Health Policy for Billie's Busy Kids, LLC

8/14/2019 Health Policy for Billie's Busy Kids, LLC

1/44Child Care Center-Revised 6/201

This document is a model Health Policy. It includes both WACitems and what Snohomish Health District considers to be bestpractice when caring for children.

To meet licensing reuirements a health policy must beindi!iduali"ed for each child care center. This documentcontains many sections mar#ed inredthat need to be filled inwith specific information rele!ant to your center. $a#e sure tota#e out any red words in parentheses or in italics that were putin to help you complete this document. Do not hesitate to addadditional points to reflect your center%s policies.

$a#e sure you read through the entire policy as you wor# on it.If any items are unclear or are in conflict with what you do atyour center& ma#e any necessary changes to reflect your owncenter%s practices. 'or e(ample& if you do not care for infants&ma#e sure to remo!e all sections from your plan that relate toinfants. Call the Communicable Disease )utreach program if

you ha!e uestions or need clarification on which items arereuired by WAC. The WACs can be found on the Departmentof *arly +earning%s website www.del.wa.go!.

)nce finali"ed& your health policy should reflect e(actly what isdone in your center. ,se your health policy to train all staff andto inform parents.

Note: The table of contents has been set up so that it can be easily updated. a!e all chan"esto the docu#ent. $hen you are finished% clic! once so#e&here in the #iddle of the table ofcontents &hich should select the entire table. Then ri"ht clic!% select 'update field( and then'update entire table.( The table of contents &ill auto#atically update itself.

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HEALTH POLICYRevised January 2013

Child Care 7ame= 3illie%s 3usy :ids Child Care and Preschool& ++CStreet= ->?22 S ?2

City1State1@ip= ranite 'alls& WA ?>2B2Telephone= 2B//222-222Animal Control= 2B>00


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#$%&E OF CO'#E'#(

I')U*+, EME*-E'C+ P*OCEDU*E(......................................................................................./

CO'#$C# O* E0PO(U*E #O %OD+ F&UID(...........................................................................1

I')U*+ P*E2E'#IO'..................................................................................................................1

MEDIC$#IO' M$'$-EME'#......................................................................................................3

PO&IC+ $'D P*OCEDU*E FO* E0C&UDI'- I&& C!I&D*E'..............................................45

COMMU'IC$%&E DI(E$(E *EPO*#I'-................................................................................46

!E$! *ECO*D(....................................................................................................................47

IMMU'I8$#IO'(.........................................................................................................................4/

!$'D9$(!I'-..........................................................................................................................41

#OO#!%*U(!I'-......................................................................................................................43

-E'E*$& C&E$'I'-: ($'I#I8I'-: $'D &$U'D*+.............................................................4;I'F$'# C$*E..............................................................................................................................


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INJURY/ EMERENCY PROCE!URE"

MINOR EMERENCIE"

Staff trained in first aid will refer to the PediatricPlus CP& A*D& and 'irst Aid for children&'amily and Adults located with the first aid supplies. lo!es will be used if any body fluids arepresent. Staff will refer to the child%s emergency form and call parents1guardians& emergencycontacts& or health care pro!ider as necessary.

Staff will record the incident on either theAccident eport or theIncident eportwhich are #eptin the forms folder in each classroom or in the office. These forms will include the date& time&place& and cause of the in4ury or illness& if #nown. A copy will be gi!en to the parent1guardian thesame day and another copy placed in the child%s file.

The incident will also be recorded on the Incident +og& which will be located in the office.

Incident +ogs will be re!iewed monthly by the Program super!isor1DirectorThe logs will bere!iewed for trends. Correcti!e action will be ta#en to pre!ent further in4ury or illness. All reports&including this log& are considered confidential.

LI#E$THREATENIN EMERENCIE"

)f #ore than one staff person is present: one staff person will stay with the in4ured1ill child andsend another staff person to call ?--. )f only one staff person is present: person will assess forbreathing and circulation& administer CP for one minute& if necessary& and then call ?--.

Staff will pro!ide first aid as needed according to the PediatricPlus CP& A*D& and 'irst Aid forchildren& 'amily and Adultslocated with the first aid supplies. lo!es will be worn if any bodyfluids are present.

A staff person will contact the parent1guardian8s9 or the child%s alternate emergency contactperson.

A staff person will stay with the in4ured1ill child& including transport to a hospital if necessary&until a parent& guardian& or emergency contact arri!es.

The incident will be recorded on either theAccident eport or theIncident eportand Incident+og as described in J$inor In4uriesK section.

Serious in4uries1illnesses& which reuire medical attention& will be reported to the licensorimmediately. A copy of the illness or in4ury form will be sent to the licensor no later than the dayafter the incident. A copy will be placed in the child%s file.

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#IR"T AI!

When children are in care& staff members with current training in CardioPulmonaryesuscitation 8CP9 and 'irst Aid are with each group or classroom. Documentation of stafftraining is #ept in personnel files.

'irst aid #its are inaccessible to children and located in e!ery classroom and in all !ans.

The first aid #its contain=

first aid guidesterile gau"e padssmall scissorsadhesi!e tape

3andAids8different si"es9

roller bandageslarge triangular bandageglo!es 87itrile or late(9

twee"ers for surface splintersCP mouth barrierdigital thermometer with slee!esblood cleanup #it

An une(pired bottle of Syrup of Ipecac will be storedin the office loc#ed with the medications.Syrup of Ipecac is administered only after calling Poison Control.

A fully stoc#ed first aid #it will be ta#en on all field trips andplayground trips and will be #ept ineach !ehicle used to transport children*. These tra!el first aid #its will also contain=

liuid soap and paper towels

water

instant hand saniti"er 8for staff use only9

chemical ice 8nonto(ic9

change for phone calls and1or cell phone +choose one or both*

an emergency dose of critical medication such as an *pipen& Er.or

asthma inhaler for those children who need it

All first aid #its will be chec#ed by the8title of assigned person9and restoc#ed 8how often9orsooner if necessary. The e(piration date for Syrup of Ipecac will also be chec#ed at this time.+,ecause yrup of )pecac #ay be unavailable at phar#acies-% epired yrup of )pecac is not arule violation- er letter of 3uly% 2004*

CONTACT OR E%PO"URE TO &O!Y #LUI!"

When staff reports blood contact or e(posure& the center will follow the 8name of center%sbloodborne pathogen e(posure control plan9and the current guidelines set by the WashingtonState Department of +abor and Industries.

The 8name of center%s bloodborne pathogen e(posure control plan9 is stored8where9.

INJURY PRE'ENTION

The child care site will be inspected at least 8uarterly& monthly9for ha"ards by the 8title ofassigned person9.

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Ha"ards include& but are not limited to=

safety ha"ards 8bro#en toys& euipment& drowning& cho#ing& sharp ob4ects& etc9

proper security of the center 8secure doors& proper super!ision& etc9

trip1fall ha"ards 8rugs& cords& uncontained toys& etc9

poisoning ha"ards 8plants& chemical storage& etc9

electrical ha"ards 8electrical cords& outlets& etc9

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Toys will be ageappropriate& safe& in good repair& and not bro#en. $irrors will be shatterproof.

Ha"ards or contamination will be reported immediately to the 8title of responsible person9. Thisperson will ensure that the ha"ard or contamination is remo!ed& made inaccessible& or repairedimmediately to pre!ent in4ury. Staff will re!iew their rooms daily and remo!e any bro#en ordamaged euipment& toys& etc.

Re#ove references to loose-fill #aterial if your play"round has rubber #ats. The playground willbe inspected daily before use for bro#en euipment& en!ironmental ha"ards& garbage& animalcontamination& areas of low surfacing material such as at the ends of slides and under swings&and other ha"ards by the 8title of assigned person9. +oosefill surfacing material will be ra#ed8wee#ly& daily9.

Playground euipment will be free from entrapments& entanglements& and protrusions and willbe chec#ed for these ha"ards 8how often= monthly or uarterly9by the 8title of assigned person9.This safety inspection is documented on a 8name of playground maintenance chec#list9& whichis #ept 8where9.

Proper super!ision will be maintained during all outdoor play. Staff will position themsel!es to

obser!e the entire play area.

The accident and in4ury log will be monitored by the 8title of assigned person9 at least 8howoften9to identify accident trends and implement a plan of correction.

ME!ICATION MANAEMENT

Choose one state#ent and delete the other:

8Prescription medications only9 $edications are pro!ided only to those children with a healthcare pro!ider%s prescription. If a child has a condition where the Americans with Disabilities Act8ADA9 applies& reasonable accommodations will be made and the child will be gi!en medication.

G ) G

8Prescription or o!erthecounter medications9$edications are pro!ided to any child with ahealth care pro!ider%s prescription or a medication consent form from the child%s parent1guardian

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When administering bul# medications& the method used to pre!ent contamination of the bul#container is 8describe method used G e(amples include suee"ing medication from bottle onto aclean paper towel for each child& or only sprayon sunscreens are used& or using clean glo!esfor each child& etc.9.

A!MINI"TRATION

$edications are administered by the 8title of indi!idual8s9 who will administer medications9.

)nly staff persons who ha!e been oriented to 8name of center9%s medication policies andprocedures can gi!e medications. Documentation of this training will be #ept 8where9.Thesepolicies are re!iewed with all staff members who administer medications 8how often9.

3efore a staff member may administer medications& parents will pro!ide instructions anddemonstrate the use of speciali"ed medication administration procedures 8for e(ample= how touse the nebuli"er or *piPen& children%s preferences for swallowing pills& how to deli!er eye

drops& etc9. This is documented 8where G medication administration form& indi!idual health plan&other9.

To gi!e liuid medication& staff use a measuring de!ice designed specifically for oral or liuidmedication. $easuring de!ices for indi!idual use are pro!ided by 8whom G parent& center9 andstored 8how9.

$edications are not mi(ed in formula or food unless there are written directions to do so from ahealth care pro!ider with prescripti!e authority before the medication is gi!en.

Staff administering medications will wash hands before preparing medications and after gi!ing

the medication. $edications are prepared on a clean surface away from toileting1diaperingareas.

Staff will carefully read labels on medications before each administration& noting=

child%s name

medication name

amount to be gi!en

time and dates to be gi!en

how long to gi!e

how to gi!e 8e.g. by mouth& to diaper area& in ear& etc9

Staff will ma#e sure information on the label is consistent with information on the 8name ofmedication authori"ation form9.

CHIL!REN TA+IN THEIR O,N ME!ICATION

Children may ta#e their own medication if the abo!e reuirements are met A7D=

There%s a written statement from the parent reuesting the child ta#e their own

medication.

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There%s a written statement from the health care pro!ider with prescripti!e authority

stating that the child is physically and mentally capable of ta#ing their own medication.

All storage criteria stated in this policy are met.

A staff member obser!es and documents that the child too# the medication.

!OCUMENTATION*ach time staff administer a medication& staff will document the necessary information on a8name of medication treatment formM can be the bac# of the center%s medication authori"ationform9. This written record will include=

child%s full name& date& time& name of medication& and amount gi!en 8indicate if self

administered9

the full signature of the staff person gi!ing each dose of medication or obser!ing the

child ta#ing the medication 8if staff initial after each administration& a fullcorresponding signature is needed on the form to !alidate the initials9

a written e(planation why a medication that should ha!e been gi!en was not gi!en

any obser!ations of the child in relation to the medication ta#en 8e(ample= side effects

or relief of symptoms9

when Jas neededK medications are administered& staff must document the symptoms

that prompted administration

Staff will report any side effects that occur to 8title of indi!idual9and to the parent immediately.This will be documented on the 8name of medication formM for e(ample& the bac# of themedication authori"ation form9.

'or children with special health needs& detailed instructions for medications or medicationdeli!ery de!ices& such as nebuli"ers& insulin pumps& or *piPens& will be documented on the

8program name9Indi!idual Plan of Care form.

$edication authori"ation and documentation forms are considered confidential and will bestored 8where9.

)utdated medication authori"ation1treatmentforms will be #ept in the child%s file while in careand are #ept up to one year after the child lea!es care.

The program implements the following system for trac#ing administration of controlledsubstances= 8escribe syste#:for e(ample& only - wee#%s worth of medication will be acceptedfrom the parent at a time. Pills will be counted at each administration. This will be documented

on 8name of medication count !erification form9.9

"TORAE

Children%s medication will be #ept 8where9. This is a location inaccessible to childrenM away fromsources of moisture& heat& and lightM away from foodM and protected from sources ofcontamination.

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Staff medication will be stored 8where9 inaccessible to children. Staff medications are clearlyidentified as such.

*(ternal medications that go on the s#in will be #ept as stated abo!e but also separate from oralor in4ectable medications.

All controlled substances will be #ept as stated abo!e and in a loc#ed container.

$edications reuiring refrigeration will be stored in a labeled container to #eep them separatedfrom food.

*piPens will be stored in an unloc#ed location& inaccessible to children& but easily accessible tostaff in an emergency. This location is 8whereM the same room as the child is recommended9.

!I"PO"AL)utdated medications or medications no longer being used will promptly be returned to parents

or guardians. If the parent1guardian is not a!ailable& the 8title of person9will call ->//


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open or oo"ing sores& unless properly co!ered and 2 hours ha!e passed since

starting treatment& if treatment is necessary

lice or nits 8for head lice& children and staff may return to child care once no nits are

!isible9

fatigue& irritability& or confusion that pre!ents participation in regular acti!ities& such as

sleeping or resting more than usual for that child& not wanting to eat& or multiple cold

symptoms that #eep the child from regular acti!ities LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL

LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL

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Temperatures are ta#en with a digital thermometer with singleuse disposable co!ers o!er thethermometer. )ral temperatures are ta#en on preschool through schoolage childrenM underarm 8a(illary9 temperatures are ta#en on all other children. 7o rectal nor ear temperatures areta#en.

Parents are notified in writing when their children ha!e been e(posed to infectious diseases orparasites1lice. The notification may consist of either a letter to parents which will be deli!ered by8how G placing in children%s cubbies& placing by the signin boo#& other9 and1or posting anotification for parents 8where9.

'ollowing an illness or in4ury& children will be readmitted to the program when=

they no longer ha!e the abo!e symptoms

they ha!e been without fe!er for 2 hours without being treated by an antipyretic such

as acetaminophen 8Tylenol9 or ibuprofen

2 hours ha!e passed since starting appropriate treatment

they no longer ha!e significant discomfort

the center has been ad!ised by a Public Health 7urse on communicable diseaseguidelines for child care

'ollowing surgery or in4ury reuiring medical care& a note from the physician stating that thechild may return to routine child care acti!ities and en!ironment may be reuired.

COMMUNICA&LE !I"EA"E REPORTIN

+icensed child care facilities are reuired to report communicable diseases to their local publichealth department 8WAC 20-/--B9. The following is a partial list of the official diseases that

must be reported. They were selected because they represent diseases that are most li#ely tobe found in child care settings. 'or a complete list of reportable diseases& call the SnohomishHealth District. Children and staff who ha!e a reportable disease may not be in attendance atthe center unless appro!ed by the local health department.

The following communicable diseases will be reported to the Snohomish Health Districtat2B


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Animal bitesCampylobacteriosis 8Campy9CryptosporidiosisCyclosporiasisDiphtheria*nterohemorrhagic *. Coli& including *. Coli

/-B=H

'ood or waterborne illnessiardiasisHaemophilus Influen"a Type 3 8HI39Hepatitis A 8acute infection9Hepatitis 3 8acute and chronic infection9Hepatitis C 8acute and chronic infection9Influen"a 8if more than -/ of children and staff

are out ill9

+isteriosis$easles 8rubeola9$eningococcal disease$umpsPertussis 8Whooping cough9Polioubella

SalmonellosisShigellosisTetanusTuberculosis 8T39Qersiniosis

Should a child at the center become ill and e(pose others to any of the abo!e mentioneddiseases& parents and legal guardians will be notified in the following manner8escribe #ethodof co##unication& including time line for notification of parents& method of contact& use of health

department for further uestions9. +etter written by the Snohomish Health District

This will be the responsibility of the 8title of responsible person9.

*!en though a disease may not reuire a report& the child care will consult with theCommunicable Disease )utreach programat theSnohomish Health Districtat2B


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Teachers& !olunteers& coo#s& and bus dri!ers 8or others9will be oriented to any special needs ordiet restrictions before the child first enters the program. Plans for children with special needswill be documented and staff will be oriented to the Indi!iduali"ed Care Plan for that child.

The abo!e information will be updated annually or sooner if changes are brought to the attentionof a staff person.

IMMUNI-ATION"

To protect all children and the staff& and to meet state health reuirements& the center onlyaccepts children fully immuni"ed for their age. The Certificate of Immuni"ation Status 8CIS9 foreach child is #ept on file to show the Department of Health and the Department of *arly+earning 8D*+9 that the center is in compliance with licensing standards.

A completed CIS form is collected upon enrollment in the following manner= 8escribe #ethodof initially collectin" i##uni8ation infor#ation:the parent or staff may transfer the immuni"ationdates from the health care pro!ider%s immuni"ation record onto a CIS form. The parent mustsign the CIS form to !erify the information.93elow has been modified to address new C)* rules

Children may attend child care without an immuni"ation=

when the parent and eligious organi"ation signs the e(emption form stating they

ha!e eligious $embership *(emption & )

when the parent signs the e(emption form stating they ha!e

religious1personal1philosophical reasons for not obtaining specific immuni"ation8s9&A7D

the health care pro!ider signs that the parent has recei!ed a consult regarding ris#s of

not immuni"ing )

the parent and health care pro!ider signs that the child is medically e(empt

The CIS form is #ept 8where G child%s file& immuni"ations binder& other9and returned toparent1guardian when the child lea!es the program. A copy of indi!idual records& including theCIS& must be #ept for one year after the child lea!es.

The CIS records are re!iewed and updated 8how often9by the 8title of responsible person9.

Children may attend child care without an immuni"ation=

when the parent signs the e(emption form stating they ha!e personal& religious or

philosophical reasons for not obtaining specific immuni"ation8s9& )

the health care pro!ider signs that the child is medically e(empted

Children who ha!e been e(empt from immuni"ations will not be permitted to attend child careduring an outbrea# of an immuni"ation pre!entable disease for which they are not immuni"ed.This is for the unimmuni"ed child%s protection and to reduce the spread of the disease.

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In the #itchen& hands will be washed 8where G in the separate handwashing sin#& in thedesignated compartment of the twocompartment sin#& etc.9.

The use of hand saniti"ers 8is1is not9permitted at this facility. )f hand saniti8ers are used%describe ho& and &hen they are used by staff and include the follo&in" 9 sentences. The use ofhand saniti"er is 7)T a replacement for handwashing. Hand saniti"ers are not used on

children. Instructions for the proper use of hand saniti"ers are posted in the classrooms.

TOOTH&RU"HIN

This section is optional. elete if the center does not have a toothbrushin" pro"ra#.

Toothbrushing is done in the 8list the classrooms that do toothbrushing9 8how often9.

Toothbrushing will be super!ised to ensure=

the establishment of a routine which enhances learning

that children under the age of si( use no more than a pea si"e amount of fluoridetoothpaste

proper toothbrushing techniue

that toothbrushes are not shared and that they are handled properly

*ach child will ha!e his1her own toothbrush that will=

be stored properly to decrease cross contamination

o open to air with bristles up

o unable to drip on one another

o do not contact each other or any other thing

o toothbrush caps are not used be clearly mar#ed with the child%s name on the handle with a nonto(ic& permanent mar#er

ha!e soft& rounded nylon bristles and be si"ed appropriately for the child

be replaced twice each year when used less than twice a day& B days a wee#& or sooner if

the bristles become splayed or the toothbrush is contaminated

Teachers1child care staff will brush their own teeth to model the desired beha!ior. Staff trainingwill be pro!ided yearly on the etiology of tooth decay& oral health promotion& and toothbrushingprotocol.

Choose N option belo& +the sin! #ethod or the table #ethod*:

Children brush teeth at the sin#& located 8where9. The toothbrushing procedure at the sin# is=

A pitcher of water is obtained from a food preparation sin#.

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Teach the children to brush in a pattern and mo!e from area to area 8lefttoright& inside

and outside& toptobottom9 around the mouth. 'inish with the top of the teeth.

3rushing should continue for at least one minute. *(posure to fluoridated toothpaste is

effecti!e e!en with unsatisfactory brushing techniue.

Child spits e(cess toothpaste into the sin#.A stepping stool is pro!ided.

Child returns the toothbrush to the teacher who rinses it under the faucet 8or in child%s

own cup of water9and replaces it in the toothbrush rac#. After all the children ha!e brushed& the sin# is cleaned with the


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)f usin" a saniti8er other than bleach and &ater% include this para"raph. Saniti"ing means theremo!al of germs and bacteria to a le!el that will not cause illness. eneral saniti"ing is donewith 8name of saniti"ing solution9. The label for this product states that the product is safe forfood contact surfaces. 'loors& bathrooms& and diaper changing areas are saniti"ed with 8nameof saniti"ing solution9.The use of these saniti"er products was re!iewed by the 8local health

department G or G Department of *arly +earning9on 8date9. When using these products& thelabel directions are followed& including concentration& contact time& and rinsing.

)f usin" bleach and &ater as a saniti8in" solution% include the net para"raph and chart.Saniti"ing means the remo!al of germs and bacteria to a le!el that will not cause illness.Saniti"ing is done with a solution of bleach and water. The bleach used contains no scents orsurfactants. A minimum contact time of the saniti"er with the surface is - minute. After thislength of time& the saniti"er may be wiped off with paper towels or the surface may be allowed toair dry.

The following recipes will be used when ma#ing a saniti"ing solution=

A*A F,A7TITQ Amount of 3leach Amount of WaterDiapering area&bathroom& floors

Small - tablespoon - uart

+arge cup - gallon

'ood contactsurfaces& toys&sleeping mats&dishes& utensils&pots and pans

Small teaspoon - uart

+arge - teaspoon - gallon

Whene!er possible& the saniti"er solution is made in large uantity& di!ided into spray bottles&and labeled with the preparation date.

Cleaner and saniti"er spray bottles are labeled with contents.

The use of sponges is not permitted in the center.

CLEANIN "CHE!ULE

This center%s minimum schedule for general cleaning is=

Tables& highchairs& and counters used for food ser!ice will be cleaned and saniti"ed

before and after each meal or snac#.

3athrooms will be cleaned and saniti"ed daily. This includes sin#s& toilets& counters&

and floors. Toilet seats will be cleaned and saniti"ed throughout the day and asneeded.

Re#ove the follo&in" infor#ation on potty chairs if you do not use the# at the center:

Pottychairs will be immediately emptied into toilet& washed& and saniti"ed in a

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designated sin# or utility sin# separate from classrooms. This designated sin# islocated 8where9. The sin# must then be cleaned and saniti"ed.

Carpeting& rugs& and furniture will be !acuumed daily. This includes carpeting that

may be on walls or surfaces other than the floor.Carpets will be cleaned monthly ininfant areas ande!ery 8three1si(9months in other childoccupied rooms. Carpet

cleaning will be done by 8name of carpet cleaning company or title of staff personresponsibleM note= professional steam cleaning is strongly recommended9 . Spotcleaning will be done as necessary. 6acuuming and mopping of the center will notoccur while children are present 8carpet sweepers are o# to use9.

Hard floors will be swept and mopped with 8name of floor cleaning product9daily and

saniti"ed daily. ,tility mops will be hung to dry an area with !entilation to the outsideandinaccessible to children. $op heads are 8washed ho& oftenin the washingmachineM replaced ho& oftenM other9.

Toys will be washed& rinsed& saniti"ed& and airdried or toys that are dishwasher safe

can be run through a full wash and dry cycle. This is done 8how often in each room Grecommend daily for high use infant1toddler toys and wee#ly for other toys9.

Toys that children place in their mouth will be saniti"ed between uses by different

children. The following system for ongoing rotation of mouth toys will be implementedin infant and young toddler rooms= 8describe the system9. )nly washable toys will beused.

Cloth toys and dress up toys will be laundered according to the U+aundry% section of

this policy.

Re#ove this infor#ation if &ater tables are not used.Water tables will be emptied andsaniti"ed after each use or more often as needed. Children will wash hands beforeand after play and be closely super!ised.

'or art acti!ities& the handwashing sin# can be used I' the counters& sin#s& and

faucets are cleaned& rinsed& and saniti"ed prior to use as an art sin#.

7ap mats1cotswill be cleaned and saniti"ed 8how often9& between uses by different

children& after a child has been ill& and as needed. They will be stored 8describe howand where mats1cots will be stored so that sleeping surfaces don%t touch if they arenot saniti"ed after each use9.

Re#ove this infor#ation if the center does not care for infants.In infant areas& cribs

mattresses and railings will be saniti"ed 8daily or wee#ly9& before use by a differentchild& after a child has been ill& and as needed. Highchairs will be washed& rinsed& andsaniti"ed after each use.

eneral cleaning of the center is done 8how often9 and more often when children or

staff members are ill. Dusting is done 8how often9. Toy shel!es are cleaned and

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saniti"ed 8how often9.Door #nobs are cleaned and saniti"ed 8how often9and moreoften when children or staff members are ill. Wastebas#ets will ha!e disposable linersand are emptied daily or more often if necessary.

oom deodori"ers are not used at the center due to the ris# of allergy1lung irritation.

Cleaning duties are assigned to specific staff. These assignments are posted8where9. As cleaning duties are completed& the staff person will mar# off that duty.

LAUN!RY

+inens and bedding are 8sent home G ) G are washed by the center at a temperature of atleast -/o' G or G with bleach or other product in the rinse cycle9. This center%s minimumschedule for laundry is=

+inens and bedding are 8washed1sent home9wee#ly or more freuently as needed.

Re#ove this infor#ation if the center does not care for infants.Infant bedding is changed8how often G daily is recommended9.

Cloth toys and dress up clothes are laundered 8how often9. If they cannot be washed in

the washing machine& they will be hand washed in warm soapy water& rinsed& thendipped into a 8bleach or other product9solution for 8amount of time9 and allowed to airdry.

3edding will be stored 8describe how and where bedding will be stored G such as

remo!ed from mats and stored separately in children%s cubbies9.

Soiled laundry is #ept inaccessible to children 8where1how9. Soiled laundry is #ept separatefrom clean laundry. +aundry machines are separate from #itchen and food preparation areasand are inaccessible to children. Dryers are !ented to the outside of the building.

Children%s coats and other personal items will not touch during storage.

A change of clothes is a!ailable for the children and is pro!ided by 8parents1center9. Theseclothes are stored 8where9.

Staff members are encouraged to wear an apron o!er street clothes to decrease the spreadof communicable disease G ) G staff members are encouraged to ha!e a change of

clothing a!ailable onsite.

IN#ANT CARE

$onthly consultation !isits in the infant room are conducted by 8name of infant nurseconsultant9. The consultant is acurrently licensed 8choose 1:egistered 7urse& 7ursePractitioner& Physician Assistant& or Physician9& with training and1or e(perience in pediatrics.

22 e!ision /012/-/


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Infants will be at least 8how old G one month& si( wee#s9 of age when enrolled.

INTERACTION" AN! EN'IRONMENT

Infant room staff members ha!e been trained in understanding and reacting appropriately to

infant cues. Staff members interact regularly with each infant throughout the day by= encouraging infants to handle and manipulate a !ariety of ob4ects

pro!iding a safe en!ironment for climbing& mo!ing& e(ploring

pro!iding materials and opportunities for large and small muscle de!elopment

reading and tal#ing to infants

pro!iding daily indoor opportunities for freedom of mo!ement outside their cribs& in an

open& uncluttered space. The room has areas where all infants can be safely placedon the floor at any gi!en time. Infants are placed 8choose one: directly on the floor& onmats on the floor& on blan#ets9. +Note: ats are reco##ended because they are easyto clean and saniti8e &hen soiled*.)nclude this sentence if blan!ets are used: 'loorplay blan#ets are used only for that purpose and are changed when soiled with spitup

or other body fluids.

placing infants on their tummy part of the time when they are awa#e and staff are

obser!ing them

pro!iding outdoor opportunities 8how oftenM 2/


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IN#ANT &OTTLE #EE!IN

Infants will be fed according to their need rather than an adult prescribed time schedule. Infantsare held when fed a bottle. 3ottles will not be propped. Infants able to hold their own bottle willbe held when possible 8if it is not possible& the teacher will sit close and interact with the childduring the feeding time9. Infants will not be gi!en a bottle while lying down unless the bottlecontains only water. +ying with a bottle puts a baby at ris# for baby bottle tooth decay& cho#ing

and ear infections. 3ottles will be remo!ed from the infant when he1she finishes feeding. Whenfeeding an infant& staff will watch for cues 8signs9 to #now when the infant has had enough.

'ood preparation areas in the infant room will be cleaned and saniti"ed daily.

All bottles and containers of breast mil# must be labeled with the infant%s full name and the date.This is done by 8whom G classroom staff or parents9. Staff must ensure that the correct formulaor breast mil# is gi!en to each infant.

A refrigerator located 8where9is used to store bottles and unser!ed& lefto!er infant food. Therefrigerator temperature is chec#ed 8how often9 to ensure it is not more than -R'. A log of these

temperatures is #ept 8where9. 3ottles will be stored in the coldest part of the refrigerator& not inthe door. A thermometer will be #ept in the door of the refrigerator.

)f bottles are provided by the parents% include this section: 'ull bottles will be refrigeratedimmediately upon arri!al at the center& unless being fed to an infant right away. Any preparedformula or thawed breast mil# not used will be sent home with the family at the end of the day.'ro"en breast mil# is stored at -/R' or less 8where9. This mil# is stored at the center for no morethan 2 wee#s.

)f bottles are prepared at the center% include this section:This center prepares bottles 8when G in the morning& on demand& other9. Staff uses the

following steps to prepare bottles= Staff must wash hands before preparing or ser!ing bottles.

All infant bottles and baby foods are prepared 8where G by the food preparation sin# in

the classroom& in the #itchen9. Cold water used for mi(ing bottles or drin#ing isobtained from 8where G the designated food prep sin# in the classroom& a pitcherbrought in from the #itchen9. Water from a hand washing sin# is not used for bottlepreparation.

)nclude this bullet if the infant roo# has a food preparation area: The food preparation

area has a sin# that is separated from the diaper changing area by 8what G eight feetof space G or G a solid barrier 2 inches in height from the counter surface9.

Powdered formula in cans will be dated when opened and stored in a cool& dar#

place. ,nused portions will be discarded or sent home one month after opening. 'ormula will be mi(ed as directed on the can.

'ormula will not be used past the manufacturer%s e(piration date.

If prepared bottles are not warmed immediately& the bottles are stored in the

refrigerator.

'ormula and breast mil# bottles are warmed 8how1where G under running warm water& in a bottlewarmer& or in a container of water or croc# pot that is not warmer than -2/R'9. 8If a croc# pot is

2 e!ision /012/-/


25/44

used& include this sentence= The croc# pot will be secured to a!oid it being #noc#ed off thecounter.9 3ottles are ne!er warmed in a microwa!e. A microwa!e heats une!enly and cancause Jhot spotsK& posing a burn ris#. $icrowa!ing also destroys much of the nutritionalcomponent in breast mil#.

'ro"en breast mil# is thawed 8how G in the refrigerator& under warm running water& in a

container of water less than -2/R'9 then warmed as stated abo!e. Thawed breast mil# will notbe refro"en.

The contents of any bottle not fully consumed within an hour are thrown away. 3ottles that ha!ebeen used don%t go bac# into the refrigerator. 3acteria begin to multiply once bottles are ta#enfrom the refrigerator and warmed. 'amilies are ad!ised to send se!eral small bottles or portions&enough for one day only& to minimi"e the amount of breast mil# or formula that is discarded.

3ottle nipples are #ept co!ered when not in use to reduce cross contamination.

&OTTLE CLEANIN

3ottles& bottle caps& nipples& and other euipment used for bottle feeding are pro!ided by the8whom G parent1guardian& child care center9. These items will not be reused without first beingcleaned and saniti"ed by 8how G washing in a dishwasherM or washing& rinsing& and boiling forone minuteM or the parent1guardian G parents are as#ed to bring enough bottles to last an entireday9.

CARIN #OR &REA"T#E! IN#ANT" OPTIONAL "ECTION

)ur child care welcomes breastfed babies and acti!ely accommodates mothers nursing theirbabies. Staff #nows the benefits of breastfeeding for babies and moms. The staff encourages

pregnant mothers to continue breastfeedingwhen returning to wor# or school. The 8title ofperson9will pro!ide information and resources to new moms needing assistance with pumping&safe storage and transfer of breast mil#& and other support. Staff safely store and handle breastmil# brought into the center.

The infant room 8or other appropriate space9pro!ides comfortable places for nursing andpri!ate places for pumping. Staff is trained to de!elop a trusting relationship with all parents andcaregi!ers. They help assist new moms and babies with the home to child care transition. Theycommunicate often with parents& encourage parents to dropin any time and understand theuniue needs of the breastfed baby 8may need to feed more often& coordinating bottle feedingswith mom%s !isits& delayed introduction to solid foods9. Staff is trained to create a positi!e

feeding en!ironment for all infants and recogni"e and respond appropriately to infant feedingcues.

IN#ANT #OO! "A#ETY

When they begin to selffeed& infants% hands are washed with soap and water before eating.

Staff members wash hands thoroughly before preparing any infant foods. Staff ne!er touchesinfant food with bare hands. 3aby foods are prepared 8where G by the food preparation sin# in

2B e!ision /012/-/


26/44

the classroom& in the #itchen9. Cold water used for preparing baby foods is obtained from8where G the designated food prep sin# in the classroom& a pitcher brought in from the #itchen9 .Water from a hand washing sin# is 7)T used to prepare baby foods.

)nclude this bullet if the infant roo# has a food preparation area: The infant food preparationarea has a sin# that is separated from the diaper changing area by 8what G eight feet of space G

or G a solid barrier 2 inches in height from the counter surface9.

3aby food is ser!ed from a dish with a clean spoon& not from the baby food 4ar. )pened babyfood 4ars are #ept co!ered and refrigerated& and are discarded or sent home with the family after2 hours. ,nconsumed baby food portions in the ser!ing bowl will be thrown away.

IN#ANT AN! TO!!LER "OLI! #OO!"

The center will wor# with the infantOs parent1guardian to de!elop a plan for the infantOs feedingsthat is acceptable to the parent1guardian. 7ew foods are ne!er introduced at the centerM theintroduction of new foods is always done by the family first +Note: The 5#erican 5cade#y of

ediatrics reco##ends &aitin" to introduce solid baby food until the child is 6 #onths of a"e.*The center uses the following guidelines=

Developmental (tage,$ge of Infant #ype of Feeding

,nder 0 months of age Ser!e only formula or breast mil# unlessfamily pro!ides a written order from thechildOs health care pro!ider.

When baby can= 8at about 0 months9Sit with supportHold head steady

Close lips o!er the spoon:eep food in mouth and swallow it

Continue ser!ing formula or breast mil#.Any substitution reuires a written orderfrom the childOs health care pro!ider.

A7D3egin iron fortified baby cereal and plainpureed fruits and !egetables uponconsultation with parents.

When baby can= 8at about 0> months9Sit without support3egin to chewSip from a cup with helprasp and hold onto things


A7DStart small amounts of water in a cup.

A7D

+et baby begin to feed self.A7DStart semisolid foods such as cottage

cheese& mashed tofu& mashed soft!egetables or fruits.

When baby can= 8at about >-/ months9Ta#e a bite of foodPic# up finger foods and get them


20 e!ision /012/-/


27/44

into the mouth3egin to hold a cup while sipping

from it

A7D3egin offering small pieces of cheese& tofu&

chic#en& tur#ey& fish or ground meat.3egin offering small pieces of soft coo#ed

!egetables& peeled soft fruits.3egin offering toasted bread suares&

unsalted crac#ers or pieces of softtortilla.3egin offering coo#ed plain rice or noodles.

A7DSer!e only formula& breast mil#& diluted 4uice

or water in the cup.

When a baby can= 8at about -/-2 months9'inger 'eedChew and swallow soft& mashed and

chopped foods

Start to hold and use a spoonDrin# from a cup


A7D

3egin offering small si"ed& coo#ed foods.3egin offering a !ariety of whole graincereals& bread and crac#ers& tortillas.

3egin offering coo#ed soft meats& mashedlegumes 8lentils& pinto beans& #idneybeans& etc.9& coo#ed egg yol#s& softcasseroles.

When a baby can= 8about -2 months9*at a !ariety of foods from all food

groups without signs of an allergic

reaction

)ffer small amounts of formula& breast mil#or water in the cup during meals.

A7D

3egin offering whole mil#.3egin offering fruit pieces and coo#ed!egetables.

3egin offering yogurt and cheese slices.

Crac#ed high chair trays or tabletops are not appro!ed for food ser!ice. Infant finger food canbe placed directly on an appropriate& clean& saniti"ed high chair tray. Staff members face infantsand allow them to control the pace of the feeding. Toddlers will eat from plates& ha!e a papernap#in& and de!elopmentally appropriate utensils. Staff members ser!ing or preparing food wearglo!es and use tongs or spoons to minimi"e bare hand contact.

7o egg whites 8allergy ris#9 or honey 8bacteria ris#9 will be gi!en to children less than -2months of age.

Euice will be limitedM it will only be offered in a cup and always diluted.

2 e!ision /012/-/


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NAPPIN PRACTICE" #OR IN#ANT" AN! TO!!LER"

Children 2? months of age or younger will be allowed to follow their indi!idual sleep pattern.Alternati!e& uiet acti!ities 8no T6 or !ideo9 will be pro!ided for the child who is not napping.

Sleeping schedules are discouraged. Howe!er& parents may reuest that an infant be wo#en upif sleeping more than < hours. This may be necessary to assist with the infant%s 2hour

sleep1wa#e cycle.

A 8what G crib& basinet& play yard& etc9will be furnished for napping. When the child carepro!ider and parent agree& and the infant can safely do so& transitioning to a mat or cot willhappen. Note: if children sleep in so#ethin" other than cribs% #a!e all necessary chan"es inthis section.

3ecause infants sleeping on their stomachs are at a higher ris# of death from Sudden InfantDeath Syndrome& S.I.D.S.& the following will ta#e place at this center=

Infants will sleep on their bac#s unless they roll o!er themsel!es. Infants are not

awa#ened to return them to their bac#s if they roll o!er themsel!es.

Crib sheets will fit the mattress snugly and securely in all corners and sides. Cribs will not contain bumper pads& pillows& soft toys& fleece& cushions& or thic#

blan#ets.

)nly one thin blan#et will be used and #ept no higher than chest le!el. The blan#et

will be tuc#ed around the foot of the mattress.

Soft bedding and toys will not be allowed in cribs.

Hanging mobiles will be remo!ed once the child is able to sit up and1or reach the

mobile.

Should a parent or legal guardian reuest an alternate sleep position it must be

specified in writing by the parent1guardian and the child%s health care pro!ider.

)f you use so#ethin" other than cribs% re#ove this section. Cribs will meet the following safetyreuirements=

constructed with !ertical slats that are no more than 2 inches apart or ha!e solid

barriers& such as Ple(iglas

corner posts will be the same height as the side and end panel

no cutout designs

sturdy and in good repair 8no sharp edges& points& unsealed rough surfaces& splinters&

peeling paint& crac#s& missing1bro#en parts9

mattresses will be firm& snug fitting& intact& and waterproof& and will fit snugly against

the crib frame

)f you use so#ethin" other than play yards% re#ove this section. Play yards will meet thefollowing safety reuirements=

ha!e no holes in the netting

play yards will be sturdy and in good repair

play yards will be chec#ed to ensure they ha!e not been recalled due to sides that do

not properly loc#& protruding bolts& or other safety concerns

2> e!ision /012/-/


29/44

3ecause sleeping in infant seats or swings ma#es it harder for infants to breathe fully and mayinhibit gross motor de!elopment& infants will not sleep in car seats& swings& and infant seats.Children who arri!e at the center asleep in car seats will be immediately transferred to their crib.

Cribs and play yards will be spaced at least


30/44

emo!e disposable glo!es and use them to wrap up dirty items. Discard all dirty

items in a footoperated step can.

Pro!ider wipes own hands with a wet wipe.

Diaper and dress the child.

Wash the child%s hands with soap and water. 'or infants younger than 0 months& a

diaper wipe can be used to wipe off the child%s hands.

eturn child to a safe area. emo!e and discard paper. If !isible soil is present& clean with soapy water& and then

rinse with water. Saniti"e the changing table and any euipment or supplies youtouched with 8what G bleach water solution& name of other disinfectant9. Allow oneminute of contact time with the disinfectant.

Wash hands with soap and water.

Children are not left unattended during the diaper changing procedure.

7othing but the child& changing pad 8& paper9& and diaper supplies is placed on the changingtable& counter& or sin#. The changing surface is not used for other acti!ities& including writing.

*ach diaper change is recorded on a 8name of diapering log9.

Disposable diapers are remo!ed from the facility and the garbage liner is changed daily andmore often if necessary. These diapers are disposed of with curbside garbage.

Note: re#ove if reusable diapers are not used. eusable diapers are not rinsed& are indi!iduallybagged& and are 8what G gi!en to a commercial ser!ice& sent to a laundry& or returned to theparent or guardian9.

Soiled clothing is not rinsed& is indi!idually bagged& and is returned to the parent or guardian.

#OO! "ER'ICE

This section should specifically reflect ho& and &here you prepare foods.


31/44


32/44

This center has a bac#up system if the food does not arri!e& if the food arri!es at an

improper temperature& or if for some other reason that the food cannot be ser!ed.This bac#up system is 8describe system9.

#OO! "TORAE

'ood is stored away from and ne!er below #itchen chemicals.

aw meats and unpasteuri"ed eggs are stored away from and below all other foods.

All food items are stored off the floor. Dry food items are stored 8whereM in cabinets& on shel!es&in a different room& in a shed& etc9. All dry goods are stored in labeled containers with tightfitting lids. These containers are labeled with the date when the item was opened.

All refrigerated foods are #ept sealed or co!ered 8e(cept when cooling foods to -R'9. Allrefrigerated foods are dated.

TEMPERATURE CONTROL

efrigerators and free"ers ha!e thermometers placed in or near the door. efrigeratortemperature is maintained at -o' or less. The refrigerator temperature is chec#ed daily and isrecorded on a 8name of form9. 'ree"er temperatures are maintained at -/o' or less.

'oods are coo#ed to the correct internal temperature as follows=

poultry X -0Bo'

ground beef and ground por# X -BBo'

beef X -Bo'

por# X -Bo'

eggs X -Bo'

fish 5 seafood X -Bo'

coo#ed !egetables X -/o'

'ood temperatures will be monitored using a stem thermometer. The stem thermometer isstored 8where9and is calibrated 8how often9.

Hot holding food= hot food will be held at a temperature of -/ o' or abo!e until ser!ed.

Cold holding food= food reuiring refrigeration will be held at a temperature of - o' or less until

ser!ed.

)f the center uses a #icro&ave% include this para"raph. If the microwa!e is used to heat food=

the food is rotated and stirred during heating

the food is co!ered to retain moisture

the internal temperature is monitored and coo#ed until the food reaches the proper

coo#ing temperature listed abo!e

the food is allowed to sit for 2 minutes prior to ser!ing to allow the temperature to

spread e!enly throughout the food


33/44

Thawing of fro"en foods is done=

by placing in the refrigerator&

by placing in a pan in the sin# with cool water running o!er the food&

during the coo#ing process if the food is to be coo#ed immediately& or

in the microwa!e

)f sac! lunches are brou"ht fro# ho#e% include this para"raph. Sac# lunches from home are#ept cool to pre!ent bacteria growth. Choose one of the follo&in":

Parents are e(pected to include an ice pac#& gel pac#& fro"en 4uice bo(& ice cubes in a

lea#proof container& or other cold product to #eep the lunch at a cool temperature.G ) G

Staff will chec# sac# lunches from home and refrigerate any lunches that contain any

of the following items= meat products& sliced fruit or !egetables& dairy products& otherperishables.

HAN!LIN LE#TO'ER" )nclude this section only if the center serves coo!ed leftovers.

3efore storing coo#ed foods& the food is cooled by +choose one of the follo&in"*

Placing food in shallow containers 2K deep or less. +ea!e unco!ered and immediately

put the pan into the refrigerator on a top shelf.G ) G

Cooling to /o' within 2 hours and then to -o' within additional hours.

Temperatures during the cooling process will be ta#en and recorded e!ery hour.)nce they ha!e cooled to a temperature of -o' or less& the food is co!ered& dated& and storedin the refrigerator.

Pre!iously prepared foods may be reheated one time only to an internal temperature of -0B

o

'within 0/ minutes.

+efto!ers that were prepared more than > hours ago are discarded.

#OO! HAN!LIN

All staff will wash hands with soap and water at a designated hand washing sin# prior topreparing or ser!ing food& e!en if food ser!ice glo!es are worn.

Ill staff will not prepare or handle food.

This center maintains a U7o 3areHand Contact% rule when handling readytoeat foods. Thecoo# wears glo!es or uses utensils when preparing readytoeat foods. lo!es are changedwhen they become contaminated. Staff in the classrooms wear glo!es or use utensils whenser!ing food to the children.

)f the center serves #eals or snac!s fa#ily-style% include the follo&in" para"raph. When mealsare ser!ed familystyle& children use utensils to ser!e themsel!es. Steps are ta#en to ensure


34/44

children only touch their own food. Children are super!ised so that they do not touch eachother%s food. Staff members sit with the children during meals and snac#s.

In addition to food preparation& the coo# has the following responsibilities at the center G +istresponsibilities here. The coo# does not change diapers unless all food preparation has beencompleted for the day. ptional:The coo# does not substitute in infant or toddler rooms unless

all food preparation is completed for the day.

+ITCHEN CLEANIN AN! "ANITI-IN

All chemicals and cleaning supplies are stored away from and below food and food preparationareas. All chemicals are stored in their original containers. All spray bottles are labeled with thecontents and the date.

To ensure food safety& the #itchen will be #ept clean. efrigerators will be cleaned and saniti"edmonthly& or more often as needed. Tabletops where the children eat are washed and saniti"edbefore e!ery meal and snac#. :itchen counters& sin#s& and faucets will be washed& rinsed& and

saniti"ed daily before any food preparation and as needed during food preparation.

Sponges are not used on food contact surfaces. Cutting boards will be washed& rinsed& andsaniti"ed between each use.

All dishes& cups& utensils& etc. will be washed 8how G ,sing a threestep method whereby dishesare washed with soap and water& rinsed& and then saniti"ed with 8name of saniti"er9& or in anautomatic dishwasher capable of reaching -/o'& or in an automatic dishwasher that saniti"esthe dishes with 8name of chemical G bleach& iodine& uaternary ammonia9.

#OO! ,OR+ER E!UCATION

Choose one of the follo&in" three para"raphs to include in your plan.This center%s coo# has a current Washington State 'ood Wor#er Card. The coo# o!ersees thefood handling at the center. +Note: )f so#eone else oversees the food handlin"% then both that

person 5N the coo! #ust have food handler=s cards.*He1She will pro!ide orientation and ongoing training as needed for all staff in!ol!ed in food handling. Documentation will be posted8where9.

)

The coo# and at least one staff member per classroom ha!e current Washington State 'ood

Wor#er Cards. The coo# 8or other designated person9will pro!ide orientation and ongoingtraining as needed for all staff in!ol!ed in food handling. Documentation will be posted 8where9.

)

All staff members preparing or ser!ing food ha!e a Washington State 'ood Wor#er Card.Documentation will be posted 8where9.


35/44

NUTRITION

)f parents provide food for their children% include this para"raph. When parents pro!ide theirchildren meals or snac#s& they must meet the nutritional reuirements as outlined by theWashington State $eal Pattern for Child Care. If the meal pro!ided does not meet nutritionalreuirements& the center will supplement the meal with the missing components. The center will

help the parent pro!ide more nutritionally adeuate meals in the future by 8how9+ea#ples:"ivin" parents a ac!-a-ac! brochure fro# the Child Care >ealth ro"ra#% sendin" ho#e asu##ary of &hat a sac! #eal #ust contain% etc.*

)f parents are allo&ed to brin" in food for special occasions% include this para"raph. Parents areallowed to bring in snac#s for all the children that may not meet the nutritional reuirements onspecial occasions such as birthdays. The snac#s pro!ided by parents must be limited to storepurchased uncut fruits and !egetables and foods prepac#aged in original manufacturer%scontainers. 3efore bringing in the food for a special occasion& parents1guardians must discussthe food choices with staff to address any food safety and allergy concerns.

)nly pasteuri"ed mil# or pasteuri"ed dairy products are ser!ed. 7ondairy mil# substitutions willonly be ser!ed with written permission from the child%s 8parent G or G health care pro!ider9 forchildren o!er the age of twel!e months. The 8center will G or G parents must9pro!ide anappropriate mil# substitute 8such as calciumfortified rice mil# or soymil#. The amount ofreuired mil# fat in the mil# product is determined by the childOs age=

If the age of thechild is

#hen the fat content of the mil> must be

,nder -2 months 'ull strength formula or full strength breast mil# unless there arespecific written instructions from a licensed health care pro!ider.

3etween -2 monthsand 2 months

'ull strength whole mil# or breast mil# unless there is specificwritten instruction from a licensed health care pro!ider.

)!er 2 months With fat content of pro!ider%s or parent%s choiceM 2 or - isrecommended by pediatricians

The center will prepare& date& and conspicuously post menus of snac#s and meals at least onewee# in ad!ance. The center uses a 8how many G note: #ust be 2 or #ore9wee# cycle menu&with no repeated meal1snac# combinations& to ensure !ariety. The past menus will be #ept onsite for 0 months. If needed& substitutions of comparable nutrient !alue may be made and anychanges will be recorded on the menu.

The menu will=

consist of a wide !ariety of foods that are low in fat& sugar& and salt

place emphasis on ser!ing fruits and !egetables often

include a 6itaminC rich food e!ery day

include 6itaminA rich foods three or more times each wee#

ptional:include a protein or dairy for each afternoon snac#

ptional:incorporate ethnic& cultural& and seasonal foods regularly


36/44

$eals and snac#s will be ser!ed e!ery 2 to < Y hours. The following meals1snac#s are pro!idedby the center=

Time= $eal1Snac#LLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL

LLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL

)f the center serves brea!fast% include the follo&in" section. +Note: )t is reco##ended to serve abrea!fast if the center opens before ?:00*. *ach brea#fast meal contains=

a fruit or !egetable 8the center ser!es fruit instead of 4uice most often9

a dairy product 8such as mil#& cheese& yogurt& or cottage cheese9

a grain product 8such as bread& cereal& rice ca#e& or bagel9

*ach lunch and dinner meal contains=

a dairy product 8such as mil#& cheese& yogurt& or cottage cheese9 meat or meat alternati!e 8such as beef& fish& poultry& legumes& tofu& or beans9


fruits or !egetables 8two fruits& two !egetables& or one fruit and one !egetable to eual

the total portion si"e reuired9

*ach snac# contains two of the four components=

a dairy product 8such as mil#& cheese& yogurt& or cottage cheese9

meat or meat alternati!e 8such as meat& legumes& beans& egg9


fruit or !egetable

*ach snac# or meal includes a liuid to drin#. The drin# could be water or one of the reuiredcomponents such as mil# or fruit1!egetable 4uice.

When 4uice is ser!ed in place of a fruit or !egetable it must be one hundred percent fruit or!egetable 4uice.

If a child has a food allergy or special dietary need& the parent and the child%s health carepro!ider will identify a protocol for managing the child%s special dietary need. The center willde!elop an allergy management plan or an indi!idual care plan with parent input for the child.

This plan will include 8describe: information on alternati!e foods with comparable nutriti!e !alue&a reuirement that the parents must supply food for the special diet& etc.9

$ealtime and snac# time will support children%s de!elopment of healthy eating habits. 'or safetyand rolemodeling& staff members sit& eat& and ha!e casual con!ersations with children duringmealtimes. Staff members are trained in helping ser!e food familystyle.

Coffee& tea and other hot be!erages will not be consumed by staff while children are in theircare& in order to pre!ent scalding in4uries. Staff will not consume pop or other nonnutritional


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be!erages while children are in their care. During meal and snac# times& staff will eat only thosefoods that are ser!ed to the children.

PHY"ICAL ACTI'ITY

All children birth to age fi!e should engage in daily physical acti!ity that promotes fitness forhealth and mo!ement s#ills. Promoting and fostering en4oyment of mo!ement and motor s#illcompetence and confidence at an early age helps to ensure that children de!elop acti!e&healthy habits. Current research also shows that regular physical acti!ity of infants and youngchildren is an important component of early brain de!elopment and learning. )ur center followsthe 7ASP* guidelines for physical acti!ity for children age birth to fi!e 8Acti!e Start& 7ASP*&2//29=

IN#ANT" +Re#ove this section if center does not care for infants*Positi!e early mo!ement e(periences increase the infant%s chances of achie!ing full

de!elopmental potential throughout life. Infants will= be placed in a safe setting 8name areas= carpeted floor& mats& sectionedoff areas etc9

that encourages e(ploration and does not restrict mo!ement for prolonged periods oftimeM Container use will be limited to 8name time frame9 G ) G This center does not useany containers e(cept for highchairs when solid foods are introduced.

ha!e help from staff to facilitate mo!ement by=

o recei!ing regular& attenti!e interaction 8using facial& !erbal and non!erbal

e(pressions9 that encourages playful acti!ityo ha!ing an open en!ironment suitable for the e(ploration and de!elopment of

rolling o!er& reaching& sitting& crawling& creeping and standingo ha!ing daily Jtummy timeK G placing infant on his1her tummy to promote wiggling

and scooting which contributes to large motor s#ill de!elopment

TO!!LER"With ample opportunity for e(ploration and learning& basic mo!ement s#ills li#e running&

4umping& throwing& and #ic#ing will de!elop. Toddlers will=

not be sedentary for more than 0/ minutes at a time e(cept when sleeping

get at least


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engage in at least an hour and up to se!eral hours of unstructured physical acti!ities

in a safe area both indoors and outdoors suitable for large muscle acti!ities 8gross motormo!ement9

!I"A"TER PREPARE!NE""

This center has de!eloped a disaster preparedness policy. See the 8title of center%scomprehensi!e disaster plan9. This plan is located 8where9and a copy is #ept in the disaster #it.

Parents should read& re!iew& sign& and date the plan upon enrollment and annually thereafter.

Annually& staff and parents1guardians will be oriented to this disaster policy and documentationof staff orientation will be #ept in the disaster plan manual. The 8title of person9 will beresponsible for orienting new staff or substitutes to these plans.

Procedures for medical& dental& poison& earthua#e& fire& and other emergency situations will be

posted in each classroom. These plans include= which staff is responsible for each part of the plan

procedure for accounting for all children during and after an emergency

e!acuation routes and meeting location

Indi!iduali"ed Care Plans for children with special needs

how children will be cared for until parents are able to pic# them up

how contact will be made with parents1guardians when normal lines of communication

are not a!ailable

transportation arrangements& if necessary

'ire drills are conducted monthly& as per the state fire marshal in WAC 2-2-2. Documentation&including date and time of the drill and a debriefing1e!aluation of the drill& is #ept 8where9.

Disaster and earthua#e preparation and pre!ention training are documented. Staff membersrecei!e training on how to use the fire e(tinguisher8how often9 by 8whom9.

Fuarterly& the center conducts and documents a disaster drill. )ne type of disaster will bechosen for staff and children to practice& such as earthua#e or intruder alert. Parents will benotified of the drill.

'ood& water& medication& and supplies for 2 hours of sur!i!al are a!ailable for each staff and

child. These supplies are stored 8where9and are chec#ed 8how often9.

"TA## HEALTH

TU&ERCULO"I" T&

7ew employees must ha!e the results of a one step $antou( Tuberculin 8T39 s#in test prior tostarting wor#. The new employee doesn%t need the test if=

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they ha!e had a documented negati!e T3 s#in test within one year prior to

employment

they ha!e had a positi!e T3 s#in test in the pastM they will always ha!e a positi!e s#in

test& despite ha!ing undergone treatment. These employees do not needdocumentation of a s#in test. Instead& documentation must be on record that theemployee has had a negati!e 8normal9 chest (ray& or documented proof of treatment.

Staff must be retested for T3 when the center is notified that any staff has been e(posed to T3.The center will comply with the public health department for followup.

OTHER ILLNE""

Staff members who ha!e a communicable disease are e(pected to remain at home until theperiod of communicability has passed. Staff will also follow the same procedures listed underJ*(clusion of Ill ChildrenK in this policy.

The 8title of person9will re!iew the 8name of center%s 3loodborne Pathogen *(posure Control

Plan9with each staff person within -/ days of hire. Staff are offered the Hepatitis 3 !accineseries 8whenM upon employment G or G within 2 hours of a bloodborne pathogen e(posuree!ent9.

Staff immuni"ations will be recorded upon employment. ecommendations of immuni"ations forchild care pro!iders will be a!ailable to staff.

OTHER HEALTH I""UE"

Adult si"ed bathrooms will be onsite.

Staff recei!e training on topics li#e stress management and body mechanics.

Separate space will be pro!ided for staff to wor# or ta#e brea#s. This space is a!ailable 8where9.

ptional: Step stools will be pro!ided for children to reach the sin# and diaper changing table8with super!ision9 to help protect employees% bac#s.

Staff members who are pregnant or considering pregnancy should inform their health carepro!ider that they wor# with young children and discuss possible ris#s.

'or staff who become stressed or frustrated& the following will be pro!ided8describe what isa!ailable9.

CHIL! A&U"E AN! NELECT

Any instance when staff ha!e reason to suspect the occurrence of any physical& se(ual& oremotional child abuse or neglect& child endangerment& or child e(ploitation as reuired underCW chapter 20.& a report is filed by the staff directly in!ol!ed with the child. The child%s file ison hand when placing the call. Call ->00*7DHA$& 8->00


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8title of responsible person9 if needed. The 8title of responsible person9 will contact the licensorimmediately after a report of abuse is made.

If there is an immediate danger to a child& a report is made to local law enforcement.

Signs of child abuse or neglect are recorded on the 8name of report form9& which are located

8where9.

Documentation of staff orientation or training on the indicators of child abuse and neglect are#ept in staff files. egular trainings occur e!ery 8how freuently9.

CHIL!REN ,ITH "PECIAL NEE!" / INCLU"ION

Children with special needs are accepted into the program under the guidelines of theAmericans with Disabilities Act 8ADA9. Confidentiality is assured with all families and staff in theprogram. All families are treated with dignity and with respect for their indi!idual needs and1or

differences.

A written 8name of formM e(amples include Indi!idual Care Plan& Plan of Care& Children withSpecial 7eeds 'orm& etc9is de!eloped by the director& parent1guardian& and teacher for eachchild with special needs. It includes instructions from the parent and health care pro!iderregarding medications& specific food or feeding reuirements& lifethreatening allergies&treatments& and special euipment or health needs. The parent pro!ides training to staff on anyprocedures that will be done to the child while in care. This written plan of care is updated 8howoften9or sooner if needed. The director see#s further information or training if necessary forcenter staff from local resources. Snohomish Health District 7utritionist will be contacted forconsultation andinstructions on handling food allergies or special menu reuirements

This plan includes how the child%s special need would be met in the case of a disaster. At aminimum the center will plan for the child to stay at the center for 2 hours without being able tocontact the child%s parents.

Children with special needs are gi!en the opportunity to participate in the program to the fulleste(tent possible. This is accomplished by consulting with outside agencies1organi"ations asneeded. The center cooperates with other agencies that can pro!ide ser!ices to the child onsite.

The center has a policy as to how they try to accommodate an undiagnosed special need in

which a parent refuses to see# medical and1or de!elopmental assessment and inter!ention fortheir child.

All staff members recei!e general training on wor#ing with children with special needs andupdated trainings on specific special needs that are encountered in their classrooms. Describehow staff training is trac#ed and documented.

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&EHA'IOR MANAEMENT/UI!ANCE PRACTICE"

Teaching staff follow the center%s beha!ior management and guidance practices& which arebased on 8what principles G describe9.

7oise le!els in the center are #ept low& so that teachers can be heard without the need to raise

their !oices.

Staff members get to #now each indi!idual child%s needs and stage of de!elopment and guideeach child accordingly. Staff point out positi!e social interactions rather than only focusing onnegati!e beha!ior. Staff help children problem sol!e when conflicts arise. Staff members e(hibita range of techniues such as ignoring& conseuences& cooloff& and redirecting when beha!iorissues occur. Describe other beha!ior management practices briefly or refer to parenthandboo#.

3eha!ior plans are implemented in coordination with the parent1guardian when necessary.Community resources are consulted when needed.

Teaching staff recei!e the following training on beha!ior management= Describe the beha!iortraining that teaching staff recei!e. Include information on the freuency of this training and whopro!ides the training 8such as Child Care esource 5 eferral& Snohomish Health DistrictDistance +earning& Compass Health& local hospitals& independent STAS trainers9.

ANIMAL"

)nclude this section only if the child care has ani#als on-site.Animals in this center will be carefully chosen in regards to care& temperament& health ris#s& and

appropriateness for young children.

The following animals are onsite at the child care= 8+ist what animals and where they are andpotential health ris#s associated with these animals9 LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL

LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL

)ccasionally an animal may !isit the child care. Prior to any animals !isiting the child care&parents will be informed of the date and time of the animal%s !isit and any potential health ris#s

by 8how9.

'or additional child care animal information& including cleaning and handwashing policies&please refer to this center%s 8Title of pet policy& such as JCare and Handling of PetsK9 which is#ept 8where9.

'I"ITIN ANIMAL POLICY

)nclude this section only if the child care has nani#als on-site. ther&ise delete.

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This child care program does not ha!e any pets onsite. Parents1families are discouraged frombringing their pets onsite.

In the rare e!ent that an animal is !isiting the site& or if the children ha!e contact with animalswhile on a field trip& the following policies will be implemented=

Parents will be notified& in writing& of the type of animal that will be !isiting and any

potential health ris#s associated with that animal by 8how9. The site director will ensure that no children are allergic to the animal.

The site director will ha!e primary responsibility of super!ising all acti!ities associated

with the animal%s !isit as related to safety and hygiene. This includes ma#ing sure thatthe animal has an acceptable temperament for interactions with children and that theanimal is current on all !accinations 8if appropriate9. Any animal that has a history ofbiting or other aggressi!e beha!iors will not be allowed onsite.

The animal will be properly cared for while onsite. This is the responsibility of the

!isiting animal%s owner.

The animal will not be allowed in any food preparation areas. Items associated with

the animal& including cages& food& water& etc.& will not be placed on foodcontact

surfaces. Children will be closely super!ised while handling the animal. Children will be in small

groups of < or fewer while handling the animal.

Children will immediately wash hands after handling or feeding the animal.

Handwashing will be closely super!ised by staff.

After the animal lea!es the site& staff will clean and saniti"e the area. Sin#s that are

used for food preparation or cleaning dishes are not used to clean animal supplies orcages. If necessary& animal supplies will be cleaned 8in which sin# G preferably a

4anitorial or utility sin#9.

Staff will wash hands after cleaning and saniti"ing the area.

TRAN"PORTATION "A#ETY

)nclude this section if the child care transports children. ther&ise delete.All !ehicles will bemaintained in good operating condition. A safety chec# will be done 8how often9by the dri!er. All!ehicle maintenance is conducted by 8who9. 6ehicles will be properly licensed and insured.

Childadult ratios will be maintained in !ehicles. All adults and children riding in the !ehicle willuse ageappropriate safety restraints 8seatbelts& car seats& booster seats9. estraints forchildren with special needs will be appropriate for the child. Car seats and booster seats are

pro!ided by 8the center G or G parents1guardians9. To ensure car seats and booster seats areproperly installed& 8describe steps ta#en G e(amples include ta#ing !ehicle with seats installed toa car seat safety chec# location& insisting parents pro!ide car seat installation information fromthe manufacturer& etc.9.

All !ehicles will contain a first aid #it& 8type of communication G cell phone& two way radio9 as ameans of communication& emergency supplies for children with special needs 8e(ample= *piPenor inhaler9& and all children%s emergency information. Dri!ers will not use cell phones whileoperating the !ehicle.

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Signed field trip permission slips are #ept onsite at the center.

Dri!ers will ha!e a current dri!er%s license& bac#ground chec#& and CP1 'irst Aid training.Dri!ers recei!e training on safe !ehicle operation from 8who9. This training consists of 8describetraining9.

ee net pa"e for si"nature pa"e

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'ame of Center

Health Policy e!iew$onth& 2/-/

"INATURE"

This program%s health policies ha!e been re!iewed as complete. The signing ofthe document does not imply obser!ation of procedures in practice& nor the ualityof the program. I ha!e re!iewed these health policies and they appear to meetminimum licensing reuirements de!eloped by the Washington State Departmentof *arly +earning for child care facilities certified by them.

e!iew Date= L$)7TH and dayLLL2/-/

e!iewed by=LLLLLLLLLLLLLLLLLLL e!iewed by=LLLLLLLLLLLLLLLLL$icha Horn&*HS Alba SuZre"& 7& 3S7*n!ironmental Health Specialist egistered 7urse

LLLLLLLLLLLLLLLLLLLLLLLDirector%s 7ameDirector& 7ame of Center

Documents

Health Policy for Billie's Busy Kids, LLC