(A) Each day infants shall be allowed to safely and comfortably sit, crawl, toddle, walk and play according to the infant's stage of development, in a designated space that does not allow the infant to access the underside of the crib.
(B) The provider shall devise and implement a program of activities suitable to the age level and ability of the infant in care.
(1) Each infant shall be removed from the crib, swing, infant seat, exercise seat or other equipment throughout the day for individual attention.
(2) Outdoor play shall be provided on a daily basis for infants in suitable weather.
(C) The provider shall maintain a daily written record for each infant that is given to the infant's caretaker on a daily basis. The record shall include the following information:
(1) Food intake.
(2) Sleeping patterns.
(3) Times and results of diaper changes.
(4) Information about daily activities.
(D) Each infant shall be removed from his or her crib for all feedings. Infants shall be held or fed sitting up for bottled feedings. At no time shall a bottle be propped for an infant.
(E) Infant food shall be prepared and served in a manner appropriate to the developmental needs of each child. The provider shall introduce new foods only after consultation with the caretaker. The provider shall comply with written feeding instructions from the caretaker, infant's physician, physician's assistant or certified nurse practitioner (CNP), which shall include the following:
(1) Type of food and/or formula.
(2) Amount of food and/or formula.
(3) Feeding times or frequency of feedings.
(F) Formula, breast milk, or other liquids in a bottle shall not be heated in a microwave oven.
(1) If formula or breast milk is to be warmed, bottles shall be placed in a container of hot, not boiling, water or be placed in a commercial bottle warmer. The container of water shall be emptied and cleaned each day. The bottle shall be shaken well, and the formula or breast milk temperature tested before feeding.
(2) Frozen breast milk shall be thawed under cold running water or in the refrigerator.
(G) The unused portion of formula, breast milk or food remaining in a container from which the infant has been directly fed shall not be reheated or served again.
(H) The provider shall store, prepare and serve food, formula and breast milk in a safe and clean manner.
(I) When infant formula is prepared by the provider, it shall be prepared according to the manufacturer's instructions or instructions from the infant's physician, physician assistant or CNP.
(J) Providers that care for formula-fed infants shall have the appropriate commercially prepared formula for the infant available in the home in the event that the caretaker does not provide a quantity sufficient to meet the infant's daily needs.
(K) Open containers of ready to feed and concentrated formula shall be covered, dated and refrigerated according to the manufacturer's instructions. Prepared formula and food shall be discarded or sent home daily if not used.
(L) All formula or prepared food shall be labeled with the infant's name and date of preparation. All formula shall be refrigerated immediately after preparation or upon arrival if the formula is prepared by the caretaker and sent home daily. All commercially prepared food shall be stored according to manufacturer's instructions and not served after the expiration date.
(M) If breast milk is provided by the caretaker, it shall be labeled with the infant's name and the date expressed. Providers shall follow the chart below in regard to storing breast milk:
Breast milk storage
If the breast milk is stored: Then keep it as long as:
at room temperature (up to 78 degrees Fahrenheit) 6 to 8 hours
in the refrigerator (39 degrees Fahrenheit or lower) up to 5 days counted from the day the breast milk was expressed
in a freezer compartment inside a refrigerator (5 degrees Fahrenheit) 2 weeks
in a freezer compartment of a refrigerator with separate doors (0 degrees Fahrenheit) 3 to 6 months
chest or upright deep freezer (-4 degrees Fahrenheit) 6 to 12 months
Replaces: 5101:2-14-08, 5101:2-14-32
R.C. 119.032 review dates: 03/31/2013
Promulgated Under: 119.03
Statutory Authority: 5104.011
Rule Amplifies: 5104.011
Prior Effective Dates: 4/1/82, 5/20/83, 10/1/83, 9/1/86, 9/25/86, 2/15/88, 5/1/89, 10/15/96, 10/1/97 (Emer.), 12/30/97, 4/1/03