(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)