1. A. In addition to the requirements set out in COMAR 14.31.05 and 14.31.06, a licensee shall ensure a program that provides mother-infant services also meets the requirements of this regulation.

2. B. A licensee may provide care and service for children who are mothers with an infant if:

   1. (1) The licensing agency approves the program in writing;
   2. (2) The licensee ensures that adolescents follow the advice of a licensed physician regarding the health care of the adolescent's child;

   3. (3) The licensee provides the mother with:

      1. (a) Sanitary space, a table, and plumbing necessary to change diapers;
      2. (b) Competent instruction in the care and nurturing of infants;
      3. (c) Limits on her social activities to ensure that she is responsible for her infant;
      4. (d) Opportunity, encouragement, and structure for the completion of her education;
      5. (e) Encouragement to develop her capacity for and understanding of her independence;
      6. (f) Assurance that any child care center or home where the infant may be placed during daytime hours is licensed under State law;
      7. (g) Professional guidance, training, and counseling in human sexuality; and
      8. (h) A bed in a room separate from where the infant sleeps after the infant is 6 months old;

   4. (4) The licensee assures that the infant is provided with:

      1. (a) Protection from harm;
      2. (b) Access to health care;
      3. (c) Proper food and nutrition;
      4. (d) Physical warmth and nurture;
      5. (e) Protection from disease;
      6. (f) Physical comfort;
      7. (g) Proper sleeping environment in an appropriate crib;
      8. (h) Appropriate feeding schedule;
      9. (i) Regularly changed diapers in a sanitary environment;
      10. (j) When the infant is 6 months old, a crib in a room separate from where the mother sleeps;
      11. (k) Pediatric care in accordance with Early and Periodic Screening, Diagnosis, and Treatment schedules; and
      12. (l) Required immunizations;

   5. (5) The licensee ensures that direct care workers in this program:

      1. (a) Receive 10 hours of training specific to infant care before assuming duties in a mother-infant program as part of the training requirements of COMAR 14.31.06; and
      2. (b) Annually receive 15 hours of training specific to the mother-infant program as part of the training requirements of COMAR 14.31.06; and

   6. (6) The program provides the licensing agency with a written policy regarding the care of an adolescent's child by another adolescent in residence in which the following conditions are met:

      1. (a) The adolescent assumes care of no more than one other child in addition to her own at any time;

      2. (b) The adolescents discuss the expectations of the caregiver, including:

         1. (i) Duration of child care;
         2. (ii) The child's nutritional and toileting needs; and
         3. (iii) Any arrangements for compensation or exchange of baby-sitting; and
      3. (c) The arrangement is reviewed and approved by the program administrator or the program administrator's designee.

Authority: Article 41, §§6-101 and 6-104; Article 83C, §§2-102, 2-104, 2-113, 2-120, and 2-123—2-125; Education Article, §§8-301—8-303; Family Law Article, §§5-506, 5-508, 5-509, 5-509.1, and 5-510; Health-General Article, §§2-104, 7-904, 8-404, 10-922, and 10-924; Annotated Code of Maryland

Effective date: November 22, 2004 (31:23 Md. R. 1651)

COMAR 01.04.08 revised and recodified to COMAR 14.31.07 as an emergency provision effective June 30, 2005 (32:15 Md. R. 1314); revised and recodified permanently effective November 28, 2005 (32:23 Md. R. 1828)