Daycare Deals

So, I was reminded of something today when a family member called me. I've never actually written a post on how to go about starting a daycare. I am humbly apologetic to those who may have found the blog and needed to know how to begin a daycare. I started the blog in May 2010 (on a different website even) without thinking about the prospective providers. I will now remedy my error. :) ***Please note that regulations that will change daycares in KS are being proposed. The current regulations may change a little in the middle of you starting your daycare.

To start a KS daycare (or just start looking into it), these are my best recommendations.

1. Find out your local contact information for daycares in your county/area. The local contacts can be found here, listed by county. If it directs you to a website, you should find the childcare licensing information by going to the part about the health department.

2. Schedule or attend (an already scheduled--SG county has monthly scheduled orientations) orientation at your local health department. (Less populated areas of KS may do these over the phone.)

3. Call your local contact to see who your local fire marshal is. I would schedule a walk through of the area you are planning to use. *This is important because the fire marshal will inform you of how many/where fire alarms should be located. They can be expensive, so you'll know how many to expect. Also, you may plan to have the kids in the basement, but your basement may not be acceptable as a place for the kids. (It has to have two means of egress.)

4. Review this checklist. This is the same list that an inspector uses to evaluate your house. This will guide you in what needs to be locked up/stored high.

5. If you are ready to go on with your daycare, fill out the paper application and mail it to your local office or fill out the online application here.  *The fire marshal should have come out a second time to complete your official inspection before you send off your application. The orientation class and CPR/First Aid are also requirements. ***Applications can take awhile (possibly 3-6 months), so you should plan to have the application completed in advance of when you want to start your daycare.

6. [This is optional.]  See if a surveyor from your area will come by to check out your home before making an official visit. It would be easier to know if you need to lock something up/move something before a formal visit. Plus, they won't bring the carbon-paper forms with them...yet (They're really busy, but they might be able to swing by.)

Good luck!!!

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 Before starting a KS daycare, you can make sure you're ready and know what to expect. These are some ways to prepare/questions to ask yourself/things to know.

1. Contact your local contact for information on the local resource and referral agency. My agency (Childstart) sends out a checklist to use when deciding if a home daycare is for you. I would assume that the other referral agencies would do the same.

2.  Be good with keeping track of expenses. Most important: Be sure you can afford to do daycare. Taxes are not taken out during the year, so you might have to pay taxes to the Federal and KS governments. Money should be set aside during the year so that it's not a huge blow to you at tax time. (This may not happen the first year--initial daycare setup costs, but I would be prepared to pay in to the government.)

3. Figure out if you can afford the startup costs. If you don't have the items already, it can be expensive to accumulate children's toys and other needs. *I recommend Craigslist, Freecycle, and consignment sales for items.

4. Know that swingsets have to have appropriate ground cover. The grass/dirt is not approved.

5. Ask yourself if your spouse/partner will be ok will having small children around the house. The house gets beat up a little--they're kids. I've got food/chocolate milk on my ceilings, crayon on my table, spills everywhere, fingerprints on the walls. (Having the marks of your chosen career as daily reminders can take a toll on your spouse/partner. I would consider his/her feelings about this.)
 
I've run out of thoughts for now, but I'll update if I think of anything else. Please leave comments/questions in the comment section.

• ·      Should go live within the next week --This is live now.
• ·      Anyone/anywhere can search for your daycare. Currently, the default listing is only name and license number.  If a provider chooses to,  she/he could request that an address and phone number is listed. *I will not be listing my phone number or address because anyone could look up this information.
• ·      All licensed providers/centers will be listed in the system. You cannot opt out of having your name and license number listed.
• ·      The information in the system will be from the last 3 years.
• ·      Complaints—even if no violations were found—will be listed.
• ·      New complaints will not be listed until the complaint is closed.
• ·      The training requirements will not have to be met until 2-3-13, but your NOSF will show that your surveyor consulted you about needing to complete the required trainings. This consultation will be listed in the online system.

• ·      If a currently licensed provider moves to another county or changes his/her program type, he/she needs to have a new orientation that is KDHE approved.
• ·      All providers are required to provide orientation pertaining to his/her own home. Areas to go over should be: supervision plan, safe sleep policy, health & safety practices, confidentiality, and anything else that the provider deems necessary. (Documentation showing that an orientation was given should be kept in the substitute/employee’s file. Must be in compliance with this by May 2012.
• ·      Some counties provided orientations for registered providers separate from licensed providers. If your county did this and you were formally registered, you will need to attend a licensed orientation. *SG county combined registered and licensed, so anyone in SG county should be fine.
• ·      Providers should be able to provide the month/day/year of their orientation. *They said that providers who have been doing care for many, many years shouldn’t have to attend another orientation unless they switch types or move counties.

• ·      Providers who are currently licensed have until 2-3-13 to meet the new training requirements. The required trainings include: First Aid/CPR, signs of abuse and neglect, Safe Sleep, Basic Child Development.
• ·      If your county formerly offered a signs and systems of abuse class, the class will need to be retaken if the class did not cover head trauma. *SG county classes that were previously offered do not count and will need to be taken again.
• ·      SIDS/Safe Sleep classes must be KDHE approved. If you took SIDS/Safe Sleep at one of the trainings days that KDHE provided in 2010, the class will count for the SIDS/Safe Sleep requirement. *I attended a Safe Sleep class at the SG County health department. That class would count for me.
• ·      Pediatric/First Aid and Infant/Child CPR class certifications must be kept current. *The card for pediatric first aid may night say that it covered pediatric first aid, but that is ok as long as you can tell your surveyor that it was covered. The CPR card must say Infant/Child on it.
• ·      Resources for KDHE approved classes: KSCL online, Child Care Aware, Child Start, your local referral/resource agency
• ·      Each year, the annual 5 hours must be KDHE approved. The classes provided by the food program do count for annual hours.

• ·      If switching license types or adding a new substitute/employee, the new person will not have until 2-3-12 to meet the training requirements. All new substitutes will have only 30 days to meet the training requirements.

• ·      All cribs used in a daycare must have a sticker dated after 6-28-11.

• ·      Unused formula/breastmilk in a bottle that an infant did not finish cannot be stored in a refrigerator. It must be discarded.
• ·      Formula/Breast milk cannot be heated in a microwave
• ·      Must be in compliance with this by May 2012.

• ·      They get phone calls from upset parents asking if it is okay that a provider won’t take non-potty trained children or won’t take children under 2, etc. If you have personal policies, KDHE says to put them in your handbook/policies. *KDHE cannot mandate what we charge or if we choose not to take non-potty trained children. They just have parents who call to complain.
•  Bagging up soiled clothing (potty-training accident, etc) is something KDHE supports because the provider is following the regulations. [Parents apparently call about this a lot.] *This section doesn't really concern the new regulations, but KDHE spoke about this.
• 
  
• WATER
• ·      It seems like common sense, but all children should be given water if they request it. They should not be told that it isn’t time for water/drink time yet.
• ·      Must be in compliance with this by May 2012.

• ·      In a temporary absence (must be less than 3 hours per day), a substitute must meet these three requirements:

• ·      In an extended absence (more than 3 hours per day), a substitute must have the same new trainings as the provider:

• ·      Play areas now have to meet “use zone” requirements. If you pull your swing it either direction, you should have 1 in of clear space for every foot that the swing is extended in front or behind the swing. The space in front of the slide must be clear as well. (I think this is the way to explain it. My surveyor just went out to the playset and held the swing back to make sure enough space was met.)  *KDHE cannot regulate the depth of the approved surface under the play area. They can cite a violation if any bare spots are showing.
• ·      Manicured grass is not allowed under anchored play equipment. Approved surfaces are listed in the regulations. Sand is included as an approved surface. Landscaping mulch is not.
• ·      If you have moveable play equipment, ie Little Tykes toys, they do not have to be on top of approved ground cover. They should be on the grass or a mat should be under them to protect the children.
• ·      Trampolines must remain inaccessible to children in care but do not have to be in a separate fenced area. They should be as far removed from the play area as possible. Steps must be removed, enclosure zipped, and all children (even the provider’s are not allowed on the trampoline during daycare hours).
• ·      Must be in compliance with this by May 2012.
• ·      As of March 1, 2012, all new licensees must have an outdoor play area. 

• ·      They expanded the guns/weapons information. Even items such as bb guns, air guns, fishing knives should be locked away.
• ·      Guns and ammunition must be locked in separate containers. Even if they are in the same gun safe, the ammunition must be in a separate locked box.
• ·      Must be in compliance with this by May 2012.

• ·      No blanks should be on the forms. Write no or N/A if needed.

• ·      Accordion gates are absolutely not allowed in daycare at all anymore. EVER.
• ·      At the top of the stairs, the baby gate needs to be one which is mounted on one side of the wall.
• ·      At the bottom of stairs, a pressure gate may be used, but not an accordion.
• ·      Must be in compliance with this by May 2012 

• ·      Written, posted, and documented that the provider shared the supervision plan with parents. Plans would likely go something like “Our main play area is… This is how I supervise them in this area…” or “Our kitchen is here…This is how I supervise…”
• ·      I would recommend running your supervision plan by your surveyor before reviewing it and posting it.
• ·      Must be in compliance with this by May 2012 

• ·      If the weather does not permit outside play, 1 hour of physical activity must still be met. This can include dancing, jumping, etc.
• ·      If a child isn’t a napper, he/she must be given a quiet activity during nap time.
• ·      If showing a movie/tv show(G rated), children cannot be forced to watch it. If they do not watch, they need to be given an alternate activity.
• ·      Must be in compliance with this by May 2012. 

• ·      A blanket (even a lightweight one) is not advised for infants under 12months. Swaddling is not allowed unless a doctor’s note is given and the provider gets an exception. *The regs state that a lightweight blanket could be used, but KDHE is saying no blankets. The regulation does say that sleepers or sleep sacks are okay.
• ·      Must be in compliance with this by May 2012.

• ·      Children/Staff should wash their hands after handling pets. The regulations go into further detail about handwashing.
• ·      Must be in compliance with this by May 2012

• ·      All new regulations except for the training requirements must be met by May 2012.
• ·      The training requirements must be met by 2-3-13.
• ·      All complaints, NOSF forms, and any consultations (including those made about not yet meeting the training requirements) will be listed in the online system for anyone to see. *Example: I renew in October. If I haven’t met all the training requirements (even though I have until 2-3-13) before my annual survey, a consultation is written on my NOSF. Potential parents will be able to see that. Hopefully they will understand that a consultation is not a bad thing in this situation.
• ·      Blankets are not to be used with infants.
• ·      Play areas must have approved ground cover.
• ·      Accordion gates are never to be used in daycare.

These are some classes being offered that can help meet the training requirements we need to be in compliance with the new regulations. We need signs & symptoms of abuse, Safe Sleep/SIDS, a basic child development class (I cannot say if any of these classes meet the basic child development requirement), and to keep our CPR/first aid certifications current. I like that I know when these classes are in March and April because I want to wait until our Sedgwick County surveyors are trained in March before taking any classes; this way I can take them with my substitute if my sub will need to meet the requirements. To sign up, call 641-1485 or email angela.bitker@yahoo.com. All of these classes are KDHE approved.

February
21st, 7pm-10pm, $34, Adult, Child and Infant CPR/AED
23rd, 7pm-9pm, $10, Basic Training Health and Safety
28th, 7pm-9pm, $10, Child Abuse and Neglect Signs and Symptoms of Childhood Illness

March
6th, 7pm-9pm, $10, Fearful, Flexible and Feisty Temperaments
7th, 7pm-9pm, $10, Basic Training Chiold Development and Discipline Techniques
12th, 7pm-10pm, $34, Adult, Child and Infant CPR/AED
26th, 7pm-9pm, $10, Child Abuse and Neglect Signs and Symptoms of Childhood Illness
27th, 7pm-9pm, $10, Play: The Good Four Letter Word

April
3rd, 7pm-9pm, $10, Fearful, Flexible and Feisty Temperaments
9th, 7pm-9pm, $10, Pediatric First Aid Introduction and Refresher
11th, 7pm-10pm, $34, Adult, Child and Infant CPR/AED
16th, 7pm-9pm, $10, Reducing the Risk of SIDS
17th, 7pm-9pm, $10, Child Abuse and Neglect Signs and Symptoms of Childhood Illness


 Call 641-1485 or email angela.bitker@yahoo.com to sign up for these classes.


(Disclosure: I am in no way associated with the teacher of these classes. I just wanted to pass information along about these classes.)

First of all, KDHE updated the regulations. You can find them here on KDHE's site if you haven't already seen them.

Were you aware that KDHE hosted a Twitter discussion about the new regs last Friday? I wasn't. I don't do Twitter, but it is easy to access the information with just a Google search. I found the questions and answers from the other day, and I have provided the information for you below. Since they do a lot of referring to the regs, I'll include an explanation and wording from the regulations if I feel that it is needed. My explanation will be in [].

I just came across this article for those of us who were unable to attend the May 17th hearing on the proposed regulations. I liked it because the article states some of the concerns that providers had about the proposed regulations. You can also download and listen to the hearing.

Some highlights I found from the live tweets were:

1:48 PM @KansasWatchdog: Insurance counselor at KDHE hearing says proposed regulations have good intentions but overly burden child care providers


2:22 PM @KansasWatchdog: Provider says touching a child every 15 minutes when napping is not common sense.


2:34 PM @KansasWatchdog: Child care provider at KDHE hearing concerned that new regulations will result in less diversity in services; wonders about KDHE’s purpose.


2:54 PM @KansasWatchdog: Child care provider says new touching regulation while sleeping would provide false sense of security to parents about SIDS issue.


Find the article here.

Source: Earl F Glynn. Concerns about new child care regulations at KDHE hearing. http://kansas.watchdog.org/6857/concerns-about-new-child-care-regulations-at-kdhe-hearing/

According to KDHE's website, some of the forms were updated as of 8/2011. I get my renewal packet in the mail in July, so the new form was a surprise to me. I figured that some of you might not be aware of the change either. The only difference I could find was with the health assessment form that the doctor/nurse fills out. It has changed a lot. Find the new form here.

What this means for providers:

According to my local office, this new form is to be used for all new children in care. However, it was suggested that the new form be sent with parents if they are taking their child/children to the doctor. Also, if you do a yearly update of records to make sure that all contact information/shot records, etc. are correct, then you should update to the new health assessment form.

As far as I am aware, the KDHE surveyors will not require current children to have the updated health assessment. If you have questions on this, please let me know.

Also, as it is almost January, the new regulations are supposed to be start being enacted at the beginning of 2012. See my post about that here.

Update: Find an article that details parts of the hearing if you are interested. 

I attended a meeting for home daycare providers a couple weeks ago at my local health department. I went to get information about the proposed regulations. So, this is what I was told:


KDHE is pushing the regulations back to the beginning of the year. It will likely be January 2012 (hopefully not later) before we know exactly what the new regulations will be. 

Other news:
The SG County surveyors were all supposed to be issued tablets, printers, and cameras at the end of Sept. The survey findings will be sent electronically to KDHE right away. With these tablets, some surveys are taking around 3 hours because the tablets keep having issues. Hopefully, the bugs will get worked out of this new system. Update: My surveyor said that they should be using the new tablets starting in January.

For a refresher on the proposed regulations, click here and look for the summary. They've taken down the information from KDHE's website about the actual wording of the regulations.

I received this information in an email from my local office. This information concerns parents and caregivers of premature infants.

KDHE has been notified by the FDA to advise parents, caregivers and health care providers not to feed SimplyThick, a thickening product, to premature infants.

This product may be associated with necrotizing enterocolitis (NEC), a life-threatening condition.

Since May 13, 2011 FDA has been notified of 15 cases of NEC, including two deaths, involving premature infants who were given SimplyThick for varying amounts of time. The product was mixed with mothers’ breast milk or infant formula products. In Kansas, two cases of NEC have been reported in premature infants that were given this product.

NEC most often occurs in premature infants while still hospitalized. The current situation is unusual because some of the infants had been discharged from the hospital on a feeding regimen that included SimplyThick and then developed symptoms of NEC while at home.

NEC is a life-threatening condition characterized by inflammation and death of intestinal tiss ue. Signs and symptoms of NEC include appearance of a bloated abdominal area, feeding intolerance, greenish-tinged (bile) vomiting and bloody stools.

SimplyThick is one brand of thickening agent available to medical centers and consumers. The product is sold in packets of individual servings and in 64-ounce dispenser bottles. The product can be purchased from distributors and local pharmacies throughout the United States. Images of the SimplyThick label and packaging can be viewed at: www.flickr.com/photos/fdaphotos/sets/72157626641899297/.

Health care professionals and patients are encouraged to report adverse events or side effects related to the use of this product to the FDA's MedWatch Safety Information and Adverse Event Reporting Program by:
• Completing and submitting the adverse report online: www.fda.gov/MedWatch/report.htm
• Downloading the pre-addressed, postage-paid FDA Form 35003 at: www.fda.gov/Safety/MedWatch/HowToReport/DownloadForms /default.htm (or calling 1-800-332-1088 to request the form), completing it and faxing it to 1-800-FDA-0178; or Mailing the completed form to MedWatch 5600 Fishers Lane, Rockville, MD 20857.

For additional information on this investigation please call the FDA at 888-INFO-FDA or the KDHE Epidemiology Hotline at 877-427-7317.

So, I normally just delete the emails about crib standards because my father-in-law built mine; it isn't a drop-side either. However,  I decided to read the one today from my health department. I'll just copy and paste the text from the email and highlight the important information:

It is important to note that Beginning June 28, 2011 all cribs manufactured and sold (including resale) must comply with the new standards. Child care facilities have until December 28, 2012 to phase out non-compliant cribs.  This is more than a “drop-side’ issue and it is unlikely that cribs currently in use comply with the new standards.  The attached material includes information for providers on how to obtain documentation that a crib in current use or one considered for purchase meets the new federal standards.

You can find the "attached material" mentioned above here. It's the pdf about New Federal Crib Standards.

Next Steps:
1. Determine if your current crib meets the new standards.
2. Decide if you want to buy a whole new crib if your current crib does not meet the new standards. You might decide that you would like to use a pack n play instead of a crib due to the cost of cribs.

They have finally posted the date for the hearing on the new regulation changes:

The Kansas Department of Health and Environment,
Division of Health, Bureau of Child Care and Health Facilities,
will conduct a public hearing at 1 p.m. Tuesday,
May 17, in the Memorial Hall Auditorium, 120 S.W. 10th
Ave., second floor, Topeka, to consider the revocation of
family day care home regulations

Please try to attend the hearing if possible.  If you cannot attend the hearing, you can email (dtenney@kdheks.gov) or write a letter with your thoughts on these regulations. They are not finalized yet--providers have a chance to be heard at the hearing. If you would like something changed though, make sure to say how you would like it changed. The panel must take every comment into consideration, so let your voices be heard!

Information on comments:
The time period between publication of this notice and
the scheduled hearing serves as the required public comment
period of at least 60 days for the purpose of receiving
written public comments on the proposed amended
regulations. At any time during the public comment period
any interested parties may submit written comments
to Dorothy Tenney, KDHE, Child Care Licensing and
Registration Program, 1000 S.W. Jackson, Suite 200, Topeka,
66612-1274, by fax at (785) 296-0803, or by e-mail todtenney@kdheks.gov. During the hearing, all interested
parties will be given a reasonable opportunity to present
their views orally on the proposed new regulations as
well as an opportunity to submit their written comments.
In order to give each individual an opportunity to present
their views, it may be necessary for the hearing officer to
request that each presenter limit any oral presentation to
an appropriate time frame.



For now, this is the summary that is listed on the Kansas Register. (I like the more detailed PDF):

Summary of Regulations:
K.A.R. 28-4-93. Online information dissemination
system. Provides definitions of terms used throughout
the regulation; requires applicant or licensee to notify the
department if requesting that facility address and telephone
number be withheld from publication.
K.A.R. 28-4-113. Definitions. Provides definitions of
terms used throughout the day care and group day care
home regulations.
K.A.R. 28-4-114. Applicant; licensee. Describes application
process for license and applicant and licensee
requirements; addresses operation of more than one facility
and prohibits licensure concurrently for more than
one type of child care or child and adult care on same
premises; lists license capacity, counting a child not functioning
at developmental level, capacity not to be exceeded,
provision for emergency care, and additional
children on premises; requires appointment of substitute
for primary care provider; requires posting of temporary
permit or license and availability of current regulations;
addresses closure.
K.A.R. 28-4-114a. Initial and ongoing professional development.
Requires orientation for applicant and anyone
caring for children; describes health and safety training;
requires first aid and CPR; lists initial and annual
professional development requirements; requires documentation.
K.A.R. 28-4-115. Facility. Describes water and sewerage
systems requirements and drinking water for infants;
addresses general environmental requirements, fire
safety approval, fire inspector approval for use of basement
or second floor, and prohibits use of third floor;
requires refrigerator and storage of refrigerated medications
in locked box; addresses storage of hazardous items
and storage of guns and other weapons; requires designated
outdoor play area.
K.A.R. 28-4-115a. Supervision. Requires and describes
contents of a supervision plan; describes requirements for
general supervision of children, indoor and outdoor supervision,
and evening and overnight care.
K.A.R. 28-4-116. Daily care of children. Requires communication
with parents; addresses requirements for
daily schedule of activities; assisting child with personal
care, hand washing; prohibits smoking; lists requirements
for nutrition and food service; requires recordkeeping.
K.A.R. 28-4-116a. Napping and sleeping. Requires rest
period for each child; describes elements of safe sleep
practices, lists requirements for sleeping surfaces and
consumer warnings or recalls; addresses transition from
crib or playpen to other surface.
K.A.R. 28-4-120. Family day care home certificate of
registration. Revoked effective July 1, 2011.
K.A.R. 28-4-121. Required immunizations for children
under 16 years of age. Revoked effective July 1, 2011.
K.A.R. 28-4-428a. Education and training requirements.
Requires orientation for applicant and staff; describes
health and safety training, requires first aid and
CPR; lists education and annual in-service training
requirements; requires documentation.
K.A.R. 28-4-440. Infant and toddler programs. States
program requirements, including use of ground floor
only, separate units from those for older children; prohibits
floor furnaces; for infants, requires separate sleeping
area and crib or playpen for each infant; lists requirements
for cribs and playpens and consumer warnings or
recalls; lists elements of safe sleep policies and practices;
requires attendance to children when awake; requires
adult-size rocking chair for each unit and chairs, tables,
etc., for children not held for feeding; requires provision
of towels and washcloths or disposable products; addresses
cleaning of items that children may place in their
mouths; lists staff requirements; addresses program
requirements; lists food service requirements; lists
requirements for toileting; requires daily communication
with parents and guardians.

Economic Impact:

Cost to the agency: There is no additional cost to the
agency. Any costs will be absorbed in the current budget.
Cost to licensees: There is no cost for licensees pertaining
to the online information dissemination system.
For the professional development and training requirements
(K.A.R. 28-4-114a and K.A.R. 28-4-428a) a number
of current licensees and care providers, as part of their
own professional development, already meet these
requirements. For those who do not meet the requirements,
there are low-cost training opportunities through
resource and referral agencies, county health departments,
and other community partners. The proposed new
regulations allow current licensees and staff up to one
calendar year to complete the requirements.
K.A.R. 28-4-116a and K.A.R. 28-4-440 prohibit the use
of drop-side cribs in child care facilities after December
28, 2012. This prohibition is due to a recent change in
federal standards for the manufacture and sale of cribs,
which include a requirement that child care facilities
phase out the use of drop-side cribs by that date. The
purpose of the delayed compliance date is to provide adequate
time for the manufacture of complying cribs and
for facilities to obtain complying cribs. In Kansas, licensed
day care homes, group day care homes, and child care
centers with infants enrolled may use either cribs or playpens
for napping or sleeping infants. It is unknown how
many facilities currently have cribs that must be replaced
by December 28, 2012. For those facilities replacing noncompliant
cribs, the estimated cost per crib is $200-$500.
Child care facilities will continue to have the option to
use the less expensive playpens.
Costs to other governmental agencies or units: There is
no known additional cost.

As always, this is the information I have. If you have questions/comments, let me know. I'll do my best to respond.

 First of all, this is just a bill. It may or may not be passed, so please do not PANIC. I would just like everyone to be aware of what is happening in KS in regards to child care.

I received an email today from my county office about two new bills that have been introduced into the House. This is the exact wording in the email I received:

Again, these are bills that have just been introduced.

I found an article on the repeal of Lexie's Law:

http://www.khi.org/news/2011/jan/27/legislator-calls-repeal-lexies-law/

Let me know in the comments what you think about these 2 proposed bills.