PURPOSE: This rule sets forth the requirements for personnel, indoor and outdoor space and equipment. Editor’s Note: The secretary of state has determined that the publication of this rule in its entirety would be unduly cumbersome or expensive. The entire text of the material referenced has been filed with the secretary of state. This material may be found at the Office of the Secretary of State or at the headquarters of the agency and is available to any interested person at a cost established by state law.

1. (1) Personnel. Agencies, who by mission, serve a medically fragile or drugand alcoholaffected population, or both, shall employ and schedule a licensed nurse for not less than twenty (20) hours per week. At least one (1) staff shall be present at all times who is trained in infant/child cardiopulmonary resuscitation (CPR).

2. (2) Physical Requirements.

   1. (A) General Requirements.

      1. 1. Stairways shall be well-lighted and

free of obstructions. Stairways having more than three (3) steps shall have a handrail the children can reach.

1. 2. Porches, decks, stairwells or other

areas having a significant drop-off from which children might fall and be injured shall have an approved railing or approved barrier. The railing or barrier shall be constructed to prevent the child from crawling or falling through or becoming entrapped.

1. 3. Approved safety gates at stairways

and doors shall be provided and used as needed.

1. 4. Protective outlet covers or twist-lock

outlets shall be used in areas accessible to the children.

1. 5. Heaters, floor furnaces, radiators, hot

water heaters or other equipment which pose a threat to children shall be separated from areas used by children by partitions, screens or other approved barriers.

1. 6. Smoking shall be prohibited in child

care, food preparation and food service areas.

1. (B) Indoor Space.

   1. 1. General requirements.

      1. A. Open windows and doors shall be

securely screened. Barriers to prevent children from falling against windows or falling from windows shall be provided when windows are less than twenty-four inches (24”) from the floor and not constructed of safety glass or other nonbreakable material.

1. B. Walls, ceilings and floors shall be

finished with material which can be cleaned easily and shall be free of splinters, cracks and chipping paint. Floor covering shall be in good condition. Lead-free paint shall be used for all painted surfaces.

1. C. Concrete floors in areas utilized

for child care shall be covered with carpet, tile, linoleum or other floor covering.

1. D. Floor surfaces under indoor equip-

ment from which children might fall and be injured, shall be protected with pads or mats which will effectively cushion the fall of a child. Carpeting alone is not an acceptable resilient surface under indoor equipment.

1. E. Toilet and handwashing facilities

shall be in working order and convenient for the children’s use.

1. F. Paper towels, soap and toilet paper

shall be provided and easily accessible so the children can reach them without assistance.

1. G. Locks or latches shall not be used

on bathroom or bathroom stall doors.

1. H. One (1) potty chair, junior com-

mode or toilet with an adaptor seat shall be provided for every four (4) children being toilet trained. Potty chairs shall be located in the bathroom and shall be emptied, cleaned and disinfected after each use.

1. (C) Diapering Area.

   1. 1. A safe diapering table with a water-

proof washable surface shall be used for changing diapers. The diapering table shall be located within or adjacent to the group space so staff using the diapering table can maintain supervision of his/her group of children at all times.

1. 2. Facilities shall have one (1) diapering

table for every group of eight (8) infant/toddlers.

1. 3. Diapering supplies, and a properly

equipped hand washing sink with warm running water, soap and a towel shall be adjacent to the diapering area.

1. (D) Outdoor Space.

   1. 1. General requirements.

      1. A. An outdoor play area shall be

available on, or adjoining, the agency’s property. The area shall be located so it is convenient and the children can gain access to it without hazard. It shall be fenced when necessary for the protection of children from traffic, water or other hazards.

1. B. The play area shall be safe for chil-

dren’s activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.

1. C. The fall-zone area under and

around outdoor equipment where children might fall and be injured shall be covered with impact-absorbing materials which will effectively cushion the fall of a child. This material may include sand, pea gravel, tanbark, shredded tires, wood chips, rubber matting or other approved resilient material.

1. (E) Swimming and Wading Pools. 13 CSR 35-71

   1. 1. Swimming and wading pools used by

children shall be constructed, maintained and used in a manner which safeguards the lives and health of children.

1. 2. Swimming and wading pools shall be

fenced to prevent access by children. The fence shall be at least forty-eight inches (48") high with a self-closing, self-latching door that must be unlatched from the inside and should be constructed so that a four-inch (4") sphere could not be passed through the fence.

1. 3. Children using swimming or wading

pools shall be instructed in water safety and supervised by an adult at all times.

1. 4. An adult with a current lifeguard

training certificate, including infant/child cardiopulmonary resuscitation (CPR) training, shall be on duty at all times when a swimming pool containing a water depth of fortyeight inches (48") or more is being used.

1. 5. An adult who has completed a course

in basic water safety, which includes infant/child CPR, shall be on duty when a swimming pool containing less than fortyeight inches (48") of water is being used.

1. (F) Sleeping Equipment.

   1. 1. An individually assigned crib,

portable crib or playpen shall be provided for each infant and toddler. Stack cribs shall not be used.

1. 2. Cribs and playpens shall have side rail

spokes which conform to current United States Consumer Product Safety Commission standards.

1. 3. The crib mattress or playpen pad

shall be correctly sized to the crib or playpen, in good condition, waterproof and kept clean and dry. Sheets and covers shall be changed immediately when soiled or wet.

1. (G) Tables and Seating Equipment.

   1. 1. Individual chairs and table space for

the licensed capacity of the facility shall be available for children twelve (12) months of age and older. Chairs shall be proportioned so children sit comfortably and securely.

1. 2. Infants and toddlers who are unable

to sit at a table shall have one (1) piece of mealtime feeding equipment for every four (4) infant/toddlers which may include feeding tables, high chairs, infant seats or other safely designed infant seating equipment. Equipment shall be provided which will allow the child to sit comfortably and securely while being fed. Appropriate restraints shall be used.

1. (H) Indoor Play Equipment and Materials.

   1. 1. General requirements.

      1. A. Play equipment and materials shall

be clean, in good condition with all parts intact and accessible to children.

1. B. Play equipment and materials shall

be replaced as needed to maintain the number of items required for the licensed capacity of the facility.

1. 2. Preschool and school-age children.

   1. A. Children twenty-four (24) months

of age and older shall have an ample variety of age-appropriate toys, books, creative materials and activities which provide fun, stimulation, development and opportunities for individual choices.

1. B. The following shall be required:

   1. (I) Blocks, construction and trans-

portation toys;

1. (II) Manipulatives;
2. (III) Creative arts;
3. (IV) Large muscle activities;
4. (V) Library and language activi-

ties;

1. (VI) Music and rhythm activities;
2. (VII) Dramatic and housekeeping

play; and (VIII) Science activities or sensory experiences.

1. C. Infants and toddlers.

   1. (I) Infants and toddlers shall have

safe toys which shall be washed or sanitized at least weekly or when soiled. Toys, parts of toys or other materials shall not be small enough to be swallowed. Toys and materials shall include each of the following:

1. (a) Push-pull toys;
2. (b) Balls or other large muscle

equipment;

1. (c) Blocks, stacking toys or other

manipulatives; and

1. (d) Cloth or plastic-coated

books.

1. 3. Outdoor equipment.

   1. A. All outdoor equipment shall be

safely constructed, in good condition and free of sharp, loose or pointed parts. Only leadfree paint shall be used.

1. B. Outdoor equipment shall be pro-

vided for the ages and number of children in care to meet their physical and developmental needs.

1. C. Children shall be instructed in the

safe use of outdoor equipment.

1. D. Stationary equipment such as

swings, slides and climbers shall be securely anchored, have no exposed footings and be placed to avoid accidents or collisions.

1. E. Any hanging apparatus that might

entrap, close or tighten upon a child shall not be used.

1. F. Trampolines shall not be used.

Mini-trampolines, aerobic bouncers or other similar small jumping equipment may be used with close supervision.

AUTHORITY: sections 210.481, RSMo (1986), 210.486 and 210.506, RSMo (Cum. Supp. 1993).* This rule originally filed as 13 CSR 40-71.100. Emergency rule filed Nov. 1, 1993, effective Nov. 12, 1993, expired March 11, 1994. Emergency rule filed March 2, 1994, effective March 12, 1994, expired July 9, 1994. Original rule filed Nov. 1, 1993, effective June 6, 1994. Moved to 13 CSR 35- 71.100, effective Oct. 30, 2008. *Original authority: 210.481, RSMo (1982), amended 1985 and 210.486 and 210.506, RSMo (1982), amended 1993.