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(a) Every family shelter-based drop-off child supervision program must designate at least one qualified individual as a shelter child supervision liaison for every 30 children enrolled in the program. If a site has more than one liaison, one must be designated head liaison.
(1) Coverage for shelter child supervision liaison. When a shelter child supervision liaison is not present to supervise a family shelter-based drop-off child supervision program, the permittee shall designate an interim liaison. In addition, the permittee must notify the Department in writing within five business days of the separation from service of a required shelter child supervision liaison. When a shelter child supervision liaison is separated from service or will be on leave for more than five business days, the permittee must notify families and program staff in writing of the name of the designated interim liaison. This written communication must be kept on site and made available to the Department upon request.
(2) Qualifications. Each shelter child supervision liaison must have a baccalaureate degree from an accredited college or university in the social sciences, applied health sciences, or human services, or a related degree approved by the Department.
(3) Accreditation. In determining shelter child supervision liaison qualifications, the Department may accept documentation from schools, colleges, and universities approved by the State Education Department or other accreditation organization acceptable to the Department certifying that the liaison has met the specific Code requirements. All liaison documentation must be submitted to the Department for review and shall be kept on site and made available to the Department upon request.
(b) A shelter child supervisor must have at a minimum an associate's degree in the social sciences, applied health sciences, or human services, or a related degree that is approved by the Department, or a Child Development Associate (CDA) certification. In determining shelter child supervision liaison qualifications, the Department may accept documentation from schools, colleges, and universities approved by the State Education Department or other accreditation organization acceptable to the Department certifying that the liaison has met the specific Code requirements. All liaison documentation must be submitted to the Department for review and shall be kept on site and made available to the Department upon request.
(Added City Record 9/20/2017, eff. 10/10/2017; amended City Record 6/12/2018, eff. 7/12/2018)
(a) Applicability. These requirements for child abuse and criminal justice screening shall apply to any person who has, will have, or has the potential for unsupervised contact with children in a program, and shall include, but not be limited to: individual owners, permittees, partners, members and shareholders of corporations, limited liability companies or other entities who are the owners or operators of the program; educational, child supervision, administrative and maintenance employees; employees who are school bus drivers or who are assigned to accompany children during transportation to and from the program; volunteers, including parent volunteers and student teachers, trainees or observers; and consultants and other persons employed by persons, corporations, partnerships, associations or other entities providing services to the program. Employees of independent contractors providing maintenance, construction, transportation, food or any other goods or services to a program shall be screened in accordance with this section, or shall be prohibited from working in any area, vehicle or facility owned, occupied or used by the program unless such person is working under the direct supervision and within the line of sight of a screened employee of the program. These requirements shall not apply to persons authorized by parents to escort or transport children to and from programs where the parents have privately arranged for such escort or transportation.
(b) Pre-employment verification. A permittee shall obtain and verify credentials, including certificates and educational transcripts, as applicable, and references prior to employment of all persons listed in subdivision (a) of this section. All such documents, along with any English language translations required pursuant to 24 RCNY Health Code § 47.13(a), shall be kept on site and made available to the Department upon request.
(c) Screening. The permittee shall not permit any employee or individual in any other capacity specified in 24 RCNY Health Code § 47.19(a) to begin work in any area, vehicle, or facility owned, occupied, or used by the program until either:
(1) the following, arranged by the permittee, have been completed: (a) fingerprinting, and receipt and review of records of criminal convictions and pending criminal actions, and (b) receipt and review of report from the Statewide Central Register of Child Abuse and Maltreatment (hereinafter "SCR"), and either:
(A) the results of the screenings are satisfactory; or
(B) if any of the results of the screenings are unsatisfactory, the permittee has received approval of a corrective action plan submitted pursuant to 24 RCNY Health Code § 47.21; or
(C) the permittee has ensured that the individual must be continuously supervised by a satisfactorily screened staff member with authority to intervene in the actions of such individual. For all employees, the permittee must request a new report from the SCR every 2 years. All documents obtained in accordance with the requirements of this section, along with any required English language translations, must be kept on site and made available to the Department upon request.
(d) Individual consent. A permittee shall obtain written consent from each such person for fingerprinting and criminal record review, and shall provide written notice to such persons that there will be an inquiry submitted to the SCR, pursuant to Social Services Law § 424-a(1), or successor law, and that copies of the reports received by the permittee as a result of such review and screening shall be provided to the Department.
(e) Refusal to consent. A permittee shall not hire or retain as an employee, or otherwise allow on its premises any person who is required to have, but refuses to consent to, fingerprinting and criminal record review. To the extent consistent with Article 23-A of the New York State Correction Law, the permittee shall not hire or retain any person who has a record of criminal convictions or arrests, except as provided in subdivision (h) of this section.
(f) Employee to notify permittee. Permittees shall require all employees to have criminal justice and child abuse screening and to notify the permittee immediately or as soon thereafter as possible upon being arrested, and immediately upon receiving notice of the filing of an allegation of child abuse, maltreatment, neglect, or other inappropriate behavior that could threaten the welfare of a child.
(g) Reports to the Department. Permittees shall notify the Department within 24 hours when they have received an indicated report from the SCR; an employee report that an allegation has been filed against the employee; or a record or report of criminal conviction(s), pending criminal action, or when they learn or should have learned of an arrest or criminal charge for any misdemeanor or felony for any person required to have a criminal record review or SCR screening. Permittees must also notify the Department within 24 hours whenever a child attending a program has been seriously injured, has died, or a child in their care or supervision has been unaccounted for, left behind at any location outside the child's assigned classroom or where supervision has not been maintained in the manner required by this Code for any period of time while in the care of the permittee.
(h) Actions required. To the extent consistent with Article 23-A of the New York State Correction Law, and except where the permittee has submitted and obtained Department approval of a corrective action plan in accordance with 24 RCNY Health Code § 47.21:
(1) A permittee shall not hire, retain, utilize or contract for the services of a person who:
(A) Has been convicted of a felony at any time, or who has been convicted of a misdemeanor within the preceding ten years; or
(B) Has been arrested and charged with any felony or misdemeanor, and where there has been no disposition of the criminal matter; or
(C) Is the subject of an indicated child abuse and maltreatment report, in accordance with a determination made after a fair hearing, pursuant to § 422(8) of the Social Services Law.
(2) A permittee shall not dismiss or permanently deny employment to current and prospective staff solely because they are defendants in pending criminal actions, but may suspend current employees or defer employment decisions on prospective employees until disposition of the pending criminal action.
(3) A permittee shall prohibit unsupervised contact with children by any person who has not received screening clearance for criminal convictions or by the SCR, or as specified in paragraph (1) of this subdivision.
(i) References. For all prospective staff, the permittee shall make a written inquiry to an applicant's three most recent employers and shall obtain three references prior to hiring. If prospective staff have not had three prior employers, references may be accepted from persons who are not family members and who state, in writing, that the applicant is well-known to them as a student, volunteer, or other stated capacity, and that the applicant is suited by character, fitness, and ability to work with children. Such documentation shall be kept on site and made available to the Department upon request.
(j) Services for certain children. Permittees must allow access to children receiving assessments and services of professional consultants retained by Early Intervention program providers or New York City Department of Education committees on preschool special education, or successor programs, without requiring proof of consultants' fingerprinting, SCR clearances or references.
(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; amended City Record 12/26/2019, eff. 1/25/2020)
(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)
(a) Daily attendance record. A daily attendance record shall be kept in a form provided or approved by the Department. Daily entries must include at a minimum each child's name and arrival and departure time.
(b) Daily health inspections. A health inspection of each child shall be made daily by the educational director, designated teachers, shelter child care liaisons, or child supervisors 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 program.
(2) The Department must be notified by the permittee within 24 hours of the occurrence of a death or serious injury to a child while in the care or supervision of the program.
(3) When any child is unexpectedly absent from the program, the permittee must notify the child's parent of the absence by telephone, text or e-mail message or other means of immediate communication within one hour of the child's scheduled time of arrival and must maintain a record of having made such notification and the information obtained in the log required by 24 RCNY Health Code § 47.29(d).
(d) Parent reports of absences. Permittees must notify parents when children are initially enrolled in the program that parents must report children's absences to the program as follows:
(1) Daily. Parents must notify the program prior to their child's scheduled arrival time, but no later than one hour after the scheduled arrival time, that a child will not be attending the program that day.
(2) Communicable diseases. Parents must report to the permittee within 24 hours of such absence of any absence for: chicken pox, conjunctivitis, diarrhea, diphtheria, food poisoning, hepatitis, haemophilus influenza type b infection, impetigo, measles, meningitis (all types), meningococcal disease, Methicillin resistant staphylococcus aureus (MRSA), mumps, 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 permittee 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 permittee must isolate or exclude any child, staff or volunteer 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, staff or volunteer who has been excluded must not be permitted to return to the child care program without a written statement from a health care provider indicating that the child, staff member or volunteer 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. Any child, staff or volunteer isolated or excluded pursuant to this subdivision must be reported to the Department.
(Amended City Record 9/20/2017, eff. 10/10/2017; amended 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 plans and approved by the Department prior to the issuance of a permit. Permittees shall provide notice of the location and contact telephone numbers of the program 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 NYPD, FDNY, Poison Control Center, Child Abuse Hotline, and the Department) 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 permittee 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) Each permittee must:
(A) at the time of the child's admission into the program, obtain written consent from a parent or guardian authorizing the permittee or other caregivers to obtain emergency health care for the child; and
(B) secure emergency 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 staff/child ratios required by 24 RCNY Health Code § 47.23 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 permittee must follow the child's individualized health care plan.
(c) Epinephrine auto-injectors.
(1) Each permittee shall maintain on site at the 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 permittee shall designate a sufficient number of staff to be trained to administer an epinephrine auto-injector to a child in the program 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 an epinephrine auto-injector shall be on site 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 permittee shall designate at least one staff person to be responsible for the storage, maintenance, control, disposal, and general oversight of each such epinephrine auto-injector to ensure such device remains available for use in an unexpired, operable condition.
(4) Notwithstanding the requirements of 24 RCNY Health Code § 47.31(e), and subject to the terms of a child's individualized health plan as described in 24 RCNY Health Code § 47.29(b)(2), if a child appears to be experiencing anaphylactic symptoms, staff trained in accordance with the requirements of 24 RCNY Health Code § 47.29(b)(2) may administer an epinephrine auto-injector to such 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 permittee 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 permittee 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 permittee 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 permittee shall maintain a log, to be kept on site and made available to the Department upon request, of illnesses, accidents, epinephrine auto-injector administrations, and injuries sustained by children in the program, in a form provided or approved by the Department. The permittee shall provide a child's parent with information concerning each 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 maintained on site and made available to the Department upon request.
(f) The Department may promulgate rules to specify how permittees shall comply with this section.
(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) Medication policy required. Each permittee shall establish a policy as to whether the permittee will or will not administer medication, and incorporate such policy in the program's health care plan component of the written safety plan required by 24 RCNY Health Code § 47.11. Notwithstanding any program's general policy not to administer medication, such policy shall indicate that the program may be required to administer medication to a child with a disability, pursuant to the Americans with Disabilities Act.
(b) Exempt staff. A program that employs staff who are also currently State licensed physicians, physician assistants, registered nurses, nurse practitioners, licensed practical nurses, or emergency medical technicians may administer medications without such staff obtaining additional qualifications or certification.
(c) Health care consultant and duties. All permittees that choose to administer medications to children shall designate a health care consultant of record, who shall be a health care provider as defined in this Article. The permittee shall confer with the health care consultant and shall obtain approval of the consultant for the portion of the health care plan regarding policies and procedures related to the administration of medications. The consultant shall review documentation of all staff authorized to administer medications and determine if staff have required professional licenses or certificates of completion of required training. A health care plan shall be valid for two years and shall be updated when designated staff has changed. The health care consultant shall visit the program at least once every two years and shall review the permittee's health care policies, procedures, documentation, practice and compliance with its health care plan for administering medications. If the consultant determines that the approved health care plan is not being reasonably followed by the permittee, the consultant may revoke his or her approval of the plan. If the consultant revokes his or her approval of the health care plan, the health care consultant shall immediately provide written notification to the permittee and the Department, upon which notification the program shall immediate cease administering medication, and immediately notify all parents and guardians of children in the program of such cessation, until such time as a new health care plan is approved. All relevant documentation shall be kept on site and made available to the Department upon request.
(d) Staff members certified to administer medications. Only a trained, designated staff person may administer medications to children, except where the only administration of medications will be over-the-counter ("OTC") topical ointments, including sunscreen lotion and topically applied insect repellant; and of asthma inhalers, nebulizers, and epinephrine auto-injectors to children whose parent or guardian has provided written consent, medical authorization, and training. The staff person administering medications to children shall be at least 18 years of age, possess current certifications in first aid, CPR, and medication administration training (MAT) in a course approved or administered by the Department or the State Office of Children and Family Services. MAT certificates shall be made available for inspection by the Department on request. MAT certifications shall be effective for a period of three years from the date of issuance. Recertification training shall extend certification for additional three-year periods. If a designated staff person ceases to work in a program for a continuous period of one year, certification shall automatically lapse. Where certification lapses, the person may be recertified after repeating initial MAT or recertification training, as required by the Department. Where a permittee has failed to comply with requirements for the administration of medications set forth in this section, the Department may require retraining or may prohibit the permittee from administering medications.
(e) Medication administration procedures. Except as provided in 24 RCNY Health Code § 47.29(c), permittees and designated staff may administer prescription and OTC medications for eyes or ears, oral medications, topical ointments and medications, and inhaled medications in accordance with the provisions of this section.
(1) A copy of the permittee's written policies regarding the administration of medications shall be reviewed, explained, and provided to parents at the time of enrollment.
(2) The permittee shall obtain from a child's parent and health care provider a statement in writing that indicates medicine to be administered and schedule of administration.
(3) A parent, or other adult authorized in writing by the parent, may administer medications to a child while the child is attending a program at any time.
(4) The permittee shall maintain a medication administration log, to be kept on site and made available to the Department upon request, to document the name of the child to whom medication was administered, the date and time of administration, the type and quantity of medication administered, and name of the staff member, parent, or other parentally authorized adult who administered the medication.
(5) Permittees and designated staff may not administer medications by injection, vaginally or rectally, except as follows:
(A) For a child with special health care needs where the parent, program and the child's health care provider have agreed on a plan, pursuant to which the permittee or designated staff may administer medications by injection, vaginally or rectally; or
(B) Where the permittee or designated staff hold a valid New York State license as a physician, physician's assistant, registered nurse, nurse practitioner, licensed practical nurse, or advanced emergency medical technician.
(6) Nothing in this section shall be deemed to require any permittee to administer any medication, treatment, or other remedy except to the extent that such medication, treatment or remedy is required under the provisions of the Americans with Disabilities Act.
(7) Permittees who agree to administer medications shall do so, unless they observe circumstances specified by a child's health care provider, if any, under which medication shall not be administered. In such instances, the permittee shall contact the parent immediately.
(8) Medication may only be administered with written consent of the parent in accordance with written instructions from the child's health care provider including, but not limited to circumstances, if any, under which the medication or prescription shall not be administered. Medication shall be returned to the parent when no longer required by the child.
(9) When the permittee has written parental consent and written instructions from a health care provider authorizing administration of a specified medication if the permittee observes a specific condition or change of condition in the child while the child is in the program, the permittee may administer the medication without obtaining additional authorization from the child's parent or health care provider.
(10) To the extent that such information is not included on the medication label, written instructions by the health care provider shall include:
(A) child's name;
(B) health care provider's name, telephone number, and signature;
(C) date authorized;
(D) name of medication and dosage;
(E) frequency the medication is to be administered;
(F) method of administration;
(G) date the medication shall be discontinued or length of time, in days, the medication is to be given;
(H) reason for medication (unless this information shall remain confidential, pursuant to law);
(I) most common side effects or reactions; and
(J) special instructions or considerations, including but not limited to possible interactions with other medications the child is receiving or concerns regarding the use of the medication as it relates to a child's age, allergies, or any pre-existing conditions.
(11) Medications shall be kept in the original labeled bottle or container. Over-the-counter medication shall be kept in the originally labeled container and shall be labeled with the child's first and last name. Prescription medications shall contain the original pharmacy label.
(12) If medication is to be given on an ongoing, long-term basis, the parent's consent and health care provider's written instructions shall be renewed in writing at least once every six months. Any changes in the original medication shall require a permittee to obtain new written instructions from the health care provider.
(13) A permittee may administer over-the-counter topical ointments, including sunscreen lotion and topically applied insect repellant, upon the written instructions of the parent. Such administration shall be consistent with any directions for use noted on the original container, including but not limited to precautions related to age and special health conditions, and no additional certifications to administer medications are required by the permittee or designated staff. If the only administration of medication offered by the program will be the administration of over-the-counter topical ointment, including sunscreen lotion and topically applied insect repellant, a designated health care consultant is not required. The permittee or designated staff shall record in the medication log applications of such topically applied ointments, sunscreen lotions and topically applied insect repellants, with the name of the child, date and time administered, and staff signature.
(14) For all children for whom the permittee administers over-the-counter medications, pursuant to this paragraph, copies of parental written consent and instructions shall be maintained in the child's medical record file.
(15) Medications shall be kept in a clean area that is inaccessible to children. If refrigeration is required, medications shall be stored in either a separate refrigerator or a leak-proof container in a designated area of a food storage refrigerator, separated from food and inaccessible to children. Permittees shall comply with all applicable law for secure storage of all medications.
(16) Staff shall document dosages and times that medications are given, observable side effects, reasons for not giving medication and medication administration errors, and shall report to the parent and to the child's health care provider, in accordance with the provider's written instructions; medication errors shall be immediately reported to the Department.
(17) No children shall independently self-administer medications or assist in the administration of their own medications except under direct supervision of designated staff.
(18) Nothing in this section shall prevent a parent, guardian or other legally authorized individual in relation to a child from administering medication to a child while such child is in a program. In these circumstances, the permittee shall document the dosages and time that the medications were administered to the child by such individual. If the only administration of medication in such program is done by such individual, no certifications to administer medication are required by the permittee or staff.
(f) [Repealed.]
(Amended City Record 9/20/2017, eff. 10/10/2017; amended City Record 6/12/2018, eff. 7/12/2018)
(a) Staff to be excluded. The permittee shall exclude any staff person from work in accordance with 24 RCNY Health Code Article 11, if such staff person reports having an illness or symptoms of a communicable disease reportable, pursuant to 24 RCNY Health Code Article 11. Such staff person shall not be permitted to return to the program without a written statement of recovery from a health care provider if the staff person was a case of measles, mumps, rubella, pertussis (whooping cough), scarlet fever, meningitis (all types), or poliomyelitis, or if the staff person was a case of any other communicable disease reportable, pursuant to 24 RCNY Health Code Article 11.
(b) Physical examination certificates. No member of the teaching staff or shelter child supervision staff, or substitute, volunteer worker, office worker, kitchen worker, maintenance worker, or other staff member who regularly associates with children shall be permitted to work in a program unless such person is healthy and capable of carrying out the responsibilities of the job. Prior to commencing work, all such individuals shall present a certificate from a licensed health care provider certifying that, on the basis of medical history and physical examination, such individual is physically and mentally able to perform assigned duties. Such certificate shall be submitted every two years thereafter as a condition of employment. Certificates of required physical examinations and other medical or personal health information about staff shall be kept on file on paper or electronically, on the premises of the program, and shall be kept confidential and separate from all other personnel or employment records and made available for review by the Department upon request.
(c) Staff and volunteer immunizations.
(1) Each staff and volunteer must obtain a report from a health care provider who is a licensed physician, nurse practitioner, physician's assistant, or doctor of osteopathy certifying that such person has been immunized with 2 doses of measles-containing vaccine; 2 doses of mumps-containing vaccine; 1 dose of rubella-containing vaccine; 2 doses of varicella-containing vaccine (chicken pox); 1 dose of tetanus, diphtheria and acellular pertussis (Tdap). Persons born on or before December 31, 1956 are not required to have measles, mumps or rubella vaccines. A history of having health care provider documented varicella or herpes zoster disease is acceptable in place of varicella vaccine. A history of having measles, mumps or rubella disease shall not be substituted for the measles, mumps or rubella vaccine. A laboratory test demonstrating detectable varicella, measles, mumps, or rubella antibodies is also acceptable in place of varicella, measles, mumps and rubella vaccine. A staff or volunteer may be exempted from this immunization requirement for medical contraindications in accordance with ACIP or other nationally recognized evidence-based guidelines upon submission of appropriate documentation from a treating licensed physician. Each staff and volunteer must submit such report of immunization to the permittee.
(2) Reports of immunizations shall be confidential and must be kept by the permittee in a paper or electronic file with other staff and volunteer health information, except that such reports must be made available to the Department immediately upon request. Documentation of exemption from immunization must also 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.
(3) No permittee or person in charge of a childcare program shall permit any staff or volunteer to attend such program without appropriate documentation of the immunizations required pursuant to paragraph (1) of this subdivision.
(d) Test for tuberculosis infection. The Department may require testing for tuberculosis at any time of any persons in a program when such testing is deemed necessary for epidemiological investigation.
(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; amended City Record 12/26/2019, eff. 1/25/2020)
(a) Hand washing. Staff and children shall 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 shall be prominently posted in each lavatory and by each sink.
(c) Individual personal care. Hair brushes or cloth towels shall not be provided for use. If toothbrushes, combs, or washcloths are provided, each child shall have items for his/her exclusive use and they shall be stored in an individually labeled container.
(d) Changes of clothing. At least one change of weather-appropriate clothing shall be available so that any child who soils clothing may receive a change. Soiled clothing and cloth diapers shall be handled in a manner that protects occupants from exposure to wastes and maintains an appropriately sanitary environment.
(e) Bathing. Children shall not be regularly bathed on premises; but shall be washed in case of accidents.
(f) Self-care/hygiene routines for night care programs. Permittees shall establish procedures and policies that require children to brush teeth at bedtime and after meals; comb hair upon awakening, and follow a routine for toileting, dressing and undressing.
(g) Safety precautions relating to blood. Permittees shall implement the following safety precautions for all staff having any exposure to, or contact with blood:
(1) Disposable gloves shall 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 shall take priority. A bleeding child shall not be denied care because gloves are not immediately available.
(3) Disposable gloves shall be discarded after each use.
(4) If blood is touched accidentally, exposed skin shall be thoroughly washed with soap and running water.
(5) Clothes contaminated with blood shall 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 shall be cleaned and disinfected with a germicidal solution.
(h) Smoking prohibited. There shall 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.
(Amended City Record 9/20/2017, eff. 10/10/2017; amended City Record 6/12/2018, eff. 7/12/2018)
(a) Education director/shelter child supervision liaison responsibility. The education director of a child care program and the shelter child supervision liaison of a family shelter-based drop-off child supervision program shall arrange for and verify all required training of all teaching staff and shelter child supervision staff. The education director or the shelter child supervision liaison may be certified to conduct such training or may designate other teaching staff or shelter child supervision staff to obtain such certification and conduct such training. The education director or shelter child supervision liaison shall maintain copies of certificates verifying completion of all required training; shall document written safety plan training, including dates and times that emergency response drills were conducted, evaluation of staff performance, and recommendations for improvements in training or amendments to the safety plan. All documents relevant to compliance with this section shall be kept on site and made available to the Department upon request.
(b) Employees.
(1) Child abuse, maltreatment and neglect. All staff must receive at least 2 hours of training every 24 months in preventing, identifying, and reporting child abuse, maltreatment and neglect, and requirements of applicable statutes and regulations. Such training must be provided by a New York State Office of Children and Family Services-certified trainer. New teaching and shelter child supervision staff must receive such training within 3 months of hire or of the effective date of this rule, whichever is later. Training completed while employed at a different program holding a permit under this Article shall count for purposes of compliance with this subsection. Certificates of completion of all training required pursuant to this subsection must be kept on site and made available to the Department upon request.
(2) Infection control, administration of medication, protection from hazards, and additional safety topics. Within three months of hire or of the effective date of this rule, whichever is later, all teaching staff and shelter child supervision staff shall receive training in infection control, reporting infectious diseases; administration of medication; protection from hazards; handling and storage of hazardous materials; appropriate disposal of biocontaminants; building and physical premises safety; including protection from hazards, bodies of water, and vehicular traffic; and, if applicable, safe transportation of children. Training completed while employed at a different program holding a permit under this Article shall count for purposes of compliance with this subsection. Certificates of completion of all training required pursuant to this subsection shall be kept on site and made available to the Department upon request.
(3) Emergency procedures.
(A) Except as provided in 24 RCNY Health Code § 47.37(b)(3)(A)(ii)(aa), all new teaching staff and shelter child supervision staff shall receive, within three months of hire or of the effective date of this rule, whichever is later, and, all staff, volunteers, and other individuals regularly providing services shall receive on an annual basis, training in the emergency procedures contained in the approved written safety plan, including:
(i) In-depth review of the provisions of the plan;
(ii) Announced and unannounced real-time drills demonstrating competency of all staff members in:
(aa) Emergency medical response, including:
(1) Pediatric CPR and pediatric first aid training approved by the Department. Such training is required only for staff and must be completed before staff begin providing services or within three months of the effective date of this rule, whichever is later, and every two years thereafter. Upon application for a new permit or for renewal of an existing permit, for those staff whose presence will be used for compliance with 24 RCNY Health Code § 47.23, such training must include successful completion of hands-on skill tests and certification; and
(2) Administration of epinephrine auto-injector. Such training is required only for those staff selected by the permittee for compliance with 24 RCNY Health Code § 47.29(c); and
(bb) Emergency preparedness and response planning for emergencies resulting from natural disasters or a human-caused events, including procedures for evacuation other than the monthly fire drills required by 24 RCNY Health Code § 47.59(d), relocation, shelter-in-place and lockdown, staff and volunteer emergency preparedness training and practice drills, communication and reunification with families, continuity of operations, and accommodation of infants, toddlers, and children with disabilities or chronic medical conditions. This training shall include response to critical incidents such as:
(1) Loss of a child;
(2) Situation requiring lockdown;
(3) Gas, sewer, or water main break; and
(4) Extreme weather event; and
(B) Training completed while employed at a different program holding a permit under this Article shall count for purposes of compliance with this subsection. Certificates of completion of all training required by this subsection shall be kept on site and made available to the Department upon request.
(4) SIDS, safe sleep practices, and abusive head trauma ("shaken baby syndrome"). All child care program staff and shelter child supervision staff shall complete sudden infant death syndrome ("SIDS"), safe sleep practices, and "shaken baby syndrome" identification and prevention training before beginning to provide services or within three months of the effective date of this rule, whichever is later. Certificates of completion of such training shall be kept on site and made available to the Department upon request.
(5) Allergic reactions. All teaching staff and child supervision staff shall receive training in prevention and control of allergic reactions.
(6) Additional topics.
(A) All teaching staff and shelter-based child supervision staff shall receive training every 24 months on the following topics:
(i) Cognitive social, emotional, and physical development;
(ii) Family engagement; and
(iii) Mental health first aid for children.
(B) All teaching staff shall complete at least 15 hours of training every 24 months, at least five hours of which shall be completed in each 12-month period, including the mandatory child abuse prevention and identification training in paragraph (1), and other subjects related to child health and safety, and early childhood development. The educational director shall develop a training curriculum based on assessment of the professional development needs of individual assistant teachers. The curriculum shall include, but not be limited to, the following topics:
(i) Preventing, recognizing signs of, and reporting injuries, infectious diseases, lead poisoning, asthma, and other illnesses and medical conditions;
(ii) Providing first aid and CPR;
(iii) Scheduling and conducting guided and structured physical activity;
(iv) Setting up and maintaining staff and child health records including records of immunizations;
(v) Growth and child development; including:
(aa) Early intervention;
(bb) Early childhood education curriculum development and appropriate activity planning;
(cc) Appropriate supervision of children;
(dd) Meeting the needs of children with physical or emotional challenges;
(ee) Behavior management;
(ff) Meeting nutritional needs of young children;
(gg) Parent, staff, and volunteer, communication and orientation regarding roles and responsibilities;
(hh) The selection of appropriate equipment and classroom arrangement; and
(ii) Safety and security procedures for fire safety, emergency evacuation, playgrounds, trips, and transportation.
(C) Certificates of completion of such training shall be kept on site and made available to the Department upon request.
(c) The Department may provide the training required by this section, or any part thereof, or accept training provided by others found satisfactory to the Department. All trainers' qualifications must be submitted for review to an agency designated by the Department. Persons who enroll in workshops conducted by the Department may be charged a reasonable fee to defray all or part of the costs incurred by the Department for workshop registration materials, training, testing, and certificate issuance.
(d) The Department may promulgate rules to specify how permittees shall comply with this section.
(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; amended City Record 12/26/2019, eff. 1/25/2020)
(a) Space for children's exclusive use. Rooms, areas and other spaces utilized by children in a program, including bathrooms, shall be reserved for their exclusive use and shall not be shared with other children or adults while the program is in operation.
(b) Minimum square footage/child. The minimum allowance of space for each child in a room/area separated from other rooms/areas by a physical barrier shall be 30 square feet of wall to wall space.
(Amended City Record 9/20/2017, eff. 10/10/2017; amended City Record 6/12/2018, eff. 7/12/2018)
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