(A) Daily care:
(1) The licensed type B home provider shall allow infants 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.
(2) The provider shall remove each infant from the crib, swing, infant seat, exercise seat or other equipment throughout the day for individual attention.
(3) The provider shall maintain a daily written record for each infant that is provided to the infant's caretaker on a daily basis. The record shall include the following information:
(a) Food intake.
(b) Sleeping patterns.
(c) Times and results of diaper changes.
(d) Information about daily activities.
(4) Each infant shall be removed from his or her crib or playpen 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.
(B) Bottle and food preparation:
(1) 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:
(a) Type of food and/or formula.
(b) Amount of food and/or formula.
(c) Feeding times or frequency of feedings.
(2) Formula, breast milk, or other liquids in a bottle shall not be heated in a microwave oven.
(a) ) 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.
(b) Frozen breast milk shall be thawed under cold running water or in the refrigerator.
(3) 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.
(4) The provider shall store, prepare and serve food, formula and breast milk in a safe and clean manner.
(5) If 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.
(6) Providers who 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.
(7) 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.
(8) 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.
(9) If breast milk is provided by the caretaker, it shall be labeled with the infant's name, the date pumped, and the date the bottle was prepared. Providers shall follow the chart in "Appendix A" to this rule for storing breast milk.
(1) The provider shall check diapers at least every two hours. Diapers shall be changed immediately when wet or soiled.
(2) Clothing shall be changed immediately when wet or soiled.
(3) When changing diapers the provider shall comply with the following:
(a) The provider shall wash all soiled areas of the child's body with either a wash cloth which is then appropriately sanitized or a disposable wipe.
(b) If a diaper-changing surface is used to change more than one child, the provider shall place a disposable separation material between the child and the changing surface. A different separation material shall be used for each child. The diaper changing surface shall be sanitized after each diaper change with an appropriate sanitizer. If the surface is visibly soiled, it shall be cleaned with soap and water prior to sanitizing.
(c) If an infant's diapers are to be changed in a crib, there shall be a separation material between the infant and the crib sheet. If the bedding becomes wet or soiled during the diaper change, it shall be replaced with clean bedding.
(d) No child shall be left unattended on the diaper changing table.
(4) The provider shall ensure the caretaker provides a clean supply of diapers and an extra change of clothing that shall be available at all times.
(5) The provider shall store and launder soiled diapers or clothing as follows:
(a) If soiled diapers or clothing are to be sent home with a caretaker, the provider shall store the diapers or clothing for no longer than one day in an individual covered container or plastic bag away from the child's belongings and out of the reach of children.
(b) The provider shall store soiled diapers and diapering washcloths, which are to be laundered in the home, in a covered container with sanitizing solution.
(c) If soiled diapers are to be commercially laundered, the provider shall hold them for laundering pickup for no longer than seven days.
(d) The provider shall store soiled disposable diapers in a plastic-lined covered container that prevents hand contamination and is not easily accessible to children and discard diapers daily or more frequently as needed to eliminate odor.
(e) If the provider is laundering diapers, the provider shall follow the manufacturer's guidelines.
(6) Toilet training shall occur based on a child's readiness and consultation with the caretaker regarding practices in the child's home. The provider shall ensure that toilet training is never forced.
Replaces: 5101:2-14-34, 5101:2-14-35
R.C. 119.032 review dates: 01/01/2019
Promulgated Under: 119.03
Statutory Authority: 5104.018
Rule Amplifies: 5104.018
Prior Effective Dates: 4/1/82, 5/20/83, 9/1/86, 2/15/88, 5/1/89, 10/1/97 (Emer.), 12/30/97, 4/1/03, 8/14/08.