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(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)
(a) Applicability. This section applies to all rooms and areas in a school facility that are occupied by children, or to which such children have access.
(b) Peeling lead-based paint prohibited.
(1) There shall be no peeling lead-based paint or peeling paint of unknown lead content on any surface.
(2) Peeling lead-based paint or peeling paint of unknown lead content shall be immediately abated or remediated upon discovery, in accordance with 24 RCNY Health Code § 173.14.
(3) When there has been an order to abate or remediate lead-based paint hazards issued by the Department, the owner of the building in which the program is located must use only the methods specified in such order.
(A) After such order has been served by the Department, the owner or person in charge of a school must post the notices required by 24 RCNY Health Code § 173.14(e)(1)(A) at or near the entrance of the facility.
(B) The owner or person in charge of a school must comply with the requirements of the order within 21 days after service of the order. Where compliance with the time period requirements of this subdivision would cause undue hardship and the owner or person in charge of a school demonstrates a good faith effort to timely comply, such as by showing that it has taken steps to remediate, including by retaining a contractor to conduct the remediation, and demonstrates to the satisfaction of the Department that it is maintaining adequate controls to protect children from a lead-based paint hazard, the Department may, at its discretion, extend the time period for compliance.
(4) Children must not be in nor have access to any room or area undergoing abatement, remediation or other work which disturbs lead-based paint or paint of unknown lead content until after completion of final clean-up and clearance dust testing.
(5) The work practices of 24 RCNY Health Code § 173.14 shall not apply to repair and maintenance work which disturbs surfaces of less than two (2) square feet of peeling lead-based paint per room or ten (10) percent of the total surface area of peeling paint on a type of component with a small surface area, such as a window sill or door frame.
(c) Equipment and furnishings. Equipment and furnishings shall be painted with lead-free paint.
(e) Annual survey. At least once each year, the owner or person in charge of a school must conduct a survey of the condition of surfaces in classrooms or other areas used by children that are covered with lead-based paint or paint of unknown lead content. Survey results must be recorded on a form provided or approved by the Department. The survey form must include, but need not be limited to, the following: the date of the survey; a description of, and the location of, each surface surveyed and remediation status, if applicable.
(1) Within 30 days of completion of such survey, the annual survey results must be submitted to the Department. Copies of such survey results may be submitted to the Department by mail, fax or electronically.
(2) Within 30 days of submitting to the Department, the school must notify the parent or guardian of each child attending the program of the results of the annual survey. Such notice may be provided electronically if the permittee routinely communicates with parents or guardians electronically and may refer to detailed results on a website if such results are maintained there. The school must maintain documentation indicating the date on which such notice was provided. A copy of the notice and proof of the date when such notification was made must be 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.
(f) Definitions. All terms used in this section shall have the same meanings as the terms defined in 24 RCNY Health Code § 173.14.
(Amended City Record 12/26/2019, eff. 1/25/2020)
(a) Drinking water. Drinking water from faucets and fountains must be tested for lead content by persons in charge of a school upon the effective date of this provision or by persons in charge of a new school program within 60 days of filing the notice required by 24 RCNY Health Code § 43.05 and every five years thereafter using a method approved by the Department. Copies of test results must be sent to the Department by mail, email or fax on receipt and the persons in charge of a school must investigate and take remedial action if lead levels at or above 15 parts per billion (ppb) are detected. Remedial action must be described in a corrective action plan to be submitted to the Department with reports of elevated test results. Until remedial action is completed, the persons in charge of a school must provide and use bottled potable water from a source approved by the Department or the State Department of Health.
(b) Window guards. Department approved window guards or other window opening limiting devices must be installed on all windows in all rooms, hallways, and stairwells, except windows giving access to fire escapes used as a secondary means of egress, if children under six years of age have access to such areas.
(c) All items of large furniture and all electronic appliances capable of being tipped over due to design, height, weight, stability or other features must be secured to the floors or walls of such facility, using angle-braces, anchors or other anchoring devices. Any item of furniture or electronic device which cannot be so anchored must be removed from the facility.
(Added City Record 9/20/2016, eff. 10/20/2016; amended City Record 12/26/2019, eff. 1/25/2020)
When the strict application of any provision of this article presents practical difficulties, or unusual or unreasonable hardships, the Commissioner in a specific instance may modify the application of such provision consistent with the general purpose and intent of these articles and upon such conditions as in the Commissioner's opinion are necessary to protect the health of the children. The denial by the Commissioner of a request for modification may be appealed to the Board in the manner provided by 24 RCNY Health Code § 5.21.
(Amended City Record 6/12/2018, eff. 7/12/2018)
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