Each child who has a nap or rest period shall be provided with an individual bed, cot, sleeping bag, 2 inch thick mat, crib or playpen which is placed at least 2 feet from the next sleeping child. Cribs or cots 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 cribs and cots.
Each child shall be provided with an individually identified sheet and blanket or sleeping bag which 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 at least after every 5 uses.
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.
Each meal and snack served shall meet the U.S. department of agriculture child care food program minimum meal requirements.
DCF 251.07 Note
Note: See Appendices B and C for information on the U.S. department of agriculture child and adult care food program minimum meal requirements.
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.
Enough food shall be prepared for each meal so that second portions of vegetables or fruit, bread and milk are available to children.
When food for a child is provided by the child's parent, the center shall provide parents with information about requirements for food groups and quantities specified by the U.S. department of agriculture child care food program minimum meal requirements.
DCF 251.07 Note
Note: See Appendix B and C for information on the U.S. department of agriculture child 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.
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.
Any injury to a child or evidence of unusual bruises, contusions, lacerations or burns received by a child in or out of center care shall be recorded in a medical log book and reported immediately to the administrator or other person in charge of the center.
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 space used by other children by a partition, screen or other means.
(c) Ill child procedure.
The following procedures shall apply when a child with an illness or condition, such as vomiting or diarrhea, having the potential to affect the health of other persons is observed in the child care center:
The child in the isolation area shall be provided with a bed, crib or cot and a sheet and blanket or sleeping bag, with a staff member within sight and hearing of the child, except that for sessions of up to 4 hours a kindergarten mat may be provided for the isolation room instead of a bed, crib or cot. Isolation shall be used until the child can be removed from the center.
The child's parent, or a designated responsible person when a parent cannot be reached, shall be contacted as soon as possible after the illness is discovered, and arrangements shall be made for removal of the child 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.
A child with a reportable communicable disease specified in ch. DHS 145
may not be admitted to or be permitted to remain in a child care center during the period when the disease is communicable.
When it is determined that a person in contact with children or a child enrolled in a child care center has a reportable communicable disease under ch. DHS 145
, such as German measles, infectious hepatitis, measles, mumps, or meningitis, the local public health officer, the department and the parents of exposed children shall be notified.
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.
A written record, including type of medication given, dosage, time, date and the name or initials of the person administering the medication, shall be made in the center medical log book on the same day that the medication is administered.
Sunscreen and insect repellent may only be applied upon the written authorization of the parent. The authorization shall include the ingredient strength of the sunscreen or repellent. Authorizations shall be reviewed every 6 months and updated as necessary. If sunscreen or insect repellent is provided by the parent, the sunscreen or repellent shall be labeled with the child's name. The recording of the application of sunscreen or insect repellent is not necessary.
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. Whoever does the wiping shall wash his or her hands immediately.
Bodily secretions on surfaces shall be washed with soap and water and disinfected with a bleach solution of one tablespoon bleach to one quart of water, made fresh daily. Hands shall be washed immediately.
Children shall be protected from sunburn with protective clothing, if not protected by sunscreen.
Center staff shall adopt universal precautions when exposed to blood and blood-containing body fluids and injury discharges of all children.
All persons exposed to blood or blood-containing body fluids and tissue discharges shall wash their hands immediately with soap and warm running water.
Single use disposable gloves shall be worn if there is contact with blood-containing body fluids or tissue discharges. Hands shall be washed with soap and water after removal of gloves. Gloves shall be discarded in plastic bags.
For spills of vomitus, urine, feces, blood or other body fluids, center staff shall clean and disinfect the floors, walls, bathrooms, tabletops, toys, kitchen countertops and diaper changing tables.
A child's hands shall be washed with soap and warm running water before meals and snacks and after toileting or diapering. A child's hands and face shall be washed after meals.
Persons working with children shall wash their hands with soap and warm running water before handling food, and after assisting with toileting and after wiping bodily secretions from a child with a disposable tissue.
Cups, eating utensils, toothbrushes, combs and towels may not be shared and shall be kept in a sanitary condition.
Wet or soiled clothing and diapers shall be changed promptly from an available supply of clean clothing.
Applicable rules under s. DCF 251.09 (4)
shall apply to child care workers when children 2 years of age and older require attention for diapering and toileting.
If running water is not immediately available when outdoors or on field trips, soap and water-based wet wipes may be used. When running water becomes available, hands must be washed immediately with soap and running water.
Disinfecting hand sanitizers may not replace the use of soap and water when washing hands.
Written permission from the parent to call a child's physician or refer the child for medical care in case of injury shall be on file at the center. The center shall contact the parent as soon as possible after an emergency has occurred or, if the injury is minor, when the parent picks up the child.
A center shall identify a planned source of emergency medical care, such as a hospital emergency room, clinic or other constantly staffed facility, and shall advise parents about the designated emergency medical facility.
A center shall establish and follow written procedures for bringing a child to an emergency medical care facility and for treatment of minor injuries.