PURPOSE: This rule sets forth the requirements for the care of children, including supervision, emergency drills, discipline, diapering and toileting, and daily activities.

1. (1) Care of the Child.

   1. (A) General Requirements.

      1. 1. Caregivers shall not leave any child

without competent adult supervision.

1. 2. A caregiver personally shall admit

each child upon arrival and personally shall dismiss each child upon departure. Children shall be dismissed only to the parent(s), guardian, legal custodian or to individuals approved by the parent(s), guardian or legal custodian.

1. 3. Caregivers shall provide frequent,

direct contact so children are not left unobserved on the premises.

1. 4. Children under three (3) shall be

supervised and assisted while in the bathroom.

1. 5. A caregiver shall remain in the room

with preschool and school-age children while they are napping or sleeping and shall be able to see and hear them if they have difficulty during napping or when they awaken.

1. 6. Preschool children who do not sleep

shall rest on cots or beds at least thirty (30) minutes, but shall not be forced to remain on cots or beds for longer than one (1) hour. They shall then be permitted to leave the napping area to engage in quiet play.

1. 7. Caregivers shall provide special atten-

tion on an individual basis for new children having problems adjusting, distressed children, etc. Children shall be encouraged, but not forced to participate in group activities.

1. 8. Children shall not be subjected to

child abuse/neglect as defined by section 210.110, RSMo.

1. (B) Fire and Tornado Drills.

   1. 1. Fire, tornado, and other disaster

drills shall meet the requirements of 19 CSR 30-62.087 Fire Safety.

1. (C) Discipline.

   1. 1. The provider shall establish simple,

understandable rules for children’s behavior and shall explain them to the children.

1. 2. Expectations for a child’s behavior

shall be appropriate for the developmental level of that child.

1. 3. Only constructive, age-appropriate

methods of discipline shall be used to help children develop self-control and assume responsibility for their own actions.

1. 4. Praise and encouragement of good

behavior shall be used instead of focusing only upon unacceptable behavior.

1. 5. Brief, supervised separation from the

group may be used based on a guideline of one (1) minute of separation for each year of the child's age.

1. 6. Firm, positive statements or redirec-

tion of behavior shall be used with infants and toddlers.

1. 7. Physical punishment including, but

not limited to, spanking, slapping, shaking, biting or pulling hair shall be prohibited.

1. 8. No discipline technique which is

humiliating, threatening or frightening to children shall be used. Children shall not be shamed, ridiculed or spoken to harshly, abusively or with profanity.

1. 9. Punishment or threat of punishment

shall not be associated with food, rest or toilet training.

1. 10. Children shall not be placed in a

closet, a locked or unlit room or any other place which is frightening.

1. 11. Children shall not be permitted to

intimidate or harm others, harm themselves or destroy property.

1. (D) Care of Infants and Toddlers.

   1. 1. Infants and toddlers shall have con-

stant care and supervision.

1. 2. Children shall be cared for by the

same caregiver on a regular basis.

1. 3. Caregivers shall be alert to various

needs of the child such as thirst, hunger, diaper change, fear of or aggression by other children and the need for attention.

1. (E) Diapering and Toilet Training.

   1. 1. Disposable tissues or wipes shall be

used to cleanse the child at each time of diapering. Any diapering creams, powders or other products applied at the time of diapering shall be provided by the parent(s) and labeled with the child's name.

1. 2. The diapering table shall be cleaned

thoroughly with a disinfectant after each use.

1. 3. The child shall not be left unattended

at any time while on the diapering table.

1. 4. Diapers and wet clothing shall be

changed promptly.

1. 5. Wet or soiled diapers shall be placed

in an airtight disposal container located in the diaper change area. If cloth diapers are provided by the parent(s), individual airtight plastic bags shall be used to store each soiled diaper for return each day to the parent(s).

1. 6. Caregivers changing diapers shall

wash their hands with soap and running water each time after changing a child's diaper.

1. 7. The diapering area and handwashing

area shall be separate from any food service area and any food-related materials.

1. 8. No effort shall be made to toilet train

a child until the parent(s) and provider agree on when to begin.

1. 9. The routine for toilet training shall be

discussed with the parent(s) so the same method will be used at the facility and the child's home.

1. 10. Children shall not be punished,

berated or shamed in any way for soiling their clothes. The parent(s) shall provide extra clothing for his/her child in case the child accidentally soils him/herself.

1. (2) Daily Activities for Children.

   1. (A) A daily schedule shall be established in written form which shall include activities for all ages of children in care.

   2. (B) Daily activities for preschool and school-age children shall include:

      1. 1. Developmentally appropriate play

experiences and activities planned to meet the interests, needs and desires of the children;

1. 2. Individual attention and conversation

with adults;

1. 3. Indoor and outdoor play periods

which provide a balance of quiet and active play, and individual and small group activities. Activities shall provide some free choice experiences;

1. 4. A total of at least one (1) hour of out-

door play for children in attendance a full day unless prevented by weather or special medical reasons. (Based on wind chill factor or heat index, children shall not be exposed to either extreme element.);

1. 5. Toileting and handwashing times;
2. 6. Regular snack and meal times;
3. 7. A supervised nap or rest period for

preschool children after the noon meal;

1. 8. A quiet time for school-age children

after the noon meal with a cot or bed available for those who wish to nap or rest; and

1. 9. A study time for school-age children

who choose to do homework, with a separate, quiet work space.

1. (C) Daily activities for infants and toddlers shall include:

   1. 1. Developmental and exploratory play

experiences and free choices of play appropriate to the interests, needs and desires of infants and toddlers;

1. 2. Regular snack and meal times accord-

ing to each infant's individual feeding schedule as stated by the parent(s);

1. 3. A supervised nap period. After awak-

ening, an infant may remain in the crib as long as s/he is content, but never for periods longer than thirty (30) minutes. Toddlers shall be taken out of bed for other activities when they awaken;

1. 4. Individual attention and play with

adults, including holding, cuddling, talking and singing;

1. 5. Opportunities for sensory stimulation

which includes visual stimulation through pictures, books, toys, nonverbal communication, games, and the like; auditory stimulation through verbal communication, music, toys, games, and the like; tactile stimulation through surfaces, fabrics, toys, games, and the like;

1. 6. Encouragement in the development of

motor skills by providing opportunities for reaching, grasping, pulling up, creeping, crawling and walking; and

1. 7. Opportunity for outdoor play when

weather permits.

AUTHORITY: section 210.221.1(3), RSMo Supp. 1998.* This rule previously filed as 13 CSR 40-62.170, 13 CSR 40-62.182 and 19 CSR 40-62.182. Original rule filed March 29, 1991, effective Oct. 31, 1991. Changed to 19 CSR 40-62.182, effective Dec. 9, 1993. Changed to 19 CSR 30-62.182 July 30, 1998. Amended: Feb. 18, 1999, effective Sept. 30, 1999. *Original authority: 210.221.1(3), RSMo 1949, amended 1955, 1987, 1993, 1995.