of a school 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 school. 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 ACIP guidelines or other nationally-recognized evidence-based guidelines, the person in charge of a school must not allow the child to attend the school 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 the person in charge of a school with a signed statement, in a form provided or approved by the Department, containing a summary of the results of the 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 3, 4 and 5 years of age.
(d) Medical records to be maintained. A person in charge of a school shall maintain an individual medical record file for each child. 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. When a child transfers from one school to another, a copy of the child's student health record shall be forwarded to the person charged with maintaining student health records at the child's new school.
(f) Department property. If the Department assigns a health care provider to a school, all child health related records shall be deemed the property of the Department.
(Amended City Record 6/12/2018, eff. 7/12/2018; amended City Record 12/26/2019, eff. 1/25/2020)
(a) Daily attendance record. A daily attendance record shall be kept in a form provided or approved by the Department.
(b) Daily health inspections. A health inspection of each child shall be made daily by teachers who are familiar with such child and trained to recognize signs or symptoms of illnesses in accordance with guidelines or training provided or approved by the Department.
(c) Management of ill children and reporting.
(1) An area shall be provided for separating ill children under direct adult supervision until parents remove children from the school.
(2) All health care provider diagnoses pursuant to 24 RCNY Health Code Article 11 shall be reported to the Department by the person in charge of a school.
(3) The Department shall be notified by the person in charge of a school within 24 hours of the occurrence of a death or serious injury to a child while in the care of the school.
(4) When any child is unexpectedly absent from the school for three consecutive days, the person in charge of a school shall telephone the child's parent to determine the cause of absence and shall maintain a record of the telephone call and the information obtained in the log required by 24 RCNY Health Code § 43.21(d).
(d) Parent reports of absences. At the beginning of each school year, the person in charge of a school shall notify parents that they are required to report absences in accordance with this subdivision. Parents shall report to the person in charge of a school within 24 hours any absence for: chicken pox, conjunctivitis, diarrhea, diphtheria, food poisoning, hepatitis, haemophilus influenza type b infection, impetigo, measles, meningitis (all types), meningococcal disease, mumps, Methicillin resistant staphylococcus aureus (MRSA), pertussis (whooping cough), poliomyelitis, rubella (German measles), salmonella, scarlet fever, tuberculosis, or any other disease or condition which may be a danger to the health of other children. Such disease or condition shall not include acquired immune deficiency syndrome (AIDS) or human immunodeficiency virus (HIV) infection.
(e) Reports of vaccine preventable illnesses. The person in charge of a school shall report to the Department by telephone, within 24 hours, any child who has any vaccine preventable illness, or meningitis or tuberculosis, or if there is any outbreak or unusual occurrence of any disease or condition at the facility.
(f) Isolation and exclusion pursuant to 24 RCNY Health Code Article 11. The person in charge of a school must isolate or exclude any child who is suspected or confirmed with, or has been exposed to, a communicable disease requiring isolation or exclusion under 24 RCNY Health Code Article 11. A child who has been excluded must not be permitted to return to the school without a written statement from a health care provider indicating that the child is free from such disease in communicable form and that the period of isolation or exclusion required by 24 RCNY Health Code Article 11 has ended.
(Amended City Record 12/26/2019, eff. 1/25/2020)
(a) Hand washing. Staff and children must wash hands before and after toileting or diaper changes, after contact with a child in ill health, and prior to handling or preparing any food and after playing outdoors.
(b) Signs. Hand washing signs provided by or approved by the Department must be prominently posted in each lavatory and by each sink.
(c) Individual personal care. Hairbrushes or cloth towels must not be provided for use. If toothbrushes, combs, or washcloths are provided, each child must have items for his/her exclusive use and they must be stored in an individually-labeled container.
(d) Changes of clothing. At least one change of weather-appropriate clothing must be available so that any child who soils clothing may receive a change. Soiled clothing and cloth diapers must be handled in a manner that protects occupants from exposure to wastes and maintains an appropriately sanitary environment.
(e) Bathing. Children must not be bathed on premises except that they must be washed in case of accidents.
(f) Safety precautions relating to blood. Schools must implement the following safety precautions for all staff having any exposure to or contact with blood:
(1) Disposable gloves must be immediately available and worn whenever there is a possibility for contact with blood, including but not limited to:
(A) Changing diapers where there is blood in the stool;
(B) Touching blood or blood-contaminated body fluids;
(C) Treating cuts that bleed; and
(D) Wiping surfaces stained with blood.
(2) In an emergency, a child's safety and well-being must take priority. A bleeding child shall not be denied care because gloves are not immediately available.
(3) Disposable gloves must be discarded after each use.
(4) If blood is touched accidentally, exposed skin must be thoroughly washed with soap and running water.
(5) Clothes contaminated with blood must be placed in a securely tied plastic bag and returned to the parent at the end of the day.
(6) Surfaces that have been blood stained must be cleaned and disinfected with a germicidal solution.
(g) Smoking prohibited. There must be no smoking of tobacco or other substances, or use of e-cigarettes, in any indoor or outdoor area of any premises on which a program is located.
(Added City Record 12/26/2019, eff. 1/25/2020)
(a) Emergency procedures and notices. Written policies and procedures for managing health and other emergencies shall be included in the written health and safety plan. Persons in charge of a school shall provide notice of the location and contact telephone numbers of the school to local hospitals, police precincts, fire houses and emergency transport services and information about emergency policies and procedures shall be provided to parents. Emergency procedures and emergency telephone contact numbers (for Police, Fire Department, Poison Control Center, Child Abuse Hotline, and the Department of Health and Mental Hygiene) shall be conspicuously posted in each classroom or area used by children.
(b) Necessary emergency medical care. When a child is injured, or becomes ill under such circumstances that emergency care is needed, the person in charge of a school or designee shall obtain such emergency medical care in accordance with the requirements of this section and immediately notify the child's parent or guardian.
(1) The person in charge of a school-based program or their designee must:
(A) At the time of the child's admission into the program, obtain written consent from a parent or guardian authorizing the program or other caregivers to obtain emergency medical care for the child; and
(B) Secure emergency medical care when needed, and notify a parent or guardian immediately; and
(C) Arrange for any needed transportation of any child in need of emergency health care and ensure that the supervision ratios required by 24 RCNY Health Code § 43.09 are maintained for the children remaining in the program; and
(D) Advise a parent or guardian, or the person authorized to pick up the child that day, of any developing symptoms of illness or minor injury sustained while the child is in the program.
(2) Where a parent has provided a written, individualized health care plan indicating the specific medications that can be administered and the schedule of such administration(s) for their child, including in cases of emergency, and there is a direct conflict between such plan and any provision of this section, the program shall follow the child's individualized health care plan.
(c) Epinephrine auto-injectors.
(1) Each person in charge of a school-based program shall maintain on site at the school-based program facility at least two epinephrine auto-injectors with retractable needles in each dosage appropriate for children who may be in the program, stored in an area inaccessible to children and maintained in an unexpired, operable condition such that they are available for immediate use in case of need for emergency administration to a child.
(2) Each person in charge of a school-based program shall designate a sufficient number of staff to be trained to administer an epinephrine auto-injector to a child in accordance with New York State Public Health Law § 3000-c, or any successor statute or applicable regulation. At least one staff person trained to administer such epinephrine auto-injector shall be on-site in the school-based program at all times children are present. The epinephrine auto-injector training must include:
(A) How to recognize signs and symptoms of severe allergic reactions, including anaphylaxis;
(B) Recommended dosage for adults and children;
(C) Standards and procedures for the storage and use of an epinephrine auto-injector; and
(D) Emergency follow-up procedures.
(3) Each person in charge of a school-based program shall designate at least one staff person to be responsible for the storage, maintenance, control, disposal, and general oversight of such epinephrine auto-injector to ensure such device remains available for use in an unexpired, operable condition, and that the storage location is in compliance with the requirements specified by the manufacturer.
(4) Staff trained in accordance with the requirements of paragraph (2) of this subdivision may administer an epinephrine auto-injector to a child, whether or not there is a prior or known history of severe allergic reaction in such child.
(5) Immediately following any emergency administration of an epinephrine auto-injector to a child, the person in charge of a school-based program or designee shall contact 911 for emergency medical care and notify the child's parent or guardian.
(6) Within 24 hours following any emergency administration of an epinephrine auto-injector, the person in charge of a school-based program or designee shall contact the Department to report the incident.
(7) Each epinephrine auto-injector shall be disposed of in accordance with applicable law.
(d) First aid supplies. A first aid kit, completely stocked for emergency treatment of cuts and burns, shall be provided by the person in charge of a school and shall be easily accessible for use. The first aid kit shall be kept out of reach of children and inspected periodically.
(e) Incident log. The school shall maintain an incident log of illnesses, accidents, epinephrine autoinjector administrations, and injuries sustained by children in the school, in a form provided or approved by the Department. The school shall provide a child's parent with information concerning such incident pertaining to the child on the date of such incident and shall report same to the Department within 24 hours. Logged entries shall include the name and date of birth of the child, the place, date and time of the incident, names and positions of staff and other adults present, a brief statement describing the incident, emergency treatment obtained, if any, and parental notification made or attempted. The incident log shall be made available to the Department upon request.
(Amended City Record 6/12/2018, eff. 7/12/2018)
(a) All exits must have clear and legible illuminated exit signs. All exit signs and emergency lighting must be maintained in working condition.
(b) Programs must have approved fire extinguishers in good working order and have them inspected as required by the Fire Department.
(c) Fire drills must be conducted monthly and logged. Such logs must be kept on-site and made available to the Department and the Fire Department upon request.
(d) Heating apparatuses must be equipped with adequate protective guards. Space heaters are prohibited.
(e) Premises must be free of electrical, chemical, mechanical and all other types of hazards.
(f) Smoke and carbon monoxide detectors with audible alarms must be provided in accordance with applicable law or as required by the Department or the Fire Department and maintained in working condition.
(Added City Record 12/26/2019, eff. 1/25/2020)
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