Header:
WISCONSIN ADMINISTRATIVE CODE
DEPARTMENT OF CHILDREN AND FAMILIES
CHAPTER DCF 250 FAMILY CHILD CARE CENTERS
Date:
08/31/2009
Document:
DCF 250.07 Program.
(1) PROGRAM PLANNING AND SCHEDULING. (a) A provider shall plan activities so that each child may be or do all of the following:
1. Be successful and feel good about himself or herself.
2. Use and develop language.
3. Use large and small muscles.
4. Use materials and take part in activities that encourage creativity.
5. Learn new ideas and skills.
6. Participate in imaginative play.
7. Be exposed to a variety of cultures.
8. Develop literacy skills.
Note: The Wisconsin Model Early Learning Standards are voluntary standards that were designed to help centers develop programs and curriculum to help ensure that children are exposed to activities and opportunities that will prepare them for success in school and into the future. The Standards are primarily intended as guidance on developmentally appropriate expectations and are not intended to be used as a checklist to gauge a child's progress. The Standards are based on scientific research. Copies of the Wisconsin Model Early Learning Standards are available on the Wisconsin Early Childhood Collaborating Partners website at http://www.collaboratin-gpartners.com/ or through the Child Care Information Center at 1-800-362-7353.
Wisconsin has an information and, referral service for persons with questions or concerns about a child's development called First Step that is available to the public 24 hours a day, 7 days a week. When a call is placed to First Step at 1-800-642-7837, the caller will leam about early intervention services as well as other related services in the area. When a provider or a parent has concerns about a child's growth or development a referral to a Birth-to-Three agency or the local public school should be considered to determine if the child is eligible for special services. With parental consent and consultation, it is recommended that centers who care for children who have an Individualized Family Service Plan (IFSP) or an Individualized Education Program (IEP) coordinate programming activities with the local school district or Birth to Three agency.
(b) A provider shall plan daily activities according to the age and developmental level of each child in care and shall include a flexible balance of all of the following:
1. Daily indoor and outdoor activities when a child is in care for more than 3 hours except that outdoor activities are not required during inclement weather or when not advisable for health reasons.
2. Active and quiet play.
3. Protection from excess fatigue and over stimulation.
4. Individual and group activities.
(c) Television, including videotapes and DVDs, may be used only to supplement the daily plan for children. No child may be required to watch television.
(2) CHILD GUIDANCE. (a) Each family child care center shall provide positive guidance and redirection for the children and shall set clearly specified limits for the children. A provider shall help each child develop self-control, self-esteem and respect for the rights of others.
(b) If a provider uses time-out periods to deal with unacceptable behavior, time-out periods may not exceed 5 minutes or he used for children under age 3. Time-out procedures shall be included in the center's written child guidance policy.
(c) Actions that may be psychologically, emotionally or physically painful, discomforting, dangerous or potentially injurious are prohibited. Examples of prohibited actions include all of the following:
1. Spanking. hitting, pinching, shaking, slapping, twisting, throwing, or inflicting any other form of corporal punishment on the child.
2. Verbal abuse, threats or derogatory remarks about the child or the child's family.
3. Physical restraint, binding or tying the child to restrict the child's movement or enclosing the child in a confined space such as a closet, locked room, box or similar cubicle.
4. Withholding or forcing meals, snacks or naps.
5. Actions that are cruel, aversive, humiliating or frightening to the child.
(d) A child may not be punished for lapses in toilet training.
Note: See s. DCF 250.04 (8) for information on reporting suspected child abuse and s. DCF 250.04 (3) (i) for rules requiring that inappropriate discipline of a child be reported to the Department within 24 hours after the occurrence.
(3) EQUIPMENT. (a) Safe indoor and outdoor play equipment shall be provided and shall be all of the following:
1. Scaled to the size and developmental level of the children.
2. Of sturdy construction with no sharp, rough, loose, or pointed edges, in good operating condition, and anchored when necessary.
3. Placed so as to avoid danger of accident or collision and to permit freedom of action.
(b) Various types of play equipment shall be provided to allow for large and small muscle activity, dramatic play, creative expression and intellectual stimulation.
(c) Indoor play equipment shall be provided to allow each child a choice of at least 3 activities involving equipment when all children are involved in using equipment.
(d) Outdoor play equipment shall be provided to allow each child at least one activity when all children are using equipment at the same time.
(e) Trampolines and inflatable bounce surfaces on the premises shall not be in areas accessible to children and may not be used by the children in care.
Note: Lists suggesting kinds and numbers of equipment for centers are available from the Child Care Information Center by calling 1-800-362-7353.
(4) REST PERIODS. (a) Children under 5 years of age in care for more than 4 consecutive hours shall have a nap or rest period.
(b) A provider shall permit children who do not sleep after 30 minutes and children who wake up early to get up and shall help them to have a quiet time through the use of equipment or activities which do not disturb other children.
(c) Each child who has a nap or rest period shall be provided with a bed, cot, mat at least 2 inches thick, sleeping hag, crib or playpen which is placed at least 2 feet from the next sleeping child.
(d) Each child shall be provided with an individually identified sheet and blanket or sleeping bag that may be used only by that child until it is washed. Sleeping bags and bedding shall be stored in a sanitary manner and washed at least after every 5 uses or as soon as possible if wet or soiled.
(e) Infants shall sleep alone in cribs or playpens. Two related children may share a double bed. No more than one child may occupy a single size bed, cot, mat or sleeping bag.
Note: See also s. DCF 250.06 (8) (h) 3. and 4. which require that the cot, bed, mat, sleeping bag, crib or playpen be safe and washable.
(5) MEALS AND SNACKS. (a) Food shall be provided based on the amount of time children are present, as specified in Table 250.07.
TABLE 250.07
Meals and Snacks to be Served to Children
in Family Child Care Centers
Time Present Number of Meals
and Snacks
At least 21/2 but less than 4 1 snack
hours
At least 4 but less than 8 1 snack and 1 meal
hours
At least 8 but less than 10 2 snacks and 1 meal
hours
10 or more hours 2 meals and 2 or 3 snacks
(b) Food shall be served at flexible intervals, but no child may go without nourishment for longer than 3 hours.
(c) Each meal and snack shall meet the U.S. department of agriculture child and adult care food program minimum meal requirements.
Note: See Appendices B and C for United States Department of Agriculture child and adult care food program minimum meal requirements. You may also contact the Department of Public Instruction Community Nutrition Services for information on the United States Department of Agriculture child and adult care food program at 608-267-9123.
(d) Accurate records of meals and snacks served to children shall be available for review by parents and the licensing representative. Written records of meals and snacks served to children must be kept for 3 months.
(e) Enough food shall be prepared for each meal so second portions of vegetables, fruit, bread and milk are available to children.
(f) When food for a child is provided by the child's parent, the licensee shall give the parents information about the requirements for food groups and quantities specified by the U.S. department of agriculture child and adult care food program minimum meal requirements.
(g) A child enrolled in school who is in attendance at the center when a meal or snack is served shall be offered the meal or snack.
(h) A special diet based on a medical condition, excluding food allergies, but including nutrient concentrates and supplements, may be served only upon written authorization of a child's physician and upon the request of the parent.
(i) A special diet based on a food allergy may be served upon the written request of the parent.
(6) HEALTH. (a) Contact with others who are ill. 1. A licensee, provider, household member, employee, volunteer, visitor or parent who has symptoms of illness or of a communicable disease that may be transmitted through normal contact may not be in contact with the children in care.
2. a A licensee, provider, household member, employee, volunteer, visitor or parent whose behavior with respect to any child, adult, animal or property, on or off the center's premises, raises reasonable concern for the safety of the children, may not be in contact with the children in care.
b. The department may require a licensee, provider, household member or other adult in contact with the children whose behavior gives reasonable concern for the safety of children to submit to an examination by a licensed mental health professional as a condition of licensure or employment.
Note: See also s. DCF 250.11 (2) (e) which requires a written statement front a physician or licensed mental health professional when there is reason to believe that the physical and mental health of a person may endanger children in care.
3. No person with a health history of typhoid, paratyphoid, dysentery or other diarrheal disease may work in a center until it is determined by appropriate medical tests that the person is not a carrier of the disease.
(b) Observation of children. 1. Each child upon arrival at the center shall be observed for symptoms of illness. For a child who appears to be ill, the licensee shall follow the procedure under par. (c).
2. A provider shall note in a medical log book any injury or evidence of unusual bruises, contusions, lacerations or burns received by a child in or out of the center and any incidents requiring the services of medical personnel.
Note: See s. DCF 250.04 (6) (c) for information on maintaining a medical log book.
(c) Ill child. Unless a center has been previously authorized to care for mildly ill children under par. (d), any child who appears to be ill shall be moved to a separate room or area and shall be provided with a bed, crib or cot and a sheet and blanket or sleeping bag. The licensee shall notify the parent or emergency contact and arrange to remove the child from the center as soon as possible.
(d) Care of a mildly ill child. A child who is mildly ill may be cared for at the center when all of the following conditions are met:
1. The space for the care of a mildly ill child is a self-contained room that is separate from children who are well.
2. The parent consents in writing.
3. The written health policy of the center allows a mildly ill child to remain at the center.
4. The center follows and implements procedures in a written plan for the provision of care to mildly ill children that has been approved, and signed by a licensed physician, a family nurse practitioner or a pediatric nurse practitioner, and which covers all of the following:
a. Admissions and exclusions.
b. Staffing.
c. Staff training.
d. Monitoring and evaluation.
e. Programming.
f. Infectious disease control.
g. Emergency procedures.
5. Medical consultation is available from a physician or local health department in establishing policy for the management of mildly ill children.
(e) Communicable disease. 1. When it is determined that a person in contact with children or a child attending the center has a reportable communicable disease under ch. DHS 145, such as German measles, infectious hepatitis, measles, mumps, or meningitis, the local public health officer, the department and parents of all the enrolled children shall be notified.
2. A licensee, provider, household member, employee, volunteer, visitor or parent or a child in care may be readmitted to the family child care center if there is a written statement from a physician that the condition is no longer contagious or if the person has been absent for a period of time equal to the longest usual incubation period for the disease as specified by the department in ch. DHS 145.
Note: The Wisconsin Department of Health Services, Division of Public Health. has developed materials that identify those communicable diseases that are required to be reported to the local public health officer. These materials also provide additional guidance on the symptoms of each disease and information on how long an infected child shall be excluded from the center. The materials include a communicable disease chart and exclusion guidelines for child care centers. Copies of the communicable disease chart or the exclusion guidelines for child care centers are available front the Child Care Information Center 800-362-7353.
(f) Medications. 1. A provider may give prescription or non-prescription medications such as pain relievers, teething gels or cough syrup to a child only under the following conditions:
a. A completed written authorization on a form provided by the department, dated and signed by the parent is on file. Authorizations that exceed the period of time specified on the label are prohibited.
Note: The department's form. Authorization to Administer Medication - Child Care Centers, is used to obtain the parent's authorization to provide medications. Information on how to obtain the form is available on the department's website, http://dcf.wisconsin.gov. or front any regional licensing office in Appendix A.
b. The medication is in the original container and labeled with the child's name and with dosage and administration directions.
c. A written record, including the name of the child, type of medication given, dosage, time, date and the initials or signature of the person administering the medication shall be made in the medical log on the same day that the medication is administered.
Note: See s. DCF 250.04 (6) (c) about maintaining a medical log book.
2. a Sunscreen and insect repellent may only be applied upon the written authorization of the parent. The authorization shall include the brand and ingredient strength of the sunscreen or insect repellent. If parents provide the sunscreen or insect repellent, the sunscreen or repellent shall be labeled with the child's name. Authorizations shall be reviewed periodically and updated as necessary. The recording of the application of sunscreen or insect repellent is not required.
b. Children shall be protected from sunburn with protective clothing, if not protected by sunscreen.
3. Medications shall be stored so that they are not accessible to children.
4. Medications requiring refrigeration shall be kept in the refrigerator in a separate, covered container clearly labeled "medications."
5. No medication intended for use by a child in the care of the center may be kept at the center without a current medication administration authorization from the parent.
6. Medication for a child in care shall be administered by the center as directed on the label and as authorized by the parent.
(g) Personal cleanliness. 1. a A child's hands shall be washed with soap and warm running water before meals or snacks and after toileting or diapering. A child's hands and face shall be washed after meals. Persons working with children shall wash their hands with soap and warm running water before handling food and after assisting with toileting. Towels and washcloths shall be individual to each person and used only once.
b. If running water is not immediately available when outdoors or on field trips, soap and water-based wet wipes may be used. When running water becomes available, hands shall be washed immediately with soap and running water.
c. Disinfecting hand sanitizers may not replace the use of soap and water for washing hands.
2. Bodily secretions from a child shall be wiped with a disposable tissue. Whoever does the wiping shall wash his or her hands immediately.
3. All providers shall use universal precautions when exposed to blood or bodily fluids or discharges containing blood.
4. All persons exposed to blood or bodily fluids containing blood or other types of bodily discharges shall wash their hands immediately with soap and warm running water.
5. Single use disposable gloves shall be worn if there is contact with blood-containing body fluids or tissue discharges. Hands shall be washed with soap and warm water after removal of gloves. Gloves shall be discarded in plastic bags.
(h) Disinfecting surfaces. Surfaces containing bodily secretions shall be washed with soap and water and disinfected with a solution of one tablespoon bleach to one quart of water, made fresh daily, or a quaternary ammonia-based disinfectant prepared according to the label instructions, or a commercially prepared disinfectant containing bleach or a quaternary ammonia product. Hands shall be washed immediately.
(i) Prohibition against sharing utensils. Cups, eating utensils. or toothbrushes may not be shared.
(j) Clothing and diaper changing.
1. Wet or soiled clothing or diapers shall be changed promptly from an available supply of clean clothing or diapers.
2. Section DCF 250.09 (4) shall apply when a child 2 years of age or older needs attention for diapering or toileting.
(k) Injuries. 1. Written permission from the parent to call the child's physician or refer the child for medical care in case of injury shall be on file at the center. A provider shall contact a parent of the injured child as soon as possible after an emergency has occurred or, if the injury is minor, when the child is picked up.
Note: See DCF 250.04 (3) (a) regarding reporting injuries that require medical attention to the Department within 48 hours after the occurrence.
Note: The department's form, Child Care Enrollment, includes authorization for the center to obtain emergency medical care for a child. Information on how to obtain forms is available on the department's website, http://dcf.wisconsin.gov, or from any regional licensing office in Appendix A.
2. Superficial wounds shall be cleaned with soap and water only and protected with a bandaid or bandage.
3. Suspected poisoning shall be treated only after consultation with a poison control center.
4. The licensee shall designate a planned source of emergency medical care, such as a hospital emergency room, clinic or other constantly staffed facility and shall advise parents about that designation.
5. A daily record of injuries including the child's name, date and time of injury and a brief description of the facts surrounding the injury shall be kept in the center medical log book.
Note: See s. DCF 250.04 (6) (c) about maintaining a medical log book.
(L) Health examination and history. 1. Each child under 2 years of age, including each provider's child in care, shall have an initial health examination not more than 6 months prior to nor later than 3 months after being admitted to the center, and a follow-up examination at least once every 6 months thereafter.
2. Each child 2 years of age or older, including a provider's own children in care, shall have an initial health examination not more than one year prior to nor later than 3 months after being admitted to a center, and a follow-up health examination at least once every 2 years thereafter. School-age children are not required to have a health exam.
3. The health examination report shall be on a form provided by the department and shall be signed and dated by a licensed physician, physician assistant or a HealthCheck provider.
Note: The department's form, Child Health Report--Child Care Centers, is used to record health examination information. Information on how to obtain the form is available on the department's website, http://dcf.wisconsin.gov, or from any regional licensing office in Appendix A.
4. The health examination requirement under subd. 2. does not apply if the parents of a child request in writing that the department grant an exemption based upon the parents' adherence to religious belief in exclusive use of prayer or spiritual means for healing in accordance with the teachings of a bona fide religious sect or denomination.
5. A health history for each child, including school age children and a provider's own children, completed by the parent shall be on file at the center by the child's first day of attendance. Information relating to a child's special health care needs shall be shared with any person caring for children including emergency back-up providers and substitutes. The health history shall be recorded on a form provided by the department.
Note: The department's form, Health History and Emergency Care Plan, is used to record each child's health history. Information on how to obtain the form is available on the department's website, http://dcf.wisconsin.gov, or from any regional licensing office in Appendix A.
(m) Immunization. The center shall maintain a record of immunizations for each child to document compliance with s. 252.04, Stats., and ch. DHS 144.
Note: The department of health services form, Day Care Immunization Record, is used to record immunization information. An electronic printout from the Wisconsin Immunization Registry, or other registry maintained by a health provider may be used in place of DPH-4l92 or DPH-4192S. Information on how to obtain the form is available on the department's website, http://dcf.wisconsin.gov. or from any regional licensing office in Appendix A.
(7) PETS AND ANIMALS. (a) Animals shall be maintained in good health and appropriately immunized against rabies. Rabies vaccinations shall be documented with a current certificate from a veterinarian.
(b) Animals that pose any risk to the children shall be restricted from the indoor and outdoor areas used by children.
(c) Licensees shall ensure that parents are aware of the presence of pets and animals in the center. If pets and animals are allowed to roam in areas of the center occupied by children, written acknowledgement from the parents shall be obtained. If pets are added after a child is enrolled, parents shall be notified in writing prior to the pets' addition to the center.
(d) Reptiles, amphibians, ferrets, poisonous animals, psittacine birds, exotic and wild animals may not be accessible to children.
Note: Psittacine birds are hooked bill birds of the parrot family that have 2 toes forward and 2 toes backward, including macaws, grays, cockatoos and lovebirds.
(e) All contact between pets or animals and children shall be under the sight and sound supervision of a provider who is close enough to remove the child immediately if the pet or animal shows signs of distress or aggression or the child shows signs of treating the animal inappropriately.
(f) Pets are prohibited in any food preparation or serving area when food is being prepared or served unless the pet is confined in a cage or kennel. Litter boxes are prohibited in any food preparation, storage or serving areas. Litter boxes and animal feeding dishes, excluding water dishes, may not be placed in areas accessible to children.
(g) Indoor and outdoor areas accessible to children shall be free of pet and animal excrement.
(h) Proof of liability insurance on the child care business indicating the number of children covered and the dates of coverage from an insurance carrier specifically covering the presence of dogs and cats shall be on file with the pertinent regional licensing office in appendix A if dogs or cats are allowed in areas of the center accessible to children.
Note: Documentation could be included as a rider on a homeowner policy or a separate insurance policy on the child care business. A certificate of insurance or other documentation from the insurance company that indicates the number of children covered, dates of coverage and types of pets covered is acceptable. Service animals used to assist persons with disabilities are not considered pets when functioning as a service animal.
(i) Licensees shall ensure that the center is in compliance with all applicable local ordinances regarding the number, types and health status of pets and animals.
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