1. (a) Child care staff shall supervise every child in care at all times.

2. (b) In center-based programs, staff shall:

   1. (1) Know the number and identity of children in their care; and

   2. (2) Position themselves to:

      1. a. Be able to hear all children younger than school age at all times, continuously scan the entire environment to know where children are and what they are doing, and be able to physically respond immediately;
      2. b. Always know the whereabouts and activities of all school age children in their care when children are briefly out of sight, such as when transitioning from one area to another or using the bathroom, and shall be able to physically respond immediately; and
      3. c. Allow for visual supervision of all children while children are eating and shall be able to physically respond immediately to any child.
3. (c) The only exception to (b)(2)a. above shall be children 4 years and older may leave the classroom to use a bathroom located on the same level as the classroom, provided that child care staff are aware of each child leaving the classroom to use the bathroom and the level of the building that the bathroom is located on is used exclusively by the child care program.
4. (d) Video monitors shall not replace the supervision of children, except as provided for in He-C 4002.25(j) and (k).

5. (e) In family child care homes and small child care centers, child care staff who are working alone shall supervise children in accordance with the following:

   1. (1) The child care staff may step away from the children to meet basic care needs throughout the day, provided that:

      1. a. The time away is time limited; and
      2. b. The child care staff shall always be able to hear all children preschool age and younger and be able to physically respond immediately, if necessary;
   2. (2) The child care staff shall always know the whereabouts and activities of all school age children and shall be able to physically respond immediately;
   3. (3) The child care staff may allow school-age children 6 years of age and older to play outside when the child care staff is inside, with written parental or guardian permission; and
   4. (4) When children are eating, the child care staff shall be positioned to allow for visual supervision of all children and shall be able to physically respond immediately to any child.
6. (f) Child care staff shall not carry a child while stepping over a low wall, gate, or other similar barrier.
7. (g) Child care staff shall protect younger or less mobile children from accident or injury which could be caused by older or more physically active children.

8. (h) The program shall obtain the following documents from the parents or guardians of each child with a food allergy or other allergy, which results in a serious reaction:

   1. (1) A written care plan that includes instructions regarding food(s) or other allergens to which the child is allergic and steps for child care staff to take to avoid the allergens; and

   2. (2) A written treatment plan, detailing the treatment to be implemented in the event of an allergic reaction, which shall include:

      1. a. The names, doses, and methods of prompt administration of any medications, where the medication needs to be stored in relation to the child, taking into consideration the storage requirements in He-C 4002.20(j)(2), and instructions on how to administer the prescribed medication; and
      2. b. Specific symptoms that would indicate the need to administer one or more medications.
9. (i) At all times, at least one child care staff supervising a child with an allergy care plan shall have completed the training specified in He-C 4002.32(b)(5).
10. (j) The program manager or their designee shall notify a child’s parent or guardian when the program deviates from the planned menu as indicated on children’s allergy care plans, as applicable.
11. (k) With permission of the parent or guardian, the program shall post each child’s allergy care plan and treatment plan in the kitchen or food preparation area, the child's classroom, and wherever the child might have contact with the allergen(s).
12. (l) In the event a parent or guardian does not authorize posting of their child’s allergy care plan or treatment plan as required in (k) above, the program shall not post the plans, but ensure the plans are available in the locations in (k) above, and all staff working in those locations know where the plans are and review the plans upon entering those locations.
13. (m) All child care staff responsible for food preparation and food service, and all child care staff responsible for supervising children with an allergy, including staff covering breaks, shall read and familiarize themselves with the allergy care plans and treatment plans, to ensure that no child is accidentally exposed to an allergen.
14. (n) The program manager or their designee shall immediately notify a child’s parent or guardian in the event of a suspected allergic reaction or ingestion of or contact with a known allergen, even if a reaction did not occur.
15. (o) Program staff shall notify emergency services immediately whenever staff administer epinephrine (Epi-pen) to a child.
16. (p) Programs shall be equipped with a telephone that is operable and accessible to all child care staff during all operating hours for incoming and outgoing calls. The phone may be a cellular phone or a landline.
17. (q) Child care staff shall report any occurrence of a missing child to emergency services, as soon as child care staff have determined that the child cannot be promptly located on the premises of the child care program.
18. (r) There shall be at least one staff person present with all children during all operating hours, both on and off premises, who is trained and currently certified in pediatric cardiopulmonary resuscitation (CPR) and first aid, which shall be obtained by the American Red Cross, American Heart Association, Emergency Care and Safety Institute, National Safety Council, American Trauma Event Management, or other nationally recognized organization.
19. (s) CPR and first aid training as specified in (r) above may be received via correspondence or on-line, provided a skill test is required to be performed prior to becoming certified.
20. (t) Programs shall maintain on file, available for review by the department, copies of current CPR and first aid certificates and licenses.
21. (u) Programs shall have on the premises and on all field trips, a selection of non-expired first aid supplies adequate to meet the needs of the children.
22. (v) Programs shall store the first aid supplies required under (u) above in a portable container, in a location that is accessible by staff.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97 New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (He-C 4002.22); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.19); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.20)