A provider of therapeutic nursery services shall ensure that services:

1. A. Are appropriate to the cultural and psychosocial developmental needs of the child;

2. B. Are provided:

   1. (1) For a minimum of 3 hours per day, 3 days per week at each site; and
   2. (2) In either a free-standing program or as an integral component of a preschool program in which services are offered in a therapeutic milieu;

3. C. Are provided by staff who:

   1. (1) As determined by the program, are appropriately credentialed and privileged; and

   2. (2) Organize and manage the milieu to:

      1. (a) Foster clinically appropriate social, intellectual, emotional, and physical growth;
      2. (b) Handle aggression in a nonpunitive manner that promotes growth and learning;
      3. (c) Reinforce the child's ability to function with peers in a social environment;

      4. (d) Model and provide opportunities for children to behave in age-appropriate ways, such as:

         1. (i) Being playful;
         2. (ii) Assuming responsibility for carrying out routine activities;
         3. (iii) Exhibiting independence and initiative in planning their own learning;
         4. (iv) Getting along with others; and
         5. (v) Being courteous;
      5. (e) Facilitate the child's awareness of appropriate behavior in a predictable, constructive, and timely manner; and
      6. (f) Help children to make choices and to negotiate disagreements among themselves, rather than resolving conflicts for them;

4. D. Are provided in an environment that:

   1. (1) Is consistent with existent standards of program design;
   2. (2) Is organized so that the child can function in an environment with a minimum of adult direction;
   3. (3) Has space that facilitates the activities of each learning center allocated to each center;
   4. (4) Has sufficient space and separation between learning centers so that children can engage in activities of their choice without distracting or being distracted by others;
   5. (5) Provides materials that are available for children's use and are otherwise appropriately stored; and
   6. (6) Displays exhibits of children's work that reflect children's current experiences, developmental level, diversity, and individuality;
5. E. Are designed to develop or improve the ability of the primary caretaker to care for the child; and
6. F. Maintain linkage with schools and preschool programs to effect transition at the appropriate time and with the necessary support services.

Authority: Health-General Article, §§10-901 and 10-902, Annotated Code of Maryland

Effective date: January 2, 1995 (21:26 Md. R. 2187)