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

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NOTICES OF PROPOSED RULES DAR File No. 35578(6) The provider shall ensure that each child's healthassessment is reviewed, updated, and signed or initialed by theparent at least annually.R430-100-15. Child Nutrition.(1) If food service is provided:(a) The provider shall ensure that the center's mealservice complies with local health department food serviceregulations.(b) Foods served by centers not currently participatingand in good standing with the USDA Child and Adult Care FoodProgram (CACFP) shall comply with the nutritional requirements ofthe CACFP. The licensee shall either use standard Departmentapprovedmenus, menus provided by the CACFP, or menusapproved by a registered dietician. Dietitian approval shall be notedand dated on the menus, and shall be current within the past 5 years.(c) Centers not currently participating and in goodstanding with the CACFP shall keep a six week record of foodsserved at each meal or snack.(d) The provider shall post the current week's menu forparent review.(2) The provider shall offer meals or snacks at least onceevery three hours.(3) The provider shall serve children's food on dishes,napkins, or sanitary high chair trays, except for individual servingsize items, such as crackers, if they are placed directly in thechildren's hands. The provider shall not place food on a bare table.(4) The provider shall [post a list of children's foodallergies and sensitivities in the food preparation area, and shall ]ensure that caregivers who serve food to children are aware of [thisinformation]food allergies and sensitivities for the children in theirassigned group, and that children are not served the food or drinkthey have an allergy or sensitivity to.(5) The provider shall ensure that food and drink broughtin by parents for an individual child's use is labeled with the child'sname, and refrigerated if needed, and shall ensure that the food ordrink is only consumed by that child.R430-100-16. Infection Control.(1) Staff shall wash their hands thoroughly with liquidsoap and warm running water at the following times:(a) before handling or preparing food or bottles;(b) before and after eating meals and snacks or feedingchildren;(c) before and after diapering a child;(d) after using the toilet or helping a child use the toilet;(e) before administering medication;(f) after coming into contact with body fluids, includingbreast milk;(g) after playing with or handling animals;(h) when coming in from outdoors; and(i) after cleaning or taking out garbage.(2) The provider shall ensure that children wash theirhands thoroughly with liquid soap and warm running water at thefollowing times:(a) before and after eating meals and snacks;(b) after using the toilet;(c) after coming into contact with body fluids;(d) after playing with animals; and(e) when coming in from outdoors.(3) Only single use towels from a covered dispenser or anelectric hand-drying device may be used to dry hands.(4) The provider shall ensure that toilet paper isaccessible to children, and that it is kept on a dispenser.(5) The provider shall post handwashing procedures[at]that are readily visible from each handwashing sink, and theyshall 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 30 days of hire by an acceptableskin 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 center.[(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 center; and(b) shall be placed in a leakproof container, labeled withthe child's name, and returned to the parent.[(17)](14) If the center uses a potty chair, the providershall clean and sanitize the chair after each use.[(18)](15) Staff who prepare food in the kitchen shall notchange diapers or assist in toileting children.[(19)](16) The center 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.92 UTAH STATE BULLETIN, January 15, 2012, Vol. 2012, No. 2
DAR File No. 35578NOTICES OF PROPOSED RULES[(20)](17) The center shall not care for children who areill with an infectious disease, except when a child shows signs ofillness after arriving at the center.[(21)](18) The provider shall separate children whodevelop signs of an infectious disease after arriving at the centerfrom the other children in a safe, supervised location.[(22)](19) The provider shall contact the parents ofchildren who are ill with an infectious disease and ask them toimmediately pick up their child. If the provider cannot reach theparent, the provider shall contact the individuals listed asemergency contacts for the child and ask them to pick up the child.[(23)](20) 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.[(24)](21) The provider shall post a parent notice at thecenter 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.R430-100-17. Medications.(1) If medications are given, they shall be administered tochildren only by a provider trained in the administration ofmedications as specified in this rule.(2) All over-the-counter medications provided by parentsand all prescription medications shall:(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 center 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 orperson picking up the child signs upon 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;(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 centerfor children who are no longer enrolled.]R430-100-18. Napping.(1) The center shall provide children with a dailyopportunity for rest or sleep in an environment that providessubdued lighting, a low noise level, and freedom from distractions.(2) Scheduled nap times shall not exceed two hours daily.(3) A separate crib, cot, mat, or other sleeping equipmentshall be used for each child during nap times.(4) Mats and mattresses used for napping shall [be atleast 2 inches thick and shall ]have a smooth, waterproof surface.(5) The provider shall maintain sleeping equipment ingood repair.(6) If sleeping equipment is clearly assigned to and usedby an individual child, the provider must clean and sanitize it asneeded, but at least weekly.(7) If sleeping equipment is not clearly assigned to andused by an individual child, the provider must clean and sanitize itprior to each use.(8) The provider must either store sleeping equipment sothat the surfaces children sleep on do not touch each other, or elseclean and sanitize sleeping equipment prior to each use.(9) A sheet and blanket or acceptable alternative shall beused by each child during nap time. These items shall be:(a) clearly assigned to one child;(b) stored separately from other children's when not inuse; and,(c) laundered as needed, but at least once a week, andprior to use by another child.(10) The provider shall space cribs, cots, and mats aminimum of 2 feet apart when in use, to allow for adequateventilation, easy access, and ease of exiting.(11) Cots and mats may not block exits.UTAH STATE BULLETIN, January 15, 2012, Vol. 2012, No. 2 93
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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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Page 48 and 49: NOTICES OF PROPOSED RULES DAR File
Page 112 and 113: NOTICES OF 120-DAY (EMERGENCY) RULE
Page 118 and 119: FIVE-YEAR NOTICES OF REVIEW AND STA
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FIVE-YEAR NOTICES OF REVIEW AND STA
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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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