Agencies | Governor
Virginia Regulatory Town Hall

Proposed Text

highlight

Action:
Promulgate new regulation for Voluntary Registration ...
Stage: Proposed

CHAPTER 180
VOLUNTARY REGISTRATION OF FAMILY DAY HOMES - REQUIREMENTS FOR PROVIDERS
(Repealed.)

Part I
Introduction

22VAC40-180-10. Definitions. (Repealed.)

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise:

"Adult" means any individual 18 years of age or older.

"Age appropriate" means suitable to the chronological age range and developmental characteristics of a specific group of children.

"Age groups" means the following:

"Infant" means children from birth to 16 months.

"Toddler" means children from 16 months to 31 months.

"Preschooler" means children from 31 months up to the age of eligibility to be enrolled in kindergarten or an equivalent program.

"School age" means children who are eligible to be enrolled in kindergarten or attend public school.

"Age of eligibility to attend public school" means five years of age or older by September 30.

"Care, protection and guidance" means responsibility assumed by a family day home provider for children receiving care in the home, whether they are related or unrelated to the provider.

"Certificate of registration" means a document issued by the commissioner to a family day provider, acknowledging that the provider has been certified by the contracting organization or the department and has met the Requirements for Voluntary Registration of Family Day Homes. (22VAC40-180-10 et seq.).

"Child" means any individual under 18 years of age.

"Commissioner" means the Commissioner of Social Services.

"Commissioner's designee" means a designated individual or division within the Department of Social Services that is delegated to act on the commissioner's behalf in one or more specific responsibilities.

"Contracting organization" means the agency which has contracted with the Department of Social Services to administer the voluntary registration program for family day homes.

"Denial of a certificate of registration" means a refusal by the commissioner to issue an initial certificate of registration.

"Department" means the Virginia Department of Social Services.

"Department's representative" means an employee or designee of the Virginia Department of Social Services acting as the authorized agent of the commissioner in carrying out the responsibilities and duties specified in Chapter 10 (§ 63.1-195 et seq.) of Title 63.1 of the Code of Virginia.

"Evaluate" or "evaluation" means the review of a family day provider by a contracting organization upon receipt of an application for a certificate of registration to verify that the applicant meets the Requirements for Providers.

"Family day home" means a child day program offered in the residence of the provider or the home of any of the children in care for one through 12 children under the age of 13, exclusive of the provider's own children and any children who reside in the home, when at least one child receives care for compensation. From July 1, 1993, until July 1, 1996, family day homes serving nine through 12 children, exclusive of the provider's own children and any children who reside in the home, shall be licensed. Effective July 1, 1996, family day home serving six through 12 children, exclusive of the provider's own children and any children who reside in the home, shall be licensed. However, no family day home shall care for more than four children under the age of two, including the provider's own children and any children who reside in the home, unless the family day home is licensed or voluntarily registered. However, a family day home where the children in care are all grandchildren of the provider shall not be required to be licensed.

"Family day provider applicant" or "provider applicant" means a person 18 years of age or older who has applied for a certificate of registration.

"Monitor" or "monitoring visit" means to visit a registered family day provider and to review the provider's compliance with the applicable requirements described in the Requirements for Providers.

"Parent" means a biological, foster or adoptive parent, legal guardian, or any person with responsibility for, or custody of, a child enrolled or in the process of being enrolled in a family day home.

"Physician" means a person licensed to practice medicine.

"Provider" or "registered family day provider" means a person who has received an initial or renewed certificate of registration issued by the commissioner. This provider has primary responsibility for providing care, protection, supervision, and guidance to the children in the registered home.

"Provider assistant" means a person 14 years of age or older who has been designated by the family day provider and approved by the contracting organization to assist the provider in the care, protection, supervision, and guidance of children in the home.

"Refusal to renew a certificate of registration" means the nonissuance of a certificate of registration by the commissioner after the expiration of the existing certificate of registration.

"Registration fee" means the payment to a contracting organization by a provider or applicant upon filing an application for a certificate of registration.

"Registered family day home" means any family day home which has met the standards for voluntary registration for such homes pursuant to regulations promulgated by the State Board of Social Services and which has obtained a certificate of registration from the commissioner.

"Renewal of a certificate of registration" means the issuance of a certificate of registration by the commissioner after the expiration of the existing certificate of registration.

"Requirements for Providers" means the procedures and general information set forth for providers operating family day homes who voluntarily register. This includes staffing requirements and a self-administered health and safety checklist.

"Revocation of a certificate of registration" means the removal of a provider's current certificate of registration by the commissioner for failure to comply with the applicable Requirements for Providers.

"Substitute provider" means a provider who meets the Requirements for Providers and who is readily available to provide substitute child care in a registered provider's home or in the substitute provider's home.

"USDA" means United States Department of Agriculture.

22VAC40-180-20. Legal authority. (Repealed.)

Section 63.1-196.04 of the Code of Virginia was amended and reenacted in the 1993 General Assembly session to establish provisions for the voluntary registration of family day homes.

Part II
Provider Registration and General Procedures

22VAC40-180-30. Provider eligibility. (Repealed.)

A. A family day provider and substitute provider shall be 18 years of age or older.

B. A family day assistant shall be 14 years of age or older.

C. A family day provider, assistant or assistants and substitute provider shall be able to read, write, understand and carry out the responsibilities in the Requirements for Providers.

D. A family day provider and substitute provider shall live in a county, city, or town that does not have a local ordinance for the regulation or licensure of family day homes.

E. A family day provider shall not be required by law to be licensed.

22VAC40-180-40. Application for registration. (Repealed.)

A. A family day provider applicant for a certificate of registration shall submit to the contracting organization a completed application form, which shall include, but not be limited to:

1. The health and safety checklist and statements of assurance as noted in Part III (22VAC40-180-120 et seq.);

2. A tuberculosis test report as noted in subsection C of this section;

3. A criminal records check and Child Protective Services Central Registry Clearance as indicated in subsection D of this section;

4. A sworn disclosure statement as noted in subsection D of this section; and

5. General information as noted in subsection B of this section.

B. The provider shall also indicate a preference as to whether:

1. The provider applicant is interested in participating in the USDA food program (if the registrant is not currently participating);

2. The provider applicant is willing and able to serve as a substitute provider (after the primary provider obtains consent from parents of enrolled children) and is interested in being included on the substitute provider list maintained by the contracting organization.

C. Health information shall be submitted on the family day provider applicant, assistant or assistants and substitute providers, if any, and any other adult household member who comes in contact with children or handles food served to children. The applicant shall return the completed application form along with a tuberculosis (TB) form which provides written proof of the results of a tuberculosis examination for the applicant, the provider assistant, if any, and all other persons who care for children in the family day home as follows:

1. Initial tuberculosis examination and report.

a. Within 90 days before the date of initial application for registration or within 30 days before employment or having contact with children in a registered home, each individual shall obtain a tuberculin skin test indicating the absence of tuberculosis in a communicable form;

b. Each individual shall submit a statement that he is free of tuberculosis in a communicable form, including the results of the test;

c. The statement shall be signed by a physician, the physician's designee, or an official of a local health department; and

d. The statement shall be filed in the individual's record maintained at the family day home.

EXCEPTION: An individual may delay obtaining the tuberculosis test if a statement from a physician is provided that indicates the test is not advisable for specific health reasons. This statement shall include an estimated date for when the test can be safely administered. The individual shall obtain the test no later than 30 days after this date.

2. Subsequent evaluations.

a. An individual who had a significant (positive) reaction to a tuberculin skin test and whose physician certifies the absence of communicable tuberculosis shall obtain chest x-rays on an annual basis for the following two years.

(1) The individual shall submit statements documenting the chest x-rays and certifying freedom from tuberculosis in a communicable form;

(2) The statements shall be signed by a licensed physician, the physician's designee, or an official of a local health department;

(3) The statements shall be filed in the individual's record maintained at the family day home; and

(4) Following the two-year period during which chest x-rays are required annually, additional screening shall be obtained every two years.

b. An individual who had a nonsignificant (negative) reaction to an initial tuberculin skin test shall obtain additional screening every two years thereafter.

c. Any individual who comes in contact with a known case of tuberculosis or who develops chronic respiratory symptoms shall, within 30 days of exposure or development, receive an evaluation in accordance with subdivision C 1 of this section.

3. At the request of the contracting organization or the Department of Social Services, a report of examination by a physician shall be obtained when there is an indication that the safety of children in care may be jeopardized by the physical or mental health of a specific individual.

D. Information certifying that those in contact with children do not have a criminal background shall be submitted. Attachments will include:

1. A criminal records check, as specified in § 63.1-198.1 of the Code of Virginia, conducted no more than 90 days before the date of initial application and no more than 90 days before the date of application for renewal, for the provider applicant, the provider assistant, and the substitute provider, if any, and any adults residing in the home;

2. A Child Protective Services (CPS) Central Registry Clearance conducted no more than 90 days before the date of initial application and no more than 90 days before the date of application for renewal, for the provider applicant, the provider assistant, and the substitute provider, if any, and any adults residing in the home; and

3. A sworn disclosure statement for the provider applicant, the provider assistant, and the substitute provider, if any, and any adults residing in the home.

§22VAC40-180-50. Registration fees. (Repealed.)

A. At the time an application for a certificate of registration is submitted to the contracting organization, the provider applicant shall pay a nonrefundable registration fee not to exceed $50 for a two-year period. The fee shall be paid in the form of a check or money order made payable to the contracting organization. (This does not include the fee for the criminal records check, CPS Central Registry Clearance or the tuberculosis test.)

B. An additional fee shall not be required if a minor change in the information collected, e.g., change in name, occurs before the expiration date of the current certificate of registration or if the provider requires a duplicate copy of the certificate of registration due to loss or destruction of the original.

C. An additional fee shall only be charged if a second home visit is required because:

1. The provider changes location (not to exceed $50);

2. The original certificate of registration was revoked (not to exceed $50); or

3. The provider's completion of a corrective action plan needs to be verified (not to exceed $10).

22VAC40-180-60. Issuance of a certificate of registration. (Repealed.)

A. After the provider applicant has satisfactorily met the requirements for voluntary registration, the contracting organization shall certify the provider applicant as eligible for registration to the commissioner and recommend the issuance of a certificate of registration.

B. The commissioner shall issue the certificate of registration, which shall not be transferable, to a specific provider at a specific location.

C. If it is necessary to change any identifying information (name and phone) noted on the certificate of registration prior to the end of the two-year registration period, the provider shall advise the contracting organization no later than 14 calendar days after the change.

D. If the provider changes location prior to the end of the two-year registration period, the provider shall permit and participate in a second home visit and an evaluation of the new residence within 30 days of occupying the residence.

E. The provider shall not claim in advertising or in any written or verbal announcement to be registered with the Commonwealth of Virginia unless a certificate of registration is currently in effect.

F. A provider who has been denied a certificate of registration or who has had a certificate of registration revoked or refused renewal by the commissioner shall not be eligible for issuance of a certificate of registration until six months after the date of such action, unless the waiting period is waived by the commissioner as noted in Chapter 10 (§ 63.1-195 et seq.) of Title 63.1 of the Code of Virginia.

22VAC40-180-70. Renewal of a certificate of registration. (Repealed.)

A. The certificate of registration shall be subject to renewal upon expiration.

B. No later than 45 days before the expiration of the current certificate of registration, the provider shall submit to the contracting organization a completed renewal application form which shall include, but not limited to, the required information specified in 22VAC40-180-40.

22VAC40-180-80. Denials, revocations, refusals to renew and provider appeals procedures. (Repealed.)

A. A provider's certificate of registration may be denied, revoked, or refused renewal by the commissioner for cause including, but not limited to:

1. Failure to comply with adult-child ratios, staffing requirements, or other standards set forth in the Requirements for Providers;

2. Use of fraud in obtaining a certificate of registration or in the subsequent operations of the family day home;

3. Any conduct or activity which adversely affects or presents a serious hazard to the health, safety, and general well-being of an enrolled child, or which otherwise demonstrates unfitness by a provider to operate a family day care home;

4. Refusal to furnish the contracting organization or the department with records;

5. Refusal to permit immediate admission to the family day home to the parent of an enrolled child who is present in the home or to an authorized representative of the contracting organization or department when any enrolled child is present; or

6. Documentation maintained by a contracting organization or the department that a certificate of registration has been denied, revoked, or refused renewal by the commissioner to the provider during the six months prior to the date an application is resubmitted for a certificate of registration.

B. When a provider is found to be in violation of any of the provisions of subsection A of this section, the contracting organization shall notify the provider of the violation or violations first orally and then in writing, and, when appropriate, shall afford the provider an opportunity to abate the violation or violations within a time frame agreed upon by the contracting organization and the provider. The provider shall immediately abate the violation or violations in situations where children are at risk of abuse or neglect or serious harm or injury.

C. If the provider fails to abate the violation or violations within the agreed upon time frame or commits a subsequent violation, the contracting organization may recommend to the commissioner that the certificate of registration be denied, revoked, or refused renewal. A statement referencing the standard or standards violated shall be included with the recommendation.

D. Upon notification of the contracting organization's intent to recommend that a certificate of registration be denied, revoked, or refused renewal, a provider may request a review in writing by the contracting organization's review committee within 15 calendar days after receipt of notification.

E. The contracting organization shall submit its recommendation of the provider's eligibility for issuance of a certificate of registration to the commissioner's designee. If a certificate of registration is denied, revoked or refused renewal by the commissioner's designee, the provider may appeal the decision in accordance with the Administrative Process Act (§ 9-6.14:1 et seq. of the Code of Virginia) and may request a hearing in writing within 15 calendar days after receipt of notification of the decision.

F. After the hearing, the commissioner shall issue the final order which may be appealed in accordance with the Administrative Process Act.

G. A provider whose certificate of registration is revoked or refused renewal shall notify the parent or parents of each child enrolled within 10 calendar days after receipt of notification of such action.

22VAC40-180-90. Provider reporting requirements. (Repealed.)

A. The provider shall verbally notify the local department of social services or call the toll free number for the Child Protective Services Unit (1-800-552-7096/TDD) immediately whenever there is reason to suspect that a child has been or is being subjected to any kind of child abuse or neglect by any person.

B. The provider shall report the following incidents to the contracting organization as soon as possible but no later than the beginning of the contracting organization's next working day:

1. A lost or missing child when it was necessary to seek assistance from local emergency or police personnel;

2. Any injury that occurs while in the provider's care that results in the admission of a child to a hospital;

3. The death of a child while in the provider's care;

4. Any damage to the provider's home that affects the provider's compliance with the Requirements for Providers;

5. Any occurrence of a reportable disease, as specified in the list of reportable diseases provided by the contracting organization;

6. The termination of all family day care services by the provider; or

7. The provider's decision to surrender the certificate of registration in accordance with the Requirements of the Voluntary Registration Program.

22VAC40-180-100. Provider record requirements. (Repealed.)

A. The provider's records shall be open for inspection by authorized representatives of the contracting organizations and the department.

B. The provider shall maintain on file a signed statement from each parent, affirming receipt of the information to parents statement.

C. The provider shall maintain an individual record for each child enrolled in care. This record shall include:

1. The child's full name (including nicknames, if any), address and birth date;

2. Name, address and telephone number of each parent or other responsible person or persons;

3. Name, address and telephone number of each parent's place of employment and his or her work hours;

4. Name, address and telephone number of one or more persons designated by the parent or parents to be called in case of emergency when a parent cannot be reached during the hours the child is in care;

5. Name, address and telephone number of the child's physician;

6. Any known or suspected allergies and any chronic or recurrent diseases or disabilities;

7. The child's allergies to medication or drugs, if applicable, and directions for providing medicines to the child;

8. The name of the parent's hospitalization plan and number or medical assistance plan, if applicable;

9. The parent's signed authorization for the child's emergency medical treatment and written consent for giving of medications to the child;

10. The child's date of enrollment in and date of withdrawal from the family day home, when applicable;

11. Results of the health examination and up-to-date immunization records of each child unless there is record of a medical or religious exemption;

12. Names of persons authorized to visit or call for the child, as well as those who are not to visit or call for the child;

13. A record of any accidents and injuries sustained by a child;

14. The parent's signed authorization to use a substitute provider and his or her name, address, and phone number;

15. The parent's signed authorization to transport children and to take trips out of the immediate community;

16. Any written agreement made between the family day provider and the natural parent, guardian, or other responsible person for each child in care. The agreement may cover hours of care per day, week, or month; cost of care per day, week, or month; frequency and amount of payment per day, week, or month; and any special services to be provided by either party to the agreement.

D. The emergency contact information listed in subdivisions C 2 through C 5 of this section shall be made available to a physician, hospital or emergency care unit in the event of a child's illness or injury.

E. Whenever the provider leaves the home with the child or children, the provider shall have the emergency contact information and medical information required by subdivisions C 1 through C 9 of this section in the caregiver's possession.

F. The family day provider shall not disclose or permit the use of information pertaining to an individual child or family unless the parent or parents or guardian or guardians of the child has granted written permission to do so, except in the course of performance of official duties and to employees or representatives of the contracting organization or the department.

22VAC40-180-110. Staffing requirements. (Repealed.)

A. The provider shall ensure that the total number of children receiving care at any one time does not exceed the maximum capacity allowed by law (§ 63.1-196.04 of the Code of Virginia) for family day homes that may apply for voluntary registration.

B. The following adult-to-child ratios shall be maintained for children receiving care until October 31, 1993. (NOTE: The adult-to-child ratios for voluntary registration shall be same as those for licensed day homes effective November 1, 1993.)

1. One adult may care for nine children at any one time, within the limitations that follow. This includes provider by blood or marriage the provider's own children and any children who reside in the home.

a. Of the nine children, no more than six shall be under school age without an assistant;

b. Of the children under school age, no more than five shall be under 31 months (2 ½ years of age or younger) even when an assistant is present;

c. Of the children under 31 months, no more than three shall be under 16 months without an assistant.

2. School age children who are 10 years of age and older shall not count in determining the ratio of adults to children for staffing purposes.

Part III
Health and Safety Checklist

22VAC40-180-120. Health and safety checklist criteria. (Repealed.)

A. A health and safety checklist shall be completed by providers who apply for voluntary registration. The checklist serves as both a self-review tool for providers and an initial and renewal evaluation method for the contracting organization. Items included on the checklist are those which address the basic health and safety needs of children in care in family day homes.

B. The provider shall review and complete the checklist before being certified as eligible for issuance of a certificate of registration.

C. If the provider does not meet the criteria on the health and safety checklist at the time of the initial evaluation or monitoring visit, a corrective action plan shall be completed. This will briefly describe the standard not met, the action to be taken to meet it, the date by which it shall be completed and the signature of the provider.

D. The home shall have indoor running water and an indoor bathroom equipped with a flush toilet and a sink with running water.

E. If the provider does not have a working telephone, the caregiver shall demonstrate that one is quickly and easily accessible in case of an emergency.

FORMS (22VAC40-180) (Repealed.)

Voluntary Registration Health and Safety Checklist (rev. 8/00).

Voluntary Registration Provider Application Form, 032-05-210/2 A (rev. 6/04).

Voluntary Registration Provider Application Form, 032-05-210/2 B (eff. 6/04).

CHAPTER 181

STANDARDS FOR VOLUNTARY REGISTRATION OF FAMILY DAY HOMES

PART I     GENERAL PROVISIONS

22VAC40-181-10. Definitions.

The following words or terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise:

"Accessible" means capable of being entered, reached or used.

"Adult" means any individual 18 years of age or older.

"Age-appropriate" means suitable to the chronological age and individual needs of a child.

"Assistant" means an individual who helps the provider or substitute provider in the care, protection, supervision, and guidance to children in the home.

"Body fluids" means urine, feces, vomit, blood, saliva, nasal discharge, and tissue discharge.

"Caregiver" means an individual who provides care, protection, supervision, and guidance to children in the home, and includes the provider, substitute provider, and assistant.

"Certificate of registration" means a document issued by the commissioner to a family day provider, acknowledging that the provider has been certified by the contracting organization or the department and has met the Standards for Voluntary Registration of Family Day Homes. 

"Child" means an individual under 18 years of age.

"Child day program" means a regularly operating service arrangement for children where, during the absence of a parent or guardian, a person or organization has agreed to assume responsibility for the supervision, protection, and well-being of a child under the age of 13 for less than a 24-hour period.

"Commissioner" means the Commissioner of the Virginia Department of Social Services, his designee or authorized representative. 

"Contracting organization" means an agency which has contracted with the Virginia Department of Social Services to administer the voluntary registration program in a certain geographical area.

"Corrective action plan" means the applicant or provider's written statement detailing how a cited violation(s) will be addressed in order to return the family day home to compliance with applicable laws and regulations and to maintain future compliance.

"Department" means the Virginia Department of Social Services (VDSS).

"Evaluate" or "evaluation" means the review of a family day home provider by a contracting organization or the department upon receipt of an application for a certificate of registration to verify that the applicant and the home meets the requirements of the Code of Virginia and the Standards for Voluntary Registration.

"Family day home" means a child day program offered in the residence of the provider or the home of any of the children in care for one through 12 children under the age of 13, exclusive of the provider's own children and any children who reside in the home, when at least one child receives care for compensation.

"Inaccessible" means not capable of being entered, reached, or used.

"Infant" means a child from birth up to 16 months of age.

"Monitor" or "monitoring visit" means to visit and inspect a registered family day home provider and to review the provider's compliance with the applicable requirements described in these standards.

"Nighttime care" means care provided between 7:00 p.m. and 6:00 a.m.

"Parent" means the biological, foster or adoptive parent, legal guardian, or any individual with responsibility for, or custody of a child enrolled in or in the process of being enrolled in a family day home.

"Preschool" means children from two years up to the age of eligibility to attend public school, age five by September 30 of that same year.

"Provider" or "registered family day home provider" means a person who has received an initial or renewed certificate of registration issued by the commissioner.  This provider has primary responsibility for providing care, protection, supervision, and guidance of children in the family day home.

"Refusal to renew a certificate of registration" means the commissioner's decision not to renew a certificate of registration after receiving a renewal application and the expiration of the existing certificate of registration.

"Registration fee" means the payment to a contracting organization or the department by a provider or applicant upon filing an application for a certificate of registration. 

"Registered family day home" means any family day home which has met the standards for voluntary registration for such homes pursuant to regulations promulgated by the State Board of Social Services and which has obtained a certificate of registration from the commissioner.

"Residence" means principal legal dwelling or abode that is occupied for living purposes by the provider and contains the facilities necessary for sleeping, eating, cooking, and family living.

"Revocation of a certificate of registration" means the removal of a provider's current certificate of registration by the commissioner for failure to comply with applicable Code of Virginia requirements or the Standards for Voluntarily Registered Family Day Homes.

"Sanitized" means treated in such a way as to remove bacteria and viruses from inanimate surfaces through first cleaning and secondly using a solution of one tablespoon of bleach mixed with one gallon of water and prepared fresh daily or using a sanitizing solution approved by the U.S. Environmental Protection Agency.   The surface of the item is sprayed or dipped into the sanitizing solution and then allowed to air dry.

"School age" means eligible to attend public school, age five or older by September 30 of that same year.

"Serious injury" means a wound or other specific damage to the body such as, but not limited to, unconsciousness; broken bones; dislocation; deep cut requiring stitches; poisoning; concussion; and a foreign object lodged in eye, nose, ear, or other body orifice.

"Substitute provider" means an individual who meets the qualifications of the provider; is designated by the provider; and who provides care, protection, supervision, and guidance for children in the family day home when the provider is absent from the home for more than two hours.

"Time out" means a behavior guidance technique in which a child is moved for a brief time away from the stimulation and reinforcement of ongoing activities and other children in the group to allow the child who is losing self-control to regain composure.

"Toddler" means a child from 16 months of age up to 24 months of age.

22VAC40-181-20. Reserved.

PART II    ADMINISTRATION

22VAC40-181-30. Operational responsibilities.

A. The provider shall ensure compliance with these standards and the terms of the current certificate issued by the department and with relevant federal, state, or local laws, and other relevant regulations.

B. The provider, and any substitute providers, shall be 18 years of age or older.

C. The provider shall live in a county, city or town that does not have a local ordinance for the regulation or licensure of family day homes.

D. The provider shall meet the requirements specified in 22 VAC 40-191, Background Checks for Child Welfare Agencies. 

E. The provider shall ensure that the home's activities, services, and facilities are conducive to the welfare of children in care.

F. The provider shall be responsible for the home's day-to-day operation and shall be the primary caregiver for each enrolled child.

G. The provider shall ensure that any advertising is not misleading or deceptive as required by § 63.2-1713 of the Code of Virginia.

H. The provider will ensure compliance with the home's policies that have been disclosed to parents.

I. The provider shall ensure that the Certificate of Voluntary Registration and the Information to Parents Statement is posted in a conspicuous location in the child care area of the home.

22 VAC 40-181-40. Capacity.

A. The provider shall ensure that the total number of children receiving care at any one time does not exceed five, exclusive of the provider's own children and any children that reside in the home.

B. When at least one child receives care for compensation, all children, exclusive of the provider's own children and children who reside in the home, who are in the care and supervision of a provider, count in the capacity.

22VAC40-181-50. Application for registration.

A.   An applicant for a certificate of registration shall submit to the contracting organization a completed application utilizing forms approved by the department.

B.   A health and safety checklist shall be completed by providers who apply for voluntary registration.  The checklist serves as both a self-review tool for providers and an initial and renewal evaluation method for the contracting organization.  Items included on the checklist are those which address the basic health and safety needs of children in care in family day homes.

C.   An application will be considered complete when the application, application fee, background checks, health and safety checklist, and all required information are submitted on the forms required by the department.  If an application is incomplete, the applicant will be notified in writing within 15 days of receipt of the incomplete application.

D.   If the applicant does not submit the required information necessary to complete the application within 45 days from the notification, all materials except the non-refundable fee will be returned to the applicant.

Note:  Background checks may not be disseminated to anyone except the individual or agency that requested the background check and will only be returned if the applicant was the requesting individual.

22VAC40-181-60. Registration fees.

A. At the time an application for a certificate of registration is submitted to the contracting organization, the applicant shall pay a nonrefundable registration fee not to exceed $50 for a two-year period.  This fee is separate from any fees charged for background checks and tuberculosis screening.

B. An additional fee shall not be required if a minor change in information collected occurs, e.g. change in name, occurs before the expiration date of the current certificate of registration or if the provider requires a duplicate copy of the certificate of registration due to loss or destruction of the original. 

C. An additional fee shall only be charged if a second home visit is required because:

1.  The provider changes location (not to exceed $50);

2. The provider's completion of a corrective action plan needs to be verified (not to exceed $20).

22VAC40-181-70. Issuance of a certificate of registration.

 A. After a provider applicant has satisfactorily met the requirements for voluntary registration, the contracting organization shall certify the provider applicant as eligible for registration and recommend to the commissioner's representative that the individual be issued a certificate of registration.

B. The commissioner shall issue the certificate of registration, which is not transferable, to a specific provider at a specific location.

C. If it is necessary to change any identifying information (name or address) noted on the certificate of registration prior to the end of the two-year registration period, the provider shall advise the contracting organization or the Division of Licensing Programs, in writing, in advance if possible, but no later than seven calendar days after the change.

D. If a provider changes location prior to the end of the two-year registration period, the provider shall submit a move application, and the move inspection fee, no later than seven days after the move and participate in a second home visit and evaluation of the new residence within 30 days of occupying the new residence.

E. If a provider fails to meet the requirements of 22 VAC 40-181-70 C and D or the home cannot meet these standards within 45 days, the provider's file shall be closed. 

F. In order to determine compliance with standards during the effective dates of the certificate of registration, the contract organization and the department will make announced and unannounced inspections of the home during the hours of its operation.  The provider is responsible for correcting any areas of noncompliance found during inspections.

22VAC40-181-80. Renewal of a certificate of registration.

A. The certificate of registration shall be subject to renewal upon expiration.

B. No later than 45 days before the expiration of the current certificate of registration, the provider shall submit to the contracting organization a completed renewal application on the prescribed forms which shall include the required information specified in 22 VAC 40-181-50.

C. A home inspection is required prior to issuance of a renewal certificate to confirm compliance with these standards.

22VAC40-181-90. Complaint investigations.

A. Complaints may be received in written or oral form and may be anonymous.  Complaints may be made to the contracting agency or the department.

B. The contracting organization and the department have the responsibility to investigate any complaints regarding alleged violations of the standards or applicable statutes and complaints of the abuse and neglect of children in care.

Note:  In investigations involving suspected child abuse and neglect, the investigation will be conducted jointly with the local department of social services whenever possible.

C. When the investigation is completed, the provider will be notified of the findings of the investigation and any necessary corrective action will be identified.  The provider is responsible for correcting any areas of non-compliance found during a complaint investigation.

22VAC40-181-100. Denials, revocations, refusals to renew and provider appeals procedures.

A. A provider's certificate of registration may be denied, revoked, or refused renewal by the commissioner for cause including but not limited to:

1. Failure to demonstrate or maintain compliance with applicable standards or for violations of the provisions of the Code of Virginia;

2. Use of fraud in obtaining a certificate of registration or in the subsequent operations of the family day home;

3. Any conduct or activity which adversely affects or presents a serious hazard to the health, safety and general well-being of an enrolled child, or which otherwise demonstrates unfitness by a provider to operate a family day care home;

4. Refusal to furnish the contracting organization or the department with records:

5. Refusal to permit immediate admission to the family day home to the parent of an enrolled child who is present in the home or to an authorized representative of the contracting organization or department when any enrolled child is present; or

6. Documentation maintained by a contracting organization or the department that a certificate of registration or a license has been denied, revoked, or refused renewal by the commissioner during the six months prior to the date the application is submitted, unless the waiting period is waived by the commissioner.

B. When a provider is found to be in violation of any of the provisions of these standards, the provider shall be notified in writing of the violation, and, when appropriate, the provider shall be afforded the opportunity to abate the violation(s) within an agreed upon time frame.  The provider shall immediately abate any violation(s) in situations where children are at risk of abuse or neglect or serious harm or injury.

C. The contracting organization may recommend to the commissioner that the certificate of registration be denied, revoked or refused renewal if the provider does not correct areas of non-compliance or if the violation is such that children are placed at risk.

D. Upon notification that the department intends to deny, revoke, or refuse renewal of a certificate of registration, a provider may appeal that decision in accordance with the Administrative Process Act (§ 2.2-4000 of the Code of Virginia).  The procedures for filing an appeal will be outlined in the notice.  The applicant or provider shall submit any appeal in writing within 15 days of receipt of the notice. 

E. If the applicant or provider fails to appeal the notice within 15 days of receipt, the final order shall be entered and the decision will take effect in accordance with the department's written notice.

PART III     PERSONNEL

22VAC40-181-110. General qualifications for caregivers.

Caregivers shall:

1. Be of good character and reputation;

2. Be physically and mentally capable of carrying out assigned responsibilities; and

3. Be courteous, respectful, patient, and affectionate toward the children in care.

4. The provider and any caregiver left alone with children shall be able to speak, read, and write in English as necessary to:

a. Carry out assigned job responsibilities, and

b. Communicate effectively with emergency responders.

5.  Meet the requirements specified in 22 VAC 40-191, Background Checks for Child Welfare Agencies.

22VAC40-181-120. Qualifications and requirements for providers and substitute providers.

A. Providers and substitute providers shall be 18 years of age or older.

B. Providers applying for voluntary registration six months after the effective date of these standards must have:

1. Current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care, from the American Red Cross, American Heart Association, American Safety and Health Institute, or the National Safety Council, or a current CPR certification issued within the past two years by a community college, a hospital, a rescue squad, or a fire department; and

2. Current certification in first aid from the American Red Cross, American Heart Association, American Safety and Health Institute, or the National Safety Council, or current first aid certification issued within the past three years by a community college, a hospital, a rescue squad, or a fire department.

EXCEPTION: A provider or substitute provider who is a registered nurse or licensed practical nurse with a current license from the Board of Nursing shall not be required to obtain first aid certification.

C. Use of a substitute provider shall be limited to no more than a total of 240 hours per calendar year, unless otherwise approved by contract organization and the department.

D. A substitute provider shall record and sign the time of arrival and departure on each day the substitute provider works.

22VAC40-181-130. Qualifications and requirements for assistants.

A.   Assistants shall be 16 years of age or older.

B.   An assistant under the age of 18 years of age shall always work under the direct supervision of the provider or a substitute provider.  Direct supervision means being able to hear or see the assistant and children at all times.

C.   An assistant 18 years of age or older who is left alone with children in care shall have:

1.    Current certification in cardiopulmonary resuscitation (CPR), as appropriate to the age of the children in care.

2.    Current certification in first aid.

D.   An assistant 18 years of age or older shall not be left alone with children in care for more than two hours per day.

E.   An assistant 18 years of age or older who meets the requirements for a substitute provider may act as a substitute provider when the provider is absent from the home for more than two hours.

22VAC40-181-140. Household members.

A.   Individuals who reside in the family day home shall: 

1.    Be of good character and reputation;

2.    Display behavior that demonstrates emotional stability; such that the behavior does not present a risk to enrolled children. 

B.   Individuals 14 years of age and older shall meet the requirements specified in 22 VAC 40-191, Background Checks for Child Welfare Agencies.

22VAC40-181-150. Initial tuberculosis screening for caregivers and household members.

A.   The provider shall obtain from each caregiver at the time of hire, and from each adult household member at the time of the initial application or prior to residing in the home with children, a current Report of Tuberculosis Screening on forms published by the Virginia Department of Health or a form consistent with it documenting the absence of tuberculosis in a communicable form.

B.   The form shall have been completed within the last 30 days and be signed by a physician, physicians' designee, or an official of the local Health Department.

22VAC40-181-160. Subsequent tuberculosis screening for caregivers and household members.

A.   The provider shall obtain for each caregiver and adult household member a current report of Tuberculosis Screening form, in accordance with the requirements of 22 VAC 40-180-150 at the time of renewal or more frequently as recommended by a physician or the local Health Department.

B.   Within 30 days of a caregiver's or adult household member's coming into contact with a known case of infectious tuberculosis, the provider shall obtain from the individual a new Report of Tuberculosis Screening in accordance with the requirements of 22 VAC 40-180-150.  Until a new screening form is issued which documents the absence of tuberculosis in a communicable form, the caregiver or adult household member shall not have contact with children. 

C.   The provider shall immediately obtain a new Report of Tuberculosis Screening form in accordance with 22 VAC 40-180-150 for any caregiver or adult household member who develops chronic respiratory symptoms of three weeks duration.  Until a new screening form is issued which documents the absence of tuberculosis in a communicable form, the caregiver or adult household member shall not have contact with children.

22VAC40-181-170. Physical and mental health examinations for caregivers and household members.

A.   The provider or the department's representative may require a report of examination by a licensed physician or mental health professional when there are indications that a caregiver's or household member's physical or mental health may endanger the health, safety, or well-being of children in care.

B.   A caregiver or household member who is determined by a licensed physician or mental health professional to show an indication of a physical or mental condition that may endanger the health, safety, or well-being of children in care or that would prevent the performance of duties shall be removed immediately from contact with children and food served to children until the condition is cleared as evidenced by a signed statement from the physician or mental health professional.

Statutory Authority

22VAC40-181-180. Orientation.

A.   The provider shall orient the substitute provider and assistant by the end of their first week of assuming job responsibilities.

B.   The orientation shall cover the following topics:

1.    Job responsibilities;

2.    Requirements for parental notifications listed in 22 VAC 40-181-540;

3.    Emergency evacuation, relocation, and shelter-in-place procedures;

4.    Location of emergency numbers, first aid kit, and emergency supplies;

5.    Confidential treatment of information about children in care and their families; and

6.    Requirements for reporting suspected child abuse and neglect.

C.   Documentation of the orientation shall be signed and dated by the provider and the substitute or by the provider and assistant.

Statutory Authority

22VAC40-181-190. Training.

A.   In addition to satisfactory completion of first aid training and CPR training, caregivers shall obtain a minimum of eight clock hours of training every two years prior to the expiration of a current certificate.

Note:  Training hours will be calculated from the issuing date of the certificate until the expiration date of the current certificate.

B.  The bi-annual training should be related to child care or the business of child care and cover areas such as, but not limited to:

1.    Physical, intellectual, social, and emotional child development;

2.    Behavior management and discipline techniques;

3.    Health and safety in the family day home environment;

4.    Activities for children;

5.    Child nutrition;

6.    Recognition and prevention of child abuse and neglect;

7.    Emergency preparedness; or

8.    Recognition and prevention of the spread of disease.

22VAC40-181-200. Medication administration training.

A.   Caregivers that administer prescription medication must:

1.    Have satisfactorily completed a training program whose curriculum is designed for administering medication to children that is developed or approved by the Virginia Board of Nursing and taught by a registered nurse, licensed practical nurse, doctor of medicine or osteopathic medicine, or pharmacist; or

2.    Be licensed by the Commonwealth of Virginia to administer prescription medication.

B.   Caregivers required to have this training shall be retrained at three-year intervals.

22VAC40-181-210. Documentation of education and training.

A.   The provider shall maintain written documentation of each caregiver's applicable first aid and CPR certification, orientation, annual training, and any applicable medication administration training.

B.   Written documentation of annual training shall include

1.    Name of caregiver;

2.    Name of training session;

3.    Date and total hours of the session; and

4.    Name of the organization that sponsored the training and the trainer.

C.   Documentation that each caregiver has successfully met the training requirements shall be submitted with a renewal application.

Statutory Authority

PART IV    PHYSICAL ENVIRONMENT AND EQUIPMENT

22VAC40-181-220. Home maintenance.

A.   Areas and furnishings of the family day home, inside and outside, shall be maintained in a clean, safe, and operable condition.  Unsafe conditions shall include, but not be limited to, the presence of poisonous plants; tripping hazards; unstable heavy equipment, furniture or other items that a child could pull down on himself; splintered, cracked, or otherwise deteriorating wood; chipped or peeling paint; visible cracks, bending or warping, rusting, or breakage of any equipment used or accessible to children; head entrapment hazards; and protruding nails, bolts, or other components that could entangle or snag skin.

B.   No equipment, materials, or furnishings shall be used if recalled or identified by the U.S. Consumer Product Safety Commission (CPSC) as being hazardous.

22VAC40-181-230. Hanging, suffocation, and strangulation hazards.

A.   Hanging items including; but not limited to, window blind or curtain cords, appliance cords, and ropes shall be out of reach of children under five years of age.

B.   Children shall be protected from materials that could be swallowed or present a choking hazard.  Toys or objects less than 1-1/4 inches in diameter and less than two inches in length shall be kept out of reach of children under the age of three years.

C.   Items tied across the top or corner of a crib or playpen or toys hung from the sides with strings or cords shall be removed when the child begins to push up on hands and knees or is five months of age, whichever occurs first.

D.   Hood or neck drawstrings shall be removed from a child's clothing prior to a child's using climbing play equipment.

E.   Latex gloves, balloons, and empty plastic bags large enough for a child's head to fit inside shall be inaccessible to children under five years of age.

22VAC40-181-240. Drowning hazards.

A.   Access to the water in above-ground swimming pools shall be prevented by locking and securing the ladder in place or storing the ladder in a place inaccessible to children.

B.   A nonclimbable barrier at least four feet high such as, but not limited to, a fence or impenetrable hedge shall surround outdoor play areas located within 30 feet of drowning hazards such as; but not limited to, in-ground  swimming or wading pools, ponds or fountains not enclosed by safety fences.  Facilities certified prior to the effective date of this regulation must comply fully with the requirements of this subsection within 12 months.

C.   Portable wading pools must be emptied after each use.  When not in use during the family day home's hours of operation, the wading pool shall be emptied, sanitized and stored in a position to keep them clean and dry.

D.   Portable wading pools shall not be used by children who are not potty trained.

E.   Bathtubs, buckets, and other containers of liquid accessible to children shall be emptied immediately after use.

F.    Hot tubs, spas, and whirlpools shall:

1.    Not be used by children in care, and

2.    Be covered with safety covers while children are in care if they are located in an area accessible to children.

22VAC40-181-250. Firearms and ammunition.

A.   Firearms of every type and purpose shall be stored unloaded in a locked container, compartment, or cabinet, and apart from ammunition.

B.   Ammunition shall be stored in a locked container, compartment, or cabinet during the family day homes' hours of operation.

C.   If a key is used to lock the container, compartment, or cabinet, the key shall be inaccessible to children.

22VAC40-181-260. Poisonous materials.

Potentially poisonous substances, materials, and supplies, such as but not limited to, cleaning supplies, disinfectants, deodorizers, plant care chemicals, pesticides, and petroleum distillates shall be stored away from food in areas inaccessible to children.

Exception:  Hand sanitizers, liquid hand soaps, and sunscreen labeled "keep out of reach of children" do not need to be inaccessible to children five years of age or older provided that the products are only used under adult supervision and the labels on the products do not contain any other warning words used to indicate that the product is toxic.

22VAC40-181-270. Sharp objects.

Sharp kitchen utensils and other sharp objects shall be inaccessible to children unless being used by the caregiver or with children under close supervision.

22VAC40-181-280. Machinery.

Machinery in operation such as lawnmowers and power tools shall be inaccessible to children in care.  Machinery shall be stored so that it is inaccessible to children or that children may not engage the machinery.

22VAC40-181-290. Fire safety and shock prevention.

A.   Child-resistant protective covers shall be installed on all unused electrical outlets and surge protectors accessible to children under five years of age.

B.   No electrical device accessible to children shall be placed so that it could be plugged into an electrical outlet while in contact with a water source, such as a sink, tub, shower area, or swimming and wading pool.

C.   Electrical cords and electrical appliances and equipment with cords that are frayed and have exposed wires shall not be used.

D.   Radiators, oil and wood burning stoves, floor furnaces, fireplaces, portable electric heaters, and similar heating devices located in areas accessible to children shall have barriers or screens when in use and be located at least three feet from combustible materials.

E.   Unvented fuel burning heaters shall not be used when children are in care.  Unvented fuel burning heaters include, but are not limited to, portable oil-burning (kerosene) heaters; portable, unvented liquid or gas fueled heaters; and unvented fireplaces.

F.    All flammable and combustible materials such as, but not limited to, matches, lighters, lighter fluid, kerosene, turpentine, oil and grease products, aerosol cans, and alcohol shall be stored in an area inaccessible to children.

G.   If there are open and obvious fire hazards, including the absence of fire extinguishers or smoke detectors required by the Uniform Statewide Building Code and the Statewide Fire Prevention Code; the local fire prevention or building officials or the State Fire Marshal's office shall be contacted by the department's representative.  The provider shall comply with the requirements or recommendations made by the fire prevention or building officials to eliminate fire hazards.

22VAC40-181-300. Telephone.

A.   A telephone shall be available, operable for incoming and outgoing calls, and accessible to a caregiver at all times during the family day home's hours of operation.

B.   The telephone number shall be given to parents and the department's representative in writing.

C.   The provider shall inform parents within 24 hours of any change in the telephone number and the department's representative shall be made aware of the change within 48 hours.

22VAC40-181-310. Bathrooms.

A.   The home shall have an indoor bathroom.

B.   The bathroom shall be kept clean and contain a working toilet and sink, toilet tissue, liquid soap and paper towels.

22VAC40-181-320. Water supply.

A.   The home shall have indoor running water.

B.   There shall be an ample supply of hot and cold water available to children and caregivers for handwashing.

C.   If there are open and obvious signs of water or sewage system problems, such as cloudy, murky, or muddy water, or sewage back up; the system shall be inspected and approved by a local health official or private laboratory and corrected within the time frame established by the local public utility or Health Department.

22VAC40-181-330. Insects and rodents.

A.   The home shall be kept free from rodent and insect infestation.

B.   No home shall maintain any receptacle or pool, whether natural or artificial, containing water in such condition that insects breeding therein may become a menace to public health.

22VAC40-181-340. Space.

The home shall provide each child with adequate space to allow free movement and active play indoors and out.

22VAC40-181-350. Heating and cooling.

A.   The temperature in all inside areas occupied by children shall be maintained no lower than 65°F.

B.   Fans or other cooling systems shall be used when the temperature of the inside areas occupied by children exceeds 80°F.

C.   Barriers shall be placed around fans when in use if they are used in an area accessible to children. 

22VAC40-181-360. Lighting.

A.   Rooms, halls, and stairways used by children in care shall be lighted with natural or electric lighting for the child's safety and comfort.

B.   Entrance and exit ways shall be unobstructed and be lighted with natural or electric lighting.

22VAC40-181-370. Stairs.

A.   Children under two years of age and children over two years of age who are not developmentally ready to climb or descend stairs without supervision shall not have access to stairs.

B.   Safety gates used as protective barriers shall meet the Consumer Product Safety Commission guidelines for juvenile products and be properly installed.

C.   Children over the age of two shall not have access to stairs with three or more risers that do not have protective barriers or guardrails on each side.

D.   Protective barriers or guardrails on sides of stairs shall be constructed to prevent a child from climbing over, crawling or falling through, or becoming entrapped.

22VAC40-181-380. Doors and windows.

A.   Doors with clear glass panels that reach within 18 inches of the floor shall be clearly marked with decorative objects such as pictures, art work, or decals at the eye level of children in care.

B.   Windows and doors used for ventilation shall be securely screened.

22VAC40-181-390. Smoking and prohibited substances.

The provider shall ensure that:

1.    No person smokes:

a.    Indoors while children are in care;

b.    In a vehicle when children are transported; or

c.    Outdoors in an area occupied by children.

2.    No caregiver is under the effects of medication that impairs functioning, alcohol, or illegal drugs.

22VAC40-181-400. Play equipment and materials.

A.   The family day home shall provide a sufficient quantity and variety of play materials and equipment that shall be readily accessible to children.

B.   Equipment and materials used by a child shall be appropriate to the age, size, ability, and interest of the child. 

C.   Equipment and materials used by children shall be clean, nontoxic, and free from hazards such as lead paint, sharp edges or points, loose parts, and rust.

D.   Toys mouthed by children shall be cleaned and sanitized daily.

22VAC40-181-410. Indoor slides and climbing equipment.

The climbing portions of indoor slides and climbing equipment over 18 inches high shall not be over a bare floor.

22VAC40-181-420. Outdoor play areas and equipment.

A.   A nonclimbable barrier at least four feet high such as, but not limited to, a fence or impenetrable hedge shall surround outdoor play areas located within 30 feet of hazards such as, but not limited to, streets with speed limits in excess of 25 miles per hour or with heavy traffic, or railroad tracks.  Facilities voluntarily registered prior to the effective date of the regulation must fully comply with the requirement of this subsection within 12 months of the effective date of the regulation.

B.   The highest climbing rung or platform on outdoor climbing equipment or top of slide used by children shall not exceed six feet for school age children and four feet for preschool children.

C.   Stationary outdoor playground equipment used by children shall:

1.    Not be installed over concrete, asphalt, or any other hard surface.

2.    Be placed at least six feet from the perimeter of other play structures or obstacles.

D.   Sandboxes shall be covered when not in use.

E.   Trampolines shall not be used during the hours children are in care.

22VAC40-181-430. Rest areas.

A.   A child shall be provided with an individual crib, play pen, cot, rest mat, bed, sofa, or other piece of furniture for resting or napping.

B.   Occupied cribs, play pens, cots, rest mats, beds or other piece of furniture used for resting or sleeping shall be:

1.    At least three feet from any heat-producing appliance;

2.    At least 12 inches from each other.

C.   Rest mats that are used must have at least one inch of cushioning.

D.   Rest mats shall be cleaned and sanitized on all sides at least weekly and as needed.

E.   If children sleep or rest in beds or on furniture used for other activities during the day or by other family members at other times, the furniture must be covered in clean linens each time the child rests on a bed of a family member or uses another piece of furniture to rest.

22VAC40-181-440. Cribs/playpens used for napping and daytime use.

A.   A full-size or portable crib or mesh-sided playpen or mesh-sided crib must be provided for children from birth through 12 months of age and for children over 12 months of age who are not developmentally ready to sleep on a cot, rest mat or bed.

B.   Full- sized or portable cribs shall not be used as a play space for infants. 

C.   Full-sized or portable cribs shall:

1.    Meet the  current U.S. Consumer Product Safety Commission standards;

2.    Not have been recalled;

3.    Have no more than six centimeters or 2 3/8 inches of space between slats:

4.    Have mattresses that fit snugly next to the crib so that no more than two fingers can be inserted between the mattress and the crib;

5.    Not have end panel cutouts of a size to cause head entrapment;

6.    Not be occupied by more than one child at a time.

D.   Mesh-sided cribs and mesh-sided playpens used for play and napping shall have all toys, etc. removed prior to napping and:

1.    Meet the U.S Consumer Product Safety Commission standards at the time of manufacture;

2.    Not have been recalled;

3.    Have mesh netting with mesh holes smaller than ¼ inch;

4.    Not have torn mesh sides or broken hinges, or tears in the vinyl or fabric;

5.    Have a firm floor with a secured, waterproof pad that is not more than one  inch thick;

6.    Have the sides up and the fastenings secured when a child is inside, except when the caregiver is giving the child immediate attention;

7.    Be cleaned and sanitized each day or use or more often as needed; and

8.    Not be occupied by more than one child at a time.

E.   Crib bumper pads shall not be used.

F.    Mesh-sided cribs, playpens, or pack and plays  may not be used for overnight care or when a child is expected to sleep more than four continuous hours.

22VAC40-181-450. Linens.

A.   Cribs, cots, rest mats, and beds when used for sleeping or napping by children other than infants shall have linens consisting of a top cover and a bottom cover.

B.   Cribs when being used by infants shall have a tight fitting bottom cover.

C.   Linen shall be assigned for individual use.

D.   Linen shall be clean and washed at least weekly or when soiled.

E.   Clean linens shall be used each time a child rests on the bed of a family member.

F.    No soft bedding of any kind shall be used under or around infants including but not limited to, pillows, quilts, comforters, sheepskins, or stuffed toys.

G.   Children under two years of age shall not use pillows or filled comforters.

H.   Pillows, when used for children over two years of age, shall be assigned for individual use and covered with a pillowcase.

22VAC40-181-460. Infant and toddler equipment.

A.   Infant carrier seats, swings, strollers, feeding or activity tables, and high chairs shall be used according to the manufacturer's instructions and when occupied by a child, a safety strap shall be used and securely fastened.

B.   Infant walkers shall not be used.

C.   Infants may not sleep in infant carrier seats.  If an infant falls asleep in a carrier seat in the family day home, they shall be moved to the appropriate sleeping area immediately.

D.   Infants and toddlers shall spend no more than 30 minutes of consecutive time during waking hours, with the exception of mealtimes, confined in a playpen, crib, high chair, or other piece of confining equipment.  The intervening period of time between confinements shall be at least 30 minutes.

PART V    CARE OF CHILDREN

22VAC40-181-470. Supervision.

A.   A caregiver shall be physically present on site and provide direct care and supervision of each child at all times.  Direct care and supervision of each child includes:

1.    Awareness of and responsibility for each child in care, including being near enough to intervene if needed; and

2.    Monitoring of each sleeping infant in one of the following ways;

a.    By placing each infant for sleep in a location where the infant is within sight and hearing of the caregiver;

b.    By in-person observation of each sleeping infant at least once every 15 minutes; or

c.    By using a baby monitor. 

B.   Caregivers shall actively supervise each child during outdoor play to minimize the risk of injury to a child.

C.   Infants shall be protected from older children.

D.   No child under five years of age or a child older than five years of age who lacks the motor skills and strength to avoid accidental drowning, scalding, or falling while bathing shall be left unattended while in the bathtub.

22VAC40-181-480. Determining the need for an additional caregiver.

A.   The provider shall ensure that a caregiver does not exceed 16 points by using the following point system to determine if an additional caregiver is needed:

1.    Children from birth through 15 months of age count as four points each;

2.    Children from 16 months through 23 months of age count as three points each;

3.    Children from two through four years of age count as two points each;

4.    Children from five through nine years of age count as one point each; and

5.    Children who are 10 years of age an older count as 0 points.

B.   A caregiver's own children and resident children under eight years of age count in point maximums.

22VAC40-181-490. General requirements for programs.

A.   In order to promote the child's physical, intellectual, emotional, and social well-being and growth, caregivers shall:

1.    Talk to the child;

2.    Provide needed help, comfort and support;

3.    Respect personal privacy;

4.    Respect differences in cultural, ethnic, and family backgrounds;

5.    Encourage decision-making abilities;

6.    Promote ways of getting along;

7.    Encourage independence appropriate to the development of the child; and

8.    Use consistency in applying expectations.

B.   Caregivers shall provide age-appropriate activities for children in care which shall include:

1.    Opportunities for indoor active and quiet play depending upon the ages of the children;

2.    Opportunities for vigorous outdoor play daily, depending upon the weather, the ages, and the health of the children. (For children in care for more than two hours during daylight hours);

3.    Opportunities for one or more regularly scheduled rest or nap periods.  Children unable to sleep shall be provided time and space for quiet play or restful activities;

4.    Opportunities for children to learn about themselves, others, and the world around them;

5.    Opportunities for children to exercise, initiate and develop independence according to their ages; and

6.    Opportunities for structured and unstructured play time and provider directed and children-initiated learning activities.

22VAC40-181-500. Requirements for sleeping and resting.

A.   Infants shall be placed on their backs when sleeping or napping unless otherwise ordered by a written statement signed by the child's physician.

B.   An infant, toddler, or preschool child who falls asleep in a play space other than his own crib, cot, mat, or bed shall be moved promptly to his designated sleeping space if the safety or comfort of the infant, toddler, or preschool child is in question.

C.   School age children shall be allowed to nap if needed, but not forced to do so.

22VAC40-181-510. Television, computers, videos, and video games.

A.   Use of media such as but not limited to television, videos, video games, and computers shall be limited to programs, tapes, websites, and software that are produced for children or are suitable for children. 

B.   Other activities shall be available to children during television or video viewing.

22VAC40-181-520. Behavioral guidance.

A.   Caregivers shall use positive methods of behavior guidance.  Behavior guidance shall be constructive in nature and include techniques such as:

1.    Using limits that are fair, consistently applies, appropriate, and understandable for the child's level of development;

2.    Providing children with reasons for limits;

3.    Giving positively worded direction;

4.    Modeling and redirecting children to acceptable behavior;

5.    Helping children to express feelings and frustration to resolve conflict; and

6.    Arranging equipment, materials, activities, and schedules in a way that promotes desirable behavior.

B.   When time-out is used as a behavior guidance technique:

1.    It shall be used sparingly and shall not exceed one minute for each year of the child's age;

2.    It shall be appropriate to the child's developmental level and circumstances;

3.    It shall not be used with infants and toddlers;

4.    The child shall be in a safe, lighted, well-ventilated place, and within sight and sound of a caregiver; and

5.    The child shall not be left alone inside or outside the home while separated from the group.

22VAC40-181-530. Forbidden actions.

The following acts or threats are forbidden:

1.    Physical punishment including, but not limited to, striking a child, roughly handling or shaking a child, biting, pinching, restricting movement through binding or tying, forcing a child to assume an uncomfortable position, or exercise as punishment.

2.    Enclosure in a small, confined space or any space that the child cannot freely exit himself; however this does not apply to the use of equipment such as cribs, play pens, high chairs, and safety gates when used for their intended purpose with children preschool age or younger;

3.    Punishment by another child;

4.    Withholding or forcing food, water, or rest;

5.    Verbal remarks that are demeaning to the child;

6.    Punishment for toileting accidents;

7.    Punishment by applying unpleasant or harmful substances.

22VAC40-181-540. Parent notifications.

A.   The provider shall provide written notification to the parent of an enrolled child whether the family day home business is covered by liability insurance in the amount established by VDSS ($100,000 per occurrence and $300,000 aggregate.)

1.    The provider shall obtain the parent's written acknowledgement of receipt of this notification.

2.    A copy of the parent's written acknowledgement of the receipt of this notification shall be documented in the child's record, and

3.    The provider shall provide written notification to the parent within 10 business days after the effective date of the change when there is no longer liability insurance in force on the family day home operation and maintain a copy of the notification in the child's file.

B.   Caregivers shall provide information daily to parents about the child's health, development, behavior, adjustment or needs.

C.   The provider shall give parents prior notice when the facility will be closed.

D.   The provider shall give parents prior notice when a substitute provider will be caring for children.

E.   Caregivers shall notify parents when persistent behavioral problems are identified and such notification shall include any behavioral guidance steps taken in response.

F.    The provider shall notify the parent immediately when the child:

1.    Has a head injury or any serious injury that requires emergency medical or dental treatment;

2.    Has an adverse reaction to medication administered;

3.    Has been administered medication incorrectly;

4.    Is lost or missing; or

5.    Has died.

G.   The provider shall notify a parent the same day whenever first aid is administered to a child.

H.   When the child has been exposed to a communicable disease listed in the Department of Health's current communicable disease chart, the provider shall notify the parent within 24 hours or the next business day of the home's having been informed, unless forbidden by law, except for life-threatening diseases which must be reported to the parents immediately.  The provider shall consult the local health department if there is a question about the communicability of a disease.

I.      Except in emergency evacuation or relocation, the provider shall inform the parent and have written permission as required by 22 VAC 40-181-730 C whenever the child will be taken off of the premises of the family day home, before such an occasion.

J.    If an emergency evacuation or relocation is necessary, the parent shall be informed of the child's whereabouts as soon as possible.

K.   The family day homes written medication administration decision regarding whether the provider will administer prescription medication, nonprescription medication, or no medication to an enrolled child.

22VAC40-181-550. Reports to the contracting organization or department.

A.   The provider shall report to the contracting organization or department as soon as possible but no later than 24 hours  each of the following incidents:

1.    Lost or missing child when local authorities have been contacted for help;

2.    Serious injury to a child while under the family day home's supervision;

3.    Death of a child while under the family day home's supervision.

B.   The provider shall report to the contracting organization or department within 24 hours or by the next working day:

1.    Any damage to the provider's home that affects the provider's compliance with these standards;

2.    The termination of all family day care services by the provider; or

3.    The provider's decision to surrender the certificate of registration.

22VAC40-181-560. Reports of suspected cases of child abuse or neglect.

Caregiver shall immediately call the local department of social services or call the toll-free number for the Child Abuse and Neglect Hotline whenever there is reason to suspect that a child has been or is being subjected to any kind of child abuse or neglect by any person.

PART VI     PREVENTING THE SPREAD OF DISEASE

22VAC40-181-570. Exclusion of sick children.

A.   Whenever the provider is caring for children from more than one family group, unless otherwise approved by a child's health care professional, a child shall be excluded from the voluntarily registered family day home if he has:

1.    Both fever and behavior change.   A fever means oral temperature over 101°F or armpit temperature over 100°F;

2.    Diarrhea (more watery, less formed, more frequent stools, not associated with a diet change or medication).  Children in diapers who develop diarrhea shall be excluded, and children who have learned to use the toilet; but cannot make it to the toilet, shall also be excluded;

3.    Recurrent vomiting; or

4.    Symptoms of a communicable disease listed in the Virginia Department of Health's current communicable disease chart.

B.   If a child needs to be excluded according to subsection A of this section, the following shall apply:

1.    The parents or designated emergency contact shall be contacted immediately so that arrangements can be made to remove the child from the home as soon as possible; and

2.    The child shall remain in quiet designated area and the caregiver shall respond immediately to the child until the child leaves for home.

C.   If a provider is only caring for children from a single family group, the provider shall establish written guidelines with the parent establishing when the child will be excluded from care.

22VAC40-181-580. Handwashing.

A.   Caregivers shall wash their hands with liquid soap and warm running water:

1.    When their hands are dirty;

2.    After toileting;

3.    Before preparing and serving food;

4.    Before feeding or helping children with feeding;

5.    After contact with bodily fluids;

6.    After handling or caring for animals;

7.    After handling raw eggs or meat;

8.    After diapering a child or assisting a child with toileting.

B.    Caregivers shall ensure that children's hands are washed with liquid soap and warm running water:

1.    When their hands are dirty;

2.    Before eating;

3.    After toileting and diapering;

4.    After handling and caring for animals; and

5.    After contact with bodily fluids.

22VAC40-181-590. Diapering and toileting.

A.   A child shall not be left unattended on a changing table during diapering.

B.   When a child's clothing or diaper becomes wet or soiled, the child shall be cleaned and changed immediately.

C.   During each diaper change or after toileting accidents, the child's genital area shall be thoroughly cleaned with a moist disposable baby wipe or a moist, clean individually assigned cloth, if the child is allergic to disposable baby wipes.

D.   The diapering surface shall be:

1.    Separate from the kitchen, food preparation areas, or surfaces used for children's activities;

2.    Non-absorbent and washable; and

3.    Cleaned and sanitized after each use.

E.   Soiled disposable diapers and wipes shall be disposed of in a leak-proof or plastic-lined storage system that is either foot operated or used in such a way that neither the caregiver's hand nor the soiled diaper or wipe touches the exterior surface of the storage system during disposal.

F.    A separate leak-proof storage system shall be used if cloth diapers are used.

G.   Children five years of age and older shall be permitted privacy when toileting.

H.   Caregivers shall respond promptly to a child's request for toileting assistance.

I.      The provider shall consult with the parent before toilet training is initiated.

J.    Toilet training shall be relaxed and pressure free.

K.   There shall be a toilet chair or an adult-sized toilet with platform or steps and adapter seat available to a child being toilet trained.

L.    Toilet chairs, when used, shall be emptied promptly, cleaned and sanitized after each use.

PART VII       MEDICATION ADMINISTRATION

22VAC40-181-600. General requirements for medication administration.

A.   Medication shall be given to a child:

1.    According to the home's written medication administration policy, and

2.    Only with written authorization from the parent.

B.   The parent's written authorization for medication shall expire or be renewed after 10 working days.

Exception:  Long-term prescription and nonprescription drug use may be allowed with written authorization from the child's physician and parent.

C.   When an authorization for medication expires, the medication shall be returned to the child's parent or guardian.

22VAC40-181-610. Prescription medication.

A.   The family day home may administer prescription medication that would normally be administered by a parent or guardian to a child provided the medication is administered by a caregiver who has current Medication Administration Training (MAT) certification (in accordance with 22VAC 40-180-200) or when the caregiver is licensed in Virginia to administer prescription medication.

B.   The caregiver administers only those drugs that were dispensed from a pharmacy and maintained in the original, labeled container; and

C.   The caregiver administers drugs only to the child identified on the prescription label in accordance with the prescriber's instructions pertaining to dosage, frequency, and manner of administration.

22VAC40-181-620. Nonprescription medication.

A.   The family day home may administer nonprescription medication provided the medication is:

1.    Administered by a caregiver 18 years of age or older;

2.    Labeled with the child's name;

3.    In the original container with the manufacturer's direction label attached; and

4.    Given only at the dose, duration, and method of administration specified on the manufacturer's label for the age or weight of the child needing the medication.

B.   Written consent of the parent for the provider to administer a nonprescription medication shall be maintained in the child's record.

C.   Nonprescription medication shall not be used beyond the expiration date of the product.

22VAC40-181-630. Storage of medication.

A.   Medications for children in care shall be stored separately from medications for household members and caregivers.

B.   When needed, medication shall be refrigerated.

C.   When medication is stored in a refrigerator used for food, the medications shall be stored together in a container or in a clearly defined area away from food.

D.   Medications, including those of caregivers, household members, and children in care, shall be kept inaccessible to children in care.

22VAC40-181-640. Medication records.

The provider shall keep a record of prescription and nonprescription medication given to children, which shall include the following:

1.    Name of the child to whom medication was administered;

2.    Amount and name of medication administered to the child;

3.    The day and time the medication was administered to the child;

4.    Name of the caregiver administering the medication;

5.    Any adverse reactions; and

6.    Any medication error.

PART VIII      EMERGENCIES

22VAC40-181-650. First aid and emergency supplies.

A.   The family day home shall have a well stocked first aid kit that is readily accessible to caregivers and kept inaccessible to children.

B.   The first aid kit shall be available to caregivers when children are in outdoor play areas, on field trips, and in vehicles used for transportation of children.

C.   A working battery-operated flashlight and battery-operated radio shall be available at all times.

22VAC40-181-660. Emergency information.

A.   The emergency contact information listed in 22 VAC 40-181-730 B and the parent's written authorization for emergency medical care shall be made available to a physician, hospital, or emergency responders in the event of a child's illness or injury.

B.   Annually, the provider shall review with the parent the emergency contact information to ensure the information is correct and obtain the parents signed acknowledgement of the review.

22VAC40-181-670. Posted telephone numbers.

The following telephone numbers shall be posted in a visible area close to the telephone:

1.    A 911 number or local dial number for police, fire, and emergency medical responders; and

2.    The number of the Poison Control Center.

22VAC40-181-680. Emergency preparedness and response plan.

A.   The family day home shall have a written emergency preparedness and response plan that:

1.    Includes emergency evacuation, emergency relocation, and shelter-in-place procedures;

2.    Addresses the most likely to occur scenarios, including but not limited to fire, severe storms, flooding, tornadoes, and loss of utilities.

B.   The provider shall update the plan as needed.

C.   The provider shall ensure that each caregiver receives training regarding the emergency evacuation, emergency relocation, and shelter-in-place procedures by the end of his first week of assuming job responsibilities, every two years prior to renewal inspection, and at the time of each plan update.

22VAC40-181-690. Evacuation and relocation procedures.

Evacuation and relocation procedures shall include:

1.    Method of alerting caregivers and emergency responders;

2.    Designated primary and secondary routes out of the building;

3.    Designated assembly point away from the building;

4.    Designated relocation site;

5.    Methods to ensure all children are evacuated from the building and, if necessary moved to relocation site;

6.    Methods to account for all children at the assembly and relocation site;

7.    Methods to ensure essential documents, emergency contact information, necessary medications and supplies are taken to the assembly point and relocation site; and

8.    Method of communication with parents and emergency responders after the evacuation and/or relocation.

22VAC40-181-700. Shelter-in-place procedures.

Shelter-in-place procedures shall include:

1.    Methods to alert caregivers and emergency responders;

2.    Designated safe location within the home;

3.    Designated primary route to safe location;

4.    Method to ensure all children are moved to the safe location;

5.    Method to ensure essential documents, emergency contact information, necessary medications and supplies are taken to the safe location; and

6.    Method of communication with parents and emergency responders.

22VAC40-181-710. Emergency response drills.

A.   The emergency evacuation procedures shall be practiced monthly with all caregivers and children in care during all shifts that children are in care. 

B.   Shelter-in-place procedures shall be practiced at least annually with all caregivers for children in care during all shifts that children are in care.

C.   Documentation shall be maintained of emergency evacuation and shelter-in-place drills that includes:

1.    The date and time of the drill;

2.    Number of caregivers participating;

3.    Number of children participating;

4.    Any special conditions simulated;

5.    Time it took to complete the drill;

6.    Problems encountered (if any).

D.   Records for emergency evacuation and shelter-in-place drills shall be maintained for a minimum of two years.

PART IX        RECORDKEEPING

22VAC40-181-720. General recordkeeping.

A.   The family day home shall keep a written record of children in attendance each day.

B.   The provider's attendance records shall be maintained in the home for a minimum of six months and made accessible to the department's representative and contract organization staff.

C.   Information contained in a child's record shall be privileged and confidential.  The provider shall not distribute or release information in a child's record to any unauthorized person without the written consent of the child's parent.

D.   Children's records shall be made available to a child's parent upon request, unless otherwise ordered by the court.

E.   The provider's records and reports on children shall be maintained and made accessible to the department's representative and contract organization staff while the child is enrolled and for a minimum of one year from the date of termination of services for a child.

F.    The emergency contact information listed in 22 VAC 40-181-730  B 2 through B 5 shall be made available to a physician, hospital, or emergency personnel in the event of a child's illness or injury.

G.   Caregivers shall not disclose or permit the use of information pertaining to an individual child or family unless the parent(s) or guardian(s) of the child have granted written permission to do so, except in the course of performance of official duties and to employees or representatives of the contracting organization or the department.

22VAC40-181-730. Children's records.

A.   The provider shall maintain an individual, up-to-date record at the family day home for each enrolled child.

B.   A child's record shall contain the following information:

1.    Child's full name (including nicknames (if any), sex, address, and birth date;

2.    Name, address and telephone number of each parent who has custody;

3.    Name, address, and telephone number of each custodial parent's place of employment;

4.    Name, address, and telephone number of one or more designated persons to contact in case of emergency if the parent cannot be reached;

5.    Name, office address, and telephone number of the child's physician;

6.    Information on allergies and intolerance to food, medication, or any other substances, and actions to take in emergency situations;

7.    Names of persons other than the custodial parents who are authorized to pick up the child;

8.    Appropriate legal paperwork when a custodial parent does not authorize the provider to release the child to the other parent; and

9.    Information regarding chronic physical problems, pertinent developmental information, and any special accommodations needed;

10. The name and policy number of the child's medical insurance, if applicable;

11. First and last dates of attendance;

12. Proof of the child's age and identity and the names and addresses of previously attended child day care and schools;

13. Immunization records for the child as required by 22 VAC 40-181-740;

14. Results of the health examination for the child as required by 22 VAC 40-181-750;

15. Written authorization for emergency medical care should an emergency occur and the parent cannot be located immediately unless the parent presents a written objection to provision of medical treatment on religious or other grounds;

16. Written authorization if a caregiver is to administer prescription or nonprescription medication;

17. Written authorization if the child is to participate in swimming or wading activities;

18. Written authorization if the child is taken off the premises of the family day home;

19. Record of any accidents or injuries sustained by the child while at the family day home;

20. Documentation of the review of the child's emergency contact information as required by 22VAC 40-181-660 B;

21. Documentation that the parent has received a copy of the Information to Parents Statement as prepared by VDSS;

22. Documentation that the parent has received notification regarding the presence of a pet or animal in the home;

23. Amount of time per week that an adult assistant or substitute provider instead of the provider is scheduled to care for the child and the name of the adult assistant or substitute provider;

24. The parent's written authorization to transport children in a vehicle, if applicable; and

25. Any written agreement made between the family day provider and the parent, guardian, or other responsible person for each child in care.  The agreement may cover hours of care per day, week, or month; cost of care; frequency and method of payment; any special services provided by either party to the agreement.

C.   Written information for parents.

On or before the child's first day of attendance, parents shall be provided, in writing, the following information:

1.    Operating information including the hours and days of operation, holidays, or other planned closures, and the telephone number where a caregiver may be reached or a message left for a caregiver;

2.    Check in and checkout procedures;

3.    Policies for the administration of medications;

4.    Whether or not there is liability insurance of at least $100,000 per occurrence and $300,000 aggregate in force on the family day home operation as required by §63.2-1809.1 of the Code of Virginia;

5.    Requirement for the family day home to notify parent when the child becomes ill and for the parent to arrange to have the child picked up as soon as possible if requested by the home;

6.    Policies for the provision of food;

7.    Behavior guidance policy;

8.    Amount of time per week that an adult assistant or substitute provider instead of the provider is scheduled to care for the child and the name of the adult assistant or substitute provider;

9.    Policies for termination of care; and

10. Documentation that parents have been provided the above information.

22VAC40-181-740. Immunizations for children.

A.   Before a child may attend the family day home, the provider shall obtain documentation that the child has been adequately immunized according to the requirements of §32.1-46 of the Code of Virginia and applicable State Board of Health regulations.

B.   Pursuant to subsection C of § 22.1-271.2 of the Code of Virginia, documentation of immunizations is not required for any child whose:

1.    Parent submits an affidavit to the family day home on the current form approved by the Virginia Department of Health stating that the administration of immunizing agents conflicts with the parent's or child's religious tenets or practices; or

2.    Physician or a local health department states on a Department of Health-approved form that one or more of the required immunizations may be detrimental to the child's health, indicating the specific nature and probable duration of the medical condition or circumstance that contraindicates immunization.

C.   The family day home shall obtain documentation of additional immunizations for a child who is not exempt from the immunization requirements according to subsection B of this section

1.    Once every six months of children under the age of two years; and

2.    Once between the child's fourth and sixth birthdays.

22VAC40-181-750. Physical examinations for children.

A.   The provider shall obtain documentation of a physical examination by or under the direction of a physician prior to a child's attendance or within 30 days after the first day of attendance.

B.   The physical examination prior to attendance shall have been conducted within:

1.    Two months prior to attendance for children six months of age or younger;

2.    Three months prior to attendance for children age seven months through 18 months;

3.    Six months prior to attendance for children age 19 months through 24 months;

4.    Twelve months prior to attendance for children two years of age through five years of age;

5.    Twenty-four months prior to attendance for children six years of age and above.

Exceptions:

1.    A new physical examination is not required if a copy of the physical examination is available to the admitting family day home for a child transferring from a facility licensed by the Virginia Department of Social Services, approved by a licensed family day system, voluntarily registered by the Virginia Department of Social Services, or by a contract agency of the Virginia Department of Social Services, or transferring from a Virginia Department of Education-approved child care program.

2.    For a school age child, a copy of the physical examination required for his entry into a Virginia public kindergarten or elementary school is acceptable documentation.

3.    Pursuant to subsection D of § 22.1-270 of the Code of Virginia, physical examinations are not required for any child whose parent objects on religious grounds.  The parent must submit a signed statement noting that the parent objects on religious grounds and certifying that to the best of the parent's knowledge the child is in good health and free from communicable or contagious disease.

PART X         NUTRITION

22VAC40-181-760. Meals and snacks.

A.   Children shall be served adequate, nutritious meals and snacks.

B.   Food shall be prepared, stored, served, and transported in a clean and sanitary manner.

C.   Tables and high chairs shall be cleaned after each use.

D.   The family day home shall ensure that children arriving from a half-day morning program who have not yet eaten lunch receive a lunch.

E.   Menus for the current week shall be posted in an area accessible to parents or given to the parents.  Substitutions shall be listed on the menu.

F.    All milk and milk products shall be pasteurized.

22VAC40-181-770. Meals and snacks brought from the child's home.

When food is brought from home for more than one child in care, the following shall apply:

1.    The food container(s) shall be labeled in a way that identifies the owner;

2.    The family day home shall have extra food or shall have provisions to obtain food to serve a child so that the child can have an appropriate snack or meal if the child forgets to bring food from home or brings an inadequate meal or snack; and

3.    Unused portions of food shall be discarded by the end of the day or returned to the parent.

22VAC40-181-780. Preventing choking.

To assist in preventing choking, food that is hard, round, small, thick and sticky, or smooth and slippery such as whole hot dogs sliced into rounds, nuts, seeds, raisins, uncut grapes, uncut raw carrots, peanuts, chunks of peanut butter, hard candy, and popcorn shall not be served to children under four years of age, unless the food is prepared before being served in a manner that will reduce the risk of choking. i.e., hot dogs cut lengthwise, grapes cut in small pieces, and carrots cooked or cut lengthwise.

22VAC40-181-790. Drinking water and fluids.

A.   Water shall be available for drinking and shall be offered on a regular basis to all children in care.

B.   In environments of 80°F or above, attention shall be given to the fluid needs of children at regular intervals.  Children in such environments shall be encouraged to drink fluids.

C.   Clean, individual drinking cups shall be provided daily.  Children shall not be allowed to share common drinking cups.

22VAC40-181-800. Food storage.

A.   Temperatures shall be maintained at or below 40°F in refrigerator compartments and at or below 0°F in the freezer compartments.

B.   The provider shall have an operable thermometer available to monitor refrigerator and freezer compartment temperatures.

C.   All perishable foods and drinks used for children in care, except when being prepared and served, shall be kept in the refrigerator.

22VAC40-181-810. Feeding infants.

A.   Infants shall be fed on demand unless the parent provides other written instructions.   Infant feeding instructions, if any, shall be maintained in the child's file.

B.   Infants who cannot hold their own bottles shall be picked up and held for bottle feeding.  Bottles shall not be propped.

C.   High chairs, infant carrier seats, or feeding tables with safety waist and crotch straps fastened according to manufacturer's instructions shall be used for children under 12 months of age who are not held while being fed.

D.   Infant formula shall be prepared according to the manufacturer's or physician's instructions.

E.   Bottles shall be refrigerated and labeled with the child's full name and the date, if more than one infant is in care.

F.    Refrigerated bottles of prepared formula and breast milk shall be discarded after 48 hours, or returned to the parent, if not used.

G.   Bottles shall not be heated in a microwave oven.

H.   To avoid burns, heated formula and baby food shall be stirred or shaken and tested for temperature before being served to children.

I.      Baby food shall be served from a dish and not from the container.  Food remaining in the dish after feeding shall be discarded.  Open containers shall be refrigerated and labeled with the child's full name and the date, if more than one infant is in care.

J.    Solid foods shall:

1.    Not be fed to infants less than four months of age without written parental consent, and

2.    Be fed with a spoon, with the exception of finger foods.

PART XI        TRANSPORTATION

22VAC40-181-820. Written permission for transportation and field trips.

A.   General written permission shall be obtained from the parent of each child for the provider to take the child off the premises of the family day home.  The general written permission shall be on a form that lists regularly scheduled trips (e.g., library, store, playground) and the driver if the child is to be transported.

B.   Special written permission shall be obtained from the parent of each child for the provider to take the child on special field trips (those not regularly scheduled).  The written permission shall specify the destination, duration of the trip, and if the child shall be transported, the name of the driver.

C.   Drivers must be 18 years of age or older and have a valid driver's license.

D.   During transportation the family day home must ensure the following information is onboard the vehicle:

1.    The name, address, and telephone number of the family day home;

2.    Copy of the parent's written permission to transport the children;

3.    Copy of each child's emergency contact information;

4.    Emergency supplies;

5.    Mechanism for making telephone calls to emergency responders and parents (e.g., change, calling card, cell phone).

E.   The vehicle must meet the safety standards set by the Virginia Department of Motor Vehicles and be licensed and insured according to state law.

F.    The provider shall ensure that during transportation of children;

1.    All seats are attached to the floor;

2.    Each child is in an individual car seat or individual and appropriate restraint in accordance with Virginia law;

3.    Each child's arms, legs, and head remain inside the vehicle;

4.    No child is left unattended inside or outside a vehicle.

PART XII       NIGHTTIME CARE

22VAC40-181-830. Nighttime care.

A.   For nighttime care during which a child sleeps more than four continuous hours, each child shall have a rest area that meets the requirements of 22 VAC-40-181-430.

B.   An infant shall have an individual crib that:

1.    Meets the current U.S. Consumer Product Safety Commission standards;

2.    Has not been recalled;

3.    Has no more than six centimeters or 2 3/8 inches of space between slats;

4.    Has a mattresses that fits snugly next to the crib so that no more than two fingers can be inserted between the mattress and the crib;

5.    Does not have panel cutouts of a size to cause head entrapment; and

6.    Does not have mesh sides.

C.   Double-deck cribs shall not be used.

D.   Crib bumper pads shall not be used.

E.   Crib sides shall always be up and the fastenings secured when a child is in the crib, except when the caregiver is giving the child immediate attention.

F.    Linens shall be provided for individual use and shall be clean and washed at least weekly or when soiled.

G.   Clean linens shall be used each time a child rests on the bed of a family member.

H.   No soft bedding of any kind shall be used under or around sleeping infants including; but not limited to, pillows, quilts, comforters, sheepskins, or stuffed toys.

I.      Children under the age of two years of age shall not use pillows or filled comforters.

J.    Pillows, when used for children over two years of age, shall be assigned for the individual use and covered with pillowcases.

K.   Providers shall establish a bedtime schedule for a child in consultation with the child's parent.

L.    Separate sleeping and dressing areas shall be provided for children of the opposite sex over six years of age.

M.   Each child shall have a toothbrush, and a comb or hair brush for individual use.

N.   Bath towels and washcloths, when used, shall be assigned for individual use and laundered, as needed, but at least weekly.

O.   Caregivers shall remain awake until all children are asleep and shall sleep on the same floor level as the children in care.

P.   A baby monitor shall be used if the caregiver is not sleeping in the room with a child or in a room adjacent to the room where the child is sleeping.

PART XIII      ANIMALS

22VAC40-181-840. Animals.

A.   Family pets shall not be allowed on any surfaces where food is prepared or served.

B.   A pet or animal present at the home, accessible to children, shall be in good health and show no evidence of carrying any transmittable disease.

C.   Dogs or cats, where allowed, shall be vaccinated for rabies and shall be treated for fleas, ticks or worms as needed.  Documentation of the current rabies vaccination shall be maintained by the provider.

D.   Caregivers shall closely supervise children when children are exposed to animals.

E.   Animals that have shown aggressive behavior shall not be kept in the home or on the grounds.

F.    Monkeys, ferrets, reptiles, amphibians, pscittacine birds (birds of the parrot family), or wild or dangerous animals shall not be in areas accessible to children during the hours children are in care.

G.   Animals litter boxes, toys, food dishes, and water dishes shall be inaccessible to children.

H.   All animal excrement shall be removed promptly, disposed of properly, and if indoors, the soiled area cleaned.

PART XIV     SWIMMING AND WADING ACTIVITIES

22VAC40-181-850. Swimming and wading activities.

A. Children shall be supervised, sight and sound, by an adult caregiver during all swimming or wading activities.

B. The family day home shall obtain written permission from the parent of each child who participates in swimming or wading activities.  Written parental permission must include:

1. Acknowledgement of the type of pool or water activity (in-ground, above-ground, wading pool, lake, etc.);

2.    Depth of the water;

3.    Parent's assessment of the child's swimming abilities and whether any additional floatation devices should be used; and

4.    Location of the pool or water activity.

C.   Whenever children are in a pool, lake or other swimming area that is more than three feet deep, on or off the premises of the family day home, the provider must disclose to the parent, in writing, whether a certified lifeguard or person certified in basic water rescue, community water safety, or water safety instruction is on-duty. 

D.   Outdoor swimming activities shall occur only during daylight hours.

PART XV          CHILDREN WITH SPECIAL NEEDS

22VAC40-181-860. Care of a child with special needs.

A. Caregivers shall provide a child with special needs with the care and activities recommended in writing by a physician, psychologist, or other professional who has evaluated or treated the child.

B. The written recommendation shall:

1. Include instructions for any special treatment, diet, or restrictions in activities that are necessary for the health of the child; and

2. Be maintained in the child's record.

C. The provider shall ensure the environment is appropriate to the child based on the plan of care and shall instruct other caregivers in the proper techniques of care.

D. A caregiver shall perform only those procedures and treatments for which he has the necessary training, experience, credentials, or license to perform.

E. Staffing shall be appropriate and adequate to meet the specific physical and developmental needs of a child with special needs.

F. The provider and the parent of the child with special needs shall mutually determine a recommendation for the level of staffing necessary to care for and supervise the child based on the child's chronological and functional age and degree of disability.

G. A separate area shall be provided for the purpose of privacy for diapering, dressing, and other personal care procedures for a child above age three with special needs who requires assistance in these activities.