1/18/2024

Board Members and Staff,

We appreciate the opportunity to comment on the new proposed standards for licensed child care. Despite our long comments ahead, we really do think these new standards are a big step forward, and we appreciate all the work that has gone into them so far. The reorganization is a lot better than before and we think in these next rounds of drafts we could really improve the lives of children, families, and the early childhood educators who serve them. Below we outline the ways these standards could be improved to better support children, families, and early childhood educators.

New detailed documentation of topical ointment use would create a huge administrative burden and possibly lead to providers not allowing topical ointments for children whenever possible.

The current standards do not require reporting of topical ointment use in any way. The new language of 8VAC20-781-580 A 4 (“A record shall be kept that includes the child’s name, the name of the product, date and time of use, any adverse reactions, and any application errors and action taken”) creates a medication log–like requirement.

That means, for every child, multiple times a day, teachers have to write all of that for sunscreen or if they put lotion on or if they have lip balm. This is requiring medication-like documentation for simple things like hand lotion, which already have to be approved by parents for teachers to apply. This would be an entirely new record keeping system for no real reason. It's a huge administrative burden for teachers. The most likely result if this standard were adopted is that programs would create policies to reduce topical ointments if at all possible, simply to avoid the burden of documentation. This means children would be less likely to have what they need when they have chapped lips, hands, or a diaper rash. There must be a simpler way to meet the need that led to this requirement. Perhaps, for infants, this documentation could be part of their daily documentation. Or perhaps only notifying families if there were errors or adverse reactions. To give you a sense of scale, my program puts sunscreen on 94 children three times a day in the summer—that is 282 new records each day just for sunscreen. Most parents can think of a time when their child had chapped skin and they were using lotion after each handwashing. A provider would be faced with a choice between putting lotion on that child and documenting it 10–12 times a day, refusing to allow lotion due to the documentation burden, or risking a violation for not keeping proper documentation. This regulation would have a dramatic impact and documentation should not be required for topical ointments. 

New language around supervision would prevent older children from going to their hallway cubbies without a teacher.

Supervising children is essential and how we regulate that has a dramatic impact on how children are supported. The new language around supervision is extremely restrictive and prevents teachers from scaffolding children’s learning to handle tasks out of direct sight supervision. 8VAC20-781-270 F requires children under ten to only be out of sight and sound supervision to use the restroom. Current language allows for other short periods of sound-only supervision, which allows children at our school to go to a hallway cubby or fill a water bottle in a hallway fountain. We think the language in 8VAC20-781-270 F is appropriate for children younger than preschool who should only be in sound-only supervision if using the restroom independently. At our school, we have many two-year-olds and some one-year-olds who use the restroom independently and prefer privacy. 

For older children, we recommend Virginia adopt this language, which is close to what is recommended by NAEYC: “(1) For preschool children staff must supervise by sight and sound most of the time. Supervision by sound alone is also permissible for short intervals, under five minutes, as long as staff check on children who are out of sight and children are always in a safe area” (any details needed on what a safe area is could be below). “(2) For school-age children doing tasks in a safe environment, they may be out of sight and sound supervision for up to ten minutes provided staff are nearby so they can provide immediate intervention if needed” (any other details could be added). This language would allow educators to scaffold the learning of young children so they can build competency in a safe environment. For preschoolers this is a school readiness skill. For school age children my proposed language would be consistent with how they are treated in other settings, in which they can go to the nurse’s office or a hallway bathroom.

Proposed language would prevent children two years old and younger from being on a playground with three-year-olds and above, likely resulting in reduced outdoor time and programs that don’t serve infants being unwilling to serve two-year-olds.

I have seen multiple other comments concerned about 8VAC20-781-240 G, which prevents infants, toddlers, twos, and preschoolers from occupying the outdoor area at the same time. While we understand that children of multiple ages being outside together can create a safety concern, it also can be done in a way that is not a safety concern and supports children's relationships throughout the school. We regularly have time where siblings can be outside together, which is cherished by children and families who are saddened that their children are separated from siblings all day at school.We think a significant unintended consequence of this regulation would be to reduce the amount of time children get outside. Additionally, like other commenters have stated, it will likely reduce the availability of care for children aged two to three. Many programs don’t serve infants and toddlers but serve two-year-olds and above. This regulation would impact them and could result in them no longer providing two-year-old care. We think the best way to regulate this safety concern would be to require that playground safety plans (8VAC20-781-40 A 4) include policies for how, if, and when different ages will engage together on the playground, how younger children will be kept safe, and how ratios appropriate to the youngest child will be maintained for the group. At the very least, twos should be removed from the regulation as written to minimize the impact of this change. Preferably programs would be allowed to create safety policies to allow all ages to be on the playground in a way that is safe.

This language requires significantly more laundry for soft items like pillows, stuffed animals, and dress-up clothes, which is so restrictive it is likely to reduce young children’s access to soft materials. 

The intention of 8VAC20-781-430 D is to be sure soft things are kept clean; I think adding that they shall be washable is useful, but having to wash everything each week will create a huge burden and ultimately likely decrease young children’s access to soft items in their environment. Already tired teachers will reduce the stuffed animals, dress up clothes, and floor pillows that make classrooms cozy because weekly washing is not sustainable. In our program, we wash things like the covers for our Nugget couch cushions and futons monthly, which seems a lot more practical and much less likely to have unintended consequences. 

Revised language requires even sandboxes that allow drainage to be covered when not in use.

This proposed sandbox language change is problematic for large sand areas, which are really great for children. Our school has a two-level sandbox that is nearly 200 square feet and would be impractical to cover. It was built to allow drainage for safety and cleanliness. The new language of 8VAC20-781-260 requires all sand to be covered when not in use. We advocate you keep the old language: “Sandboxes with bottoms which prevent drainage shall be covered when not in use.”

New language restricting visual media (screens) does not go nearly far enough.

I want to start with a celebration of 8VAC20-781-320 C, because it is a much needed standard. However, the language is not nearly strong enough. Toddlers, which the standards define as children more than 16 months and less than two, should not be viewing any visual media. One of teachers’ jobs is to support children to grow and learn, and screens have no part in that for children under two. Additionally, we think there needs to be stronger language to protect two year olds and preschoolers because two hours a day at school is far too much time on screens. My recommendation would be to limit children two and older to no more than 30 minutes per day. We would also urge the drafters to add language mandating the documentation and sharing with families details of all media use with the time and a description of the content used. Visual media is a beautiful thing when used helpfully but children should not be babysat by screens in our early childhood programs. 

The State Sponsored Orientation Training that is teaching inaccurate information, costing thousands of dollars a year, and wasting the time of educators continues in the new draft standards 

I have been advocating for replacing the training, 8VAC20-781-140 A, or removing this requirement for over a year. This training was put in place to meet the requirements of the Federal Child Care and Development Fund but it was created by Pennsylvania and does not reflect actually Virginia standards. Additionally it collects and inappropriate amount of personal information about educators who are mandated to take it. Lastly it contains significant amounts of superfluous information that is irrelevant to teachers without administrative responsibilities. 

This is an opportunity to change this. We believe the training Virginia uses for directors outlined in 8VAC20-781-140 D. would meet the qualifications of the federal requirements ( https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-98/subpart-E/section-98.41#p-98.41(a)(1)(i)). We recommend all staff take the training outlined in D and item A is removed. Getting a new course would also be a possible solution to this concern but given that we already have a training it would be ideal to use what we have. This is a very high priority for our organization and below is a detailed description of the problems of this training.

Replacing the term “injury” with the term “incident” will increase the burdensome paperwork, further restrict children’s healthy play, and create a lot of gray areas around what is required to be reported.

I don’t know exactly what the reasoning is for the change in language from injury to incident in 8VAC20-781-10. There are two big problems we see: over communication would likely lead to exhaustion and desensitization, and because of the broad language nearly everything could be construed as an incident. We think a tighter definition would be “an event in which a child is injured or a situation in which a standard of care defined by these regulations was unmet and injury is likely to occur” or “an event in which a child is injured or in a situation where injury could possibly appear later”. No one likes to admit it, but injuries and accidents are a big part of early childhood and tightly regulating them leads to teachers tightly regulating children’s play. Early childhood research shows us time and again that children need risky play to learn and bumps, scratches, scrapes, and bruises are a normal part of the learning process. Expanding the definition of injury this way is moving us away from creating healthy learning environments.

New requirements of specifically liquid soap is challenging for some children with sensory needs and not suitable for all environments.

8VAC20-781-490 A and six other standards have changed from simply requiring soap to specifically requiring liquid soap. We have found no research that liquid soap is superior to bar soap. Liquid soap is not required by the Federal Child Care and Development Fund. 

At our center, we have primarily liquid soap, but we do have a child with sensory needs who uses bar soap and it works well for them. Additionally, we use foaming soap, and it is unclear if this standard would allow foaming soap or not. We also use bar soap outside because liquid soap doesn’t hold up well in the temperature changes. We spend a lot of time outside and regularly wash our hands outside with bar soap. We advocate that the standards simply require soap because people can select the kind of soap appropriate for their context.

We have an opportunity to include Naloxone (Narcan) as an allowable stock medication.

While the new standards allow for the use of stock epinephrine, they miss an opportunity to allow for the use of Narcan (Naloxone) which is a lifesaving medication. We could be forward thinking and protect children’s lives by authorizing trained teachers to have and administer Naloxone in the event an individual is overdosing. Naloxone administration was recently added to the American Heart Association CPR and First Aid training which many early childhood educators receive. Naloxone should be present on site and on field trips in the event a child ingests an opioid. 

Requiring an annual review of all required policies is a significant burden over the current standards review of only emergency policies annually. 

New draft language - 8VAC20-781-40 B. “The center shall annually review all policies and procedures required by this section and shall document on the policy and procedure the date of such review.”

Currently only injury prevention and the emergency preparedness plan must be reviewed. While generally reviewing policies isn't a huge burden, the list has gone from 2 to 21 policies, including policies that are highly unlikely to change such as confidentiality, swimming, drinking water, transportation, records, and behavior guidance. Those kinds of policies are pretty much set and there is no need for review or document review. If we bought a bus, installed a swimming pool, changed our record keeping methods, or changed our school water source we would update those policies but that seems highly unlikely to change year to year. It's a regulatory burden to add to the already difficult to maintain intensive paperwork requirements when we could otherwise be focused on working with children, teachers, and families. Then C and D go on to require that notification of and training on policy changes occur, which makes more work to do and document.

I think it would be preferable to do one of the following, in order of preference:

1. Require review every five years

2. Not require documentation of review or simplify it so that it could be a single policy review checklist rather than updating each policy with a review date

3. Require review of only what is likely to need attention - injury report review

New reporting occasions when a child is unattended or unsupervised are somewhat unclear and burdensome.

Overall, we think reporting and tracking incidents is good. Two new regulations caught my attention. We think 8VAC20-781-410 B 4 is sufficient and 8VAC20-781-80 C 4 is unnecessary. We think 8VAC20-781-80 C 4 is also unclear, which dramatically increases its burden as well. We would really like to see 8VAC20-781-80 C 4 removed completely or at the very least clarified as to the details of when or how long would justify a report.

The requirement of TB screening before employment is a significant barrier to timely onboarding of new team members.

If part of the purpose of this review is to address current and relevant child care challenges , 8VAC20-781-90 D 1, which requires TB prior to the staff member’s date of employment, is a significant challenge for our program. This is a current requirement, but a change from previous versions of the standards. It creates a problem getting people in to start orientation when it could easily be the old standard which was within 15 days of employment or something narrowly safety focused, such as“prior to working with children”. Even requiring it before working with children doesn't make sense, because we do not have active TB problems in the United States and TB screening isn't required for volunteers.

Not allowing child care programs to have reptiles causes children to unnecessarily miss out on learning opportunities.

Our school has a box turtle and we have over the years had other reptiles, all of which would have not been possible with the new regulation 8VAC20-781-660 C. Mushu, a bearded dragon, was particularly a favorite reptile of many children because they could feed him, watch him eat, and see his colors change under stress.  Classroom pets are great opportunities for learning, and unlike mammals, reptiles tend to be less stressed by the classroom environment. The children learned about animals but also built relationships with all our class pets.

The term human milk is the most inclusive terminology.

This is a prime time to make a needed language update. We advocate for each instance of breast milk to be changed to the more accurate and inclusive term human milk. 

Virginia could safely allow infants on floor beds.

8VAC20-781-440 J. requires cribs for children under 12 months. While cribs are fine, some other states allow child care facilities utilizing the practice of a documented educational philosophy including least restrictive environment for infants to use floor beds that meet the other safety standards for cribs, and we think Virginia could do the same safely simply by adding, “Except when a family has an education philosophy including least restrictive environments for infants, a crib mattress may be placed on the floor, provided the all other requirements appropriate to cribs are met until the child reaches 12 months of age.” A clause requiring parental consent could be added if desired. 

Additional suggestions and appreciation in a separate comment due to word limit.