Utah State Bulletin, January 15, 2012, Vol. 2012, No. 2

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NOTICES OF PROPOSED RULES DAR File No. 35576(5) The provider shall post handwashing procedures ineach bathroom, and they shall be followed.(6) Caregivers shall teach children proper hand washingtechniques and shall oversee hand washing whenever possible.(7) Personal hygiene items such as toothbrushes, orcombs and hair accessories that are not sanitized between each use,shall not be shared by children or used by staff on more than onechild, and shall be stored so that they do not touch each other.(8) The provider shall clean and sanitize all washabletoys and materials weekly, or more often if necessary.(9) Stuffed animals, cloth dolls, and dress-up clothesmust be machine washable. Pillows must be machine washable, orhave removable covers that are machine washable. The providershall wash stuffed animals, cloth dolls, dress-up clothes, and pillowsor covers weekly.(10) If water play tables or tubs are used, they shall bewashed and sanitized daily, and children shall wash their handsprior to engaging in the activity.[(11) The licensee shall ensure that all employees aretested for tuberculosis (TB) within thirty days of hire by anacceptable skin testing method and follow-up.(12) If the TB test is positive, the caregiver shall providedocumentation from a health care provider detailing:(a) the reason for the positive reaction;(b) whether or not the person is contagious; and(c) if needed, how the person is being treated.(13)](11) Persons with contagious TB shall not work orvolunteer in the program.[(14) An employee having a medical condition whichcontra-indicates a TB test must provide documentation from ahealth care provider indicating they are exempt from testing, withan associated time frame, if applicable. The provider shall maintainthis documentation in the employee's file.(15)](12) Children's clothing shall be changed promptly ifthey have a toileting accident.[(16)](13) Children's clothing which is wet or soiled frombody fluids:(a) shall not be rinsed or washed at the facility; and(b) shall be placed in a leakproof container, labeled withthe child's name, and returned to the parent.[(17)](14) The facility shall have a portable body fluidclean up kit.(a) All staff shall know the location of the kit and how touse it.(b) The provider shall use the kit to clean up spills ofbody fluids.(c) The provider shall restock the kit as needed.[(18)](15) The program shall not care for children whoare ill with a suspected infectious disease, except when a childshows signs of illness after arriving at the facility.[(19)](16) The provider shall separate children whodevelop signs of a suspected infectious disease after arriving at thefacility from the other children in a safe, supervised location.[(20)](17) The provider shall contact the parents ofchildren who are ill with a suspected infectious disease and askthem to immediately pick up their child. If the provider cannotreach the parent, the provider shall contact the individuals listed asemergency contacts for the child and ask them to pick up the child.[(21)](18) The provider shall notify the local healthdepartment, on the day of discovery, of any reportable infectiousdiseases among children or caregivers, or any sudden orextraordinary occurrence of a serious or unusual illness, as requiredby the local health department.[(22)](19) The provider shall post a parent notice at thefacility when any staff or child has an infectious disease or parasite.(a) The provider shall post the notice in a conspicuouslocation where it can be seen by all parents.(b) The provider shall post and date the notice the sameday the disease or parasite is discovered, and the notice shall remainposted for at least 5 days.R430-70-17. Medications.(1) If medications are given, they shall be administered tochildren only by a provider trained in the administration ofmedications.(2) All over-the-counter and prescription medicationsshall:(a) be labeled with the child's full name;(b) be kept in the original or pharmacy container;(c) have the original label; and,(d) have child-safety caps.(3) All non-refrigerated medications shall be inaccessibleto children and stored in a container or area that is locked, such as alocked room, cupboard, drawer, or a lockbox. The provider shallstore all refrigerated medications in a leakproof container.(4) The provider shall have a written medicationpermission form completed and signed by the parent prior toadministering any over-the-counter or prescription medication to achild. The permission form must include:(a) the name of the child;[(a)](b) the name of the medication;[(b)](c) written instructions for administration; including:(i) the dosage;(ii) the method of administration;(iii) the times and dates to be administered; and(iv) the disease or condition being treated; and[(c)](d) the parent signature and the date signed.(5) If the provider keeps over-the-counter medication atthe facility that is not brought in by a parent for their child's use, themedication shall not be administered to any child without priorparental consent for each instance it is given. The consent must beeither:(a) prior written consent; or(b) oral consent for which a provider documents inwriting the date and time of the consent, and which the parent signsupon picking up the child.(6) If the provider chooses not to administer medicationas instructed by the parent, the provider shall notify the parent oftheir refusal to administer the medication prior to the time themedication needs to be given.(7) When administering medication, the provideradministering the medication shall:(a) wash their hands;(b) check the medication label to confirm the child'sname;76 UTAH STATE BULLETIN, January 15, 2012, Vol. 2012, No. 2
DAR File No. 35576NOTICES OF PROPOSED RULES(c) compare the instructions on the parent release formwith the directions on the prescription label or product package toensure that a child is not given a dosage larger than thatrecommended by the health care provider or the manufacturer;(d) administer the medication; and(e) immediately record the following information:(i) the date, time, and dosage of the medication given;(ii) the signature or initials of the provider whoadministered the medication; and,(iii) any errors in administration or adverse reactions.(8) The provider shall report any adverse reaction to amedication or error in administration to the parent immediatelyupon recognizing the error or reaction, or after notifying emergencypersonnel if the reaction is life threatening.[ (9) The provider shall not keep medications at the facilityfor children who are no longer enrolled.]KEY: child care facilities, child care, child care centersDate of Enactment or Last Substantive Amendment: [January1, 2010]2012Authorizing, Implemented, or Interpreted Law: Title 26,Chapter 39Health, Family Health andPreparedness, Child Care LicensingR430-90Licensed Family Child CareNOTICE OF PROPOSED RULE(Amendment)DAR FILE NO.: 35577FILED: 12/23/2011RULE ANALYSISPURPOSE OF THE RULE OR REASON FOR THECHANGE: As part of the Department's rule review requestedby the Governor's Office, the Department concluded thatsome portions of this rule may exceed the Department'srulemaking authority, and are therefore being eliminated.SUMMARY OF THE RULE OR CHANGE: The proposedchange removes requirements for tuberculosis (TB) testing ofstaff, and makes other minor modifications. The proposal toeliminate staff TB testing is based on a recommendation fromthe state's TB Advisory Board which indicated that child careproviders are not considered to be a high risk group fortuberculosis.STATUTORY OR CONSTITUTIONAL AUTHORIZATION FORTHIS RULE: Title 26, Chapter 39ANTICIPATED COST OR SAVINGS TO:♦ THE STATE BUDGET: No state agencies operate in-homechild care programs so there are no anticipated costs orsavings to state budgets associated with this rule change.♦ LOCAL GOVERNMENTS: No local governments operatein-home child care programs so there are no anticipatedcosts or savings to local government associated with this rulechange.♦ SMALL BUSINESSES: Almost all in-home child careprograms are small businesses. However the cost of TBtesting is usually born by the individual rather than thebusiness, so the agency does not anticipate any cost orsavings as a result of this change.♦ PERSONS OTHER THAN SMALL BUSINESSES,BUSINESSES, OR LOCAL GOVERNMENTAL ENTITIES:Because the cost of TB testing is usually born by theindividual rather than the business, the agency does notanticipate any cost or savings as a result of this change.COMPLIANCE COSTS FOR AFFECTED PERSONS: TBtesting costs are born by the individual being tested.Because this rule removes the requirements for individual TBtesting, there will be some cost savings to individuals who nolonger need this test. Depending on where the test iscompleted, costs per test could range from $20 to $100. Inthose rare instances where follow-up x-rays are required,costs could range from $100 to several thousand dollars,depending on where the x-ray is done and what follow-up isrequired as a result of the x-ray.COMMENTS BY THE DEPARTMENT HEAD ON THEFISCAL IMPACT THE RULE MAY HAVE ON BUSINESSES:A careful and thorough review of child care licensing ruleswas undertaken during the last year. Health careprofessionals recommended that testing of staff fortuberculosis was not necessary. Removal of this requirementwill save business both time and money. Other changesshould also reduce regulatory burdens.THE FULL TEXT OF THIS RULE MAY BE INSPECTED,DURING REGULAR BUSINESS HOURS, AT:HEALTHFAMILY HEALTH AND PREPAREDNESS,CHILD CARE LICENSINGCANNON HEALTH BLDG288 N 1460 WSALT LAKE CITY, UT 84116-3231or at the Division of Administrative Rules.DIRECT QUESTIONS REGARDING THIS RULE TO:♦ Teresa Whiting by phone at 801-538-6320, by FAX at 801-538-6325, or by Internet E-mail at twhiting@utah.govINTERESTED PERSONS MAY PRESENT THEIR VIEWS ONTHIS RULE BY SUBMITTING WRITTEN COMMENTS NOLATER THAN AT 5:00 PM ON 02/14/2012THIS RULE MAY BECOME EFFECTIVE ON: 03/01/2012AUTHORIZED BY: David Patton, PhD, Executive DirectorUTAH STATE BULLETIN, January 15, 2012, Vol. 2012, No. 2 77
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UTAH STATEBULLETINOFFICIAL NOTICES
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TABLE OF CONTENTSTax CommissionAdmi
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SPECIAL NOTICESHealthHealth Care Fi
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DAR File No. 35613NOTICES OF PROPOS
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NOTICES OF PROPOSED RULES DAR File
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FIVE-YEAR NOTICES OF REVIEW AND STA
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NOTICES OFRULE EFFECTIVE DATESState
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2012 RULES INDEXBY AGENCY (CODE NUM
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RULES INDEXKEYWORDAGENCYFILENUMBERC
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2011 COMPLETE RULES INDEXBY AGENCY
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RULES INDEXAnimal IndustryR58-1 Adm
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RULES INDEXR151-3 Americans With Di
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RULES INDEXR162-2c-204 License Rene
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RULES INDEXR277-115 Copyrighting Ma
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RULES INDEXRehabilitationR280-204 U
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RULES INDEXR315-17 End of Life Auto
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RULES INDEXWomen, Infants and Child
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RULES INDEXR414-3A-2 Definitions 35
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RULES INDEXR432-950 Mammography Qua
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RULES INDEXR590-172-4 Rule 35006 AM
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RULES INDEXLIEUTENANT GOVERNORElect
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RULES INDEXR657-26 Adjudicative Pro
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RULES INDEXPUBLIC SERVICE COMMISSIO
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RULES INDEXR865-13G-17R865-14W-1R86
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RULES INDEXR909-19 Safety Regulatio
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RULES INDEXR986-700-714 CC Payment
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Utah State Bulletin, January 15, 2012, Vol. 2012, No. 2

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