441—120.8 (237A) Standards. Conditions in the home shall be safe, sanitary, and free of hazards. The provider shall certify that the child care home meets the following minimum standards.
	   120.8(1) Facility requirements.
	      a.    	 The home shall have a nonpay, working landline or mobile telephone with emergency numbers posted for police, fire, ambulance, and the poison information center. The number for each child’s parent, for a responsible person who can be reached when the parent cannot, and for the child’s physician shall be written on paper and readily accessible by the telephone. The home must prominently display all emergency information, and all travel vehicles must have a paper copy of emergency parent contact information.
	      b.    	 Electrical wiring shall be maintained, and all accessible electrical outlets shall be tamper-resistant outlets or shall be safely capped. Electrical cords shall be properly used. Improper use includes the running of cords under rugs, over hooks, or through door openings or other use that has been known to be hazardous.
	      c.    	 Combustible materials shall be kept a minimum of three feet away from furnaces, stoves, water heaters, and gas dryers.
	      d.    	 Approved safety gates at stairways and doors shall be provided and used as needed.
	      e.    	 Annual laboratory analysis of a private water supply shall be conducted to show satisfactory bacteriological quality. When children under the age of two are to be cared for, the analysis shall include a nitrate analysis. When private water supplies are determined unsuitable for drinking, commercially bottled water or water treated through a process approved by the health department or designee shall be provided.
	      f.    	 A safety barrier shall surround any heating stove or heating element, in order to prevent burns.
	      g.    	 The home shall have at least one 2A 10BC-rated fire extinguisher located in a visible and readily accessible place on each child-occupied floor.
	      h.    	 The home shall have at least one single-station, battery-operated, UL-approved smoke detector in each child-occupied room and at the top of every stairway. Each smoke detector shall be installed according to manufacturer’s recommendations. The provider shall test each smoke detector monthly and keep a record of testing for inspection purposes.
	      i.    	 Smoking and the use of tobacco products shall be prohibited at all times in the home and in every vehicle in which children receiving care in the home are transported. Smoking and the use of tobacco products shall be prohibited in the outdoor play area during the home’s hours of operation. “No smoking” signs shall be posted at every entrance of the child care home and in every vehicle used to transport children. All signs shall include:
	       (1)  	 The telephone number for reporting of complaints, and
	       (2)  	 The Internet address of the department of public health ( www.iowasmokefreeair.gov ).
	      j.    	 Homes served by private sewer systems shall be in compliance with discharge restrictions identified at 567—Chapter 69. Discharge of untreated waste water from private sewage disposal systems is prohibited. Compliance shall be verified by the local board of health at the time of renewal of the child care assistance provider agreement and new application.
	      k.    	 A provider operating in a facility built before 1960 shall assess and control lead hazards before being issued an initial child care assistance provider agreement or a renewal of the provider agreement. To comply with this requirement, the provider shall:
	       (1)  	 Conduct a visual assessment of the facility for lead hazards that exist in the form of chipping or peeling paint;
	       (2)  	 Apply interim controls on any chipping or peeling paint found, using lead-safe work methods in accordance with and as defined by department of public health rules at 641—Chapters 69 and 70, unless a certified inspector as defined in 641—Chapter 70 determines that the paint is not lead-based paint; and
	       (3)  	 Submit Form 470-4755, Lead Assessment and Control, as verification of the visual assessment and completion of interim controls, if necessary.
	      l.    	 The child care home shall be located in a single-family residence that is owned, rented, or leased by the provider.
	      m.    	 Any driver who transports children for any purpose shall have a valid driver’s license and adequate motor vehicle insurance that authorizes the driver to operate the type of vehicle being driven. Child restraint devices shall be utilized in compliance with Iowa Code section 321.446.
	      n.    	 Providers shall inform parents of the presence of any pet in the home.
	       (1)  	 Each dog or cat in the household shall undergo an annual health examination by a licensed veterinarian. Acceptable veterinary examinations shall be documented on Form 470-5153, Veterinary Health Certificate. This examination shall verify that the animal’s routine immunizations, particularly rabies, are current and that the animal shows no evidence of endoparasites (roundworms, hookworms, whipworms) and ectoparasites (fleas, mites, ticks, lice).
	       (2)  	 Each pet bird in the household shall be purchased from a dealer licensed by the Iowa department of agriculture and land stewardship and shall be examined by a veterinarian to verify that the bird is free of infectious diseases. Acceptable veterinary examinations shall be documented on Form 470-5153, Veterinary Health Certificate. Children shall not handle pet birds.
	       (3)  	 Aquariums shall be well maintained and installed in a manner that prevents children from accessing the water or pulling over a tank.
	       (4)  	 All animal waste shall be immediately removed from the children’s areas and properly disposed of. Children shall not perform any feeding or care of pets or cleanup of pet waste.
	       (5)  	 No animals shall be allowed in the food preparation, food storage, or serving areas during food preparation and serving times.
	      o.    	 Using an injury report form, the provider shall document all injuries that require first aid or medical care. The form shall be completed on the date of occurrence, shared with the parent, and maintained in the child’s file.
	   120.8(2) Use of outdoor space.
	      a.    	 A safe outdoor play area shall be maintained in good condition throughout the year. The play area shall be fenced off when located on a busy thoroughfare or near a hazard which may be injurious to a child and shall have both sunshine and shade areas. The play area shall be kept free from litter, rubbish, and flammable materials and shall be free from contamination by the drainage or ponding of sewage, household waste, or storm water.
	      b.    	 When there is a swimming or wading pool on the premises:
	       (1)  	 The wading pool shall be drained daily and shall be inaccessible to children when it is not in use.
	       (2)  	 An aboveground or in-ground swimming pool that is not fenced shall be covered whenever the pool is not in use. The cover shall meet or exceed the ASTM International (formerly known as the American Society for Testing and Materials) specification intended to reduce the risk of drowning by inhibiting access to the water by children under five years of age.
	       (3)  	 An uncovered aboveground swimming pool shall be enclosed with an approved fence that is nonclimbable and is at least four feet high.
	       (4)  	 An uncovered in-ground swimming pool shall be enclosed with an approved fence that is nonclimbable and is at least four feet high and flush with the ground.
	      c.    	 If children are allowed to use an aboveground or in-ground swimming pool:
	       (1)  	 Written permission from parents shall be available for review.
	       (2)  	 Equipment needed to rescue a child or adult shall be readily accessible.
	       (3)  	 The child care provider shall accompany the children and provide constant supervision while the children use the pool.
	       (4)  	 The child care provider shall complete training in cardiopulmonary resuscitation for infants, toddlers, and children, according to the criteria of the American Red Cross or the American Heart Association.
	   120.8(3) Medications and hazardous materials.
	      a.    	 All medicines and poisonous, toxic, or otherwise unsafe materials shall be secured from access by a child.
	      b.    	 A first-aid kit shall be available and easily accessible whenever children are in the child care home, in the outdoor play area, in vehicles used to transport children, and on field trips. The kit shall be sufficient to address first aid related to minor injury or trauma and shall be stored in an area inaccessible to children. The kit shall, at a minimum, include adhesive bandages, bottled water, disposable tweezers, and disposable plastic gloves.
	      c.    	 Medications shall be given only with the parent’s or doctor’s written authorization. Each prescribed medication shall be accompanied by a physician’s or pharmacist’s direction. Both nonprescription and prescription medications shall be in the original container with directions intact and labeled with the child’s name. All medications shall be stored properly and, when refrigeration is required, shall be stored in a separate, covered container so as to prevent contamination of food or other medications. All medications shall be stored so they are inaccessible to children. Any medication administered to a child shall be recorded, and the record shall indicate the name of the medication, the date and time of administration, and the amount administered.
	      d.    	 Medications shall not be provided to a child if the provider has not completed preservice/orientation training that includes medication administration.
	   120.8(4) Emergency plans. Emergency plans in case of man-made or natural disaster shall be written and posted by the primary and secondary exits. The plans shall clearly map building evacuation routes and tornado and flood shelter areas.
	      a.    	 Fire and tornado drills shall be practiced monthly, and the provider shall keep documentation evidencing compliance with monthly practice on file.
	      b.    	 The provider must have procedures in place for the following:
	       (1)  	 Evacuation to safely leave the facility.
	       (2)  	 Relocation to a common, safe location after evacuation.
	       (3)  	 Shelter-in-place to take immediate shelter where the child is when it is unsafe to leave that location due to the emergent issue.
	       (4)  	 Lockdown to protect children and providers from an external situation.
	       (5)  	 Communication and plans for reunification with families.
	       (6)  	 Continuity of operations.
	       (7)  	 To address the needs of individual children, including those with functional or access needs.
	   120.8(5) Safe sleep. The provider shall follow safe sleep practices as recommended by the American Academy of Pediatrics for infants under the age of one. Infant sleep shall conform to the following standards:
	      a.    	 Infants shall always be placed on their backs for sleep.
	      b.    	 Infants shall be placed on a firm mattress with a tight fitted sheet that meets U.S. Consumer Product Safety Commission federal standards.
	      c.    	 Infants shall not be allowed to sleep on a bed, sofa, air mattress or other soft surface. No child shall be allowed to sleep in any item not designed for sleeping including, but not limited to, an infant seat, car seat, swing, or bouncy seat.
	      d.    	 No toys, soft objects, stuffed animals, pillows, bumper pads, blankets, or loose bedding shall be allowed in the sleeping area with the infant.
	      e.    	 No co-sleeping shall be allowed.
	      f.    	 Sleeping infants shall be actively observed by sight and sound.
	      g.    	 If an alternate sleeping position is needed, a signed physician authorization with statement of medical reason is required.
	   120.8(6) Discipline. Discipline shall conform to the following standards:
	      a.    	 Corporal punishment, including spanking, shaking and slapping, shall not be used.
	      b.    	 Punishment that is humiliating or frightening or that causes pain or discomfort to the child shall not be used.
	      c.    	 Punishment shall not be administered because of a child’s illness, or progress or lack of progress in toilet training, nor shall punishment or threat of punishment be associated with food or rest.
	      d.    	 No child shall be subjected to verbal abuse, threats, or derogatory remarks about the child or the child’s family.
	      e.    	 Discipline shall be designed to help the child develop self-control, self-esteem, and respect for the rights of others.
	   120.8(7) Meals and snacks.
	      a.    	 Regular meals and snacks that are well-balanced and nourishing shall be provided.
	      b.    	 Children may bring food to the child care home for their own consumption but shall not be required to provide their own food.
	      c.    	 Clean, sanitary drinking water shall be readily available to children in indoor and outdoor areas, throughout the day.
[ARC 2648C, IAB 8/3/16, effective 10/1/16]