1. (a) Child care staff shall arrange cribs, cots, beds, mats, or playpens in a manner that ensures that:

   1. (1) They do not block passageways and exit routes, to allow for emergency evacuation and access to each child by staff;
   2. (2) They are spaced at least 2 feet apart while in use or separated by a solid divider on one side only, allowing for adequate supervision by staff and air circulation; and
   3. (3) Children are placed head to toe.
2. (b) Programs shall ensure that each child requiring rest or sleep is provided with a sleeping bag, crib, cot, bed, or mat.
3. (c) Each infant 12 months of age and younger shall be placed on their back to sleep in an individual crib or play pen, unless they have demonstrated the ability to climb out.
4. (d) Child care staff shall discontinue using cribs or play pens with children who have demonstrated the ability to climb out of them.
5. (e) No crib shall be used unless manufactured on or after June 28, 2011, or if manufactured prior to that date, has a Children’s Product Certificate (CPC), or test report from the U.S. Consumer Product Safety Commission (CPSC) accepted third-party lab, provided by the manufacturer documenting the crib’s compliance with 16 CFR 1219 and 1220.

6. (f) Cribs and play pens required under (c) above shall:

   1. (1) Not be stacked;
   2. (2) Be in good repair;
   3. (3) Not have holes or tears in the mesh walls or in the material that connects the walls to the bottom of the crib or play pen;
   4. (4) Have tight fitted sheets designed for the size mattress that do not compress the mattress;
   5. (5) Not have bumper pads, blankets, flat sheets, pillows, quilts, comforters, sleep positioners, or any items or toys with infants up to 12 months of age; and
   6. (6) Have mattresses which are in good repair, free of rips or tears, and fit the crib or playpen so that the space between the mattress and crib or playpen is not more than 1 inch wide and does not create a suffocation hazard.
7. (g) If an infant up to 12 months falls asleep outside of their crib or play pen, including entering the program asleep in a car safety seat, staff shall immediately move the infant and place them on their back in a crib or play pen.
8. (h) When child care staff place infants in their crib or play pen for sleep, they shall check the infants to ensure that they are comfortably clothed and not overheated or sweaty, and that bibs and garments with ties or hoods are removed.
9. (i) Children older than 3 months shall not be swaddled or placed in restrictive or weighted sleep suits or devices unless there are written medical orders from the child’s primary licensed practitioner.

10. (j) In family and family group child care homes and small child care centers, use of an electronic monitor shall only be used to monitor sleeping children on the same level in lieu of direct supervision, in accordance with the following:

    1. (1) There is written authorization on file from the parents or guardians of the child, indicating that they are aware of and agree to the use of the monitor;
    2. (2) The child care staff responsible for their supervision can easily hear sounds from the monitor and respond; and
    3. (3) Every 15 minutes, the child care staff responsible for their supervision conduct in-person checks of infants and toddlers sleeping in a crib or playpen, to ensure that each child is safe and comfortable, including a check of their faces, viewing the color of their skin and to check on their breathing.

11. (k) In center-based programs, use of an electronic monitor, whether only audio or both audio and visual, shall be permissible in lieu of having staff in the same room with only infants or toddlers sleeping in cribs or playpens, in accordance with the following:

    1. (1) There is written authorization on file from the parents or guardians of the child, indicating that they are aware of and agree to the use of the monitor;
    2. (2) The child care staff required to maintain ratio are located in an adjoining room where they can easily hear sounds from the monitor and respond; and
    3. (3) Every 15 minutes, the child care staff conduct in-person checks of infants and toddlers sleeping in a crib or playpen, to ensure that each child is safe and comfortable, including a check of their faces, viewing the color of their skin and to check on their breathing.
12. (l) Blankets, sleeping bags, bedding, cots, and mats shall be stored in a manner that ensures that sleeping surfaces are not touching, or the items shall be washed and sanitized before re-use if stored in a way that sleeping surfaces are touching.
13. (m) All bedding shall be cleaned at least once a week and more frequently if soiled, and between uses by different children.
14. (n) Programs shall provide children who attend for more than 5 hours with an opportunity for at least one hour of quiet activities, rest, or sleep, in any combination to equal one hour, depending on the needs of each child.
15. (o) Programs shall allow children time to fall asleep and awaken at their own pace within a block of time set aside as nap or rest time.
16. (p) Programs shall provide children who do not fall asleep after 30 minutes with an opportunity to do a quiet activity.

17. (q) Child care staff shall not:

    1. (1) Require that children who are awake stay on mats, sleeping bags, cots, or beds for more than 60 minutes; or
    2. (2) Require children to sleep.

18. (r) For children 24 months through 5 years, during naptime, a center-based program may have one less staff person in a classroom than required to meet ratios in accordance with He-C 4002.35 through He-C 4002.36 provided that:

    1. (1) The total number of child care staff required to maintain all ratios are on the premises of the program;
    2. (2) The ratio of awake children to staff in the classroom shall be no more than half the number of children as stated in He-C 4002.35 through He-C 4002.36;
    3. (3) Rooms in which staff is reduced shall be equipped with a two-way communication system to allow for immediate contact with other staff for assistance and response;

    4. (4) There is a safety plan on file for review by the department, child care staff, and parents or guardians which includes plans or procedures for:

       1. a. Evacuation;
       2. b. Supervision;
       3. c. Environment;
       4. d. Schedule;
       5. e. Naptime policy; and
       6. f. Staff training and support;
    5. (5) The program provides parents or guardians with written notice of the reduction of staff; and
    6. (6) Documentation of the written notice in (5) above shall be available for review by department staff during visits.
19. (s) During rest and sleep, programs shall always maintain ratios for children under 24 months, in accordance with He-C 4002.35 and 4002.36, except as specified in (t) below.
20. (t) Ratios for children under 24 months in mixed age groups with children 24 months and older shall be based on the average age of the children in each group during naptime, in accordance with (s) above.
21. (u) Programs shall base the staff to child ratio on the average age of the children in each group in accordance with (t) above when there are mixed age groups in the same room.
22. (v) No child shall wear a necklace during nap time or during sleep, unless the necklace is fused or has a fixed knot such that it cannot be removed.

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 (from He-C 4002.28); 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 4002.22); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.26)