Daycare Deals

As of May 1st, surveyors are now required to ask 3 additional questions:

1. Do children brush their teeth after snacks?

2. Do children brush their teeth after meals?

3. Is your facility breastfeeding friendly?

Depending on a provider's answers (yes or no) to these questions, a surveyor may add a consultation to the Notice of Survey Findings. The surveyor may discuss good practices for teeth brushing and when to replace toothbrushes. For breastfeeding, surveyors may also discuss how to encourage breastfeeding mothers to continue breastfeeding after enrolled in care.

As of right now, teeth brushing is NOT mandatory for home daycares, but it sounds as if they are heading for some new regulations, teeth brushing being one.

The Administration for Children and Families (ACF) has come up with some basic standards and are allowing comment until midnight, February 17, 2015. This is a chance for providers to have input in what they are considering the basic requirements for the safety of children. To provide input, email cfocbasics@acf.hhs.gov. This was published in an article on the Federal Register. The article can be found here.  The article is lengthy, so I've tried to summarize some of the parts that differ from Kansas providers' regulations.

Education/Training

• All caregivers, substitutes, and family members over 18 (living in the home) have a background check that includes fingerprinting.
• All caregivers should have training in infectious disease prevention; emergency preparedness; nutrition and age-appropriate feeding; medication administration; and care plan implementation for children with special health care needs.

• Require developmental/behavioral screening of all children at the start of care and yearly thereafter. 

• No electrical devices near a body of water, including a sink or tub.
• Integrate a pest management program.
• If the state requires them, carbon monoxide detectors. Detectors must be tested monthly, annual battery replacement, and completely replaced every 5 years.
• No toy guns

• All play areas should be enclosed with a fence or natural barrier. Fences should have at least 2 exits, with one being away from a building.
• Gates should have self-closing latches placed where a child could not open the gate.
• Fence openings should be no more than 3 1/2 inches apart.
• Any climbing equipment must have ground cover.
• Anyone transporting children must be at least 21 years of age.
• Anyone transporting children must have a clear driving record of no crashes requiring a citation in the last 5 years. 
• Providers should not use 15-passenger vans whenever possible.

• Written policies for the following: Lost or missing child, Suspected maltreatment of a child, Suspected sexual, physical, or emotional abuse of staff, volunteers, or family members occurring while they are on the premises of the program, Injuries to children requiring medical or dental care, Illness or injuries requiring hospitalization or emergency treatment, Mental health emergencies, Health and safety emergencies involving parents/guardians and visitors to the program, Death of a child or staff member, The presence of a threatening individual who attempts or succeeds in gaining entrance to the facility.
• All providers have a sign in/sign out procedure.
• Updated health assessments in the child's file.
• Health history completed by the parent/guardian at admission in child's file.
• Two inspections a year--at least one unannounced.
• States should post results of complaints for public view.

         I've been a licensed provider for 5 years now, but I never posted any of the stack of exceptions I had heard about because none of the exceptions applied to me at the time. I just had my survey this week, and I found out about the one exception that was not written into the Lexie's Law changes in 2012 and about a newer exception form that some might not know about since it's so new.

       1.  The one exception that didn't get into Lexie's Law states that providers are allowed to use any child health assessment form instead of only being able to use the KDHE form. I know over the years I've witnessed providers ask other providers if a form from a foster care system or something else was ok instead of making everyone get the KDHE form. If you have this exception posted, you can take forms other than KDHE. If you need to print out this form, you can find it here.

       2. The new exception that might need posted in your daycare became effective March 10, 2014. Before this date, the KDHE health assessment only allowed a doctor or nurse to sign it and not a PA. This new exception form allows a PA to sign the form, which is good because so many doctor's offices have PAs now. If you need to print out this form, you can find it here.

If these don't effect your daycare, you of course don't need them. But, I thought I'd put the information out there because I wasn't aware of these 2 exceptions until my recent survey.

As of July 1, 2014, providers now need to develop additional emergency plans. These new plans include missing child, chemical release, utility failure, acts of violence/terrorism, or other situations that might require evacuation, lockdown, or shelter in place. See the information here on KDHE's website.

Some surveyors have sent out emails to providers but other areas have not been informed yet of these changes. Providers who have had recent surveys have been told that they have until next year to develop these plans.

Here are some links as you develop your plans. I'll post an example of the ones I developed.

UPDATE: After my survey, I found out that I needed to add something to my evacuation plan. You need to put in your plan the route you will take to your evacuation location so that parents could follow your "footsteps" if needed. (Also, it is ok to transport the kids in an evacuation even if you don't transport. KDHE was told that providers should put the kids in a vehicle and transport if being told to evacuate. Providers don't have to fill out the transportation paperwork [first aid kit, insurance, etc] because it would be an emergency situation.)

I've also been told that the City of Wichita would like to have providers call the police first thing for the missing child. I'm not sure about other police departments. My surveyor didn't say I needed to change anything about how my Missing Child policy was written.

https://childcareta.acf.hhs.gov/sites/default/files/epr_provider_resource_guide.pdf

http://www.naccrra.org/sites/default/files/default_site_pages/2012/disaster_guide_v02-072706-2_0.pdf

http://www.healthychildren.org/English/safety-prevention/at-home/Pages/How-to-Prepare-for-Disasters.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

http://www.chemicalspill.org/Quick/long.html

I just learned of this, so I am trying to get this out to as many providers as I can before Wednesday.