Child care workers shall permit a child who does not sleep after 30 minutes and a child who awakens to get up and to have quiet time through the use of equipment or activities which will not disturb other children.
Each child under one year of age who naps or sleeps shall be provided with a safe, washable crib or playpen that meets the applicable safety standards in 16 CFR Part 1219
and shall be placed at least 2 feet from the nearest sleeping child. Cribs or playpens may be placed end-to-end if a solid partition separates the crib or playpen and an aisle not less than 2 feet in width is maintained between sleeping surfaces.
Each child one year of age and older who has a nap or rest period shall be provided with a sleeping surface that is clean, safe, washable, and placed at least 2 feet from the nearest sleeping child. Sleeping surfaces may be placed end-to-end if a solid partition separates children and an aisle not less than 2 feet in width is maintained between sleeping surfaces. The sleeping surface shall be any of the following:
Each child one year of age and older not using a sleeping bag shall be provided with an individually identified sheet and blanket that may be used only by that child until it is washed.
Bedding shall be maintained and stored in a clean and sanitary manner, replaced immediately if wet or soiled, and washed after every 5 uses, at a minimum. A crib or playpen shall be washed and disinfected between changes in occupancy.
Center-provided transportation time shall be included in determining the amount of time children are present for the purposes of subd. 1.
Food shall be served at flexible intervals, but no child may go without nourishment for longer than 3 hours.
At a minimum, children shall be provided food for each meal and snack that meets the U.S. department of agriculture child and adult care food program minimum meal requirements for amounts and types of food.
Additional portions of vegetables, fruits, bread, and milk shall be available.
Be planned at least one week in advance, dated and kept on file for 3 months.
Any changes in a menu as planned shall be recorded on the copies of the menu kept on file and posted for parents.
When snacks are provided by parents for all children, a record of the snack served shall be posted in an area accessible to parents.
When food for a child is provided by the child's parent, the center shall provide the parent with information about requirements for food groups and quantities specified by the U.S. department of agriculture child and adult care food program minimum meal requirements.
A special diet based on a medical condition, excluding food allergies, but including nutrient concentrates and supplements, may be served only upon written instruction of a child's physician and upon request of the parent.
A special diet based on a food allergy may be served upon the written request of the parent.
Cooks, staff members, child care workers and substitutes having direct contact with the children shall be informed about food allergies and other allergies of specific children.
Except as provided in subd. 4.
, in a center where meals and snacks are served, seating and table space shall be at least equal to the licensed capacity of the center, excluding infants, so that all children can be served at the same time.
In a center where meals are served in a central lunchroom, seating and table space shall be at least equal to the number of children to be served in a shift.
Eating surfaces, including high chairs, shall be washed and sanitized before and after each use.
Each child upon arrival at a center shall be observed by a staff person for symptoms of illness and injury. For an apparently ill child, the procedure under par. (c)
shall be followed.
A center shall have an isolation area for the care of children who appear to be ill. If the area is not a separate room, it shall be separated from the space used by other children by a partition, screen, or other means to keep other children away from the ill child.
(c) Ill child procedure.
The following procedures shall apply when a child with an illness or condition that has the potential to affect the health of other persons, such as vomiting, diarrhea, unusual lethargy, or uncontrolled coughing, is observed in the child care center:
The child shall be isolated until the child can be removed from the center.
The child in the isolation area shall be within sight and sound supervision of a staff member.
The child shall be provided with a bed, crib, playpen, cot, or padded mat and a sheet and blanket or a sleeping bag.
The child's parent or emergency contact shall be contacted as soon as possible after the illness is discovered and arrangements shall be made for the child to be removed from the center.
(d) Care of a mildly ill child.
A child who is mildly ill may be cared for at the center when all of the following conditions are met:
The space for the care of a mildly ill child shall be a self-contained room and shall be separate from children who are well.
The written health policy of the center allows a mildly ill child to remain at the center.
The center follows and implements procedures in a written plan for the provision of care to mildly ill children approved and signed by a licensed physician, or a pediatric or family nurse practitioner which covers all of the following:
Medical consultation is available from a physician or local health department in establishing policy for the management of mildly ill children.
The licensee shall maintain a medical log book that has stitched binding with pages that are lined and numbered.
Pages may not be removed from the medical log book under subd. 1.
and lines may not be skipped. Each entry in the log book shall be in ink, dated, and signed or initialed by the person making the entry.
A child care worker shall record all of the following in the medical log under subd. 1.
Any evidence of unusual bruises, contusions, lacerations, or burns seen on a child, regardless of whether received while in the care of the center.
Any injuries received by a child while in the care of the center on the date the injury occurred. The record shall include the child's name, the date and time of the injury, and a brief description of the facts surrounding the injury.
Any medication dispensed to a child, on the date the medication is dispensed. The record shall include the name of the child, type of medication given, dosage, time, date, and the initials or signature of the person administering the medication.
Any incident or accident that occurs when the child is in the care of the center that results in professional medical evaluation.
DCF 251.07 Note
See s. DCF 250.04 (8)
for requirements related to reporting suspected child abuse or neglect.
The director or the director's designee shall review records of injuries with staff every 6 months to ensure that all possible preventive measures are being taken. The reviews shall be documented in the medical log book under subd. 1.
No child or other person with a reportable communicable disease specified in ch. DHS 145
may be admitted to or permitted to remain in a center during the period when the disease is communicable.
An employee, volunteer or a child may be readmitted to the group child care center if there is a statement from a physician that the condition is no longer contagious or if the person has been absent for a period of time equal to the longest usual incubation period for the disease as specified by the department.
DCF 251.07 Note
Note: The Wisconsin Department of Health Services, Division of Public Health, has developed materials that identify those communicable diseases that are required to be reported to the local public health officer. These materials also provide additional guidance on the symptoms of each disease and information on how long an infected child must be excluded from the center. The materials include a communicable disease chart and exclusion guidelines for child care centers. Copies of the communicable disease chart or the exclusion guidelines for child care centers are available from the Child Care Information Center at 800-362-7353.
Center staff may give prescription or non-prescription medication, such as pain relievers, teething gels or cough syrup, to a child only under the following conditions:
A written authorization that includes the child's name and birthdate, name of medication, administration instructions, medication intervals and length of the authorization dated and signed by the parent is on file. Blanket authorizations that exceed the length of time specified on the label are prohibited.
DCF 251.07 Note
The department's form, Authorization to Administer Medication — Child Care Centers, is used to obtain the parent's authorization to provide medications. Information on how to obtain the department's form is available on the department's website, http://dcf.wisconsin.gov
, or from any regional licensing office in Appendix A.
The medication is in the original container and labeled with the child's name and the label includes the dosage and directions for administration.
Medication shall be stored so that it is not accessible to the children.
Medication requiring refrigeration shall be kept in the refrigerator in a separate, covered container clearly labeled “medication".
All medication for a child in care shall be administered by the center as directed on the label and as authorized by the parent.
No medication intended for use by a child in the care of the center may be kept at the center without a current medication administration authorization from the parent.
Bodily secretions, such as runny noses, eye drainage, and coughed-up matter shall be wiped with a disposable tissue used once and placed in a plastic-lined container.
Surfaces exposed to bodily secretions including walls, floors, toys, equipment, and furnishings shall be washed with soap and water and disinfected. The disinfectant solution shall be registered with the U.S. environmental protection agency as a disinfectant and have instructions for use as a disinfectant on the label. The solution shall be prepared and applied as indicated on the label.
As appropriate, children shall be protected from sunburn and insect bites with protective clothing, sunscreen, or insect repellent. Sunscreen and insect repellent may only be applied upon the written authorization of the parent. The authorization shall include the ingredient strength and be reviewed and updated every 6 months. If sunscreen or insect repellent is provided by the parent, the sunscreen or repellent shall be labeled with the child's name. Recording the application of sunscreen or insect repellent is not necessary.
Children shall be clothed to ensure body warmth and comfort. Wet or soiled clothing shall be changed promptly from an available supply of clean clothing.
Center staff shall adopt and follow universal precautions when exposed to blood and blood-containing bodily fluids and injury discharges.
Single use disposable gloves shall be worn if there is contact with blood-containing bodily fluids or tissue discharges. Gloves shall be discarded in plastic bags.
A child's hands shall be washed with soap and warm running water before meals and snacks, after handling a pet or animal, and after toileting or diapering. A child's hands and face shall be washed when soiled. For children under one year of age, hands may be washed with soap and a wet fabric or paper washcloth that is used once and discarded.