CHAPTER He-C 4000  CHILD CARE LICENSING RULES

 

Statutory Authority:  RSA 170-E:34, I

 

PART He-C 4001  NH RESIDENTIAL CHILD CARE LICENSING RULES

 

REVISION NOTE:

 

          Document #13181, effective 3-24-21, readopted with amendments the “New Hampshire State Fire Code Compliance Report” form pursuant to the expedited revisions to agency forms process in RSA 541-A:19-c.  Document #13181 contained only the amended form, giving it a new effective date, and updated the revision date on the form from “10/2014” to “3/2021.”  The “New Hampshire State Fire Code Compliance Report” form must be submitted pursuant to paragraph (d) of rule He-C 4001.02 titled “Application Form and Attachments”.  The requirements on the form are set forth in paragraph (e) of He-C 4001.02.  The prior filing affecting He-C 4001.02 was Document #13151, effective 12-30-20.  The effective date of the rule remained unchanged by Document #13181.  However, the requirements on the form with revision date 3/2021 would be the valid and enforceable rule in case of any conflict between the form and He-C 4001.02(d) and (e) in Document #13151 since the form is defined as a “rule” in RSA 541-A:1, XV and is the later enactment.

 

          He-C 4001.01  Definitions.

 

          (a)  “Administer” means an act whereby a single dose of a drug is instilled into the body of, applied to the body of, or otherwise given to a resident for immediate consumption or use.

 

          (b)  “Applicant” means a person, corporation, partnership, voluntary association, or other organization, either established for profit or otherwise, who intends to operate one or more residential child care programs, and who indicates that intent to the department by submitting an application and the application attachments required by He-C 4001.02.

 

          (c)  “Authorized staff” means program staff that have completed training in medication safety and administration who are responsible for administration of medications to residents.

 

          (d)  “Child” means “child” as defined in RSA 170-E:25, I.

 

          (e)  “Child abuse” means the infliction on a child of any of the behaviors set forth in RSA 169-C:3, II (a) - (d).

 

          (f)  “Child care institution” means “child care institution” as defined in RSA 170-E:25, III.

 

          (g)  “Child endangerment” means the negligent violation of a duty of care or protection owed to a child or negligently inducing a child to engage in conduct that endangers his or her health or safety.

 

          (h)  “Child neglect” means any of the behaviors or circumstances set forth in RSA 169-C:3, XIX (a) or (b).

 

          (i)  “Clinical coordinator” means a staff member employed by the residential treatment program responsible for administrative oversight of the clinical services provided at the program. This term includes “treatment coordinator.”

 

          (j)  “Clinical staff” means individuals who have a master’s degree in a clinical field such as social work, marriage and family therapy, psychology, guidance counseling, or a degree that would make one eligible for a license from the NH board of mental health practice or NH board of psychologists.

 

          (k)  “Commissioner” means the commissioner of the NH department of health and human services, or his or her designee.

 

          (l)  “Corporal punishment” means use of aggressive physical contact or other action designed to cause the resident discomfort, used as a penalty for behavior disapproved of by the punisher.

 

          (m)  “Corrective action plan” means “corrective action plan” as defined in RSA 170-E:25, VI.

 

          (n)  “Department” means “department” as defined in RSA 170-E:25, VII.

 

          (o)  “Direct care staff” means program staff who are responsible for providing direct care to residents.

 

          (p)  “Directed corrective action plan” means a corrective action plan that is developed and issued by the department.

 

          (q)    “Evaluation” means a multi-disciplinary assessment of the resident’s level of function by professionals licensed or certified in their respective fields of practice or study, which enables facility staff to plan care that allows the resident to reach his or her highest practicable level of physical, mental, and psychosocial functioning.

 

          (r)  “Field trip” means any excursion off the premises of the residential child care program with residential child care staff, other than routine or unplanned local travel such as walks in the neighborhood, travel to the local library, or other routine travel such as travel to and from school, employment, local appointments or travel to do local errands.

 

          (s)    "Full medical withdrawal management" means a protocol for a resident receiving 24-hour nursing supervision overseen by a licensed practitioner, who may be incapable of evacuating a facility on his or her own or may have medical conditions that require immediate medical intervention, such as seizures, tremors, delirium, cardiac, or are a danger to themselves or others.

 

          (t)  “Group home” means “group home” as defined in RSA 170-E:25, II(b).

 

          (u)  “Guardian” means “guardian” as defined in RSA 170-E:25, IX.

 

          (v)  “Homeless youth” means a person 16 through 20 years of age who is unaccompanied by a parent or guardian and is without shelter where appropriate care and supervision are available, whose parent or legal guardian is unable or unwilling to provide shelter and care, or who lacks a fixed, regular, and adequate residence.

 

          (w)  “Homeless youth program” means “homeless youth program” as defined in RSA 170-E:25, II(d).

 

          (x)  “Household member" means any person who resides in a child care program other than child care personnel or children admitted to the child care program.

 

          (y)  “Incident” means:

 

(1)  Resident behavior that is extreme, including, but not limited to, behavior that is assaultive, destructive, self-injurious, or self-destructive;

 

(2)  Any behavior leading to physical intervention or seclusion of a resident; or

 

(3)  An occurrence involving an accident or injury, or requiring outside agency involvement.

 

          (z)  “Independent living” means transition to adulthood whereby the resident negotiates living on his or her own with a set of skills and goals based on the resident’s needs and interests.

 

          (aa)  “Independent living home” means “independent living home” as defined in RSA 170-E:25, X.

 

          (ab)  “License” means “license” as defined in RSA 170-E:25, XI.

 

          (ac)  “License capacity” means the maximum number of residents that can be admitted to and present in the residential child care program, as authorized by the license issued.

 

          (ad)  “Licensed clinical supervisor” means a registered nurse (RN) licensed under the state of New Hampshire pursuant to RSA 326-B, or an individual licensed by the board of licensing for alcohol and other drug use professionals or board of mental health practice to practice and supervise substance use counseling who meets the initial licensing qualifications set forth in RSA 330-C:18.

 

          (ae)  “Licensed counselor” means a master licensed alcohol and drug counselor (MLADC), a licensed alcohol and drug counselor (LADC), or a licensed mental health professional who has demonstrated competency in the treatment of substance use disorders (SUD).

 

          (af)  “Licensed health care practitioner” means a:

 

(1)  Medical doctor;

 

(2)  Physician’s assistant;

 

(3)  Advanced practice registered nurse (APRN);

 

(4)  Doctor of osteopathy;

 

(5)  Doctor of naturopathic medicine; or

 

(6)  Any other practitioner with diagnostic and prescriptive powers licensed by the appropriate state licensing board.

 

          (ag)  "Limited medical withdrawal management" means a resident is capable of evacuating the facility without assistance, is medically cleared to participate in limited medical withdrawal management by a licensed practitioner prior to or at the time of admission, and is not a danger to themselves or others. 

 

          (ah)  “Mechanical restraint” means “mechanical restraint” as defined in RSA 126-U:1, IV.

 

          (ai)  Medical director” means a practitioner licensed in accordance with RSA 329 or RSA 326-B, who is responsible for overseeing the quality of medical care and services in a specialized care program.

 

          (aj)  Medical technology dependent” means a resident with limitations so severe as to require both an assistive medical technology device to compensate for the loss of a vital body function and significant and sustained care to avert death or further disability.   Assistive medical technology devices include, but are not limited to tracheostomy tube, feeding tube, c-pap or bi-pap machines, and wheelchairs.

 

          (ak)  “Medication” means a drug prescribed for a resident by a licensed health care practitioner and over-the-counter medications.

 

          (al)  “Medication log” means a written record of medications administered to a resident.

 

          (am)  “Medication occurrence” means any error in the administration of a medication as prescribed or in the documentation of such administration, with the exception of a resident’s refusal.

 

          (an)  “Medication restraint” means “medication restraint” as defined in RSA 126-U:1, IV(a).

 

          (ao)  “Mental illness” means a substantial impairment of emotional processes, or of the ability to exercise conscious control of one's actions, or of the ability to perceive reality or to reason, when the impairment is manifested by instances of extremely abnormal behavior or extremely faulty perceptions. It does not include impairment primarily caused by:

 

(1)  Epilepsy;

 

(2)  Intellectual disability;

 

(3)  Continuous or non-continuous periods of intoxication caused by substances such as alcohol or drugs; or

 

(4)  Dependence upon or addiction to any substance such as alcohol or drugs.

 

          (ap)  “Monitoring visit” means an announced or unannounced visit made to a residential child care program by department personnel for the purpose of assessing compliance with the standards set by rule adopted by the commissioner pursuant to RSA 541-A.

 

          (aq)  “Nursing care” means the provision or oversight of a resident’s physical, mental, or emotional condition by diagnosis as confirmed by a licensed practitioner.

 

          (ar) “Orders” means instructions by a licensed practitioner, produced verbally, electronically, or in writing for medication, treatments, recommendations, and referrals, and signed by the licensed practitioner using terms such as authorized by, authenticated by, approved by, reviewed by, or any other term that denotes approval by the licensed practitioner.

 

          (as)  “Parent” means a father, mother, legal guardian, or other person or agency responsible for the placement of a resident.

 

          (at)  “Permanency” means a permanent connection with at least one adult committed to helping the homeless youth meet his or her needs throughout his or her life.

 

          (au)  “Physical intervention” means a behavior management technique in which staff use the minimum amount of physical contact on a resident, which is necessary for the circumstances, in accordance with RSA 627:6, II(b) and RSA 126-U, to protect the resident, other residents present, the staff, and the general public.

 

          (av)  “Pre-service training” means training or education required to meet the minimum qualifications for the position of program director, as specified in He-C 4001.19 (e), or direct care staff, as specified in He-C 4001.19 (f).

 

          (aw) “Procedure” means a licensee’s written, standardized method of performing duties and providing services.

 

          (ax)  “Program director” means the individual who has responsibility for the daily operation of the residential child care program.

 

          (ay)  “Program staff” means all staff, both professional and non-professional, including direct care staff, who are responsible for the supervision, care, or treatment of residents.

 

          (az)  “Pro re nata (PRN)” means medication administered as circumstances may require in accordance with licensed practitioner’s orders.

 

          (ba)  “Rehabilitative and restorative services” means interventions provided including any medical or remedial services recommended by a physician or other prescribing practitioner within the scope of the residential treatment program’s practice to reduce a physical or mental disability and restore a recipient to his or her best functional level.

 

          (bb)  “Repeat violation” means a violation of a specific licensing rule or law for which the program has been previously cited during the past 5 years, which has not been removed as a result of an informal dispute resolution or overturned as a result of an adjudicatory procedure and that posed a health or safety risk to residents.

 

          (bc)  Reportable incident” means an occurrence of any of the following while the resident is either in the program or in the care of program personnel:

 

(1)  The death of the resident;

 

(2)  Suspected abuse or neglect of the resident; or

 

(3)  The unexplained absence of a resident from the program.

 

          (bd)  “Resident” means a child who has been admitted to a residential child care program. 

 

          (be)  “Residential child care program (program)” means “child care agency” as defined in RSA 170-E:25, II. The term also means “child-care institution” as defined in 42 CFR § 672(c)(2)(a).

 

          (bf)  “Restraint” means “restraint” as defined by RSA 126-U:1, IV.

 

          (bg)  “Runaway” means a child who is absent without leave or permission from the program that is responsible for the supervision of that child.

 

          (bh)  “Sanitize” means to clean by removing all organic material then wiping down or washing with a disinfecting or germicidal solution consisting of one tablespoon of regular strength chlorine bleach to one gallon of water which is mixed fresh daily, or a commercial product which is designed to kill germs and which, when used in accordance with manufacturer’s directions, does not pose a health or safety risk to residents.

 

          (bi)  “Seclusion” means “seclusion” as defined in RSA 126-U:1, V-a.

 

          (bj)  “Short term” means a placement which is intended to last for 60 days or less, unless the residential child care program has written documentation on file that the 60 day period has been extended by the department’s division for children, youth and families (DCYF), juvenile justice services (JJS), or by the referring agency.

 

          (bk)  “Social or non-medical withdrawal management” means a treatment service provided by appropriately trained staff who provide 24-hour supervision, observation, and support for residents who are intoxicated or experiencing withdrawal with no staff-administered medication.

 

          (bl)  "Specialized care" means "specialized care” as defined in RSA 170-E:25, II(c).  Such care includes substance use disorder and behavioral health. The term also includes “specialized care program (SCP)”.

 

          (bm)  “Substance use disorder (SUD)” means a disease that affects a person’s brain and behavior and may lead to an inability to control the use of a legal or illegal substance. Substances can include alcohol and other drugs.

 

          (bn)  “SUD program” means a residential program, excluding hospitals as defined in RSA 151:2,I(a), which provides residential SUD treatment relating to the youth’s medical, physical, psychosocial, vocational, and educational needs.

 

          (bo) “Time out” means the restriction of a resident for a period of time to a designated area from which the resident is not physically prevented from leaving, for the purpose of providing the resident the opportunity to regain self-control or as a consequence to a specific behavior.

 

          (bp)  “Treatment plan” means the program’s written, time-limited, goal-oriented therapeutic plan for the child and family, which includes strategies to address the issues that brought the child into placement, and which is developed by the family, program staff, and the agency responsible for the placement of the child.  This includes, but is not limited to, a child specific planning document prepared in cooperation with DCYF, JJS, a school district, or other placing or sending organization.  A treatment planning document that complies with certification requirements satisfies licensing requirements.

 

          (bq)  “Unit” means the department’s child care licensing unit.

 

          (br)  “Volunteer” means an unpaid person who assists with the provision of food services or activities, and who does not provide direct care or assist with direct care.   

 

          (bs)  “Withdrawal management” means a residential treatment service provided by appropriately trained staff who provide 24-hour supervision, observation, and support for youth who are intoxicated or experiencing withdrawal with prescription medication administered based on the results of an appropriate evaluation tool.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; (see also Revision Note at part heading for He-C 4001)

 

          He-C 4001.02  Application Form and Attachments.

 

          (a)  All applicants for licensure shall complete and submit an application form to the department, which includes:

 

(1)  Whether the application is for a new, renewed, or revised license;

 

(2)  Whether the program will operate a group home, child care institution, independent living home, homeless youth shelter, or specialized care program;

 

(3) Whether the applicant, owner, or business organization intends to provide short-term placements;

 

(4)  The name, physical address, mailing address, and telephone number of the program;

 

(5) The name, telephone number, and mailing address of the applicant, owner, or business organization;

 

(6)  An e-mail address for the program and the applicant, owner, or business organization, if available;

 

(7)  Federal tax identification number if one has been assigned;

 

(8)  A list of all buildings in which residents will be cared for which identifies:

 

a.  The building identifier;

 

b.  The building’s purpose or function;

 

c. The type(s) of residential child care services that the applicant, owner or business organization intends to offer in the building as specified in He-C 4001.02 (a)(2) above; and

 

d.  The proposed number of residents and age range to be cared for in each residential building;

 

(9)  The total requested resident capacity of the program;

 

(10) How the program is owned and organized, whether private, partnership, or other organization type, including name of business organization, business identification number, and the names, title/position, and telephone numbers of the officers of the business or board members, if applicable;

 

(11)  Whether the program will be operating as for-profit or non-profit;

 

(12)  The name, birth name(s), and date of birth of the program director;

 

(13)  The qualifications of the program director, including education and experience;

 

(14)  For persons who have contact with residents in the residential child care program, more than 5 hours per week, excluding residents who are admitted to the program, and including any applicant, owner, officer of the business organization, program director, executive director, board member, household member, program staff, intern, volunteer or any other individual in the state of New Hampshire or the United States, information and details disclosed by the individual on their application for employment, or otherwise known by the program, regarding the following:

 

a.  Criminal convictions in a state other than New Hampshire;

 

b.  Current criminal investigations in any state;

 

c.  Current investigations of child abuse or neglect in any state;

 

d.  Previous findings of child abuse or neglect in a state other than New Hampshire;

 

e.  Current investigation of juvenile delinquency for juvenile household members; and

 

f.  Previous adjudications of juvenile delinquency for juvenile household members;

 

(15)  The information required by (14) above shall include:

 

a.  The name and position or affiliation of the individual;

 

b. Whether this information is a charge, allegation, conviction, finding, or current investigation;

 

c. The name and city of the court of DCFY office in which the case was handled, as applicable; and

 

d.  The date of any conviction or finding;

 

(16)  A statement dated and signed by the program director and the applicant, or an individual legally authorized to sign for the applicant attesting to the following:

 

“I HAVE READ AND AM IN COMPLIANCE WITH ALL APPLICABLE RULES IN He-C 4001”;

 

“I UNDERSTAND THAT THE DEPARTMENT MAY INVESTIGATE ANY CRIMINAL CONVICTION RECORD, FINDING OF CHILD ABUSE OR NEGLECT, OR INVESTIGATION OF OR FINAL DETERMINATION REGARDING ANY JUVENILE DELINQUENCY AND WILL MAKE A DETERMINATION REGARDING WHETHER THE INDIVIDUAL POSES A CURRENT RISK TO THE HEALTH, SAFETY OR WELL BEING OF CHILDREN”; 

 

“I UNDERSTAND THAT THE DEPARTMENT MAY DELAY ITS DECISION TO APPROVE OR DENY THIS APPLICATION PENDING THE OUTCOME OF ANY INVESTIGATION, WHEN THE APPLICANT, OWNER, OR PROGRAM DIRECTOR, ARE NAMED AS THE PERPETRATOR IN ANY CURRENT INVESTIGATION OF ANY CRIME, OR IN AN ALLEGATION OF ABUSE OR NEGLECT”;

 

“I UNDERSTAND THAT PROVIDING FALSE INFORMATION ON THIS APPLICATION OR ANY OF THE ATTACHMENTS, OR FAILING TO DISCLOSE ANY INFORMATION REQUIRED ON THE APPLICATION, OR REQUIRED TO BE SUBMITTED WITH THIS APPLICATION, SHALL BE CONSIDERED GROUNDS FOR LICENSE DENIAL OR REVOCATION”;

 

“I HAVE READ THE NH RESIDENTIAL CHILD CARE PROGRAM LICENSING RULES, AND UNDERSTAND THAT FAILURE TO MAINTAIN MY PROGRAM IN COMPLIANCE WITH THE APPLICABLE RULES, MAY JEOPARDIZE MY LICENSE/PERMIT”;

 

“I AUTHORIZE ANY POLICE DEPARTMENT, COURT SYSTEM OR HUMAN SERVICE AGENCY IN THIS OR ANY OTHER STATE TO RELEASE COPIES OF ANY CRIMINAL RECORDS OR CHILD ABUSE OR NEGLECT RECORDS TO THE DEPARTMENT”; and

 

“ALL INFORMATION PROVIDED AS PART OF THIS APPLICATION AND IN THE REQUIRED ATTACHMENTS IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE”;

 

(17)  The position of the individual who signed pursuant to (16) above, such as applicant, board president, board secretary, executive director, or program director;

 

(18)  For each building, a floor plan diagram of indoor residential childcare space which shall specify:

 

a.  Room dimensions;

 

b.  Location of exits;

 

c.  How each room will be used;

 

d.  The location of bathrooms and bathroom fixtures, including toilets, sinks, bathtubs, and showers;

 

e.  The location of other hand-washing sinks; and

 

f.  The length, width, and ceiling height of each bedroom;

 

(19)  For each building, a diagram of outdoor play and recreation space which shall specify:

 

a.  The overall dimensions of the outdoor play space including the length and width of the space;

 

b. The locations of exits, gates, and stationary outdoor play or recreation equipment, including the location of and type of fencing, if any, including gates;

 

c.  The location of the outdoor play space in relation to the indoor space; and

 

d. The location and description of any outdoor water and street hazards including the presence of and location of any pools, ponds, streams, rivers, streets, roads, or other hazards that are in close proximity;

 

(20)  For renewal or revisions applications, diagrams as specified in (18) and (19) above if changes have been made in the residential child care space since the last application submitted to the department; and

 

(21)  For renewal or revision applications, a check mark in the box on the form, indicating when no changes have been made to residential child care space since the last application submitted to the department.

 

          (b)  Residential child care programs that have multiple buildings on the same or adjoining property may apply for a single license for those multiple buildings provided that:

 

(1)  In accordance with residential child care space requirements specified in He-C 4001.16, each residence has adequate square footage, common living space, and complete bathroom units for the number of residents who will reside in each building;

 

(2) An individual who meets at least the minimum qualifications of a direct care staff is designated in charge in each building; and

 

(3)  All program staff and residents are aware of the identity of the direct care staff who is designated in charge in each building.

 

          (c)  With the application, the applicant shall submit to the department a completed “Health Officer Inspection Report for Residential Child Care Agencies” form (10/2014 edition) completed by the local health officer or duly appointed designee, for each building inspected, documenting that within the 12 months of the date the department receives the application, the premises have been inspected and approved by a local health officer or duly appointed designee for operation as a residential child care program.

 

          (d)  With the application, the applicant shall submit to the department a completed “NH State Fire Code compliance report” documenting that, within the 12 months of the date the department receives the application, the premises have been inspected by the local fire department or the state fire marshal’s office, for compliance with the applicable parts and sections of the State Fire Code, under RSA 153:1, VI-a, and Saf-FMO 300, including but not limited to NFPA 1 and NFPA 101, and as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5, and approved to operate as a residential child care program.

 

          (e)  The “NH State Fire Code compliance report” required under (d) above shall include the following:

 

(1)  Completed by either program personnel or the fire inspector:

 

a.  The name, address, telephone number, and license number of the residential child care program;

 

b.  The name of the applicant;

 

c.  The type of residential child care to be provided; and

 

d.  The number and age range of residents for whom the applicant intends to provide care; and

 

(2)  Completed by the fire inspector:

 

a.  The date the premises were inspected by the fire inspector;

 

b.  For each building which will be used by residents:

 

1.  An indication regarding whether the fire inspector approves or does not approve the premises to operate as a residential child care program;

 

2.  Any areas of non-compliance with the State Fire Code, under RSA 153:1, VI-a, Saf-C 6000, and Saf-FMO 300, including but not limited to NFPA 1 and NFPA 101, and as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5; and

 

3.  Any conditions or restrictions placed by the fire inspector, including but not limited to, any limits relative to the number and age range of residents to be cared for in the program or any rooms, levels, or other areas of the premises not approved for use by residents;

 

c.  An indication whether or not the fire inspector approves, does not approve, or grants a conditional approval for the residential agency type(s) to operate.

 

d.  If  a conditional approval is granted, it shall include:

 

1.  The details regarding what action must be taken; and

 

2.  The date the conditional approval will expire;

 

e.  The printed name, address, telephone number, and title of the fire inspector;

 

f.  The dated signature of the fire inspector; and

 

g.  The city or town in which the fire inspector has authority.

 

          (f)  With the application, the applicant shall submit to the department documentation from the applicable town or city that the program has been granted zoning approval or a statement that no zoning approval is required.

 

          (g)  The zoning documentation required in (f) above shall include the following:

 

(1)  The name and address of the program;

 

(2)  The name of the applicant;

 

(3)  Any zoning requirements or restrictions imposed by the town or city regarding the existence of the program, including any limits regarding ages or number of residents to be cared for in the program, and any buildings on the property that do not have zoning approval; and

 

(4)  The signature of an individual authorized to sign on behalf of zoning, and date signed.

 

          (h)  With the application, the applicant shall submit to the department background check forms as specified in He-C 4001.31 for each of the following:

 

(1)  The applicant;

 

(2)  All household members; and

 

(3)  All program directors.

 

          (i)  With the application, the applicant shall submit to the department documentation of education and experience that shows that the program director meets the requirements for his or her position, as specified in He-C 4001.19(e).

 

          (j)  The documentation of education and experience required under (i) above shall include the following:

 

(1)  Copies of transcripts, certificates, diplomas, or degrees as applicable; and

 

(2)  A resume or other documentation of previous experience.

 

          (k)  With the application, applicants that are incorporated shall submit to the department a list of the names, addresses, and telephone numbers of the current board members.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20 (see also Revision Note at part heading for He-C 4001)

 

          He-C 4001.03  Procedures for License Renewal and Revisions.

 

          (a)  No less than 3 months prior to the expiration date of the current license, each licensee shall submit to the department:

 

(1)  An application form for license renewal, completed in accordance with He-C 4001.02 (a);

 

(2)  The application attachments specified in He-C 4001.02 (c) through (e), (h) through (j) and (n); and

 

(3)  The application attachments specified in He-C 4001.02 (l) and (m), if there has been a new program director since the previous application was filed.

 

          (b)  Licensees shall be subject to a lapse in license if they submit their application materials after the date their current license expires.

 

          (c)  Prior to adding additional program types, as specified in He-C 4001.02 (a)(2), changing the type(s) of program for which a program is licensed, increasing the number of residents in one or more buildings, unless the increased number has been previously approved in writing by the department and does not result in the program exceeding its license capacity, or re-locating the program, the residential child care program shall:

 

(1)  Submit an application for license revision, completed in accordance with He-C 4001.02; and

 

(2)  When there is a relocation or revision that will exceed any limits or condition on the current health officer inspection report, NH State Fire Code compliance report or zoning approval, submit the application attachments, identified in He-C 4001.02 (c) through (g) for each building for which it is seeking a license revision.

 

          (d)  A licensee shall notify the department in writing when he or she wishes to change the name of the program, so that a revised license that reflects the name change can be issued.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14

 

          He-C 4001.04  Time Frames for Departmental Response to Applications.

 

          (a)  Pursuant to RSA 541-A:29, the department shall approve or deny an application no later than 60 days from receipt of the application and any additional information requested by the department.

 

          (b)  The 60 days specified in (a) above shall begin on the date on which all requested information is received by the department.

 

          (c)  Any outstanding corrective action plan for violations of rule or statute shall be considered additional information under (a) above.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.05  Board of Directors.

 

          (a)  Each program that is incorporated shall have a duly appointed board of directors.

 

          (b)  The applicant or licensee shall:

 

(1)  If incorporated, provide a list of the names, addresses and telephone numbers of current members of the board of directors and a copy of current rules of the board of directors are on file and made promptly available on the premises of the program for review by the department upon request during all visits; and

 

(2)  If governed by any other governing body, provide a list of the names, addresses and telephone numbers of current members of the governing body, and a copy of any rules by which the governing body will operate are on file and made promptly available on the premises of the program for review by the department upon request during all visits.

 

          (c)  The board of directors for programs that are incorporated and the owner or governing body for programs that are not incorporated shall maintain a sufficient degree of oversight of the program’s operations to ensure that the program is complying with the provisions of RSA 170-E, this part, and any policies and procedures adopted by the program.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14

 

          He-C 4001.06  Statements of Findings and Corrective Action Plans.

 

          (a)  The department shall issue a statement of findings to the program when it determines that the program has one or more violations of any of the provisions of RSA 170-E or He-C 4001.

 

          (b)  The program director or designee shall complete a written corrective action plan for each violation included on the statement of findings.

 

          (c)  The corrective action plan required in (b) above shall describe:

 

(1)  How the licensee intends to correct each violation including any interim measures the program director or designee has implemented to protect the health and safety of residents until the violation can be corrected;

 

(2)  What measures will be put in place, or what systemic changes will be made to ensure that the violation does not recur; and

 

(3)  The date by which each violation was corrected or will be corrected.

 

          (d)  The program director or designee shall complete corrective action plans and return them to the department in accordance with the following:

 

(1)  The corrective action plan shall not include the names of individuals; and

 

(2)  The statement of findings and corrective action plan shall be:

 

a.  Signed and dated by the program director or designee; and

 

b.  Returned to the department no later than 3 weeks from the date the statement of findings is sent out by the department.

 

          (e)  The program director or designee shall not alter the statement of findings or corrective action plan once it has been submitted to the department.

 

          (f)  The only exceptions to (d)(2)b. above shall be as follows:

 

(1)  When a program director or designee requests an informal dispute resolution in accordance with He-C 4001.08, the corrective action plan due date shall be 3 weeks from:

 

a.  The date the program receives notice of the department’s decision regarding the informal dispute resolution if the department is not issuing a revised statement of findings; or

 

b.  The date the department issues the revised statement of findings as a result of the informal dispute resolution; and

 

(2)  A program director or designee who cannot complete and return a corrective action plan by the due date may request and receive an extension from the department.

 

          (g)  The criteria for acceptability shall be whether the corrective action plan, when implemented, will achieve compliance with RSA 170-E and He-C 4001.

 

          (h)  The department shall reject a corrective action plan when the plan fails to:

 

(1)  Achieve compliance with RSA 170-E, He-C 4001, or any other applicable licensing rules;

 

(2)  Address the violation as written;

 

(3)  Address all violations cited on the statement of findings;

 

(4)  Prevent a new violation of RSA 170-E, He-C 4001, or any other applicable law; or

 

(5)  State a completion date.

 

          (i)  When the corrective action plan submitted to the department by the program in accordance with (d) and (f) above is not acceptable, the department shall notify the licensee in writing of the reason for rejecting the proposed corrective action plan and:

 

(1)  Attempt to resolve the problem through a telephone consultation with the executive director or program director, when the unacceptable corrective action plan needs only simple, minor modifications or additions to make it acceptable; or

 

(2)  Issue a revised corrective action plan to the program with a notice advising the program why the original corrective action plan submitted by the program is not acceptable.

 

          (j)  When a program is issued a revised corrective action plan, it shall:

 

(1)  Make any revisions to the corrective action plan as approved by the department; and

 

(2)  Return and implement the revised corrective action plan in accordance with (d) above.

 

          (k)  The department shall verify that a corrective action plan, as submitted and accepted, has been implemented by any of the following:

 

(1)  Reviewing materials submitted by the licensee;

 

(2)  Conducting a follow-up inspection; or

 

(3)  Reviewing compliance during any subsequent visit conducted in accordance with RSA 170-E:31, IV, RSA 170-E:32, II or RSA 170-E:40, II.

 

          (l)  When the findings of any inspection or investigation indicate that immediate corrective action is required to protect the health and safety of the residents or personnel, the department shall order the immediate implementation of a directed corrective action plan developed by the department.

 

          (m)  The existence of a corrective action plan shall not prohibit the department from taking other enforcement action available to it under He-C 4001, RSA 170-E, RSA 541-A or other law.

 

          (n)  All statements of findings issued for violations of any of the provisions of RSA 170-E or He-C 4001, and the corrective action plans submitted in response to those violations, shall be considered public information on or after the corrective action plan due date as specified in (d)(2)b. and (f)(1) and (2) above.

 

          (o)  An applicant or licensee may appeal a violation cited on a statement of findings only as part of an adjudicatory process regarding enforcement action taken against a license.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14

 

          He-C 4001.07  Complaints and Investigations.

 

          (a)  In accordance with RSA 170-E:40, I and II, the department shall conduct an investigation of any complaint that meets the following conditions:

 

(1)  The alleged violations occurred not more than 6 months prior to the date the department was made aware of the allegation(s);

 

(2) The complaint is based upon the complainant’s first-hand knowledge regarding the allegation(s) or on information reported directly to the complainant by a resident who has first-hand knowledge regarding the allegation(s);

 

(3)  The complaint contains sufficient specific information for the department to determine that the allegation(s), if proven to be true, would constitute a violation of any of the provisions of He-C 4001 or RSA 170-E; or

 

(4)  The complaint is received from any source and alleges a violation that occurred at any time if the complaint alleges:

 

a.  Physical injury;

 

b.  Verbal or emotional abuse so severe as to create a risk of psychological trauma; or

 

c.  One or more residents were placed in danger of physical injury.

 

          (b)  After the investigation of a complaint has been completed, the department shall:

 

(1)  When it determines that the complaint is unfounded or does not violate any statutes or rules, notify the program and take no further action;

 

(2)  When it determines that the complaint is founded, prepare a statement of findings listing the violations found as a result of the investigation and any other violations found during the visit; and

 

(3)  Notify the licensee in writing of the findings.

 

          (c)  The records compiled during an investigation shall be confidential as required by RSA 170-E:40, III.

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151 eff 12-30-20

 

          He-C 4001.08  Informal Dispute Resolution.

 

          (a)  The department shall offer an opportunity for informal dispute resolution to any applicant or licensee who disagrees with a violation cited by the department on a statement of findings, provided that the applicant or licensee submits a written request for an informal dispute resolution.

 

          (b)  The informal dispute resolution shall be requested in writing by the applicant, licensee or program director no later than 14 days from the date the statement of findings was issued by the department.

 

          (c)  The department shall review the evidence presented and provide a written notice to the applicant or licensee of its decision.

 

          (d)  An informal dispute resolution shall not be available for any applicant or licensee against whom the department has initiated action to suspend, revoke, deny or refuse to issue or renew a license.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14

 

          He-C 4001.09  Enforcement Action and Administrative Appeals.

 

          (a)  The department shall revoke or suspend a license or deny an application for a new license, license renewal or license revision, in accordance with the provisions of RSA 170-E:27, II, RSA 170-E:29, III and IV, RSA 170-E:29-a, and RSA 170-E:35 if:

 

(1)  After being notified of and given an opportunity to supply missing information, the application does not meet the requirements of He-C 4001.02;

 

(2)  After being notified by the department that an adult or a juvenile who is not a resident admitted to the program may pose a risk to residents, the applicant or licensee refuses to submit a corrective action plan which ensures that the individual is removed from employment or from the household and will not have access to the residents in care;

 

(3)  An applicant or licensee has endangered or continues to endanger one or more residents by a negligent violation of a duty of care or protection owed to the child or negligently inducing such child to engage in conduct that endangers his health or safety;

 

(4)  The applicant or licensee has been found guilty of abuse, neglect, exploitation of any person or has been convicted of child endangerment, fraud or a felony against a person in this or any other state by a court of law, or has been convicted of any crimes as referenced in RSA 170-E:29, III or IV, or RSA 170-E:29-a, or had a complaint investigation for abuse, neglect, or exploitation substantiated by the department or in any other state;

 

(5)  The applicant, licensee or designee of the applicant knowingly provides materially false or misleading information to the department, including information on the application or in the application attachments;

 

(6)  The applicant, licensee or any representative or employee of the applicant fails to cooperate with any inspection, investigation or visit by the department;

 

(7)  The applicant or licensee violates any of the provisions of RSA 170-E:24 –49 or He-C 4001;

 

(8)  The applicant or licensee has demonstrated a history or pattern of multiple or repeat violations of RSA 170-E, or He-C 4001, that pose or have posed a health or safety risk to residents; or

 

(9)  The applicant or licensee fails to submit an acceptable corrective action plan or fully implement and continue to comply with a corrective action plan that has been accepted by the department in accordance with He-C 4001.06.

 

          (b)  If a license has been revoked, or has expired without timely application for renewal having been made in accordance with He-C 4001, operation shall be discontinued immediately.

 

          (c)  The department shall notify applicants or licensees affected by a decision of the department to deny, revoke or suspend a license of their right to an administrative appeal in accordance with RSA 170-E:36.

 

          (d)  If an applicant or licensee fails to request an administrative appeal in writing within 10 days of the receipt of the notice required by RSA 170-E:36, I, the action of the department shall become final.

 

          (e)  Administrative appeals under this section shall be conducted in accordance with RSA 170-E:36, II, III, and IV, RSA 170-E:37, RSA 541-A and He-C 200.

 

          (f)  Further appeals of department decisions under this section shall be governed by RSA 541-A and RSA 170-E:37.

 

          (g)  Any licensee who has been notified of the department’s intent to revoke or suspend a license or deny an application for a license renewal may be allowed to continue to operate during the appeal process except as specified in (h) below.

 

          (h)  When the department includes in its notice of revocation or suspension an order of immediate closure, pursuant to RSA 170-E:36, III or RSA 541-A:30, III, the program shall immediately terminate its operation and not operate during the appeal process except under court order, or as provided by RSA 541-A:30, III.

 

          (i)  The department shall initiate a suspension of a license rather than revocation when it determines that the action is being initiated against a program that does not have a history of repeat violations of licensing rules or statute and the action is based on a violation or situation which is:

 

(1)  Related to a correctable environmental health or safety issue, including but not limited to, a problem with a program’s water supply, septic system, heating system, or structure; and

 

(2)  Documented by the program as being temporary in nature.

 

          (j)  Except for (h) above, any suspension of a license that has not been appealed, or any suspension of a license that has been upheld on appeal shall remain in effect until the department notifies the program whose license was suspended that the suspension has been removed because:

 

(1)  The violation which resulted in the suspension has been corrected; or

 

(2) The suspension was based on loss of fire or health officer approval and the local fire inspector or inspector from the state fire marshal’s office, or health officer has reinstated the previously rescinded approval.

 

          (k)  Upon receipt of notice of the department’s intent to revoke, suspend, deny or refuse to issue or renew a license, the applicant or licensee receiving the notice shall immediately provide the department with a list of the names, addresses and phone numbers of the person or agency responsible for the placement of each current resident.

 

          (l)  Based upon information provided under (k) above, the department shall notify the person or agency responsible for the placement of each current resident that the department has initiated action to revoke or suspend the license or deny an application for a license renewal.

 

          (m)  The department shall send a copy of the notice required in (l) above to the following entities:

 

(1)  The health officer and fire inspector in the town in which the program is located;

 

(2)  The state office of the United States Department of Agriculture, Child and Adult Food Program, if the residential child care program participates in that program;

 

(3)  The New Hampshire department of education if the program has a school on the premises; and

 

(4)  The director of DCYF.

 

          (n)  When a program’s license has been revoked or denied, the department has refused to renew a license, or an application has been denied by the department, if the enforcement action specifically pertained to their role in the program, the applicant, licensee, program director or executive director, shall not be eligible to reapply for a license, or be employed as an executive director or program director for at least 5 years from:

 

(1)  The date of the department’s decision to revoke or deny the license, if no appeal is filed; or

 

(2)  The date an order is issued upholding the action of the department, if that action has been appealed.

 

          (o)  Notwithstanding (n) above, the department shall accept an application submitted after the decision to revoke or deny becomes final, provided there has been no violation of RSA 170-E:27, II, RSA 170-E:35, I, or RSA 170-E:35, XIII, only under the following circumstances:

 

(1)  The applicant or licensee, when licensed, did not demonstrate a pattern of repeat violation of licensing rules or statute;

 

(2)  The denial was based on the applicant or licensee’s inability or failure to correct a violation caused by a temporary condition which has been corrected; or

 

(3)  The licensee or applicant who was denied an initial application shows that circumstances have substantially changed such that the department now has good cause to believe that the applicant has the requisite degree of knowledge, skills and resources necessary to maintain compliance with the provisions of RSA 170-E and He-C 4001.

 

          (p)  No ongoing enforcement action shall preclude the imposition of any remedy available to the department under RSA 170-E, RSA 541-A, He-C 4001 or other law.

 

          (q)  Requests for reconsideration or appeal of any decision by a hearings officer shall be filed within 30 days of the date of the decision.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14

 

          He-C 4001.10  Duties and Responsibilities of the Licensee.

 

          (a)  The program shall abide by the provisions specified on the license.

 

          (b)  Program staff shall:

 

(1)  Display a copy of the current license issued by the department in a prominent location in each building in which residents are housed; and

 

(2)  Not alter the license issued by the department.

 

          (c)  A license shall not be transferable to a new owner or new location.

 

          (d)  Any licensee, program staff or other person involved with a program who has reason to suspect that a resident is being abused or neglected shall report the suspected abuse to DCYF at 1-800-894-5533.

 

          (e)  When direct care staff who are witness or party to any event that meets the mandated reporting requirement in RSA 169-C:29, the program shall provide opportunity and support to such staff to make the required report.  Whenever possible, the staff directly involved or witness to the event shall make reports to the department, with assistance from administrative staff as needed to assure all necessary information is available to make a complete report.

         

          (f)  Program staff shall safeguard the confidentiality of all records and personal information regarding any resident.

 

          (g)  Applicants, licensees, and all program staff shall keep confidential all records required by the department pertaining to the admission, progress, health, and discharge of residents under their care and all facts learned about residents and their families with the following exceptions:

 

(1)  Program staff shall, upon request, make available to the department all records that programs are required by RSA 170-E or He-C 4001 to keep, and to such records as necessary for the department to determine staffing patterns and staff attendance; and

 

(2)  Other than as specified in (g)(1) above, program staff shall release information regarding a specific resident only as directed by a parent of that resident, or upon receipt of written authorization to release such information, signed by that resident’s parent, unless otherwise restricted by applicable state or federal law.

 

          (h)  Information collected by the department during the application process may be released:

 

(1)  To the applicant, licensee or his or her designated representative;

 

(2)  Upon receipt of written authorization by the applicant or licensee to release information; or

 

(3)  To federal, state and local officials or the entities that provided reports.

 

          (i)  Except for law enforcement agencies or in an administrative proceeding against the applicant or licensee, the department shall keep confidential any information collected during an investigation, unless it receives an order from a court of competent jurisdiction ordering the release of specific information.

 

          (j)  Applicants, licensees, members of the board of directors or other governing body, program staff, child care interns, child care assistants, and volunteers shall cooperate with the department during all departmental visits authorized under RSA 170-E and He-C 4001.

 

          (k)  For the purposes of (j) above, cooperation shall include, but not be limited to not interfering with efforts by representatives of the department to:

 

(1)  Enter the premises and complete an inspection;

 

(2)  Document evidence or findings by taking written statements, and by photographing toys, equipment, and learning materials or conditions inside or outside residential child care space and other areas of the premises accessible to residents;

 

(3)  Make an audio recording of conversations with individuals who have consented to the audio recording;

 

(4)  Interview program staff, members of the board of directors, or other governing body, child care interns, child care assistants, volunteers, residents enrolled in the program, and any other individual whom the department determines might have information relevant to the issues being evaluated; and

 

(5)  Review and reproduce any forms or reports which the applicant or licensee is required to maintain or make available to the department under He-C 4001.

 

          (l)  Administrators, other program staff, or other individuals shall not:

 

(1)  Require or request that the individual being interviewed ask that another person be present for the interview;

 

(2)  Attempt to influence the response of any individual being interviewed by signaling them during the interview, telling them what to say, or threatening them with retaliation for providing information to the department; or

 

(3)  Require staff or residents who have been interviewed to provide statements to program administration regarding their interview.

 

          (m)  Any violation of (l) above or any attempt by or on behalf of program staff, administrators, or other individuals to prevent program staff, residents, or other individuals from responding to questions by the department, or from making a good faith report to the department regarding any concerns they have about the operation of the program relating to statutory or regulatory requirements shall be considered failure to cooperate with the department as specified in (j) and (k) above.

 

          (n)  Except for He-C 4001.12(a), all records and written policies required by He-C 4001 shall be maintained on file and shall be made promptly available on the premises of the program for review or be submitted to the department upon request as follows:

 

(1)  For 2 years from the date the resident is discharged;

 

(2)  For 2 years from the date of termination for records related to employees; and

 

(3)  For all other records 2 years from the date the record was created.

 

          (o)  The exception to (n) above shall be when program staff shows good cause as to why the requested reports or records are not immediately available.  In such case, the provider shall make the records available within 2 business days, or otherwise obtain an extension from the unit.  Good cause shall include circumstances beyond the licensee’s control or other extenuating circumstances.

 

          (p)  When the individual who has been identified and approved by the department as program director leaves the position, the licensee or designee shall:

 

(1)  Notify the department of the departure of the program director within 10 days;

 

(2)  Within 10 days of the departure of the director, notify the department of the name of the individual who is temporarily serving as the program director and who meets at least the minimum requirements of a direct care staff; and

 

(3)  Within 120 days of the date of departure of the program director, notify the department and submit information and documentation required under He-C 4001.02(i) and (j) for the new, qualified program director.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.11  Health Requirements for Program Staff and Adult Household Members.

 

          (a)  A written record of physical examination shall be on file for all program employees and household members who will have regular contact with residents.

 

          (b)  The written record of physical examination required in (a) above shall contain or identify:

 

(1)  The name of the examinee;

 

(2)  The date of the examination;

 

(3)  Any contagious or other illness that would affect the examinee’s ability to care for residents or pose a risk to the health or safety of residents;

 

(4)  A record of a negative Mantoux Tuberculin (TB) test for individuals who are determined by a licensed health care practitioner to be at high risk for exposure to Tuberculosis or the results of a chest x-ray and medical assessment when the individual has a positive TB test due to prior exposure;

 

(5)  Any known limitations or restriction that would affect the examinee’s performance of his or her residential child care responsibilities or pose a risk to the health or safety of residents;

 

(6)  The signature of the licensed health care practitioner and date signed; and

 

(7)  The typed or printed name and telephone number of the licensed health care practitioner.

 

          (c)  The initial record of physical examination for newly hired program staff shall have been completed not more than l2 months preceding the date of hire or the date the individual began having regular contact with residents.

 

          (d)  When a newly hired program staff has not had a physical exam in accordance with (b) above, an appointment for a future physical exam shall be scheduled within 10 business days of the date the individual begins having regular contact with residents.

 

          (e)  Physical examinations required under (a) above shall be repeated at least every 3 years.

 

          (f)  A written record of the repeat physical examination required in (e) above shall be on file at the program within 60 days of the expiration date of the previous physical exam record on file at the program.

 

          (g)  When the program director or designee is aware that any program direct care staff, intern, child care assistant or volunteer have symptoms of illness that prevent them from being able to perform their duties or pose a health or safety risk to children, he or she shall prohibit that individual from caring for residents until the individual has received treatment which ensures that he or she does not have a communicable disease or is no longer symptomatic.

 

          (h)  When the program director or designee is aware that any program staff, intern, child care assistant, volunteer, resident, or household member has symptoms of a reportable communicable disease or is known to have a reportable communicable disease, the program director or designee shall contact the department’s bureau of communicable disease control for instructions regarding:

 

(1)  Whether the ill staff person is required to be excluded from the program;

 

(2)  How to control the spread of contagious illness; and

 

(3)  Reporting requirements in accordance with RSA 141-C:7 and He-P 301.

 

          (i)  The only exception to (h) above shall be for human immunodeficiency virus (HIV) infection, specifically the identity of any individual with HIV infection shall be held confidential in accordance with RSA 141-F:8.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14

 

          He-C 4001.12  Communicable Disease Issues and Health Requirements for Residents and Other Children.

 

          (a)  Parental authorization for medical treatment shall be on the premises for each resident upon his or her first day of residence in the program, except for residents in short term placement, and available in accordance with He-C 4001.10(n).

 

          (b)  Physical examinations shall be completed for children admitted to the program as residents and children who reside on the premises of the program.

 

          (c)  A child health form or an equivalent record of physical examination documenting that a physical examination was completed within the past 12 months shall be on file for each child, as specified in (b) above, within 30 days of the date any child begins residing on the premises of the program.

 

          (d)  When a child has not had a physical examination as required in (c) above, the program shall schedule an appointment for a future physical exam within 10 business days of the date the child begins residing at the program.

 

          (e)  The child health form or equivalent record of physical examination required under (c) above shall include at least the following:

 

(1)  The name and date of birth of the child or resident;

 

(2)  The date of the exam;

 

(3)  Diagnoses, if any, and a description of any health condition that might affect the child or resident’s participation in the program;

 

(4)  Documentation of immunizations, including dates immunized;

 

(5)  A history of illness and hospitalizations;

 

(6)  Reports of any screening or assessment;

 

(7)  Notations about the child or resident’s physical, mental, and social development;

 

(8)  A list of current medications, both prescribed and over the counter;

 

(9)  Any known allergies;

 

(10)  Dietary needs, including special diets; and

 

(11)  The signature of a licensed health care practitioner and the date signed.

 

          (f)  Physical examinations as required under (b) above shall be completed:

 

(1)  At least every 12 months for each child younger than 6 years of age, with a 60-day grace period to allow the program to obtain the updated physical examination record; and

 

(2)  At least every 24 months for each child 6 years of age or older, with a 60-day grace period to allow the program to obtain the updated physical examination record.

 

          (g)  Each resident shall have a dental examination based upon a schedule, which shall:

 

(1)  Take into account the needs of the resident as determined by a licensed dentist; and

 

(2)  Provide for each resident to have a dental examination at intervals of 6 to 12 months.

 

          (h)  If the program is unsuccessful in obtaining dental examinations in accordance with (g)(2) above, it shall document good faith efforts to schedule an exam.

 

          (i)  A written record documenting the date of the dental exam and treatment needed or provided, shall be maintained on the premises of the program in each resident’s permanent record.

 

          (j)  Other medical exams and evaluations shall be completed for each resident as necessary to meet his or her medical needs.

 

          (k)  When a resident is believed to have a reportable communicable disease which was not diagnosed by a physician or other health care provider, the program director or designee shall report the known or suspected communicable disease to the department’s bureau of communicable disease control in accordance with RSA 141-C:7 and He-P 301.

 

          (l)  The only exception to (k) above shall be for HIV infection, specifically, the identity of any individual with HIV infection shall be held confidential in accordance with RSA 141-F:8.

 

          (m)  SCPs shall provide services in a residential setting, including access to nursing or medical care, for all children placed in the program diagnosed as having functional limitations and are dependent upon or require medical technology to maintain or improve independence and health. 

 

          (n)  SCPs shall provide for the complex health needs of residents whom are medical technology dependent:

 

(1)  In a manner that affords the least intrusive intervention available to ensure his or her safety, the safety of others, and that promotes healthy growth and development;

 

(2)  By providing services and an environment that meets each resident’s needs; and

 

(3)  By training direct care staff in the use and care of the specific medical technology device or devices that residents in their care are dependent upon.

 

          (o)  Training shall include:

 

(1)  How to recognize symptoms that may indicate a decline in the resident’s health;

 

(2)  Seizures and seizure disorders;

 

(3)  G/J tube use and care;

 

(4)  Tracheostomy care;

 

(5)  C-pap and Bi-pap care; and

 

(6)  Any intervention or procedure that will heighten direct care staff’s attention to the health and well-being of residents, such as topics on medical changes that require immediate notification for nursing assessment.

 

          (p)  All training and education required in (n) and (o) above shall be performed by the appropriate medical professional with the requisite education and licensure to perform such training or utilize outside resources if an appropriate medical professional is not available.

 

             (q)  At the time of admission of a resident with special health care needs or who is medical technology dependent, the licensee shall obtain written and signed orders from a licensed practitioner for medications, treatment, and special diet as applicable.

 

          (r)  No resident shall be admitted until the appropriate training in (n) and (o) above has been completed.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.13  Personal Hygiene.

 

          (a)  Program staff and residents shall wash their hands as needed.

 

          (b)  Individuals who are participating in food preparation or food service shall:

 

(1)  Wash their hands as often as necessary to remove soil and contamination and prevent cross contamination;

 

(2)  Cover any cuts or abrasions with a secure bandage; and

 

(3)  Not participate in food preparation or food service activities when they have:

 

a.  An infection;

 

b.  A cut or wound which is running or weeping; or

 

c.  A communicable disease that could be spread via food preparation or food service.

 

          (c)  Program staff shall not wash their hands after diapering or toileting in sinks that are used for food preparation or clean up.

 

          (d)  Program staff shall encourage each resident to brush their teeth each morning and before going to bed, and to shower daily.

 

          (e)  Each resident shall have an opportunity to have a shower or bath, with adequate hot water, once each day.

 

          (f)  Program staff shall assist residents who are medical technology dependent, or whose functional needs require direct assistance with daily personal hygiene.  Such assistance shall be care planned and provided based on resident need.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.14  Prevention and Management of Injuries, Incidents, Emergencies and Infection Control.

 

          (a)  The program shall develop policies for how direct care staff shall respond to incidents, including but not limited to:

 

(1)  Addressing threats of self-harm and suicidal behaviors by residents;

 

(2)  Medical emergencies;

 

(3)  Addressing threatening behaviors such as physical and sexual assaults on other residents or staff;

 

(4)  The reporting requirements in He-C 4001.23(g);

 

(5)  Screening any child who runs away for indications that the child may be a victim of human trafficking and notifying necessary personnel;

 

(6)  Managing the behavior of children, including how and under what circumstances seclusion or restraint is used, pursuant to RSA 126-U:2;

 

(7)  Accessibility to respite or temporary care arrangements; and

 

(8)  How staff will be orientated and trained in accordance with He-C 4001.19(k) and (l) to prepare to work with the population served by the program.

 

          (b)  All program staff responsible for the care and supervision of residents shall be familiar with the program’s policies and procedures for managing injuries and emergencies and have access to information necessary to handle emergencies.

 

          (c)  Each building that residents will spend time in shall be equipped with a telephone that is operable and accessible to residents and staff for incoming and outgoing calls.

 

          (d)  The licensee shall maintain an information data sheet in the resident’s record and promptly give a copy to emergency medical personnel in the event of an emergency transfer to a medical facility.

 

          (e)  The information data sheet referenced in (d) above shall include:

 

(1)  Full name and the name the resident prefers, if different;

 

(2)  Name, address, and telephone number of the resident’s parent(s), guardian, or agent, if any;

 

(3)  Diagnosis;

 

(4)  Medications, both prescription and over the counter, including last dose taken and when the next dose is due;

 

(5)  Allergies;

 

(6)  Functional limitations;

 

(7)  Date of birth;

 

(8)  Insurance information; and

 

(9)  Any other pertinent information not specified in (1)-(8) above.

 

          (f)  At least one residential child care program staff person, who is trained and currently certified in cardiopulmonary resuscitation (CPR) and first aid by the American Red Cross, American Heart Association, Emergency Care and Safety Institute, National Safety Council or other nationally recognized organization or an individual certified by such organization to train, shall be present:

 

(1)  In each building that is used as a residence, at all times when residents are present; and

 

(2)  When residents are participating in any field trips off the premises of the residential child care program.

 

          (g)  The residential child care program director or designee shall obtain and maintain on file, available for review by the department, copies of current CPR and first aid certifications documenting coverage as required in (f) above.

 

          (h)  Each building and program vehicle that is used by residents shall be equipped with first aid supplies adequate to meet the needs of the residents.

 

          (i)  The first aid supplies shall be stored in a container that is accessible by residential child care program staff but not accessible to residents.

 

          (j)  First aid supplies adequate to meet the needs of the residents shall be available during all field trips.

 

          (k)  When the first aid treatment provided for minor scrapes or bruises is not effective or when a resident’s injury is more than a minor scrape or bruise, residential child care program staff shall:

 

(1)  If the injuries appear to be life threatening or appear to be severe, call emergency medical services for transport to a medical facility by ambulance;

 

(2) For all other injuries, take the injured resident to a licensed health care practitioner for medical evaluation and treatment;

 

(3)  As soon as possible after the injury occurs, notify the person or agency responsible for the resident’s placement and the parents of the injured resident whenever possible; and

 

(4)  Complete a written incident report as specified in He-C 4001.23 (a) and (b) within 24 hours of the incident.

 

          (l)  The program director or designee shall notify the unit, the parent, and the person or agency responsible for the resident’s placement within 24 hours of the death of any resident.

 

          (m)  The program director or designee shall provide a written report, detailing the circumstances of the death, to the unit and the person or agency responsible for the resident’s placement, within 72 hours of the death of any resident.

 

          (n)  In (l) or (m) above, in cases involving serious injury or death to a resident subject to restraint or seclusion in a program, the program shall, in accordance with and addition to the provisions of RSA 126-U:10, notify the commissioner, the attorney general, and the disability rights center (DRC).  Such notice shall include the notification required in RSA 126-U:7, II.

 

          (o)  The program director or designee shall conduct fire drills once each month in each building that is used as residential child care space.

 

          (p)  Monthly fire drills required in (o) above shall be held at varying times, including night time hours.

 

          (q)  Programs shall activate the actual fire alarm system for the building for at least 2 of the monthly fire drills required each year.

 

          (r)  Programs shall ensure that all residents and program staff evacuate the building during each fire drill including, if applicable, descent using the route designated on the posted fire evacuation plan.

 

          (s)  The staff person conducting the fire drill shall complete a written record of each fire drill that shall:

 

(1)  Be maintained on file at the program for one year; and

 

(2)  Be available for review by the fire inspector and the department.

 

          (t)  The written record of fire drills required under (s) above shall include at least the following:

 

(1)  The date and time the drill was conducted, and whether the actual fire alarm system was activated;

 

(2)  Exits used;

 

(3)  Number of residents evacuated and total number of people in the building at the time of the drill;

 

(4)  Name of the person conducting drill;

 

(5)  Time taken to evacuate the building;

 

(6)  Any problems encountered; and

 

(7)  A plan for correcting those problems.

 

          (u)  The program director or designee shall conduct a fire drill in the presence of a representative of the department or the local fire department upon request by either of those entities.

 

          (v)  If providing withdrawal management, any new SCPs shall comply with the appropriate chapter of NFPA 101 as published by the National Fire Protection Association and as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5, consistent with the level of needs of residents being served.

 

          (w)  All programs shall have:

 

(1)  Smoke detectors as approved in accordance with the State Fire Code, under RSA 153:1, VI-a, Saf-C 6000, and Saf-FMO 300, including but not limited to NFPA 1 and NFPA 101, as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5, consistent with the appropriate level of care being provided by the program;

 

(2)  At least one UL Listed, ABC type portable fire extinguisher, with a minimum rating of 2A-10BC installed on every level of the building with a maximum travel distance to each extinguisher not to exceed 50 feet and maintained as follows:

 

a.  Fire extinguishers shall be inspected either manually or by means of an electronic monitoring device or system at least once per calendar month, at intervals not exceeding 31 days;

 

b.  Records for manual inspection, or electronic monitoring shall be kept to demonstrate that at least 12 monthly inspections have been performed;  

 

c.  Annual maintenance shall be performed on each extinguisher by trained personnel, and a tag or label shall be securely attached that indicates that maintenance was performed; and

 

d.  The components of the electronic monitoring device or system in a. above, if used, shall be tested and maintained annually in accordance with the manufacturers listed maintenance manual; and

 

(3)  A carbon monoxide monitor on every level of the program, in accordance with Saf-C 6015.04.

 

          (x)  An emergency and fire safety program shall be developed and implemented to provide for the safety of residents and personnel.

 

          (y)  In addition to the policies required in (a) above, the program shall develop and implement an emergency operations plan (EOP), which shall:

 

(1)  Be based on the incident command system and coordinated with the emergency response agencies in the community in which the residential program is located;

 

(2)  Contain guidelines for personnel responsible for critical tasks, including, but not limited to the role of center incident commander, child care, medical treatment, and parental notification; and

 

(3)  Include response actions for natural, human-caused, or technological incidences including, but not limited to:

 

a.  Evacuation, both within building and off-site, relocation;

 

b  Secure campus;

 

c  Drop, cover, and hold;

 

d.  Lockdown;

 

e.  Reverse evacuation; 

 

f.  Shelter-in-place; and

 

g.  Bomb threat and scan.

 

          (z)  Programs shall develop a continuity of operations plan (COOP) to ensure that essential functions continue to be performed during, or resumed rapidly after, a disruption of normal activities.

 

          (aa)  All response actions in (y)(3) above shall include accommodations for children with chronic medical conditions, and children with disabilities or with access and functional needs.

 

          (ab)  Programs shall practice no less than 2 components of their EOP as described in (y) above with all staff and children at least twice per year.

 

          (ac)  All staff shall review the program's EOP in accordance with the following:

 

(1)  For currently employed staff, within the first 30 days of the development of the EOP pursuant to (y) above; or

 

(2)  For newly hired staff, within the first 30 days of employment.

 

          (ad)  In each building of the residential program, the written policies and procedures in (a) above and the EOP in (y) above shall be in an area easily accessible and known to residential staff.

 

          (ae)  Programs operating an SCP shall appoint an individual who will oversee the development and implementation of an infection control program that educates and provides procedures for staff for the prevention, control, and investigation of infectious and communicable diseases.

 

          (af)  The infection control program shall include written procedures for:

 

(1)  Proper hand washing techniques;

 

(2)  The utilization of universal precautions;

 

(3)  The management of residents with infectious or contagious diseases or illnesses;

 

(4)  The handling, storage, transportation, and disposal of those items identified as infectious waste in Env-Sw 904; and

 

(5)  The reporting of infectious and communicable diseases as required by He-P 301.

 

          (ag)  The infection control education program shall address at a minimum the:

 

(1)  Causes of infection;

 

(2)  Effects of infections;

 

(3)  Transmission of infections; and

 

(4)  Prevention and containment of infections.

 

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.15  Medication Services.

 

          (a) The licensee shall develop and implement written policies and procedures regarding administration, documentation, including a system for maintaining counts of controlled drugs, protocols for medication occurrences, and control and safety of medication that are consistent with the requirements of this section.

 

          (b)  Administration of medications to residents shall be performed by authorized staff, registered nurse (RN), licensed practical nurse (LPN) or licensed health care practitioners, accurately and in accordance with the resident’s treatment plan and the licensee’s policies.

 

          (c) Authorized staff shall know and understand the program’s written policies and procedures regarding the administration, control, and safety of medication.

 

          (d)  All residents shall be initially assessed to determine the level of support needed specific to medication administration.

 

          (e)  The assessment pursuant to (d) above shall include the resident’s:

 

(1)  Medication order(s) and medications prescribed;

 

(2)  Health status and health history; and

 

(3)  Ability to manage his or her medication, consistent with the resident’s treatment plan.

 

          (f)  Program staff shall obtain, or document their efforts to obtain, oral or written consent from the parent prior to administering any new or changed prescription medications.

 

          (g)  When the resident’s parent(s) is responsible for supplying the program with the resident’s medication, program staff shall contact the parent 2 weeks prior to the end of the supply of medication.

 

          (h)  When the responsibility of providing care to a resident is transferred to persons outside the program, for example for a home visit, and the resident is taking prescription medication:

 

(1)  The pharmacy container(s) shall be given to the person responsible for the resident;

 

(2) The program shall document the medication name, strength, prescribed dose, route of administration, and quantity of each medication provided to the persons outside the program, upon the resident’s transfer of care; and

 

(3)  Upon the resident’s return to the program, the program shall document the return of any medications including medication name, strength, prescribed dose, route of administration, and quantity of each medication with a description of why the medication was not given as the medication order stated.

 

          (i) Authorized staff shall administer only those prescription medications for which there is a medication order.

 

          (j)  Authorized staff shall administer medications only to the residents about whom they have current knowledge relative to their medication regimes.

 

          (k)  Authorized staff shall maintain a copy of each resident’s medication orders in the resident’s record.

 

          (l)  Medication orders shall be valid for no more than one year unless otherwise specified by the licensed health care practitioner.

 

          (m)  Each medication order shall legibly display the following information:

 

(1)  The resident’s name;

 

(2)  The medication name, strength, the prescribed dose, and route of administration;

 

(3)  The frequency of administration;

 

(4)  The indications for usage of all medications to be used PRN; and

 

(5)  The dated signature of the licensed health care practitioner.

 

          (n)  Written orders from a licensed health care practitioner regarding any prescription medication that is to be administered PRN shall include:

 

(1)  The indications and any special precautions or limitations regarding administration of the medication;

 

(2)  The maximum dosage allowed in a 24-hour period; and

 

(3)  The dated signature of the licensed health care practitioner.

 

          (o)  In addition to (n) above, authorized staff shall administer PRN medication in accordance with:

 

(1)  A medication order; and

 

(2)  A PRN protocol approved by the licensed health care practitioner that includes the specific condition(s) for which the medication is given.

 

          (p)  Prior to the administration of medication, authorized staff shall obtain information specific to each medication, including, at a minimum:

 

(1)  The purpose and effect(s) of the medication;

 

(2)  Response time of the medication;

 

(3)  Possible side effects, adverse reactions, and symptoms of overdose;

 

(4)  Possible medication interactions; and

 

(5)  Special storage or administration procedures.

 

          (q)  In the event of a medication occurrence, the authorized staff responsible for the administration of the medication shall forward written notification to the program director by the close of the next business day.

 

          (r)  When any medication that is administered by program staff results in serious adverse reactions including, but not limited to, impaired speech, mobility or breathing, semi-consciousness, or unconsciousness, program staff shall:

 

(1)  Immediately call 911 or notify a licensed health care practitioner for instructions regarding the need for emergency or other medical treatment;

 

(2)  Immediately comply with the instructions provided by the licensed health care practitioner;

 

(3)  Remain with the resident until he or she is fully alert and oriented and has recovered all physical capabilities that had been impaired by the medication, or until responsibility for the resident’s care is transferred to a licensed health care practitioner in a medical facility; and

 

(4)  Notify or document efforts to notify the parents within 24 hours.

 

          (s)  Prior to administering medication to any resident, program staff shall complete and document training on medication safety and administration, as specified in (t) below.

 

          (t)  Training in medication safety and administration, as required in (s) above, shall:

 

(1)  Be delivered by a physician, APRN, RN, or LPN practicing under the direction of an APRN, RN, or physician, or by another qualified individual;

 

(2)  Be provided in person, via distance learning, a video presentation, or web-based; and

 

(3)  Address the following:

 

a.  The safe storage and administration of medication, including but not limited to:

 

1.  Administration of the correct medication;

 

2.  Administration of the correct dosage of the medication;

 

3.  Administration of the medication to the correct resident;

 

4. Administration of the medication to the resident at the correct times and frequency;

 

5. Administration of the medication to the resident by the correct method of administration;

 

6.  Infection control and aseptic procedures related to administration of medication; and

 

7.  Resident’s rights regarding refusing medications;

 

b.  Possible side effects and adverse reactions to the medications to be administered and required reporting regarding those issues;

 

c.  Proper storage, disposal, security, error control, and documentation as related to the medications to be administered;

 

d.  Any other unusual occurrence related to the safe storage or administration of medication and reporting requirements regarding those issues;

 

e.  Conditions or situations requiring emergency medical intervention; and

 

f.  Methods of administration including, but not limited to oral, injection, topical application or inhalation.

 

          (u)  In addition to (t) above, authorized staff shall complete 2 hours of training annually on medication safety and administration.

 

          (v)  Documentation of training in medication safety and administration shall be maintained on file at the child care program available for review by the department.

 

          (w)  For each resident, program staff shall maintain medication information on file and available for review by the department, which includes, at a minimum:

 

(1)  A written medication order, as specified in (m) above, including special considerations for administration for each prescription medication being taken by a resident;

 

(2)  Written parental authorization to administer medication, if applicable;

 

(3)  The name and contact information of the parent, if applicable; and

 

(4)  Allergies, if applicable.

 

          (x)  In addition to (w) above, program staff shall maintain a daily medication log for each dose of medication administered to each resident.

 

          (y)  The medication log required in (x) above shall:

 

(1)  Be maintained on file in the program, available for review by the department;

 

(2)  Be completed by the authorized staff who administered the medication immediately after the medication is administered; and

 

(3)  For each medication prescribed, include at a minimum:

 

a.  The name of the resident;

 

b.  The date and time the medication was taken;

 

c.  A notation of any medication occurrence or the reason why any medication was not taken as ordered or approved;

 

d. The dated signature of the authorized staff who administered the medication to the resident; and

 

e.  For administration of a PRN, documentation including the reason for administration.

 

          (z)  The licensee shall require that all telephone orders from a licensed health care practitioner or their agent, for medications, treatments, and diets are documented in writing, including facsimiles, by the licensed health care practitioner within 24 hours.

 

          (aa)  In addition to (z) above, authorized staff shall record any changes regarding prescription medications in the resident’s medication log.

 

          (ab)  All physician medication samples shall legibly display the information described in (m)(1)–(5) above.

 

          (ac)  No person other than a licensed health care practitioner shall make changes to the written order of a licensed health care practitioner regarding prescribed medication.

 

          (ad)  All medication maintained by the program shall be stored as follows:

 

(1)  Kept in a storage area that is:

 

a.  Locked and accessible only to authorized personnel;

 

b.  Organized to allow correct identification of each resident’s medication(s);

 

c.  Illuminated in a manner sufficient to allow reading of all medication labels; and

 

d.  Equipped to maintain medication at the proper temperature;

 

(2)  Schedule II controlled substances, as defined by RSA 318-B:1-b, shall be kept in a separately locked compartment within the locked medication storage area and accessible only to authorized personnel; and

 

(3)  Topical liquids, ointments, patches, creams, and powder forms of products shall be stored in a manner such that cross-contamination with oral, optic, ophthalmic, and parenteral products shall not occur.

 

          (ae)  All medication shall be accompanied by:

 

(1)  The physician’s written order, which may be the prescription label; and

 

(2)  The manufacturer’s written instructions for dosage.

 

          (af)  Medications such as insulin, inhalers, and epi pens shall be permitted to be in the possession of a resident in accordance with the resident’s ability, as specified in the resident’s treatment plan.

 

          (ag)  All medications belonging to staff shall be stored in a locked area, separate from residents’ medications or otherwise inaccessible to residents.

 

          (ah)  The program director or designee may elect to have a supply of non-prescription medication available, including but not limited to acetaminophen, ibuprofen, aspirin, cold medicines, or antacids that may be administered to residents for minor illnesses, provided those medications are stored and administered in accordance with the requirements in this section.

 

          (ai)  All medication shall be kept in the original containers or pharmacy packaging and properly closed after each use unless otherwise allowed by law.

 

          (aj)  Any contaminated, expired, or discontinued medication, whether prescription or over the counter, shall be destroyed within 7 days of identification as contaminated, expired, or discontinued.

 

          (ak)  Destruction of prescription drugs under (aj) above shall:

 

(1)  Be accomplished by an authorized staff and witnessed by one staff; and

 

(2)  Be documented in the resident’s medication record, including the legible, dated signature of the staff person who disposed of the drugs and the staff person who witnessed the disposal.

 

          (al)  All medication shall be destroyed in accordance with the United States Environmental Protection Agency’s, “How to Dispose of Medicines Properly” guidance, (April 2011), available as noted in Appendix A.

 

          (am)  Programs providing SUD services shall have a clearly identified policy for storage and administration of naloxone that includes the following:

 

(1)  The process for regularly reviewing and updating the standing order for the naloxone kits on the premises;

 

(2)  The process for ensuring regular review of naloxone kits for expiration;

 

(3)  If naloxone is administered, the policy shall include a statement that 911 shall be called immediately; and

 

(4)  If naloxone is not administered but an overdose is suspected, the policy shall include a statement that 911 shall be called immediately.

 

          (an)  Medication administered by individuals authorized by law to administer medications shall be:

 

(1)  Prepared immediately prior to administration; and

 

(2)  Prepared, identified, and administered by the same person in compliance with RSA 318-B and RSA 326-B.

 

          (ao)  Personnel shall remain with the resident until the youth has taken the medication.

 

          (ap)  If a nurse delegates the task of medication administration to an individual not licensed to administer medications, the nurse shall follow the requirements of RSA 326-B.

 

          (aq)  Programs providing SUD services shall have a written policy establishing procedures for the prevention, detection, and resolution of controlled substance misuse, and diversion, which shall apply to all personnel, and which shall be the responsibility of a designated employee or interdisciplinary team.

 

          (ar)  The policy in (aq) above shall include:

 

(1)  Education;

 

(2)  Procedures for monitoring the distribution and storage of controlled substances;

 

(3)  Voluntary self-referral by employees who are misusing substances;

 

(4)  Co-worker reporting procedures;

 

(5)  Drug testing procedures to include at a minimum, testing where reasonable suspicion exists;

 

(6)  Employee assistance procedures;

 

(7)  Confidentiality;

 

(8)  Investigation, reporting, and resolution of controlled drug misuse or diversion; and

 

(9)  The consequences for violation of the controlled substance misuse, and diversion prevention policy.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.16  Residential Child Care Space.

 

          (a)  In all programs, space that is designated, inspected, and approved as residential child care space shall not be used for any purposes or activities that could jeopardize the health or safety of residents or otherwise negatively impact the residential child care program.

 

          (b)  Residential child care programs shall provide:

 

(1)  A living room or community space with comfortable furnishings, available, and accessible to residents for regular and informal use for general relaxation and entertainment;

 

(2)  Bedrooms that are separated by gender and that have:

 

a.  A minimum of 50 square feet of floor space per occupant;

 

b.  Ceilings that are at least 7 feet high at the highest peak;

 

c.  An outside window; and

 

d.  An operable door;

 

(3)  An area that is suitable and available for private discussions and counseling sessions;

 

(4)  Sturdy, comfortable furniture and furnishings, that are clean and in good repair;

 

(5)  Bathroom facilities that provide residents with age appropriate privacy while changing clothes, showering, attending to personal hygiene, and using the toilet;

 

(6)  When available on site, outdoor space that is maintained in a neat, safe, clean condition and is available to residents for active recreation; and

 

(7)  Screens for all operable windows in the facility.

 

          (c)  If seclusion is used, then rooms used for seclusion shall be in compliance with the provisions of RSA 126-U:5-b.

 

          (d)  Programs shall have a communication system in place so that residents and staff can effectively contact personnel when they need assistance with care or in an emergency.

 

          (e)  Programs shall assure that:

 

(1)  Damage to the residence, such as holes in walls and doors, is repaired within 7 days, or as soon as possible after the damage has occurred; and

 

(2)  Any hazardous condition in the licensed premises, including but not limited to those identified in He-C 4001.17(a),  is immediately addressed, and that residents do not have access to any hazardous conditions or materials pending repair or replacement.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.17  Health and Safety in the Residential Child Care Environment.

 

          (a)  Program staff shall maintain the residential child care environment free of conditions hazardous to residents, including but not limited to, the following:

 

(1)  Electrical hazards;

 

(2)  Guns, or live or spent ammunition;

 

(3)  Holes in flooring, loose floor tiles or loose throw rugs, which present a slipping or tripping hazard;

 

(4)  Loose and flaking paint which is accessible to residents;

 

(5)  Unclean conditions, which demonstrate a lack of regular cleaning;

 

(6)  Inadequate protections against insects and rodents; and

 

(7)  Garbage and rubbish stored in an unsanitary manner.

 

          (b)  When interior or exterior surfaces of a building built prior to 1978 are in deteriorating condition, including flaking, chipping and peeling paint, or are subject to renovations or construction, a U.S. Environmental Protection Agency certified Renovation, Repair, and Painting (RRP) contractor shall be utilized to make the deteriorated surfaces intact, in accordance with 40 CFR1.745.90(a) and (b) and He-P 1600.

 

          (c)  When there is information or evidence indicating that the building might contain asbestos hazards, the applicant, licensee, or designee shall submit evidence that the building has been inspected by a licensed asbestos inspector and is free of asbestos hazards or otherwise treated or contained in a manner approved by a licensed asbestos inspector.

 

          (d)  Program staff shall clearly label and store all toxic materials, including, but not limited to, cleaners, household chemicals and paint, separate from food items, in cabinets which are locked or otherwise inaccessible to residents. 

 

          (e)  Notwithstanding (d) above, at the discretion of the program director, residents may be allowed to use household cleaning products to complete a specific task, provided the resident completing the task shall be under the supervision of program staff while the cleaning chemicals are accessible, and the cleaning products shall not be accessible to other residents not involved in the cleaning task.

 

          (f)  Program staff shall maintain on file at the residence documentation of current vaccinations as required by law for all pets and animals that are present on the premises of the program.

 

          (g)  Pets and animals that have been determined by the department to pose a health or safety risk to children shall not be permitted on the premises of the program, including, but not limited to, the following:

 

(1)  Bats;

 

(2)  Turtles;

 

(3)  Tortoises;

 

(4)  Snakes;

 

(5)  Iguanas;

 

(6)  Other lizards or reptiles;

 

(7)  Hedgehogs;

 

(8)  Parakeets; and

 

(9)  Parrots and parrot-like birds.

 

          (h)  All enclosed living areas used by residents shall:

 

(1)  Be ventilated by means of a mechanical ventilation system or one or more screened windows that can be opened, and will not pose a hazard to residents; and

 

(2)  From September 1 through May 31, have a safe, functioning heating system, which is cleaned, serviced, and maintained at least once annually and which ensures that whenever residents are present, or expected to arrive within one hour, the temperature is maintained at:

 

a.  Not less than 65 degrees Fahrenheit during waking hours, except for areas being used for active physical exercise or recreation; and

 

b.  Not less than 55 degrees Fahrenheit during sleeping hours.

 

          (i)  Program staff, child care interns, and volunteers shall not smoke or use tobacco products while they are responsible for the care of residents or within sight of residents, nor allow residents to smoke or use tobacco, have access to tobacco products, or be exposed to second hand smoke.

 

          (j)  All living space and recreation areas used by residents shall be equipped with operable lighting sufficient to allow individuals to enter, exit and move about the premises of the program safely.

 

          (k)  All toys, equipment and learning materials shall be:

 

(1)  In good repair;

 

(2)  Safe;

 

(3)  Free of lead paint or other poisonous material; and

 

(4)  Cleaned as often as needed to keep them free of a buildup of dirt.

 

          (l)  Licensees shall provide sufficient sturdy tables and chairs to ensure each resident’s comfort for meals, snacks, and for work or play at tables.

 

          (m)  Licensees shall provide each resident with a bed equipped with:

 

(1)  A pillow and a firm mattress that is:

 

a.  Clean;

 

b.  In good repair;

 

c.  Free from rips or holes in the fabric covering that would allow residents access to the interior components of the mattress;

 

d.  Cleaned and sprayed with a disinfecting spray before being used for a new resident; and

 

e.  Replaced or sanitized promptly if soiled by urine, feces, blood, or vomit; and

 

(2)  Adequate bedding to insure his or her comfort that is cleaned and maintained as follows:

 

a.  Sheets and pillow cases shall be cleaned at least once each week and more frequently if soiled; and

 

b.  Blankets, comforters, bedspreads, and mattress covers shall be cleaned at least once each month and more frequently if soiled.

 

          (n)  Programs shall provide separate sleeping and bathroom facilities for staff and family members of staff who reside in the program.

 

          (o)  Program staff shall maintain the outside play areas free of hazards.

 

          (p)  During activities conducted in the water, including wading, swimming and boating, the following shall apply:

 

(1)  All activities shall be supervised in accordance with the following:

 

a.  Program staff shall provide close supervision to residents at all times, to include a ratio of one staff to no more than 4 residents when no lifeguard is present;

 

b.  At least one staff person who is currently certified in CPR and first aid shall be present with the residents at all times;

 

c.  At least one staff person who has completed training in water safety shall be present with the residents at all times;

 

d.  A rescue buoy, ring buoy, or water rescue throw bag shall be brought to or present at all swimming and boating activities where there is no lifeguard present; and

 

e.  Notwithstanding a. through d. above, a program may allow a resident to be at a water activity independently, if the program director provides a written and dated authorization, after assessing the following:

 

1.  A resident’s swimming ability, such as whether he or she has completed a Red Cross or other recognized swimming program;

 

2.  A resident’s ability to be independent;

 

3.  Under what circumstances the resident may be at a water activity independently; and

 

4.  Whether or not a lifeguard must be on duty or a parent or other adult must be present at the water activity; and

 

(2)  All pools used as part of the residential child care operation shall be maintained in accordance with the printed instructions of the manufacturer or installer regarding cleaning, filtration, and chemical treatment, and the following:

 

a.  Swimming pools shall be secured in a manner that is childproof and lockable; and

 

b.  Pool gates, fences, or other barriers as required in a. above shall be locked at all times, except when the residents are involved in an allowable water activity in the pool.

 

          (q)  Program staff shall comply with the following food service requirements:

 

(1)  All foods that will be served to residents shall be:

 

a.  Free from spoilage, filth, or other contamination;

 

b.  Stored in a clean dry location;

 

c.  Protected from sources of contamination;

 

d.  Stored in containers at least 6 inches above the floor;

 

e.  Stored separate from non-food items that could contaminate food or be mistaken for food;

 

f.  Stored in the original containers or in labeled containers designed for food storage; and

 

g.  Stored, handled, and prepared in a manner that protects against cross contamination between uncooked meat, poultry or fish, and other food items;

 

(2)  Canned goods that are dented, bulging, or rusted shall not be served to residents;

 

(3)  All perishable foods which are to be served to residents shall be stored at temperatures of 41 degrees Fahrenheit or below in a refrigerator and at 0 degrees Fahrenheit or below in a freezer;

 

(4)  Refrigerators and freezers used to store foods that will be served to residents shall be clean;

 

(5) Refrigerators and freezers used to store foods that will be served to residents shall be equipped with non-mercury, food-grade thermometers; and

 

(6)  Food contact surfaces shall be easily cleanable, smooth, free of cracks, breaks, and open seams or similar difficult to clean imperfections and kept clean.

 

          (r)  Toys or other items which are routinely mouthed by residents shall be cleaned and sanitized after each use by a resident, and at the end of each day.

 

          (s)  Residents who have developmental delays and are likely to put objects in their mouths, shall be closely supervised when they have access to the items noted in (t)(1)c. and (11) below.

 

          (t)  Program staff shall comply with the following child age related environmental health and safety requirements:

 

(1)  Residents younger than 6 years of age shall not have access to the following:

 

a.  Cords or strings long enough to encircle a resident’s neck, including but not limited to pull toys, telephone cords, and window blind cords;

 

b.  Balusters which are spaced more than 3 1/2 inches apart on handrails and guardrails on play structures, lofts, stairs, steps, decks, porches, balconies, or other barriers;

 

c.  Sharp knives and sharp objects or objects with sharp edges, except that, at the discretion of program staff and under close supervision, program staff may allow use of scissors or knives for specific cooking projects, craft projects, or meal times;

 

d.  Unstable or easily tipped heavy furnishings or other heavy items which, if not secured to the wall or floor or both, could easily fall on residents and would be likely to cause injury; and

 

e.  Toy boxes and any other chest type storage facilities that have a lid that does not have a safety lid support;

 

(2)  Play areas accessible to residents younger than 6 years of age shall be enclosed by a fence when the department determines that the play area is unsafe because it is located on a roof, or adjacent to any of the following:

 

a.  A street or road; or

 

b.  Any dangerous areas, any swimming pool, or any body of water;

 

(3)  All fencing required under (2) above shall:

 

a.  Be designed to restrain residents from climbing out of, over, under, or through the fence;

 

b.  Have a child proof self-latching device on any gates; and

 

c.  Be maintained in good repair, free of damage or wear that could expose residents to hazards;

 

(4)  When accessible to residents younger than 6 years of age, ground area under and extending at least 39 inches beyond the external limits of outdoor play equipment which would allow a resident to fall from a height of more than 29 inches shall be constructed and maintained at all times with an energy absorptive surface, including but not limited to sand, bark mulch, pea stone, soft wood chips, or rubber mats manufactured for use as gym mats; 

 

(5)  The energy absorptive material required in (4) above shall be:

 

a.  Maintained at a depth of at least 8 inches; and

 

b.  Checked and raked regularly to remove any foreign matter, correct compaction, and increase absorption;

 

(6)  Adult toilets and hand washing sinks used by residents younger than 6 years of age shall be equipped with footstools or platforms;

 

(7)  Foot stools or platforms required in (6) above shall:

 

a.  Have a non-porous finish that is easily cleanable; and

 

b.  Be designed to prevent tipping;

 

(8)  The fall zone under and around all indoor swings, slides, and climbing equipment from which a child could fall from a height of more than 29 inches shall be covered with mats designed for gymnastics, if they are accessible to or will be used by residents younger than 6 years of age;

 

(9)  Children younger than 3 years of age shall not have access to stairs or steps that are not equipped with safety gates;

 

(10)  Baby walkers with wheels shall be prohibited in all programs;

 

(11)  Residents younger than 4 years of age shall not have access to toys, toy parts, and other materials which pose a choking risk or are small enough to be swallowed, such as coins and balloons;

 

(12)  There shall be an individual crib or playpen for each resident 12 months of age and younger; and

 

(13)  Cribs and playpens required under (12) above shall:

 

a.  Not be stacked;

 

b.  Be free of cracked or peeling paint, splinters, and rough edges;

 

c.  Have no more than 2 3/8 inches between slats;

 

d. Have no missing, loose, broken, or improperly installed parts, screws, brackets, baseboards or other loose hardware or damaged parts on the crib or mattress supports;

 

e. Not have corner posts that extend more than one sixteenth of an inch above the end panels;

 

f.  Not have cutouts in the headboard or footboard;

 

g.  Not have holes or tears in the mesh walls or in the material that connects the walls to the bottom of the crib or play pen; and

 

h.  Have mattresses which:

 

1.  Are in good repair, free of rips or tears; and

 

2.  Fit the crib or playpen so that space between the mattress and the crib or playpen does not create a suffocation hazard.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.18  Water Supply, Septic Systems, Bathroom Facilities.

 

          (a)  The licensee shall supply a safe supply of water under pressure, which is available for drinking and household use in accordance with the following:

 

(1)  Hot water under pressure, which measures at least 100 degrees Fahrenheit, shall be available at all sinks, showers, and bathtubs located in living space that is used by residents during operating hours;

 

(2)  Hot water at taps that are accessible to residents shall be regulated to maintain a temperature at the tap of not higher than 120 degrees Fahrenheit; 

 

(3)  In accordance with Env-Dw 501.04(c), a program that has a public water system as defined in RSA 485:1-a, XV and subject to regulation by the department of environmental services, shall have on file a written document which lists the United States Environmental Protection Agency identification number of the system, assigned by the department of environmental services;

 

(4)  The written documentation required in (3) above available shall be available for review by the health officer and the department;

 

(5)  Programs that have their own independent water supply and are not considered to be public water systems as defined in RSA 485:1-a, XV, shall test their water supply in accordance with the following:

 

a.  Water testing shall be performed by a laboratory accredited under the environmental laboratory accreditation program in accordance with Env-C 300;

 

b.  For new applicants, not more than 90 days prior to the date the application is submitted to the department, water testing shall be conducted for arsenic, bacteria, nitrate, nitrite, lead, both stagnant and flushed, copper, both stagnant and flushed, fluoride, and uranium and results provided to the department with the application; and

 

c.  Ongoing water testing shall be conducted as follows and results maintained on file at the program, available for review by the health officer and the department:

 

1.  Once every 3 months for bacteria;

 

2.  Annually for arsenic, nitrate, and nitrite; and

 

3.  At least once every 3 years for stagnant lead, stagnant copper, fluoride, and uranium;

 

(6)  The results of water tests required by (a)(5)b. and c. above, and results of any other water tests shall be in compliance with the maximum contaminant levels established in Env-Dw 700 for bacteria, nitrates, nitrites, arsenic, and fluoride, and shall not exceed the action levels established in Env-Dw 714 for lead and copper;

 

(7)  Any program whose water test result has exceeded maximum contaminant levels or action levels shall:

 

a.  Immediately contact the department to report that finding, and provide the department with a plan for how it will ensure that children will not be at risk from exposure to the unsafe water; and

 

b.  Within 30 days of the date the program learns that they have failed a water test submit to the department an acceptable corrective action plan which details what action will be taken to correct the unsafe condition of the water and a date by which that action will be complete, unless the program requests, either verbally or in writing, and the department agrees to extend that deadline based on the following criteria:

 

1.  The program demonstrates that it has made a good faith effort to develop and submit the corrective action plan within the 30-day period but has been unable to do so; and

 

2.  The department determines that the health, safety or well-being of children will not be jeopardized as a result of granting the extension; and

 

(8)  When a program fails to submit a written proposed corrective action plan within 30 days of receiving the unacceptable test result under (a)(7)b. above, the department shall initiate action to suspend the license or permit in accordance with He-C 4001.09(i), until such time as laboratory results meeting those requirements are received by the department.

 

          (b)  Programs shall ensure that there are functional sewage disposal facilities designed to accommodate the license capacity of the program, in accordance with the following:

 

(1)  There shall be no visible sewage on the grounds;

 

(2)  There shall be flush toilets in working order connected to a sewage disposal system; and

 

(3)  Any program whose septic system is showing signs of failure, shall:

 

a.  Immediately make arrangements with a contractor licensed to evaluate and repair or replace septic systems to:

 

1.  Make temporary repairs to the septic system to correct the problem so that the program may continue to operate; or

 

2.  Make permanent repairs to the septic system or replace the septic system;

 

b.  Immediately contact the local health officer to inform him or her of the problem;

 

c. Immediately contact the department to verbally report the problem, and give the department a plan for how it will immediately provide that:

 

1.  All required bathroom units function properly; and

 

2.  Residents will not be exposed to any risks from the failed septic system;

 

d.  Within 10 days of the date that program staff first notice signs indicating that the septic system is in failure, submit to the department a written plan, which includes:

 

1.  What action has been taken to correct the failed septic system;

 

2.  The date by which that action will be completed; and

 

3.  An explanation of how the program will ensure that the requirements in (b) (3) c. 1. and 2. above will continue to be met until repair or replacements are completed; and

 

e.  Request an extension to d. above which the department shall grant if additional time is necessary to develop a written plan and the safety and well-being of the residents is maintained.

 

          (c)  Programs shall ensure that in each building in which residents reside, for every 4 residents there shall be one bathroom unit that is accessible to residents and equipped with:

 

(1)  An operable door; and

 

(2)  A properly functioning sink, toilet, and shower or tub.

 

          (d)  Programs shall maintain bathroom facilities in accordance with the following:

 

(1)  At least once each day and whenever visibly soiled, sinks, toilets, commodes, foot stools, potty chairs, and adapters shall be cleaned to remove visible dirt and sanitized;

 

(2)  Toilet paper, individual cloth or paper towels, and individual bar or liquid soap shall be available and accessible to residents and staff;

 

(3)  Bathrooms shall have a means of outside ventilation; and

 

(4)  Bathroom floors and other surfaces shall be cleaned at least weekly, and more often when obviously soiled.

 

          (e)  In addition to the requirements for toilets set forth in (c) above, programs that serve residents younger than 3 years of age shall:

 

(1)  Provide additional child size toilets, adult toilets with adapters, or potty chairs to meet the needs of such residents;

 

(2)  Place potty chairs within easy access to a toilet and sink to allow program staff to proceed to the toilet to empty the potty chair and proceed to the hand washing sink after toileting without having to open doors or gates, or have physical contact with other residents;

 

(3)  Not place potty chairs or commodes in food preparation areas or food service areas; and 

 

(4)  Empty and sanitize each potty-chair and commode receptacle after each use.

 

          (f)  Programs serving diapered residents and residents who are not toilet trained shall have a designated diaper changing area that:

 

(1)  Is not located in kitchens, food preparation or food service areas, or on surfaces where food is prepared or served;

 

(2)  Is located adjacent to or in close proximity to a hand washing sink to allow access for hand washing without having to open doors or have physical contact with other residents;

 

(3)  Has a non-porous, washable surface, which shall be sanitized after each diaper change and used exclusively for diaper changing;

 

(4)  Contains a foot-activated receptacle for disposal of soiled disposable diapers and cleansing articles; and

 

(5)  Is equipped with a sink used for adult and resident hand washing before or after diaper changing or toileting.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.19  Requirements for Program Staff.

 

          (a)  Program staff shall:

 

(1)  Relate with residents in a professional, respectful manner; and

 

(2)  Have the ability to identify the needs and problems of the children and possess skill in planning and implementing services of the program.

 

          (b)  The program director or designee shall, for each staff person who is responsible for the care, supervision, or treatment of residents, have on file available for review by the department documentation of job qualifications such as:

 

(1)  All required education, such as a diploma, transcripts, certificates, or degrees; and

 

(2)  All required training and experience, as set forth on an application form or resume.

 

          (c)  For the purposes of this section, the field of human services shall include residential care, education, social work, mental health, law enforcement, psychology, sociology, pastoral counseling, theology, juvenile justice, medical services, corrections, substance abuse, social services, recreation, or a related field.

 

          (d)  The department shall accept the following education and training for program staff:

 

(1)  Credit courses in human services, offered by a regionally accredited college or university, toward meeting pre-service and in-service training requirements;

 

(2)  Non-credit courses in human services, which are offered by a regionally accredited college or university, toward meeting pre-service and in-service training requirements at a ratio of 12 contact hours equal one credit; and

 

(3) Conference sessions, workshops, non-credit correspondence courses or other non-credit distance learning courses related to human services, that are open to individuals working in the residential child care field or to the public or both, and are presented by an instructor who has at least a bachelor’s degree in human services or the subject area in which he or she is teaching, at a ratio of 12 contact hours equals one credit.

 

          (e)  The program director shall meet at least one of the following pre-service training and education options:

 

(1) A master’s degree in the field of human services, business administration, or public administration, awarded by a regionally accredited college or university, plus 2 years of experiences as a professional in human services, which included administrative responsibilities; or

 

(2)  A bachelor’s degree with a minimum of 12 credits in the field of human services, business administration, or public administration, awarded by a regionally accredited college or university, plus 3 years of experience as a professional in human services, which included administrative responsibilities.

 

          (f)  Direct care staff shall be at least 21 years of age, have a high school diploma, high school equivalency certificate, or general equivalency diploma, and meet one of the following pre-service training and education requirements:

 

(1)  An associate’s or higher degree with a minimum of 12 credits in the field of human services, or other field related to residential care, awarded by a regionally accredited college or university;

 

(2)  The equivalent of 2 years of full-time experience working with children, either as a paid employee or volunteer;

 

(3)  Any combination of college credits in human services and experience with children that total 2 years, as follows:

 

a.  Two years of full-time college shall equal 60 credits;

 

b.  Two years of full-time employment shall equal 3000 hours; and

 

c.  One credit shall equal 50 hours of experience; or

 

(4)  Documentation of 7 years of parenting experience.

 

          (g)  When an applicant for a direct care staff member does not meet one of the provisions in (f) above:

 

(1)  An agreement shall be on file, signed, and dated by the individual and the program director or designee, which includes a written plan for:

 

a.  Attaining 12 credits in human services within 2 years from the date that the individual begins working as a direct care staff, with documentation on file of the completion of 3 credits every 6 months, beginning on the date of hire;

 

b.  How the program will supervise the individual while they are working on acquiring the required 12 credits; and

 

c.  Maintaining current documentation of earned credits on file in the individual’s personnel file; and

 

(2)  No more than 30% of staff shall be hired under the provisions of (g)(1)a. above.

 

          (h)  A child care assistant, intern, or volunteer shall:

 

(1)  Be at least 18 years of age;

 

(2)  Work at all times under the supervision of an on-duty staff person who meets at least the minimum qualifications for the position of direct care staff;

 

(3)  Not be responsible for the care or supervision of residents including treatment, discipline, physical intervention, counseling, or administration of medication; and

 

(4)  Not be included in the staff to child ratio.

 

          (i)  Supervision as referenced in (h) above shall require that a staff person who meets at least the minimum qualifications of direct care staff shall at all times have:

 

(1)  Knowledge of and accountability for the activity and whereabouts of the child care interns, child care assistants, or volunteers and the residents with whom he or she is working; or

 

(2)  The ability to either see or hear the child care intern, child care assistant, or volunteer and the residents with whom he or she is working.

 

          (j)  The exception to (i) above shall be that the program director or designee may at his or her discretion, authorize a specific child care assistant, intern, or volunteer to be responsible for one or more residents during time limited, specific activities, either indoors or outdoors, including off premises.

 

          (k)  Prior to having contact with residents or food, personnel shall receive a tour of and orientation to the program that includes the following:

 

(1)  The program’s complaint procedures;

 

(2)  The duties and responsibilities of the position;

 

(3)  The medical emergency procedures;

 

(4)  The emergency and evacuation procedures;

 

(5)  The infection control procedures;

 

(6)  The program confidentiality requirements;

 

(7)  Grievance procedures for both staff and residents;

 

(8)  The procedures for food safety for personnel involved in preparation, serving, and storing of food, as applicable;

 

(9)  The policies required in He-C 4001.14(a); and

 

(10)  The mandatory reporting requirements including RSA 161-F:46 and RSA 169-C:29.

 

          (l)  No new direct care staff shall be solely responsible for residents in care until he or she has completed the orientation required above.

 

          (m)  The licensee shall provide all personnel with an annual continuing education or in-service education training, which at a minimum contains the following:

 

(1)  The licensee’s infection control program;

 

(2)  The licensee’s written emergency plan;

 

(3)  The licensee’s policies and procedures; and

 

(4)  The mandatory reporting requirements including RSA 161-F:46 and RSA 169-C:29.

 

          (n)  The licensee shall:

 

(1)  Educate personnel about the needs and services required by the residents under their care and document such education to include demonstrated competencies; and

 

(2)  Ensure that all personnel have received the training necessary to be qualified personnel to include demonstrated competency in the training given with documentation maintained in the employee personnel file.

 

          (o)  Personnel and staff shall not:

 

(1) Be impaired while on the job by any substances including, but not limited to, legally prescribed medication, therapeutic cannabis, alcohol, or illegal drugs; or

 

(2)  Expose residents to tobacco, alcohol, or illegal drugs or controlled substances.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.20  Staffing.

 

          (a)  Program staff shall provide care and supervision at all times to ensure that residents are safe and that their needs are met according to their developmental level, age, emotional or behavioral needs, and in accordance with their treatment plan.

 

          (b)  In all programs there shall be a program director that assumes responsibility for the daily operation of the program.

 

          (c)  Programs shall, at a minimum, maintain the following staff to resident ratios and retain documentation of it for a 6-month period:

 

(1)  Independent living homes shall maintain a minimum staff to resident ratio of one staff person to 8 residents during awake hours and one staff person to 12 residents during sleeping hours; and

 

(2)  All other programs shall maintain a minimum staff to resident ratio of one staff person to 6 residents during awake hours and one staff person to 12 residents during sleeping hours.

 

          (d)  Notwithstanding the required minimum staff to resident ratios specified in (c) above, when a staff person takes one or more residents off the premises for a routine trip, such as a medical or dental appointment, recreation or social activity, the program may have one fewer staff person with the residents who will remain on the premises of the program, provided that:

 

(1)  The program director or designee has authorized the reduced staff to resident ratio, based upon his or her determination that the staff remaining on the premises of the program can meet the individual needs of each resident; and

 

(2)  In no case shall the staff to resident ratio go below one to 12.

 

          (e)  Notwithstanding the staff to resident ratios set forth in (c) and (d) above, when a resident’s treatment plan requires that a resident needs a staff to resident ratio that is more stringent than the required staff to resident ratios, the program shall comply with the resident’s treatment plan.

 

          (f)  The licensee shall assign at least one staff to help orient a newly admitted resident to the program and to the services available to the resident.

 

          (g)  Programs operating an SCP shall have sufficient hired and contracted staff to meet the needs of residents.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.21  Programming Requirements for Residents.

 

          (a)  Program staff shall, with input from the person or program placing the resident, have referral information on each resident, including:

 

(1)  The reason for the placement;

 

(2)  The anticipated length of stay;

 

(3)  The contact information for the parent or guardian; and

 

(4)  The contact information for the person or program placing the resident.

 

          (b)  Except for residents in short term placement, a written treatment plan shall be in place for each resident no later than 30 days from the date of admission.

 

          (c)  The written treatment plan required in (b) above shall identify:

 

(1)  The resident’s physical, social, behavioral, medical, and educational needs; and

 

(2)  How the program will meet those needs.

 

          (d)  Program staff shall review and modify the written treatment plan required in (b) above as the resident’s needs change.

 

          (e)  Once the written treatment plan required in (b) above is developed, program staff shall familiarize themselves with the identified needs of each resident and implement the plan.

 

          (f)  The program director or designee shall:

 

(1)  Not rely upon residents to maintain the facility; and

 

(2)  Only allow residents to perform work inside or outside the program, which is:

 

a.  Compliant with child labor laws and regulations; and

 

b.  Consistent with the resident’s age and abilities.

 

          (g)  Program staff shall:

 

(1)  Plan daily activities that promote healthy development and provide for social relationships, creative activities, hobbies, and participation in neighborhood, school, and other community groups appropriate to the age, developmental level, and needs of each resident;

 

(2)  Provide that work assignments for the resident do not interfere with the regular school programs, study periods, recreation, or sleep;

 

(3)  Provide each resident with clothing that is individually fitted and appropriate to the season;

 

(4)  Instruct each resident regarding good health practices, including proper habits in eating, bathing and personal hygiene;

 

(5)  Provide each resident with a clean towel and washcloth weekly, or more often if towels or washcloths become soiled or odorous; and

 

(6)  Provide each resident with necessary individual toilet articles and supplies for personal grooming and hygiene suitable to their age and needs.

 

          (h)  Each child shall have education and training, including:

 

(1)  Regular school attendance as required by law; and

 

(2)  The opportunity to complete high school or the opportunity for vocational guidance.

 

          (i)  Academic programs within the facility shall meet the requirements of the New Hampshire department of education.

 

          (j)  Each child shall be given the opportunity to practice his or her religious beliefs.

 

          (k)  The program staff shall assess the resident's needs and prepare a discharge plan at least 30 working days prior to the resident's discharge, except in the case of an unplanned or emergency discharge.

 

          (l)  In the case of an unplanned or emergency discharge, the program staff shall prepare a discharge summary, which explains the circumstances of the discharge as soon as practicable.

 

          (m)  The program shall not exceed the maximum number of residents licensed by the department, unless authorized by the department, such as during an emergency.

 

          (n)  The licensee shall:

 

(1)  Establish procedures to prepare the staff and residents for the arrival of new resident; and

 

(2)  Provide staff with appropriate information to receive the new resident and assist in his or her adjustment, which shall include at a minimum:

 

a.  Reason for placement, medical condition(s) and behavior problems, as applicable; and

 

b.  Specific instructions related to the individual needs of the resident, including the need for an individualized restraint method consistent with RSA 126-U, if appropriate.

 

          (o)  Licensees shall:

 

(1)  Meet the needs of the residents;

 

(2)  Initiate action to maintain the program in full compliance at all times with all relevant health and safety requirements contained in applicable federal, state, and local laws, rules, regulations, and ordinances;

 

(3)  Establish, in writing, a chain of command that sets forth the line of authority for the operation of the program;

 

(4)  Verify the qualifications of all personnel; and

 

(5)  Provide sufficient numbers of personnel who are present in the program and are qualified to meet the needs of residents during all hours of operation.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.22  Discipline.

 

          (a)  Program staff shall:

 

(1)  Establish and make residents aware of rules or limits for acceptable behavior which are consistently applied, realistic, designed to promote cooperation and respect, and are appropriate and understandable to the development level of the resident; and

 

(2)  Make residents aware of the consequences of not complying with the established limits or rules for acceptable behavior.

 

          (b)  Program staff shall not:

 

(1)  Abuse or neglect residents;

 

(2)  Use corporal punishment;

 

(3)  Attempt to control any resident’s behavior by actions which are humiliating, threatening, shaming, frightening, or otherwise damaging to residents;

 

(4)  Withhold food from residents;

 

(5)  Shame, humiliate, or discipline any resident for toileting accidents;

 

(6)  Prevent a resident from using bathroom facilities, except as necessary to protect a resident’s safety, as documented in the resident’s case plan or treatment plan;

 

(7)  As a means of discipline or punishment:

 

a.  Require or deny residents sleep or rest;

 

b.  Require residents younger than 6 years of age to go to their crib, bed, or playpen;

 

c. Withhold a resident’s shoes or clothing, except as necessary to protect the resident’s health or safety or to prevent the resident from running away;

 

d.  Require a resident to perform physical exercise or perform tasks, which are humiliating, unusual, or physically exhausting; or

 

e.  Use group punishment for misbehaviors of individuals except when documented as part of the treatment plan;

 

(8)  Use sensory deprivation;

 

(9)  Use mechanical restraints, and specifically any equipment, material, or device that is applied to a resident for the purpose of restricting his or her movement or activity; or

 

(10)  Allow residents to discipline other residents.

 

          (c)  Each use of time out shall:

 

(1)  Not be in a locked room;

 

(2)  Be appropriate to the resident’s developmental level and circumstances; and

 

(3)  Be limited to the minimum amount of time necessary to:

 

a.  Allow the resident to regain self-control;

 

b.  Be effective as a consequence; or

 

c.  Protect the safety of the resident in time out or other residents.

 

          (d) The applicant, licensee, program director and program staff shall take prompt action to protect residents from abuse, neglect, corporal punishment, or other mistreatment by any individual.

 

          (e)  Program staff shall use restraint in accordance with RSA 126-U.

 

          (f)  Program staff shall use seclusion in accordance with RSA 126-U.

 

          (g) The staff person in charge shall evaluate each use of seclusion at least every 60 minutes to determine if further use of this intervention is necessary.

 

          (h)  Each use of seclusion or restraint shall be documented on an incident report in accordance with He-C 4001.23, He-C 4001.14(t)(5), and RSA 126-U:7.

 

          (i)  The program director, treatment coordinator, or designee shall review the documentation regarding each use of seclusion no later than one working day after its use, and sign and date the documentation.

 

          (j)  Before any program staff participates in a physical intervention or the use of seclusion he or she shall have completed a curriculum in physical intervention techniques that is designed to protect the child from risk of harm to self, others, property, or the public.

 

          (k)  Physical intervention methods used shall be consistent with the curriculum required in (j) above and be reviewed annually with program staff to maintain competency.

 

          (l)  Physical intervention shall be used only:

 

(1)  After less restrictive behavior management techniques have been tried and found to be ineffective in helping the resident gain control; and

 

(2)  When necessary to:

 

a.  Ensure the physical safety and security of the out of control resident, or other residents;

 

b.  Prevent harm to program staff or other persons; or

 

c.  Prevent serious damage to property.

 

          (m)  To reduce the risk of injury to a resident as a result of physical intervention, program staff shall use the minimum amount of force necessary to control the resident.

 

          (n)  During any physical intervention process, program staff shall evaluate the resident throughout the process, to ensure that the resident is not being injured, and to determine whether continued physical intervention is necessary. If the physical intervention exceeds 15 minutes, approval from the program director or a supervisory employee designated by the program director shall be required, per RSA 126-U:11, III.

 

          (o)  In the event that a physical intervention continues for longer than 30 minutes:

 

(1)  Program staff trained to conduct such assessments shall conduct a face-to-face assessment of the resident’s mental, emotional, and physical well-being;

 

(2)  Program staff shall contact the program director or designee so that he or she can evaluate the need for continued physical intervention and the need for services from law enforcement, or a licensed health care practitioner; 

 

(3)  Such assessments shall be completed at least every 30 minutes throughout the physical intervention; and

 

(4)  Program staff shall document all assessments as required in He-C 4001.23(b)(2).

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.23  Incident Reports.

 

          (a)  Program staff directly involved in or witness to any incident shall complete a legible, written incident report whenever there is an incident, as defined in He-C 4001.01(y).

 

          (b)  For reportable incidents, as defined in He-C 4001.01(bc), licensees shall have responsibility for:

 

(1)  Completing a preliminary review of an incident to determine if abuse or neglect could have been a contributing factor to the incident;

 

(2)  Providing the following information to the department within 48 hours of a reportable incident:

 

a.  The program name;

 

b.  A description of the incident, including what led to the incident, where it occurred and identification of injuries, if applicable;

 

c.  The name of the licensee(s) or personnel involved in, witnessing, or responding to the reportable incident;

 

d.  The name of resident(s) involved in or witnessing the reportable incident;

 

e.  The date and the beginning and ending time of the reportable incident;

 

f.  The action taken in direct response to the reportable incident, including any follow-up;

 

g.  If medical intervention was required, by whom, and the date and time;

 

h. When the resident’s guardian, agent, surrogate decision-maker, or personal representative, if any, was notified;

 

i.  The signature of the person reporting the reportable incident;

 

j.  The date and time the resident’s licensed practitioner was notified, if applicable; and

 

k.  The date the licensee performed the preliminary review required by (1) above; and

 

(3)  For uses of seclusion, restraint, or other intentional physical contact with a child which is in response to a resident’s aggression, misconduct, or disruptive behavior, in addition to (2) above, the following:

 

a.  Authorization by the staff in charge; and

 

b.  Documentation as required by He-C 4001.23(b)(2) and either RSA 126-U:7 or RSA 126-U:10.

 

          (c)  Incident reports shall be maintained as part of the involved resident’s records and be made available on the premises of the program for review by the department.

 

          (d)  Program staff shall provide the resident’s parents with information regarding incident reports on the next business day, which shall include all of the information included on the incident report.

 

          (e)  If the parent(s) do not have a telephone or cannot be reached, program staff shall document their efforts to notify the parent(s) and send a written copy of the incident report to the parent(s).

 

          (f) For uses of seclusion, restraint, or other intentional physical contact with a child which is response to a child’s aggression, misconduct, or disruptive behavior, program staff shall notify the resident’s parents or guardians in accordance with RSA 126-U:7 including verbal and written documentation.

 

          (g)  Immediately following any fire or emergency incident, licensees shall notify the department by phone, followed by written notification within 72 hours, with the exception of a false alarm or emergency medical services (EMS) transport for a non-emergent reason.

 

          (h)  The written notification required by (g) above shall include:

 

(1)  The date and time of the incident;

 

(2)  A description of the location and extent of the incident, including any injury or damage;

 

(3)  A description of events preceding and following the incident;

 

(4)  The name of any personnel or residents who were evacuated as a result of the incident, if applicable;

 

(5)  The name of any personnel or residents who required medical treatment as a result of the incident, if applicable; and

 

(6)  The name of the individual the licensee wishes the department to contact if additional information is required.

 

          (i)  As soon as is practicable but no longer than 24 hours after the use of a medication restraint, the resident’s licensed practitioner shall be notified of the use of such restraint.

          

          (j)  When a resident has an unexplained absence, after searching the building and grounds without finding the resident, and it has been determined that the resident is a danger to themselves or others, the licensee shall immediately notify the local police department, the department and the resident’s guardian, agent, surrogate decision-maker, or personal representative, if any.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.24  Nutrition.

 

          (a)  Programs shall offer residents 3 meals and 2 snacks each day that meet US Department of Agriculture dietary allowances.

 

          (b)  Residents shall not be denied meals or snacks for any reason except according to a physician’s order. 

 

          (c)  No resident shall be secluded at mealtime unless he or she poses a risk of harm to himself, herself, or others.

 

          (d)  Residents shall not be coerced to eat against their will, except by written order of the resident’s licensed health care practitioner.

 

          (e)  Programs shall meet the nutritional needs of each resident on a therapeutic or medically prescribed special diet.

 

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

          He-C 4001.25  Transportation and Trips.

 

          (a)  Program staff shall bring on all field trips, a copy of the authorization for medical treatment required under He-C 4001.12 (a), for each resident participating in the field trip.

 

          (b)  Residents who are transported by the program and during any program sponsored activity shall be transported in vehicles that are:

 

(1)  Driven by individuals who are at least 21 years of age and hold a valid driver’s license;

 

(2)  Inspected in accordance with Saf-C 3200;

 

(3)  Maintained in a safe operating condition;

 

(4)  Registered in accordance with Saf-C 500;

 

(5)  Insured for personal liability, and medical payments; and

 

(6)  Free of obstructions on the floors and seats.

 

          (c)  Program staff shall be prohibited from using cell phones while operating a vehicle to transport residents.

 

          (d)  Program staff shall not permit any resident to remain in any vehicle unattended by program staff unless the resident is at a level of supervision that allows the resident to be unaccompanied by program staff for specific activities, and if driving, the resident has a valid driver’s license.

 

          (e)  Keys to vehicles, including vehicles belonging to program staff, shall not be accessible to residents, except for a resident who is driving a vehicle pursuant (d) above.

 

          (f)  The number of individuals who are transported by the program, or transported in any vehicle during any program-sponsored activity, shall be limited to the number of persons the vehicle is designed to carry.

 

          (g)  Residents younger than 5 years of age who are transported by the program or transported in any vehicle during any program sponsored activity shall not be transported in any vehicle exempted from seat belt requirements under RSA 265:107-a, II.

 

          (h)  In all programs individual, age appropriate child restraints or seat belts shall be provided for and used by each resident in accordance with RSA 265:107-a.

 

          (i)  Programs shall comply with RSA 126-U:12 regarding restrictions in the use of mechanical restraints during the transport of residents.

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

 

          He-C 4001.26  Independent Living Homes.

 

          (a)  Independent living homes shall comply with He-C 4001.01 through He-C 4001.25, and this section, except as provided in (b) below.

 

          (b)  Independent living homes shall be exempt from:

 

(1)  He-C 4001.21(f)(1), regarding responsibility for the operation and maintenance of the facility;

 

(2)  He-C 4001.17(d), specifically regarding resident’s access to cleaning products;

 

(3)  He-C 4001.21(g)(3), regarding clothing requirements; and

 

(4) He-C 4001.14(c)(1), regarding program staff certified in cardiopulmonary resuscitation (CPR) and first aid being present in each building when residents are present, provided that certified staff are on the premises.

 

          (c)  Program staff shall be on the premises when one or more residents are on the premises.

 

          (d)  Independent living homes shall not be required to have staff in the residence when residents are not on the premises of the program.

 

          (e)  Program staff shall provide an effective communication system between the residents of an independent living home and staff to ensure that program staff are available to address the needs of the residents at all times.

 

          (f)  Kitchen facilities shall be available and accessible for use by all residents and program staff.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14

 

          He-C 4001.27  Short Term Placements.

 

          (a)  The requirements in this section shall apply only to residents who are in short term placement.

 

          (b)  Programs that admit residents for short term placements shall comply with He-C 4001.01 through 4001.25, and this section.

 

          (c)  Within 5 calendar days of the date the resident is admitted to the program, the program shall obtain or document efforts to obtain the following for each resident:

 

(1)  Written authorization for emergency medical treatment, signed by the resident’s parents, as required under He-C 4001.12 (a);

 

(2)  Any history of childhood diseases;

 

(3)  Any current medications prescribed for the resident;

 

(4)  The date of the resident’s last visit to a licensed health care practitioner;

 

(5)  The date and reason for any previous hospitalizations and surgeries;

 

(6)  Current medical problems;

 

(7)  Any allergies to food or medications;

 

(8)  Any special dietary needs or restrictions; and

 

(9)  Any functional limitations.

 

          (d)  Within 3 weeks of the date the resident is admitted to the program, a record of physical examination completed in accordance with He-C 4001.12 (c) and (d) shall be completed or scheduled to be completed and available for review by the department.

 

Source.  #2664, eff 3-30-84, EXPIRED: 3-30-90

 

New.  #8581, eff 4-20-06, EXPIRED: 4-20-06

 

New.  #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14

 

          He-C 4001.28  Homeless Youth Program.

 

          (a)  The requirements in this section shall apply only to programs which serve residents who are in homeless youth placement.

 

          (b)  Programs receiving homeless youth in accordance with RSA 170-E:25, II(d), shall do so for the purpose of providing shelter, basic needs, and services, which shall include an individual assessment, referral, housing, and case management to facilitate safety, permanency, well being, and independent living.

 

          (c)  The program shall submit to the department with the license application a written policy consistent with the mandated reporting statute RSA 169-C:29 through RSA 169-C:39, with a particular focus on neglect and abandonment.

 

          (d)  The homeless youth program shall provide training to all staff on the mandated reporting statute RSA 169-C:29 through RSA 169-C:39 and on the policy in (c) above.

 

          (e)  Homeless youth programs shall comply with RSA 170-E:27-a, except that the notification in RSA 170-E:27-a, I(c), shall be to the department’s division for children, youth and families.

 

          (f)  Homeless youth programs shall document attempts to contact a parent or legal guardian of a resident 16 or 17 years of age in accordance with RSA 170-E:27-a.

 

          (g)  Agencies licensed as homeless youth programs which have a license for one or more additional types of residential child care programs shall submit to the department with the license application a policy consistent with RSA 169-C:16, II, and RSA 169-D:9-c, I, to address supervision, commingling, and safety for multiple populations.

 

          (h) Homeless youth programs shall develop written protocols with local police department(s) regarding notification to the local police department for residents who are 16 or 17 years of age. In cases where local police departments refuse to participate in the development of such protocols, the homeless youth program shall document the efforts taken to engage them.

 

          (i)  Homeless youth programs shall comply with He-C 4001.01 through 4001.25, and this section with the exception of:

 

(1)  He-C 4001.12 (b)–(i); and

 

(2)  He-C 4001.21(b)–(e).

 

          (j)  Homeless youth programs shall maintain written documentation for each resident including the following information:

 

(1)  Name, sex and age of the resident;

 

(2)  Name, address and telephone number of an adult next of kin or guardian, if available;

 

(3)  Date of admission;

 

(4)  Referral source, if any;

 

(5)  Medical or health information, if available;

 

(6)  Any diseases or injuries diagnosed while in care; and

 

(7)  Educational status.

 

          (k)  Homeless youth programs shall obtain urgent medical or dental care for each resident, as needed.

 

          (l) If parental authorization for medical treatment, in accordance with He-C 4001.12(a), is not obtainable for residents who are 16 or 17 years of age, the homeless youth program shall document efforts to obtain such authorization.

 

          (m)  If urgent medical or dental treatment is not available due to lack of parental authorization, the program shall contact the division for children youth and families for assistance.

 

          (n)  Homeless youth programs shall provide residents with information about educational rights in accordance with the McKinney Vinto Act (42 USC 11431 et. seq.).

 

          (o)  Homeless youth programs shall make appropriate referrals for the resident based on the health, education, housing, and permanency needs of each resident including available community-based services and resources.

 

          (p)  Homeless youth programs shall develop a transition and discharge plan for each resident that addresses the resident’s needs at the time of discharge.

 

Source. #10319, eff 7-1-13

 

          He-C 4001.29  Specialized Care Programs (SCPs).  Residents who have medical or behavioral health needs, or both,  requiring specialized care necessitates programming that incorporates an increased awareness of the unique needs, as well as attention, adaptation, and accommodative measures beyond what are considered routine. For the purposes of this section, such medical or behavioral health needs are those defined in He-C 4001.01(bl), and which may be congenital, developmental, or acquired through disease, trauma or environmental causes, and which impose limitations in performing daily self-maintenance activities or substantial limitations in a major life activity.

 

          (a)  SCPs shall comply with:

 

(1)  He-C 4001.01 through He-C 4001.25 and this section; and

 

(2)  Any other federal, state, and professional standards related to the treatment of any medical diagnosis of any resident.

 

          (b)  SCPs shall develop and implement written policies and procedures governing the operation of the program relative to the provision of services, available for review by the department, that include the following:

 

(1)  Intake and admissions procedures that clearly state the criteria for the SCP population to be served;

 

(2)  A description of the services provided within the program to meet the special medical needs of the residents;

 

(3)  A description of the professional services provided on site and in the local community that will be contracted or accessed to ensure the special medical needs of the residents are met;

 

(4)  The organizational chart, job descriptions of staff, and contracts with medical staff, clinical staff, and consultants used to meet the special medical needs of the population being served; and

 

(5)  How direct care staff will be orientated and trained to prepare to work with the population being served.

 

          (c)  The program director, together with relevant members of the administration, clinical and direct-care staff, shall annually review all policies and procedures and revise them as needed to ensure consistency with current practice and professional standards.

 

          (d)  All clinical services provided by the licensee shall:

 

(1)  Focus on the residents strengths;

 

(2)  Be sensitive and relevant to the diversity of the residents;

 

(3)  Be child and family-centered;

 

(4)  Be designed to acknowledge the impact of violence and trauma on resident’s lives, which shall be addressed in the services provided;

 

(5)  For programs providing SUD services, the services shall be evidence-based by meeting one of the following:

 

a.  The services shall be included as an evidence-based mental health and substance abuse intervention on the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Evidence-Based Practices Resource Center” available at https://www.samhsa.gov/ebp-resource-center, or as noted in Appendix A;

 

b.  The services are published in a peer reviewed journal and found to have positive effects; or

 

c.  The treatment and support service provider shall be able to document the services effectiveness based on a theoretical model with validated research or a documented body of research generated from similar services that indicates effectiveness; and

 

(6)  For programs providing SUD services, the services shall be delivered in accordance with the following:

 

a.  The American Society of Addiction Medicine’s (ASAM), “The ASAM Criteria, (Third edition), available as noted in Appendix A; or

 

b. The U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Knowledge Application Program (KAP) Resource Documents and Manuals” (July 2020 edition), available at https://www.samhsa.gov/kap/resources, or as noted in Appendix A.

 

          (e)  The licensee shall assess and monitor the quality of care and services it provides to residents on an ongoing basis.

 

          (f)  SPCs providing behavioral health services shall employ or with contract with:

 

(1)  A clinical coordinator who shall:

 

a.  Be a full-time employee;

 

b.  Meet the definition of clinical staff in He-C 4002.01(i); and

 

c.  Have 2 years post-graduate experience in human services; and

 

(2)  Clinical staff to meet the needs of the residents who shall:

 

a.  Be a full-time employee or a part-time employee with a minimum of 22 hours a week; and

 

b.  Meet the criteria specified in He-C 4002.01(j).

 

          (g)  All programs providing SUD services shall employ or contract with:

 

(1)  A medical director who is:

 

a.  A licensed practitioner who is licensed in the state of New Hampshire; and

 

b.  Has experience providing medical services to residents with behavioral health or substance use disorder needs;

 

(2)  A nurse who is currently licensed in the state of New Hampshire pursuant to RSA 326-B, or licensed pursuant to the multi-state compact, and who is an RN or LPN with at least 2 year's relevant experience in substance use disorder treatment or behavioral health services; and 

 

(3) A clinical services director who is a LADC or MLADC licensed by the NH board of licensing for alcohol and other drug use professionals or an individual licensed by the board of mental health practice and who has at least 2 year's relevant experience in substance use disorder treatment or behavioral health services.

 

          (h)  In addition to (g) above, SCPs shall:

 

(1)  Provide administrative services that include the appointment of a full-time, on-site program director who is responsible for the day-to-day operations of the SPC, who meets the following qualifications:

 

a.  For programs providing SUD services, the program director shall be at least 21 years of age and have a minimum of one of the following combinations of education and experience:

 

1.  A bachelor’s degree from an accredited institution and one year of relevant experience working in a health related field;

 

2.  A New Hampshire license as an RN, with at least one year relevant experience working in a health related field;

 

3.  An associate’s degree from an accredited institution plus 3 years relevant experience in a health related field;

 

4.  A MLADC or LADC license issued by the State of New Hampshire; or

 

5.  Licensed by the board of mental health practice with at least one year of relevant experience working in SUD treatment; or

 

b.  For SCPs not providing SUD services, the program director shall comply with the requirements specified in He-C 4001.19(e);

 

(2)  Contract with or employ professional staff to meet the needs of residents, including but not limited to clinical, medical, and social needs; and

 

(3)  Employ direct care staff to implement service plans on a daily basis.

 

          (i)  The licensee shall:

 

(1)  Assign all direct care staff and clinical staff to a staff person who has supervisory or administrative responsibility and experience suitable to the goals of the program and the responsibilities of the staff supervised; and

 

(2)  Require direct care and clinical staff to have scheduled supervision with the assigned supervisor regarding children's needs and methods of meeting those needs, which shall occur a minimum of weekly or more frequently as needed.

 

          (j)  The licensee shall provide orientation for all new employees to acquaint them with the program's philosophy, organization, policies, and services.  No new direct care staff shall be solely responsible for children in care until he or she has completed the orientation.

 

          (k)  Programs providing SUD services shall:

 

(1)  Ensure that all staff who perform direct care to residents or who are providing treatment, education, and recovery support services shall be under the direct supervision of a licensed clinical supervisor pursuant to the supervision requirements in Alc 400;

 

(2)  Provide the SPC with sufficient supplies, equipment, and lighting to ensure that the needs of residents are met;

 

(3)  Implement any POC that has been accepted or issued by the department;

 

(4)  Require that all personnel follow the orders of the licensed practitioner for each resident and encourage the residents to follow the licensed practitioner’s orders;

 

(5)  Employ or contract with a nurse who is currently licensed in the state of New Hampshire pursuant to RSA 326-B, or licensed pursuant to the multi-state compact, and who is an RN or LPN with at least 2 years relevant experience in SUD treatment or behavioral health services;

 

(6)  Employ or contract with a clinical services director who is a LADC or MLADC licensed by the NH board of licensing for alcohol and other drug use professionals or an individual licensed by the board of mental health practice and who has at least 2 years relevant experience in treatment of SUD or behavior services; and

 

(7)  Require staff to obtain continuing requirements, in accordance with Alc 400, and maintain documentation of the training in the employee’s individual personnel file for review by the department.

 

          (l)  In programs providing SUD services, all direct care personnel shall be at least 21 years of age unless they are:

 

(1)  A licensed nursing assistant working under the supervision of a nurse in accordance with Nur 700; or

 

(2)  Involved in an established educational program working under the supervision of licensed staff.

 

          (m)  An SCP that is not able to meet the needs of any resident whom requires specialized care, as described in this section, shall notify the department and expeditiously seek an alternative placement, which can provide for the resident’s needs on a long-term basis and ensure that all needs are met until such time discharge can safely occur.

 

          (n)  SCPs shall assess each resident within 24 hours of admission to determine each resident’s needs and abilities on the following:

 

(1)  Walking and ambulation;

 

(2)  Transfers;

 

(3)  Ability to self-evacuate;

 

(4)  Fall risk;

 

(5)  Mood and behavior;

 

(6)  Communication;

 

(7)  Nutrition and oral health;

 

(8)  Medications and treatments including nebulizers and oxygen;

 

(9)  Personal hygiene and assistance with activities of daily living;

 

(10)  Whether or not safety devices, such as helmet, mittens, or safety belt, are needed; and

 

(11)  Nursing care and services.

 

          (o)  The assessment conducted in accordance with (n) above shall be:

 

(1)  Incorporated into the resident’s service plan/treatment plan; and

 

(2)  Documented in the resident’s file and available for review by department staff.

 

          (p)  In addition to the treatment plan required in He-C 4001.21(b), SCPs shall develop a service plan, meaning a written guide, in consultation with the resident or guardian, agent or personal representative, if applicable, as a result of the assessment conducted in accordance with (n) above for the provision of care and services which shall:

 

(1)  Be completed within 24 hours of the completion of the assessment and within 24 hours of the completion of subsequent assessments;

 

(2)  Identify the resident's needs;

 

(3)  Identify the services that the SCP will provide and the staff person responsible for providing or arranging for the services while the child is in care;

 

(4)  Include the following areas:

 

a.  Educational;

 

b.  Vocational;

 

c.  Health, including medical, dental, and ancillary services;

 

d.  Behavior management, including specific individual modifications of the restraint plan, if necessary;

 

e.  Life skills; and

 

f.  Social services, including family work, psychological and psychiatric services, and counseling; and

 

(5)  Be made available to all personnel for residents whom they assist;

 

(6)  Be completed in consultation with the resident and guardian or agent, if any, unless the resident and guardian or agent are unable or unwilling to participate, it shall be documented in the resident record; and

 

(7)  Be available on site for review by the department.

 

          (q)  The service plan identified in (p) above shall include on an ongoing basis:

 

(1)  The date a problem or need was identified as a result of the assessment conducted in (n) above;

 

(2)  A description of the problem or need;

 

(3)  The goal or objective of the plan;

 

(4)  The action or approach to be taken;

 

(5)  The responsible person(s) or position; and

 

(6)  The date of reevaluation, review, or resolution.

 

          (r)  The licensee shall explain all service plans to all child care personnel responsible for implementing the service plan on a daily basis, to the child's family or guardian, as appropriate, and to the resident in a manner consistent with her or his maturity and capacity to understand.

 

          (s)  All service plans shall be reviewed and updated as often as necessary, but no less frequently than every 6 months to re-assess the resident’s needs and determine if:

 

(1)  The service plan will be continued for another 6 months;

 

(2)  The service plan will be revised to meet the needs of the resident; or

 

(3)  The service plan will be discontinued because the plan is no longer needed; and

 

(4)  Shall be available for review by the department.

 

          (t)  Progress notes shall be written at least every 90 days and include, at a minimum:

 

(1)  Service plan outcomes;

 

(2)  The resident’s physical, functional, and mental abilities; and

 

(3)  Changes in behavior, such as eating habits, sleeping pattern, and relationships.

 

          (u)  If a resident refuses care or services that could result in a threat to their health, safety, or well-being, or that of others, the licensee or their designee shall:

 

(1)  Inform the resident of the potential results of their refusal;

 

(2)  Notify the licensed practitioner and guardian, if any, of the resident’s refusal of care; and

 

(3)  Document in the resident’s record the refusal of care and the resident’s reason for the refusal.

 

          (v)  If a resident is non-verbal or incapable of understanding the need for care or services as identified in (u) above but exhibits behaviors that represent refusal of any care or services:

 

(1)  Such behaviors shall be documented in the resident’s record; and

 

(2)  Staff shall consult with appropriate personnel of the SCP to determine if the care plan requires modifications or if the needs of the resident exceed the services that the SCP is able to provide.

 

          (w)  The licensee shall insure that medically necessary glasses, hearing aids, prosthetic devices, corrective physical or dental devices, or any equipment necessary or treatments prescribed by the examining physician are provided to the resident if the resident’s parent or guardian does not provide them.

 

          (x)  The licensee shall not require any resident to receive medical treatment or screening when the parents of such resident object based on sincerely held religious beliefs. However, the SPC may seek a court order for medical treatment of a resident if it believes such medical treatment is in the resident's best interest.

 

Source. #13151, eff 12-30-20

 

          He-C 4001.30  Treatment Planning Process for Specialized Care Programs.

 

          (a)  SCPs shall conduct a psycho-social assessment with recommendations for treatment for the resident. 

 

          (b)  Based on the assessment and recommendations, the SCP shall conduct a treatment team meeting and develop a treatment plan within 30 calendar days of placement of the child.

 

          (c)  The treatment plan shall include:

 

(1)  The summary of the psycho-social assessment;

 

(2)  A transitional section for the child and family that includes:

 

a.  An estimate by the treatment team members of the child’s length of stay, based upon referral information and the SCP’s assessment; and

 

b.  The child’s permanency plan identifying the following alternatives for the child in care, including the identified resource if known at the time of the treatment plan:

 

1.  Reunification with the family;

 

2.  Adoption;

 

3.  Guardianship by a relative or other person;

 

4.  Permanent placement with a fit and willing relative; or

 

5.  Another Planned Permanent Living Arrangement (APPLA) in accordance with RSA 169-C:24-b, II(c); and

 

(3)  Community reintegration and transition tasks that identify the following:

 

a.  Specific needed supports or services that would provide for the child to successfully transition out of the SCP and into the community;

 

b.  The treatment team member who is responsible for completing each task necessary; and

 

c.  The projected time frame for completion of each task.

 

          (d)  The treatment plan shall at a minimum, contain the following domains relating to rehabilitative and restorative services provided by the SCP:

 

(1)  Safety and behavior of the child;

 

(2)  Family;

 

(3)  Medical;

 

(4)  Education, if clinically necessary; and

 

(5)  Adult living preparation if determined clinically necessary.

 

          (e)  Each domain identified in (d) above shall address:

 

(1)  The goals and measurable objectives to be achieved by the child and family;

 

(2)  The time frames for completion of objectives; and

 

(3)  The individualized interventions that will be used to address the objectives, including:

 

a.  Identification of the staff or individual providing or implementing the stated intervention;

 

b.  The frequency of the intervention; and

 

c.  How that intervention is documented.

 

          (f)  The treatment plan shall include the date and signatures of the following team members, indicating that they participated in the process:

 

(1)  The child;

 

(2)  The child’s parents or guardian(s);

 

(3)  The prescribing practitioner; and

 

(4)  The clinical coordinator or the SCP’s program director. If the prescribing practitioner is also the clinical coordinator, he or she shall indicate dual functions.

 

          (g)  When any of the individuals in (f) above do not participate, the SCP shall document its efforts to involve them.

 

          (h)  Revisions to the treatment plan outside the scheduled treatment plan reviews shall include the signatures of the prescribing practitioner, clinical coordinators, and other team members identified in (f) above, as available, and shall be explained in writing to any individuals of the team who are unable to participate.

 

          (i)  The treatment team and the staff of the SCP shall implement the treatment plan, which shall be reflected in the child’s daily routine, logs, progress notes, and discharge summary.

 

          (j)  The treatment team shall consist of the individuals identified in (f) above in addition to the following invited participants:

 

(1)  Clinical staff of the SCP;

 

(2)  Attorney or guardian ad litem (GAL) for the child;

 

(3)  A representative of the local educational agency when clinically appropriate;

 

(4)  Other persons significant in the child’s life if clinically appropriate, including but not limited to:

 

a.  Teachers;

 

b.  Staff members from the SCP;

 

c.  Counselors;

 

d.  Friends;

 

e.  Relatives; and

 

f.  Educational surrogate.

 

          (k)  The treatment plan shall be filed in the child’s record and copies provided to the individuals identified in (f) above.

 

          (l)  During each treatment team meeting, the treatment team shall review and update the treatment plan as necessary, in accordance with the following:

 

(1)  Three months from the initial treatment plan; and

 

(2)  Every 3 months thereafter until discharge, at no point exceeding 3 months.

 

          (m)  Changes and updates to the treatment plan shall be made based on progress identified by the treatment team, areas of continued treatment needs, achievement of goals or objectives, and effectiveness of interventions, in accordance with the requirements of (f) through (l) above.

 

          (n)  SCPs shall acquire signatures on the treatment plans of individuals identified in (f) above within 7 calendar days of the treatment team meeting, such that:

 

(1)  Reasonable efforts to obtain the signature of the parent(s)/guardian(s) and DCYF shall be documented as meeting the requirements of (n); and

 

(2) Any team members participating through electronic means, other than the prescribing practitioner or clinical coordinator, may provide verbal assent in lieu of signature on the treatment plan but this shall not preclude efforts identified in (1) above.

 

          (o)  Once the treatment plan is complete, all clinical and direct care staff shall receive supervision and instruction to ensure that they consistently implement each child’s treatment plan.

 

          (p) All residential treatment programs shall provide and coordinate services and treatment interventions to meet the goals identified in the treatment plan, as follows:

 

(1)  Treatment interventions shall meet the individual needs of the children and families in therapeutic and group-living experiences;

 

(2)  Treatment programs shall include individual/group problem solving and decision-making;

 

(3) The clinical coordinator shall ensure therapeutic interventions and other services are implemented and integrated into the treatment programming for the individual child and family;

 

(4)  Services required by the treatment plan including individual, group, and family counseling to children shall be available within the SCP or shall be referred to community agencies depending on the need of the child and family; and

 

(5)  Direct care staff that provides group counseling shall receive supervision from clinical staff.

 

          (q)  Services required by the treatment plan, including counseling of children and families, shall be available within the SCP or shall be provided through the local community, as follows:

 

(1)  Treatment plans shall provide and allow for increased community-based integration and involvement, based on progress and individualized needs; and

 

(2)  The clinical coordinator or another staff member who meets the requirements of clinical staff may provide individual or family counseling;

 

          (r)  The program shall maintain a multi-disciplinary, self-contained means of service delivery to meet the needs identified within the treatment plan, as follows:

 

(1)  There shall be a clinical staff to child ratio of one clinical staff to 10 children;

 

(2) There shall be clinical services provided through the residential treatment program’s on-site program unless a special circumstance is identified through the treatment plan to support utilizing a community provider;

 

(3)  Clinical staff shall provide treatment interventions to meet the individual needs of the children and families served and shall provide a therapeutic group-living experience;

 

(4)  Unless otherwise specified in the child’s treatment plan, any combination of individual, group, or family counseling services shall be provided to each child or the family a minimum of 3 times a week;

 

(5)  There shall be a family-centered services component designed to promote and provide opportunities for families to be involved in all aspects of their child’s care, including, but not limited to:

 

a. Activities designed to promote permanency and support continued family involvement throughout placement;

 

b. Services that promote family involvement and partnership in a therapeutic process from intake to discharge, which supports the identified permanency plan;

 

c.  Implementation of the reasonable and prudent parent standard by staff including a description of how the program will identify and support normal age and developmental experiences including social, extracurricular, enrichment, and cultural activities in the community;

 

d. Whenever possible, activities in the family’s home at the family’s convenience, and other services to support the identified permanency plan;

 

e. Parental education, as needed to support the child and family’s permanency, safety, and well-being;

 

f. Communication that includes the family in the program’s initial orientation process and ongoing activities; and

 

g. The program’s grievance procedures, which shall ensure that children may constructively address their concerns without fear of retaliation; and

 

(6)  The residential treatment program shall organize its clinical staff and family workers in a flexible manner so long as families are seen face-to-face no less than one time per week, unless otherwise specified in the child’s treatment plan, as follows:

 

a.  Technology may be used to supplement clinical services as a part of the child’s treatment; and

 

b.  The utilization of a video-conferencing technology shall not replace face-to-face contact unless documented in the child’s treatment plan with the agreement of the treatment team;

 

          (s)  The program shall be staff-secure and be able to serve those children whose needs require a high level of treatment and supervision, as follows:

 

(1)  There shall be a minimum staff to child ratio of one staff to 4 children during hours when children are awake; and

 

(2)  Except for residential treatment programs that have an independent living component housed in a separate area and have the capability of moving children that need more supervision back to the intensive care level, there shall be an awake staff member in each building housing children.

 

Source. #13151, eff 12-30-20

 

          He-C 4001.31  Background Checks and Determination of Eligibility for Employment.

 

          (a)  The applicant, program director, or his or her designee shall complete and submit to the child care licensing unit (CCLU) the “Staff and Household Member Form” (December 2020) certifying that:

 

“All information provided above is accurate.

 

I have not been convicted of a felony consisting of murder, child abuse or neglect, crimes against children (including pornography and trafficking), spousal abuse, rape or sexual assault, kidnapping, arson, physical assault or battery, or a drug related offense (in the last 5 years) or convicted of a violent misdemeanor committed as an adult against a child including child abuse, child endangerment, sexual assault or child pornography, or a crime which shows that I might be reasonably expected to pose a threat to a child, such as violent crime or sexually related crime against an adult.”.

 

          (b)  The “Staff and Household Member Form” (December 2020) shall be submitted to the CCLU:

 

(1)  Prior to the start date of any employee, volunteer, or other individual who will be working in the residential program licensed by CCLU;

 

(2)  Within 5 days from when an individual who is a household member turns 18 years of age, other than residents admitted to the program;

 

(3)  Prior to the day any individual age 10 and older becomes a household member, other than residents admitted to the program; or

 

(4)  Three months before the 5- year anniversary date on which the current individual’s state and federal criminal records checks were last completed.

 

          (c) In accordance with RSA 170-E:29-a, for every individual 18 years of age or older submitted on “Staff and Household Member Form” (December 2020), the program shall ensure that the individual completes:

 

(1)  A   criminal history record check through the NH department of safety, criminal records unit, to include an electronic submission of fingerprints for a check Federal Bureau of Investigations file, with authorization for the release of the criminal history record check to the child care licensing unit, in accordance with the department of safety's policy and procedure;

 

(2)  A completed and notarized Form CCLU 2 “NH Child Abuse and Neglect Central Registry Name Search Authorization” (eff 2020); and

 

(3)  All forms and any required fees to complete registry checks in states or territories other than NH when the individual lives or has lived in any state other than NH, or a United States territory, within the previous 5 years.

 

          (d)  The only exception to (c) above shall be for individuals who have been determined eligible by the unit during the previous 5 year period and who have been employed or a household member in any New Hampshire licensed child care program within the 6 months prior to submission of the “Staff and Household Member Form” (December 2020).

 

          (e)  For every individual age 10 years through 17 years submitted on “Staff and Household Member Form” (December 2020), the program shall submit to CCLU:

 

(1)  A completed and notarized Form CCLU 2 “NH Child Abuse and Neglect Central Registry Name Search Authorization” (eff 2020); and

 

(2)  All forms and any required fees to complete registry checks when the individual has lived in any state other than NH, or a United States territory, within the previous 5 years.

 

          (f)  The only exception to (e) above shall be for individuals who completed the registry checks through the unit during the previous 5 year period and who have been employed or a household member in any New Hampshire licensed child care program within the 6 months prior to submission of the “Staff and Household Member Form” (December 2020).

 

          (g)  The program director and any direct care staff listed on the “Staff and Household Member Form” (December 2020), who do not have a current employment eligibility card shall submit to the department:

 

(1) A completed application Form CCLU 1-C “DHHS/Office of Legal Services, Child Care Licensing Unit Employment Eligibility Card Application” (11/2017); and

 

(2)  A non-refundable $50.00 fee payable in cash, or if paid by check or money order, the exact amount of the fee made payable to the “Treasurer, State of New Hampshire”.

 

          (h)  Upon receipt of the information requested in (g) above, the department shall assess the individual’s eligibility for employment in accordance with RSA170-E:29-a, V or VI, and if eligible, issue an employment eligibility card, which shall be valid for 5 years from the date of issuance.

 

          (i)  Once the employment eligibility card is issued, the individual shall reapply for the employment eligibility card as necessary to keep the card current while the individual works in the residential program.

 

          (j)  The following individuals shall be exempt from the requirement to obtain an eligibility card in (g) above:

 

(1)  Applicants;

 

(2)  Volunteers;

 

(3)  A student participating in a work study program, internship, practicum, or attending college full time; and

 

(4)  Employees determined eligible to work prior to the 2020 effective date of this rule, who remain employed by the same licensee at the time of submission of the “Household and Personnel Form” (2017) as required in (a) above.

 

          (k)  A copy of each individual's “Staff and Household Member Form” (December 2020) returned to the program by the unit, along with a copy of his or her non-expired child care employment eligibility card, as applicable, shall be on file at the program.

 

          (l)  If the department determines that an individual is ineligible, in accordance with RSA170-E:29-a, V or VI, it shall provide notice to the individual that:

 

(1)  The individual has been determined by the department to be ineligible;

 

(2)  The basis for the determination that the individual is ineligible; and

 

(3)  The individual’s right to challenge his or her criminal record pursuant to Saf-C 5703.

 

(m)  The department shall include in its notice under (e) above:

 

(1)  The basis for the determination that the individual poses a risk; and

 

(2)  The need for the residential child care program to inform the department in writing of the specific action it has taken as required under (e)(2) above.

 

          (o)  If the department determines that an individual is ineligible to work in child care, in accordance with RSA 170-E:29-a, V or VI, it shall provide notice to the residential child care program that:

 

(1)  The individual has been determined by the department to be ineligible;

 

(2)  The program shall take immediate action to prohibit the individual from being on the premises of the residential child care program and from having access to the residents admitted to the program; and

 

(3)  The residential child care program shall inform the department in writing of the specific action it has taken as required under (2) above.

 

Source. #13151, eff 12-30-20

 

PART He-C 4002  NH CHILD CARE PROGRAM LICENSING RULES

 

          He-C 4002.01  Definitions.

 

          (a)  “Accredited college or university” means a college or university acknowledged as meeting acceptable levels of quality through accreditation by any of the accrediting organizations recognized by the US department of education or the council for higher education accreditation.

 

          (b)  “Agency” means “child day care agency” as defined in RSA 170-E:2, IV.  The term also includes “child care program” or “program.”

 

          (c)  “Agency administrator” means a person who meets the qualifications of a center director and is employed by the licensee to oversee multiple child care agencies by a single or the same applicant, licensee, or permittee.

 

          (d)  “Applicant” means “applicant” as defined in RSA 170-E:2, I.

 

          (e)  “Assistant group leader” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education and experience requirements specified in He-C 4002.35.

 

          (f)  “Assistant teacher” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.35.

 

          (g)  “Associate teacher” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.35.

 

          (h)  “Authorized staff” means child care staff that have completed training in medication safety and administration who are responsible for administration of medications to children.

 

          (i)  “Center based program” means any program owned and operated by one applicant which is not licensed as a family or family group child care home and is licensed to provide any of the following types of child care:

 

(1)  Group child care center;

 

(2)  Infant and toddler program;

 

(3)  Night care program;

 

(4)  Preschool program;

 

(5)  School-age program; or

 

(6)  Any combination thereof.

 

          (j)  “Child” means “child” as defined in RSA 170-E:2, II.

 

          (k)  “Child care” means “child day care” as defined in RSA 170-E:2, III.

 

          (l)  “Child care staff” means:

 

(1)  All child care staff categories as specified in He-C 4002.34 and 4002.35; and

 

(2)   Agency administrator and site coordinator, as defined in He-C 4002.01(c) and 4002.01(bf), respectively.

 

          (m)  “Clean” means to remove dirt, debris, and bodily fluids by scrubbing and washing with a detergent solution and rinsing with water.

 

          (n)  “Commissioner” means “commissioner” as defined in RSA 170-E:2, V.

 

          (o)  “Corporal punishment” means the intentional infliction of physical pain by any means for the purpose of punishment, correction, discipline, instruction, or any other reason.

 

          (p)  “Corrective action plan (CAP)” means “corrective action plan” as defined in RSA 170-E:2, VI.

 

          (q)  “Department” means “department” as defined in RSA 170-E:2, VII.

 

          (r) “Developmentally appropriate” means actions, environment, equipment, supplies, communications, interactions, or activities that are based on the developmental level and abilities, the family culture, and the individual needs of each child in care.

 

          (s)  “Family child care home” means “family day care home” as defined in RSA 170-E:2, IV(a).

 

          (t)  “Family child care assistant” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.34(f).

 

          (u)  “Family child care provider” means the individual in whose home family or family group child care services are provided, who is responsible for the operation of the program, and who provides the child care for at least ⅔ of the operating hours.

 

          (v)  “Family child care worker” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.34(e).

 

          (w)  “Family group child care home” means “family group day care home” as defined in RSA 170-E:2, IV(b).

 

          (x)  “Full day school program” means a program administered by a public or private school that is approved by the department of education.

 

          (y) “Group child care center” means “group child care center” as defined in RSA 170-E:2, IV(c).

 

          (z)  “Group leader” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.35(q).

 

          (aa)  “Guardian” means “guardian” as defined in RSA 170-E:2, VIII.

 

          (ab)  “Household member” means any person residing in the home of an applicant for licensure as a program, if the program will be located in that home.

 

(ac)  “Incident Command System” (ICS), means a standardized on-scene emergency management system specifically designed to provide for the adoption of an integrated organizational structure that reflects the complexity and demands of single or multiple incidents, without being hindered by jurisdictional boundaries.  ICS is the combination of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure, designed to aid in the management of resources during incidents, in coordination with local emergency response agencies in the community in which the program is located.

 

          (ad)  “Infant” means a child from the time of birth through 12 months old, except as referenced in He-C 4002.37.

 

          (ae)  “Infant and toddler program” means “day care nursery” as defined in RSA 170-E:2, IV(d).

 

          (af)  “In-service professional development” means professional development activities including training or education acquired after an individual meets the qualifications for his or her position and which is acceptable toward meeting the annual professional development requirements for childcare staff, as specified in He-C 4002.33.

 

          (ag)  “Junior helper” means a person who is engaged in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.34(j) or He-C 4002.35(o).

 

          (ah)  “Lead teacher” means a person who is employed in or is seeking employment in a New Hampshire licensed childcare program, who meets the age, education, and experience requirements specified in He-C 4002.35(k).

 

          (ai)  “License” means “license” as defined in RSA 170-E:2, IX.

 

          (aj)  “License capacity” means the number and ages of children specified on the license or permit allowed to be on the premises at any one time.

 

          (ak)  “Licensed practitioner” means a physician, physician's assistant, advanced registered nurse practitioner, dentist, or other licensed professional with prescriptive authority.

 

          (al)  “Licensing coordinator” means a person employed by the department who consults with and inspects programs for compliance with RSA 170-E and He-C 4002.

 

          (am)  Medication” means a drug prescribed for a child by a licensed practitioner.

 

          (an)  Medication error” means any error in the administration of a prescribed or over-the-counter medication, or an error in the documented administration of any medication or over-the-counter medication.

 

          (ao)  Medication order” means a document, produced  electronically or in writing, for an identified child by a licensed practitioner for medications, treatments, and referrals, and signed by the licensed practitioner using terms such as authorized by, authenticated by, approved by, reviewed by, or any other term that denoted approval by the licensed practitioner.

 

          (ap)  “Monitoring visit” means “monitoring visit” as defined in RSA 170-E:2, X.

 

          (aq)  “Night care program” means “night care agency” as defined in RSA 170-E:2, IV(e).

 

          (ar)  “Over-the-counter medications” means non-prescription medications.

 

          (as)  “Parent” means a father, mother, guardian, or person legally authorized to act on behalf of a child.

 

          (at)  “Permit” means “permit” as defined in RSA 170-E:2, XI.

 

          (au)  “Preschool program” means “preschool program” as defined in RSA 170-E:2, IV(f).

 

          (av)  Program” means any or all of the various types of childcare agencies providing care on or off the approved licensed premises listed below:

 

(1)  Center based;

 

(2)  Infant and toddler;

 

(3)  Family child care home;

 

(4)  Family group child care home;

 

(5)  Group child care center;

 

(6)  Night care;

 

(7)  Preschool; and

 

(8)  School age.

 

          (aw)  “Project leader” means a person who is engaged in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.35(s).

 

          (ax)  “Qualified substitute director” means a person who assumes the responsibilities of a center director or site director and who meets the age, education, and experience requirements of the position for which they are substituting in order to meet the requirements under He-C 4002.35(a) and (b).

 

          (ay)  “Regularly” means “regularly” as defined in RSA 170-E:2, XII.

 

          (az)  “Related coursework” unless otherwise specified, means courses completed at an accredited college or university in child growth and development, lifespan development, human growth and development, infant and toddler development, developmental psychology, family studies, early childhood, elementary, and special education, and any other coursework focused on children.

 

          (ba)  “Repeat citation” means a citation of a specific licensing rule or law for which the program has been previously cited during the past 3 years, and which has not been removed as a result of an informal dispute resolution or overturned as a result of an adjudicatory procedure. A repeat citation does not need to include the same set of circumstances, or involve the same child care staff or the same child or children as in the original citation.

 

          (bb)  “Rough handling” means an aggressive physical act against a child, except when necessary to protect a child from harming themselves or others.

 

          (bc)  “Sanitize” means to clean to remove all organic material then wipe down or wash with a solution of chlorine bleach and room temperature or cool water which is mixed fresh daily per manufacturer’s directions for sanitation and left on the surface for 2 minutes or with an environmental protection agency (EPA) approved germicide designed to kill germs and which, when used in accordance with manufacturer’s directions, does not pose a health or safety risk to children.

 

          (bd)  “School-age program” means “school-age program” as defined in RSA 170-E:2, IV(g).

 

          (be)  “Serious safety risk” means behavior of such intensity, frequency, or duration that the safety of the child or others is placed in serious jeopardy.

 

          (bf)  “Site coordinator” means a person who is qualified as a site director and is employed to oversee multiple school age program licenses by a single applicant, licensee, or permittee.

 

          (bg)  Site director” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.35(p).

 

          (bh)  Statement of findings” means a written report issued by the department which details the findings of a visit or an investigation conducted by the department.

 

          (bi)  “Substitute” means a person who assumes the responsibility of associate teachers, lead teachers, or group leaders, on a temporary basis, who meets the age requirements of the position for which they are substituting.

 

          (bj)  Toddler” means a child 19 months to 35 months old, except as referenced in He-C 4002.37.

 

          (bk)  “Topical substances” include, but are not limited to, non-prescription medications such as sunscreen, insect repellent, powders, teething aids, and diaper ointments.

 

          (bl)  “Unit” means the child care licensing unit within the department.

 

          (bm)  “Water activity” means any activity during which children have access to swimming pools, water features, or other bodies of water, whether the children will be in, on, or near a pool or body of water.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.02  Licensure and Approval: Initial Applications, License Renewal, and Revisions.

 

          (a)  Any person or entity who intends to operate a program shall create an account in “NH Connections” at https://nhpublichealth.force.com/nhccis/s/login/?ec=302&startURL=%2Fnhccis%2Fs%2F or obtain an application packet from the unit.

 

            (b)  All applicants for licensure shall complete and submit an application by either applying online via the portal described in (a) above or by submitting “Application for Family Child Care Program” (April 2022) or "Application for Child Care Center" (April 2022) to the department, which shall not be considered complete until the department receives all of the information as specified in (d) below.

 

          (c)  Center based programs with multiple buildings on the same or contiguous properties may apply for a single license for those buildings provided that:

 

(1)  The buildings function as a single program;

 

(2)  The buildings are in close proximity to ensure that no street, road, or obstacle is present which would impede the safe flow of individuals between the buildings;

 

(3)  There is a means of communication between the buildings, which allows the multiple buildings to function efficiently as a single program;

 

(4)  Staffing requirements for center based agencies with multiple buildings are met as specified in He-C 4002.35; and

 

(5)  In each building, there are adequate square footage and bathroom facilities for the number of children who will be cared for, in accordance with He-C 4002.22.

 

          (d)  Except as specified in (i) below, the applicant shall submit to the department the following attachments with the application:

 

(1)  A “Child Care Personnel Health Form” (11/2017) or an equivalent record of a health screening documenting that the family child care provider, the center director, or site director has had a physical examination and is able to work with children completed no more than one year prior to the date the department receives the application;

(2)  A completed health officer inspection form documenting that, within the 12 months immediately preceding the date the department receives the application, the premises have been inspected and approved by a local health officer, for operation as a program;

 

(3)  A New Hampshire fire code compliance report documenting that, within the 12 months preceding the date the application for licensure is received by the department, the premises have been inspected for compliance with Saf-FMO 300 and Saf-C 6000, state fire code by the local fire department or the state fire marshal’s office, and approved to operate as a program;

 

(4)  Documentation from the applicable town or city that the program has been granted zoning approval or that no zoning approval is required;

 

(5)  Background check forms as specified in He-C 4002.41 for:

 

a.  The owner or applicant;

 

b.  All household members age 10 years and older; and

 

c.  The center director, agency administrator, site director, or site coordinator as applicable; and

 

(6)  A copy of any documents required by the secretary of state regarding trade names, limited liability corporations, or corporations, as applicable.

 

          (e)  For any family or family group child care provider between 18 and 21 years of age, the agency shall submit documentation that the individual meets the education requirements specified in He-C 4002.34.

 

          (f)  For all center based programs, the agency shall submit documentation that the center director, agency administrator, site coordinator, or site director meets the education and experience requirements for the applicable program type(s) as specified in He-C 4002.35.

 

(g)  All family child care providers, center directors, agency administrators, site coordinators, and site directors shall submit with the application documentation of the completion of the professional development requirements listed in He-C 4002.33(a).

 

          (h)  The documentation of education and experience required under (e) through (g) above shall include:

 

(1)  Copies of transcripts, certificates, diplomas, a non-expired appropriate level credential issued by the NH professional development system, or degrees as applicable; and

 

(2)  A résumé or verification of previous experience if such experience is required to meet the qualifications for the position.

 

(i)  In accordance with RSA 170-E:6, school-age programs which are operating in buildings in which public or private schools are currently located shall not be required to submit the documentation required in (d)(2) through (4) above.

 

(j)  No less than 3 months prior to the expiration date of the current license, each licensee shall submit to the department the following through the “NH Connections” portal at https://nhpublichealth.force.com/nhccis/s/login/?ec=302&startURL=%2Fnhccis%2Fs%2F or by using the forms below:

 

(1)  A signed and completed application “Application for Family Child Care Program” (April 2022) or "Application for Child Care Center" (April 2022) for license renewal, in accordance with He-C 4002.02;

(2)  The application attachments specified in (d)(2), (3), and (6) above;

 

(3)  A completed “Staff and Household List” (9/2018);

 

(4)  The application attachments specified in (d)(1) and (f) above, if there has been a new center director, agency administrator, site coordinator or site director since the previous application was filed and the department has not received the required information regarding the change in director; and

 

(5)  A diagram of the indoor and outdoor space if changed since the previous application.

 

(k)  Upon receipt of a complete license application and inspection by department staff, the department shall:

 

(1)  Issue a 6-month permit to the applicant for a new license; or

 

(2)  Issue a 3-year license to the applicant for a license renewal.

 

(l)  The license issued in accordance with (k) above shall reflect the maximum number of children approved by the local fire inspector, health officer, and zoning officials, and in accordance with the available floor space as measured by the department in accordance with He-C 4002.22(e) and the number of available toilets and sinks in accordance with He-C 4002.22(d).

 

(m)  In accordance with RSA 541-A:30, I, an existing license shall not expire until the department takes final action upon the renewal application, provided a licensee submits a timely application in accordance with this section.

 

(n)  The license or permit shall:

 

(1)  Not be transferable to a new owner or to a new location; and

 

(2)  No longer be valid when:

 

a.  The licensee or permittee has surrendered a license or permit;

 

b.  The license has expired and a complete application form with attachments has not been received by the department; or

 

c.  The license or permit has been revoked or suspended; and

 

1.  The licensee or permittee did not request an administrative hearing; or

 

2. The licensee or permittee requested an administrative hearing and, following that hearing, a decision was issued upholding the revocation or suspension.

 

(o)  The licensee or permittee shall submit an application for revision:

 

(1)  When he or she wishes to add additional program types or change the type(s) of program for which they are licensed or permitted; or

 

(2)  Prior to moving to a new location.

 

(p)  A licensee or permittee who wishes to increase his or her license capacity shall:

 

(1)  Submit a written request to the department;

 

(2)  Obtain approvals from the local fire inspector, health inspector, and zoning officials, when the increase exceeds the limits established in the current approvals;

 

(3)  Submit diagrams of indoor and outdoor space if there have been changes in the child care space; and

 

(4)  Not increase enrollment beyond the current license capacity until the department issues the program a revised license or permit or other written authorization by the department for the increased license capacity.

 

(q)  A licensee or permittee who discontinues using a space for child care shall notify the department in writing within 5 business days of the change so that it can record the change in the file and revise the license accordingly if necessary.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.03  Time Frames for Departmental Response to Applications.

 

(a)  Pursuant to RSA 541-A:29, the department shall approve or deny an application, petition, or request no later than 60 days from receipt of the application, petition, or request and any additional information requested by the department.

 

(b)  The 60 days specified in (a) above shall begin on the date on which all requested information is received by the department.

 

(c)  The department shall approve or deny waiver requests and applications for license revisions within 60 days of receipt of the completed waiver request or application for revision.

 

(d)  Any outstanding corrective action plan for citations of rule or statute shall be considered additional information under (a) above.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.04); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.12)

 

He-C 4002.04  Waivers of Rules.

 

(a)  Applicants, licensees, or permittees who wish to request a waiver of rules shall contact the unit to initiate the waiver request process.

 

(b)  Applicants, licensees, or permittees with a “NH Connections” portal account shall request a waiver through their account or by providing the following information in writing:

 

(1)  The program name, address, phone number, email address, and license number;

 

(2)  The rule numbers for which the waiver is being requested;

 

(3)  A brief explanation of the reason for the waiver, the length of time for which the waiver is requested, how the program will meet the intent of the rule, and any affect the granting of the waiver will have on the health and safety of the children in the program;

 

(4)  The number and range of ages of the children who will be affected;

 

(5)  The signature of the family child care provider, center director, agency administrator, site coordinator, or site director, as applicable; and

 

(6)  A copy of a notice which has been provided to each parent, explaining the specifics of the waiver request and informing parents that they may call the unit if they have any concerns about the requested waiver.

 

(c)  A waiver shall be granted to the applicant, permittee, or licensee if the department determines that the alternative proposed by the applicant or licensee:

 

(1)  Meets the objective or intent of the rule; and

 

(2)  Does not negatively impact the health, safety, or well-being of the children.

 

(d)  When a waiver is approved, the licensee’s subsequent compliance with the alternatives approved in the waiver shall be considered equivalent to complying with the rule from which waiver was sought.

 

(e)  The department shall not approve any request for a waiver of any of the provisions of RSA 170-E or of any rules of other state agencies which are referred to in this chapter.

 

(f)  The department shall deny or rescind a waiver request when:

 

(1)  The rule for which a waiver is being requested is related to fire safety or environmental health or safety and the requested waiver has not been approved by the fire inspector or local health officer, as required by the department;

 

(2)  The program has an outstanding corrective action plan that requires submission and approval by the department;

 

(3)  The department finds that approval of the requested waiver will jeopardize the health or safety of children;

 

(4)  The department finds that approval of the requested waiver will impair the program’s ability to adequately care for children;

 

(5)  The department finds that approval of the requested waiver will impair the operations of the program; or

 

(6)  The department determines that the program has not submitted a written plan for compliance with the rule or an acceptable plan for satisfying the intent of the rule as an alternative to complying with the rule.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.05); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.03)

 

          He-C 4002.05  Program Administration and License and Permit Requirements.

 

          (a)  The program shall:

 

(1)  Abide by the provisions specified on the license or permit; and

 

(2)  Not alter the license or permit issued by the department.

 

(b)  Authorization to exceed the license capacity shall be granted only when the program requests and receives prior authorization from the department to temporarily exceed its license capacity as provided under (c) below.

 

            (c)  The department shall authorize a licensee to exceed its license capacity on a temporary basis for up to a maximum of 20 workdays in a calendar year, if the department finds that the approval will not result in:

 

(1)  More than 4 children younger than 3 years of age being cared for at the same time in a family or family group child care home;

 

(2)  More than 2 children younger than 24 months of age in a family child care home, without an additional family child care worker or family child care assistant present and assisting in the care of the children;

 

(3)  More than 2 children over license capacity in a family or family group child care home;

 

(4)  More than 4 children over license capacity in all other programs; or

 

(5)  Health or safety risks to children.

 

(d)  In center-based programs, the licensee shall employ an identified:

 

(1)  Center director for center-based programs; or

 

(2)  A site coordinator or site director for programs licensed solely as a school-age program.

 

(e)  The center director, agency administrator, site coordinator, or site director referenced above shall meet the qualifications specified for their position in He-C 4002.35.

 

(f)  When the center director, agency administrator, site coordinator, or site director on record with and approved by the department leaves the position, the licensee, permittee or his or her designee shall submit to the department:

 

(1)  Written notice of the vacancy 5 business days prior to the vacancy occurring when known,  or within 5 business days of the date of the vacancy; and

 

(2)  The name and qualifications of the individual who will substitute in the role together with documentation that the individual accepted the position.

 

(g)  Any individual assuming the role of center director or site director on a temporary basis who is not qualified for the position in accordance with He-C 4002.35 shall serve in that role for not more than 90 consecutive days.

 

(h)  Not more than 90 consecutive days after the date the qualified center director or site director previously on record with and approved by the department leaves the position, the program shall:

 

(1)  Replace that individual with a fully qualified center director or site director as specified; and

 

(2) Submit to the department information and documents for the new qualified center director or site director, including:

 

a.  Name;

 

b.  The effective hiring date;

 

c.  Documentation of education and experience; and

 

d.  All information required in He-C 4002.02(d)(1) and (h).

 

(i)  When an agency administrator or site coordinator leaves his or her position, the program shall: 

 

(1)  Replace him or her with a new agency administrator or site coordinator within 90 days and submit information as specified in (h)(2) above; or

 

(2)  Submit information in (h)(2) above for each center director or site director at each location if the agency administrator or site coordinator position will not be filled.

 

(j)  In accordance with RSA 170-E:6-b, each licensee and permittee shall either maintain liability insurance or provide disclosure to parents that the program is uninsured.

 

(k)  All documentation required by the department, whether maintained by the program in electronic or paper format, shall be complete, legible, and:

 

(1)  On file on the premises of the program; and

 

(2)  Accessible and available for review by the department, upon request, for one year, unless otherwise specified.

 

(l)  The applicant, licensee, permittee, or any child care staff shall submit any reports or make available to the department any records or information required by the department for investigation, monitoring or licensing purposes within 2 business days of a written request from the department.

 

(m)  The applicant, licensee, permittee, or any child care staff shall not:

 

(1)  Make false or misleading statements to the department, whether verbal or written; or

 

(2)  Falsify any documents, other written information, or reports issued by or required by the department under He-C 4002.

 

(n)  Applicants, licensees, permittees, and child care staff shall allow representatives of the department to:

 

(1)  Enter and complete an inspection of the premises;

 

(2)  Document evidence or findings through written records, audio recording of conversations or statements with individuals who have consented to the recording, and by photographing inside or outside child care space, other areas of the premises, toys, equipment, and learning materials;

 

(3) Interview child care staff, members of the board of directors or other governing body, or children in the program; and

 

(4)  Review and or reproduce any forms or reports which the applicant, licensee, or permittee are required to maintain or make available to the department under He-C 4002.

 

(o)  Administrators, other program staff, or other individuals shall not:

 

(1)  Require or request that the individual being interviewed by department staff ask that another person be present for or be recorded during the interview unless the individual being interviewed requests that another person be present with them;

 

(2)  Attempt to influence the response of any individual whom department staff is interviewing by signaling them during the interview, telling them what to say, or threatening them with retaliation for providing information to the department;

 

(3)  Require or request staff or children who have been interviewed by the department to provide statements to program administration or other staff regarding their interview; or

 

(4)  Require or encourage parents to refuse granting permission for their child to be interviewed by representatives of the department.

 

(p) In accordance with RSA 170-E:3, IV, when licensed child day care entity ceases operating as a licensed program and continues to provide child care services as a legally licensed exempt provider, it shall notify the department of the date it ceased being licensed, return its license to the department, and notify the parent or legal guardian of all children in the program or who enroll in the program that it is no longer licensed by the department.

 

          (q)  A licensee who has an unplanned temporary closure shall notify the department of such closure as soon as practicable.

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.06); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.06  Statements of Finding and Corrective Action Plan.

 

(a)  The department shall issue a statement of findings to an applicant, licensee, or permittee for each licensing and monitoring visit, and each investigatory visit which results in non-compliance.

 

(b)  A non-compliance under He-C 4002.23, He-C 4002.24, or He-C 4002.25 shall not require a corrective action plan as specified in (g) below when the department determines that all of the following conditions are met:

 

(1) The citation is not a repeat citation;

 

(2) The non-compliance is corrected prior to or immediately during the visit;

 

(3) The non-compliance is not a New Hampshire state fire code violation; and

 

(4) The non-compliance does not immediately jeopardize the health, safety, or well-being of a child or children in care.

 

          (c)  At the close of any visit or when an investigation is concluded, or as soon as possible thereafter, the department shall review with the center director, site director, family child care provider, or his or her designee, a summary of any citations of rules found during the visit.

 

          (d)  Within 21 calendar days of the visit review in (c) above, and in accordance with RSA 170-E: 10, III, the department shall provide the statement of findings via email, if a valid email address has been provided by the program, by uploading to the programs “NH Connections” portal, if applicable, or by U.S. mail if an email address has not been provided.

 

          (e)  The program shall not alter the statement of findings including but not limited to revising evidence or dates as documented by the department.

 

          (f)  The family child care provider, center director, or site director shall complete a corrective action plan for each citation included on the statement of findings, which shall include: 

 

(1)  The action the program has taken or will take to correct the citation(s);

 

(2)  The steps the program will take to ensure compliance with these rules and the applicable statutes in the future;

 

(3)  The date by which each of the citations was corrected or will be corrected;

 

(4)  The interim measures the program has implemented to protect the health and safety of children, when the citation cannot be corrected immediately; and

 

(5)  The signature of the provider for family and family group child care homes and of the center director, agency administrator, site director, or site coordinator for center-based programs.

 

          (g)  The family child care provider, center director, agency administrator, site director, or site coordinator shall complete corrective action plans and return them to the department in accordance with the following:

 

(1)  The corrective action plan shall be submitted to the department within 21 calendar days of the date the department issues the statement of findings; and

 

(2)  The names of individuals shall not be included in the corrective action plans.

 

          (h)  In addition to the corrective action plan, the program may submit a separate response to the department's findings. The response shall be posted with the corrective action plan on the website, in accordance with RSA 170-E: 10, II and III. 

 

          (i)  When the corrective action plan submitted to the department by the program in accordance with (f) and (g) above is not acceptable for correcting the citation, the department shall issue a directed corrective action plan to the program.

 

          (j)  Not withstanding (h) and (i) above, when the department determines that there is an imminent threat to the health or safety of children, it shall issue a directed corrective action plan to the program, without first offering the program an opportunity to complete a corrective action plan.

 

          (k)  When a program receives a corrective action plan issued by the department, in accordance with (i ) or (j) above, it shall:

 

(1)  Add any additional details regarding the action plans the program feels are necessary; and

 

(2)  Complete and return the corrective action plan in accordance with (f) and (g) above.

 

          (l)  The department shall initiate enforcement action without first requesting that the program submit a corrective action plan when a program has repeatedly been out of compliance with licensing rules or statute or has been cited for a rule or statute which resulted in physical or mental injury to a child or caused a child to be in danger of physical or mental injury.

 

          (m)  Programs shall comply with approved corrective action plans and corrective action plans issued in accordance with (i) and (j) above.

 

(n)  Programs shall maintain on file on the premises and make available upon request to clients and perspective clients, a copy of the statement of findings and corrective action plan approved or issued by the department for the visit immediately preceding the visit represented on the statement of findings posted in accordance with He-C 4002.14(a)(2).

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.07); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.07  Informal Dispute Resolution.

 

(a)  An opportunity for informal dispute resolution shall be available to the licensee or permittee who disagrees with a citation issued by the department, per RSA 170-E:10-a.

 

(b)  When requesting an informal dispute resolution, the applicant, licensee, center director, or site director shall:

 

(1)  Submit a written notice to the department requesting an informal dispute resolution no later than 14 days from the date of issuance of the statement of findings; and

 

(2)  Include in the notice why the applicant, licensee, or permittee believes that the citation was issued erroneously as noted in the statement of findings.

 

(c)  In accordance with RSA 170-E:10-a, written notice of the department’s decision shall be provided to the applicant or licensee within 30 days from receipt of the request and receipt of any and all information from the applicant, licensee, or permittee.

 

(d)  An informal dispute resolution shall not be an option for any applicant, licensee, or permittee against whom the department has initiated a fine, a conditional license, or action to suspend, revoke, deny, or refuse to issue or renew a license or permit, unless the applicant, licensee, or permittee waives their right to the appeal the action initiated.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.08); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 402.11)

 

He-C 4002.08  Staff and Child Attendance Records.

 

(a)  The program shall maintain daily child attendance records, in either paper or electronic format, including the child’s full name, date of birth, and their arrival and departure times in the program and each room or group throughout the day, as applicable, recorded in real time by staff or parents.

 

(b)  The program shall maintain daily staff attendance records, in either paper or electronic format, including the staff’s full name, scheduled work hours, their position as identified under He-C 4002.35, and their arrival and departure times at the program and in each room or group throughout the day, as applicable, recorded in real time by the staff.

 

(c)  The only exception to (b) above is staff shall not be required to sign in and out for breaks lasting fewer than 15 minutes when the staff remains in the building, or to conduct necessary tasks on the premises.

 

(d)  The licensee shall maintain all child and staff attendance records available for review by the department for 6 months.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.09); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.09  Staff Record Requirements.

 

(a)  The program shall maintain on file for each staff member:

 

(1)  Documentation of the staff’s qualifications, including a resume, transcripts, diplomas, or any other documentation, which demonstrates their qualifications;

 

(2)  Documentation of a completed background check in accordance with He-C 4002.41;

 

(3)  A record of health screening, in accordance with (b) below;

 

(4)  Documentation of orientation, certifications, training, and professional development, as applicable;

 

(5)  Documentation verifying the staff reviewed the program’s emergency operations plan in accordance with He-C 4002.16(j);

 

(6) Documentation verifying the staff reviewed their job description required in He-C 4002.16(e); and

 

(7)  Documentation of supervision regarding disciplinary actions or investigations specific to the staff member.

 

(b)  A written record of a health screening for all child care staff, household members and other individuals who have 5 or more hours per week of contact with children shall:

 

(1)  Be on file at the program and available for review by the department for all child care staff within 60 days of the date of hire or the date the household member or individual begins having daily contact with children; and

 

(2)  Include, at a minimum, the information on the “Child Care Personnel Health Form” (11/2017) provided by the department, or its equivalent.

 

(c)  The only exception to (b) above shall be for child care staff working in school age programs who are currently employed in a public or private school.

 

(d)  The initial record of the health screening required in (b) above for newly hired child care staff shall:

 

(1)  Have been completed not more than 12 months preceding the date of hire or the date the individual began having contact with children; and

 

(2)  Include a statement by the health care provider that indicates the individual has no apparent health conditions that would prohibit or inhibit his or her ability to care for children.

 

(e)  Health screenings required under (b) above shall be repeated every 3 years and a new record of a health screening shall be on file at the program no more than 3 years and 60 days after the date of the previous health screening record on file at the program.

 

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.10); ss by #9605, eff 11-26-09; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.10  Child Record Requirements. 

 

(a)  Child care staff shall ensure that for each child, upon the child’s first day in attendance in the program, there is a   “Child Care Registration and Emergency Information” (April 2022) form or an equivalent form provided by the child care program completed and signed by the parent, on file, which contains:

 

(1)  Full legal name of the child;

 

(2)  Child’s date of birth;

 

(3)  Child’s physical address and mailing address;

 

(4)  Child’s home telephone number;

 

(5)  Date of enrollment in the program;

 

(6)  The name, physical address, and mailing address of the parent(s) responsible for the child, if different from the child’s address;

 

(7)  Telephone numbers for the child’s parents and instructions as to how the parents can be contacted during the hours that the child is at the program;

 

(8)  Email addresses for the parents, if available;

 

(9)  Names and telephone numbers of at least one person who will assume responsibility for the child, if for any reason, the parents cannot be reached immediately in an emergency;

 

(10)  Any chronic conditions, allergies, or medications in case of sudden illness or injury;

 

(11)  Written parental permission for first aid treatment;

 

(12)  Written parental permission for emergency medical transportation and treatment;

 

(13) The name and telephone number of each child’s physician or health care provider; and

 

(14)  Names and telephone numbers of any person(s) other than parents who are authorized to remove the child from the program.

 

(b)  The program shall require each child’s parent(s) to review, sign, and date, on an annual basis, the “Child Care Registration and Emergency Information” (April 2022) form, or its equivalent, to ensure that accurate, current information is on file.

 

(c)  The program shall ensure each child’s registration and emergency information form contains the following statements:

 

(1)  “NOTE TO PARENT/S or GUARDIAN/S: The licensing authority for this program is the bureau of licensing and certification, child care licensing unit.  Child care programs are required to post a copy of the statement of findings and corrective action plan for the most recent visit in a location which is accessible to parents, and must maintain copies of the statement of findings and corrective action plan for the preceding visit and make them available for parents to review upon request.  Statements of findings and corrective action plans are also available on-line at:  https://nhpublichealth.force.com/nhccis/NH_ChildCareSearch or by calling the unit at 603-271-9025; or 1-800-852-3345 ext. 9025”;

 

(2)  “During visits to programs, licensing staff speak with children regarding the care they receive at a program if in the judgment of the licensing staff the children’s response would be valuable in determining compliance with licensing rules.  Licensing staff are experienced in working with children and trained to speak with children in a manner that is respectful and non-leading.  Children will remain with their class or group during these conversations with licensing staff, and at no time will a child be forced to speak with a licensing coordinator. Please indicate whether licensing staff may speak with your child while they are with their class or group:

 

a. I give permission for child care licensing staff to speak with my child while with their class or group;

 

b. I do not give my permission for child care licensing staff to speak with my child while with their class or group.”; and

 

(3)  “If licensing staff believes your child may have specific information regarding an alleged event at the program, and determines that it is best to interview your child separately and not with their class or group, please indicate your preference among the following options:

 

a.  I give permission for child care licensing staff to interview my child at the child care program separate from their class or group;

 

b.  I wish to be notified prior to child care licensing staff interviewing my child at the child care program separate from their class or group;

 

c.  I do not give my permission for child care licensing staff to interview my child at the child care program separate from their class or group.”

 

(d)  The program shall request and maintain on file for each child documentation of immunizations in accordance with RSA 141-C:20-a, RSA 141-C:20-b, and He-P 301.14.

 

(e)  The documentation described in (d) above shall be on file on the first day the child is in attendance at the program or, pursuant to 45 CFR § 98, 41(a)(1)(i)(C), for children experiencing homelessness or for children in foster care within 60 days of the first date of attendance, to allow families or persons responsible for their care to obtain and provide documentation of immunizations.

 

          (f)  Exemptions from the immunizations required under (d) above shall be in accordance with RSA 141-C:20-c.

 

          (g)  Programs shall complete the department’s annual report of children’s immunizations in accordance with RSA 141-C:20-e and He-P 301.15(d).

 

          (h)  The program shall maintain on file a completed child health screening form “New Hampshire Early Childhood Health Assessment Record” (May 2012) provided by the department, or an equivalent record of physical examination which is available for review by the department for each child no more than 60 calendar days after the date of admission.

 

          (i)  A written record of a health screening or physical examination update shall be on file in accordance with the following:

 

(1)  For children younger than 6 years of age, programs shall have on file a copy of a physical examination completed within 60 days of the date of expiration of the last record of physical exam on file; and

 

(2)  For children ages 6 and older, programs shall have on file a copy of the physical examination record completed within the year prior to enrollment. 

 

          (j)  Programs shall not be required to obtain physical examination records for children whose parents object in writing, on the grounds that such physical examination is contrary to their religious beliefs.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.11); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.11  Children Who Are Ill. 

 

(a)  Child care staff shall observe each child, each day upon arrival and throughout the day for injuries and symptoms of illness which:

 

(1)  Impair or prohibit the child’s participation in the regular child care activities; or

 

(2)  Require more care than child care staff are able to provide without compromising the health and safety of the ill, or injured child, or the other children in their care. 

 

(b) Unless a program is following guidance issued by the department’s division of public health as a result of a disease outbreak or public health emergency, the program shall not deny admission or dismiss a child due to illness, unless one of the following conditions exist:

 

(1)  An oral or forehead temperature of 101 degrees Fahrenheit or greater, or 100 degrees Fahrenheit or greater when taken via the armpit, accompanied by behavior changes or signs or symptoms of illness until medical evaluation indicates inclusion in the program;

 

(2)  Symptoms and signs of possible severe illness such as unusual lethargy, uncontrolled coughing, irritability, persistent crying, difficult breathing, wheezing, or other unusual signs until medical evaluation allows inclusion;

 

(3)  Uncontrolled diarrhea, that is, increased number of stools, increased stool water, and/or decreased form that is not contained by the diaper, until diarrhea stops;

 

(4)  Vomiting illness, including two or more episodes of vomiting in the previous 24 hours, until vomiting resolves or until healthcare provider determines illness to be non-communicable, and the child is not in danger of dehydration;

 

(5)  Rash with fever or behavior change, until a healthcare provider determines that these symptoms do not indicate a communicable disease; or

 

(6)  The conditions in (a)(1) or (a)(2) are met.

 

(c)  Child care staff shall provide any child who is ill an opportunity to rest or an opportunity to do a quiet activity in a comfortable, private, supervised area, including areas not regularly considered child care space, such as offices, provided the space is safe for children to occupy, until parents arrive to remove the child from the program.

 

(d)  The family child care provider, center director, site director, or designee shall contact the bureau of disease control and prevention for instructions in accordance with the following:

 

(1)  When child care staff or children in the program have symptoms of or are known to have a communicable disease to determine whether the ill individual is required to be excluded from the program; and

 

(2)  To determine reporting requirements in accordance with RSA 141-C:7, He-P 301.03(c) and (d), and He-P 301.03(h).

 

(e)  When any child care staff or children in the program have symptoms of or are known to have a communicable disease:

 

(1)  Any spills of bodily fluids shall be immediately cleaned and sanitized;

 

(2)  Persons involved in cleaning surfaces contaminated with bodily fluids shall:

 

a. Wear protective disposable gloves while cleaning, disinfecting, and sanitizing the contaminated surface; and

 

b.  Immediately wash their hands with soap and running water after discarding the gloves; and

 

(3)  Any materials, including disposable gloves and diapers contaminated by bodily fluids, shall be immediately disposed of in a plastic bag with a secure tie or in a covered, plastic bag-lined, hands-free receptacle.

 

Source.  #2664, eff 3-30-84; amd by #4157, eff 11-3-86; amd by #4228, eff 2-23-87; ss by #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.12); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.12  Record of Injury. 

 

(a)  If any child has a serious injury while in the care of the program, consisting of fractures, dislocations, stitches, second or third degree burns, concussions, loss of consciousness, or requires emergency medical treatment or hospitalization, the family child care provider, center director, or site director shall:

 

(1)  Immediately notify emergency personnel and the child’s parents;

 

(2)  Notify the department within 48 hours via e-mail, fax, or the NH Connections portal; and

 

(3) Within 7 days, provide the department a written report via e-mail, fax, or the NH Connections portal, detailing the nature and circumstances of the serious injury.

 

(b)  Child care staff shall administer first aid treatment to any injured child:

 

(1)  When the injury is a minor scrape or bruise, first aid treatment, including but not limited to cleaning or applying a cold cloth or band aid, shall be provided by any child care staff; and

 

(2)  When the injury is more than a minor scrape or bruise, a staff member who is certified in first aid in accordance with standards from organizations as referenced in He-C 4002.20(m)(2) shall administer first aid treatment.

 

(c)  Child care staff shall complete a written record of the injury and all first aid provided.

 

(d)  All records of injury shall include:

 

(1)  The name and date of birth of the child;

 

(2)  The date and time of the injury;

 

(3)  A description of where and how the injury occurred including what the child was doing at the time he or she was injured;

 

(4)  Identification of the injury including type of injury, body part injured, and side of body, if applicable;

 

(5)  A description of first aid provided and any other treatment required including the identity of the individual or medical facility that provided the treatment;

 

(6)  The names and dated signatures of child care staff and others who witnessed the injury;

 

(7)  The name and dated signature of the staff person who was responsible for supervising the child when the injury occurred;

 

(8)  The time and method by which the child’s parent(s) were notified;

 

(9)  The dated signature of the parent(s) or a notation by staff that parents refused to sign; and

 

(10)  The dated signature of the family child care provider, center director, site director, or his or her designee, indicating that he or she has reviewed the report.

 

(e)  The injury record required under (c) above shall be:

 

(1)  Provided to the parents of the child who was injured;

 

(2)  Provided to the department only for all serious injuries; and

 

(3)  Maintained in a separate file at the program, and available for review by the department for 3 years.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.14); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.13  Children With Disabilities. 

 

(a)  The licensee shall accept and make reasonable accommodations to welcome and serve, or continue to serve, any child with a disability.

 

(b)  In determining whether accommodations are reasonable and necessary, the program shall:

 

(1)  Refer to the Americans with Disabilities Act; and

 

(2)  If applicable, request parental release of information from professionals providing services to the child specific to the disability.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.15); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.14  Required Postings.

 

(a)  The program shall post in a prominent location:

 

(1)  The current license or permit, visible to parents, staff, and visitors;

 

(2)  The most recent statement of findings and corrective action plan approved by the department, where it is visible to parents, staff, and visitors;

 

(3) A written plan for emergency procedures and managing injuries, which shall include:

 

a.  The location of first aid supplies;

 

b.  The location of child care registration and emergency information forms;

 

c.  The name, address, and telephone number of the hospital to which children will be taken in case of acute emergency when parents cannot be contacted or delay of treatment appears dangerous;

 

d.  Instructions to dial 911 to access emergency responders;

 

e.  The Northern New England Poison Center at 1-800-222-1222; and

 

f.  The names and telephone numbers of emergency substitute staff;

 

(4)  Emergency and evacuation procedures, posted next to each exit;

 

(5)  With permission of the parent, each child’s allergy care plan and treatment plan, in the kitchen or food preparation area, the child's classroom, and wherever the child may have contact with the allergen(s); and

 

(6)  For programs that provide meals or snacks to children ages one year and older, the weekly written menus which reflect all meals and snacks served to children in a location where it is accessible to parents.

 

(b)  In the event a parent does not authorize posting of their child’s allergy care plan as required in (a)(5) above, the program shall ensure the plan is located in those locations and all staff working in those locations know where the plans are and review the plan upon entering those locations.

 

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.16); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.15  Notice and Reporting Requirements to the Department and Parents.

 

(a)  A licensee or permittee shall notify the unit:

 

(1)  Using the “NH Connections” portal or in writing prior to changing the name or advertising under a new name, including any documentation from the secretary of state, if applicable, when he or she wishes to change the name of the program, so that a revised license which reflects the name change can be issued;

 

(2)  Using the “NH Connections” portal or in writing within 2 business days when there is a change in mailing address, email address, or phone number;

 

(3)  Using the “NH Connections” portal or in writing within 5 business days when child care staff, other staff, or household members are no longer working in the program or part of the household, to include their full name and the date he or she left the program;

 

(4)  In writing 5 business days prior to the vacancy when known, or within 5 business days of the date of the vacancy of the center director, agency administrator, site coordinator, or site director, pursuant to He-C 4002.05(f);

 

(5)  Within one business week when the licensee voluntarily ceases operations, pursuant to He-C 4002.05(p);

 

(6)  When a licensee ceases operations as a licensed provider and operates legally licensed exempt, pursuant to He-C 4002.05(p);

 

(7)  When a licensee temporarily closes for longer than 30 days, pursuant to He-C 4002.05(q);

 

(8)  Within 48 hours of a child sustaining a serious injury, pursuant to He-C 4002.12(a)(2);

 

(9)  Prior to making any structural changes to indoor or outdoor child care space that would create a wall, change room capacity, or egress, or adding new space, pursuant to He-C 4002.22(c)(1);

 

(10)  Within 24 hours of any changes in indoor or outdoor space due to an emergency, pursuant to He-C 4002.22(c)(2);

 

(11)  In writing within 5 business days regarding changes pursuant to He-C 4002.02(q) and He-C 4002.22(c)(3);

(12)  No later than the next business day after calling law enforcement or emergency responders to the program for incidents or events involving enrolled children;

 

(13)  When there is a motor vehicle accident involving program staff and children, or when children are involved in a motor vehicle accident during a program-sponsored trip involving a driver not employed by the program or licensee;

 

(14)  Within 24 hours of any occurrence of a missing child or a child who has been put at risk due to lack of supervision; and

 

(15)  Within 24 hours of the death of a child, and provide the department a written report detailing the circumstances that led up to the death within 72 hours.

 

(b)  A licensee, permittee, or his or her designee shall:

 

(1)  As mandated reporters, report to the division for children, youth, and families at 1-800-894-5533, if the licensee, permittee, child care staff, or other person involved with a program suspects that a child is being abused or neglected, in accordance with RSA 169-C:29; and

 

(2)  Contact the bureau of disease control and prevention in accordance with He-C 4002.11(d).

 

(c)  The center director, site director, family child care provider, or designee shall notify a child’s parent(s):

 

(1)  Immediately to report any allegation of abuse or neglect involving their child while in the care and custody of the licensee;

 

(2)  Immediately to report that their child was the victim of corporal punishment, rough handling, or other harsh treatment by child care staff;

 

(3)  Immediately to report that child care staff failed to supervise their child;

 

(4)  Immediately to report that their child’s health, safety, or well-being was seriously jeopardized due to non-compliance with He-C 4002 or RSA 170-E;

 

(5)  Immediately to report that their child sustained a serious injury that required emergency medical treatment or hospitalization, in accordance with He-C 4002.12(a)(1);

 

(6)  Immediately if their child sustains a bump or injury to their head or face that is more than a minor injury such as a scrape or scratch, resulting in any one of the following:

 

a.  Excessive bruising or swelling;

 

b.  An increase in fussiness or sleepiness;

 

c.  Dizziness, clumsiness, or trouble with coordination;

 

d.  Nausea or vomiting;

 

e.  Loss of consciousness;

 

f.  Headache;

 

g.  Speech, vision, or hearing impairment; or

 

h.  Discharge or blood from the bump;

(7)  Except as required in (6) above, as soon as possible on the date their child sustains an injury that is more than a minor scrape or bruise which requires first aid treatment, medical treatment, or medical consultation;

 

(8)  Immediately in the event of a suspected allergic reaction or ingestion of or contact with a known allergen, even if a reaction did not occur;

 

(9)  Immediately in the event of a medication error, and by the end of the day in the event of an error in documentation the administration of medication;

 

(10)  Immediately after calling the police when the program determines that their child is missing;

 

(11)  Immediately if their child dies while under the care of the program;

 

(12)  Upon determining the need to remove their child from the program due to illness, in accordance with He-C 4002.11(b);

 

(13)  Within 24 hours, notify all parents via posting of written notice at the program, email to parents, or private social media account whenever a communicable disease or condition is identified in the program;

 

(14)  Whenever the program deviates from the planned menu as indicated on children’s allergy care plans, as applicable; and

 

(15)  In writing:

 

a.  When the program reduces staff during naptime in accordance with He-C 4002.26(v)(5) and (6); and

 

b.  At least 2 days prior to of the use of any pesticides in accordance with He-C 4002.23(j).

 

            (d)  Child care staff shall provide a written report by the next business day to the parents of the child or children involved to fully inform them of the details of the incident described in (c)(1)-(7) above, including if known:

 

(1)  The name of who was involved in, and who witnessed the incident, while keeping the identities of other children confidential;

 

(2)  What occurred prior to and following the incident;

 

(3)  When and where the incident occurred; and

 

(4)  Any action taken, or that will be taken by the program as a result of the incident.

 

(e)  In addition to the circumstances for notifying emergency services as prescribed in first aid and CPR training, the licensee or permittee shall notify emergency services:

 

(1)  In the event of a missing child, call the police as soon as it is determined that the child is not on the premises;

 

(2)  Immediately whenever staff administer epinephrine (Epi-pen) to a child; and

 

(3)  Immediately when a child dies. 

 

(f)  When the unit determines that a child was the victim of abuse, neglect, corporal punishment, or other harsh treatment, a child was physically injured because he or she was not supervised, or any child’s health, safety, or well-being was otherwise jeopardized due to a program’s non-compliance with licensing rules, the department shall notify the child’s parents.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.17); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.16  Requirements for Written Policies and Procedures and Job Descriptions.

 

(a)  Licensees shall have and implement written policies regarding:

 

(1)  A retention plan to prevent expulsion of children, which outlines how the program will address children’s behaviors that pose a serious safety risk, which includes at a minimum:

 

a.  Parent notification and ongoing communicating regarding their child’s behavior;

 

b. The steps the program will take to assist the child in maintaining enrollment;

 

c. Parent notification when the child’s enrollment cannot be maintained; and

 

d. The responsibilities of the program if the child’s behavior results in a serious safety risk to the child or others within the program; and

 

(2)  Children’s access to and use of television, video, and electronic devices, which shall include at a minimum:

 

a.  Age and developmentally appropriate materials;

 

b.  Supervision by staff when in use and installation of any monitoring software; and

 

c.  How the program will comply with parental restrictions regarding their child’s use of electronic media.

 

(b)  The policy required in (a)(1) above shall only apply when addressing a child's behavior and not a parent's misconduct or the parent's failure to comply with other child care rules or laws.

 

(c)  Programs operating exclusively outdoors shall have written policies to include:

 

(1)  The conditions when the program will not operate due to inclement weather, including excessive heat, extreme cold or when there is a severe weather alert;

 

(2)  The expectation of parents to provide appropriate clothing according to the season and current weather conditions; and

 

(3)  How child care staff will monitor children regarding their comfort including their warmth or signs of overheating and the action child care staff will take in response to children’s comfort related to the weather conditions.

 

(d)  The program shall provide the written policies to parents at enrollment. 

 

(e)  The licensee shall have a written job description for each direct child care staff position, including the scope of responsibility, required tasks, and the position to whom they report, with documentation of  review on file in accordance in He-C 4002.09(a)(6).

 

(f)  Programs shall have an emergency operations plan (EOP) prior to issuance of a permit or renewal of a license.

 

(g)  All EOPs shall:

 

(1)  Be modeled on the National Incident Management System (NIMS), which includes the Incident Command System (ICS), in coordination with local emergency response agencies in the community in which the program is located;

 

(2)  Contain procedures for communication and reunification with families; and

 

(3)  Include response actions, for natural, human-caused, or technological incidences including, but not limited to:

 

a.  Evacuation, both within the building and off-site;

 

b.  Secure campus;

 

c.  Drop, cover, and hold;

 

d.  Lockdown;

 

e.  Reverse evacuation;

 

f.  Shelter-in-place; and

 

g.  Bomb threat or scan.

 

(h)  All response actions in (g)(3) above shall include accommodations for infants and toddlers, children with chronic medical conditions, and children with disabilities or with access and functional needs.

 

(i)  Programs that plan to resume operations after an emergency shall have a continuity of operations plan (COOP) to ensure that essential functions continue during, or resume rapidly after, a disruption of normal activities.

 

(j)  All staff shall review the program's EOP within 30 days of their date of hire and sign and date an acknowledgement of their review, with the acknowledgement kept on file for review by department staff.

 

(k)  Upon enrollment, programs shall provide families with information from the EOP that addresses communication and reunification procedures.

 

(l)  In addition to the requirements for policies and procedures above, the licensee shall provide all child care staff with all policies and procedures upon hire, and ensure that they are familiar with them and comply with them, as applicable.

 

(m)  Child care staff shall review and sign off on changes to policies and procedures required in rule within 30 days of the date of the changes, with documentation of the review kept on file for review by department staff.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.18); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.17  Emergency Preparedness and Practice Drills. 

 

(a)  Except for nature-based programs that operate solely outside, programs shall conduct fire drills in accordance with the following:

 

(1)  Programs that operate continuously throughout the year shall conduct at least one drill each month of operation;

 

(2)  Programs that operate only during the school year shall conduct a drill within 14 days of opening each year and monthly thereafter;

 

(3)  Programs that operate only during the summer months shall conduct one fire drill in each month of operation;

 

(4)  Child care personnel shall conduct fire drills at varying times during operating hours, including night time hours, if applicable, to ensure that each child attending the program experiences fire drills;

 

(5)  Child care staff shall activate the actual fire alarm system for the building for at least 2 of the required monthly fire drills required each year and use a fire alarm or smoke detector to signal all other fire drills; 

 

(6) All children and child care staff shall evacuate the building during each fire drill; and

 

(7)  Child care staff shall check daily attendance records to ensure that all children and staff are accounted for, after the building is evacuated.

 

(b)  The only exception to (a)(5) above shall be for school age programs operating in a public or private school, use of the actual fire alarm system for the building shall not be required for the monthly fire drills.

 

(c)  Programs shall complete a written record of fire drills, which shall be:

 

(1)  Maintained on file at the program for one year; and

 

(2)  Available for review by the fire inspector and the department.

 

(d)  The written record of fire drills required under (c) above shall include:

 

(1)  The date and time the drill was conducted and if the actual fire alarm system was used;

 

(2)  The exits used;

 

(3)  The number of children evacuated and total number of people in the building at the time of the drill;

 

(4)  The amount of time taken to evacuate the building; and

 

(5)  The name of the person conducting the drill.

 

(e)  The center director, site director, or family child care provider or his or her designee shall conduct a fire drill in the presence of a representative of the department or the local fire department upon request by either of those entities.

 

(f)  In order to assure that staff and children are familiar with all of the EOP drills, programs shall:

 

(1)  Practice evacuation off-site and bomb threats once per year with all child care staff; 

 

(2)  Practice at least 2 other components of their EOP with all child care staff and children each calendar year; and

 

(3)  Review all EOP response actions with all staff at least 4 times each calendar year.

 

(g)  Child care personnel shall record and maintain on file for review, a log of the practice drills and staff reviews required in (f) above, that include:

 

(1)  The date and time of the drill time,

 

(2)  The type of drill practiced or drill reviewed:

 

(3)  The method of review or practice, such as in-person, or review of on-line training;

 

(4)  The name of all staff that participated in the review or drill; and

 

(5)  The signature and date of the person conducting the review or drill.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.19); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.18  Interactions Between and Among Adults and Children.

 

(a)  Child care staff shall nurture and encourage each child in care by providing each child with a variety of developmentally appropriate learning and social  experiences and establishing and maintaining a learning environment that provides for the emotional well-being of each child.

 

(b)  When a child is engaging in unacceptable behavior, child care staff shall:

 

(1)  Redirect a child’s attention to a desirable activity by providing positive guidance, positively worded directions, and developmentally appropriate explanations for limits and rules;

 

(2)  Establish developmentally appropriate rules or limits for acceptable behavior, which are equitable, consistently applied, and developmentally appropriate;

 

(3)  Demonstrate desired behavior and problem-solving skills and then redirect children to acceptable behavior;

 

(4)  Arrange equipment, materials, activities, and schedules in a way that promotes desirable behavior; and

 

(5)  Implement safe, logical, and natural consequences related to the misbehavior and enforce those consequences as soon as possible after the misbehavior has occurred.

 

(c)  Child care staff shall use separation, or time out only as a method to enable a child to regain control of his or herself, and not as a punitive disciplinary technique.

 

(d) When a child is separated from the group, he or she shall be able to see and hear the other children and be within hearing and vision of child care staff, except when child care staff remove a child from the classroom to a quieter area which is visible by other child care staff, to provide one-on-one attention.

 

(e)  Child care staff and household members shall not:

 

(1)  Abuse or neglect children;

 

(2)  Use rough handling on children;

 

(3)  Use corporal punishment on children;

 

(4)  Require children to stand or sit facing walls or corners;

 

(5)  Shame, humiliate, threaten, or frighten children;

 

(6)  Confine infants or toddlers in high chairs or other seating devices or equipment, which restricts their movement, as a disciplinary technique;

 

(7)  Place or confine children in equipment that is not appropriate for their age, including but not limited to cribs, playpens, or highchairs;

 

(8)  Withhold food from children, forcibly feed children, or discipline children for not eating;

 

(9)  Discipline any child for toileting accidents, lapses in toileting habits, or prohibiting children from using the toilet as a form of discipline;

 

(10)  Use isolation as a form of discipline;

 

(11)  Require children to rest, sleep, or go to their mat, crib, or rest area as a means of discipline, or discipline children for not sleeping or resting during naptime;

 

(12)  Yell in anger or frustration at or with children; or

 

(13)  Use profanity or obscene language with children or among themselves where children can hear them.

 

(f)  The applicant, licensee, permittee, and all child care staff shall take prompt action to protect children from abuse, neglect, and corporal punishment, including but not limited to actions in (e) above.

 

(g)  If a child’s actions poses an imminent serious safety risk to the child or others that could result in serious bodily harm, child care staff may move the child to another area, holding the child as gently as possible and as briefly as necessary to protect the child and others.

 

(h)  If a child has multiple incidents as described in (g) above, and does not respond to techniques described in (b) above, the center director, site coordinator, or family child care provider shall consult with parents to design an effective behavior management plan.

 

(i)  Staff shall notify the center director, site director, site coordinator, or family child care provider on the same day when interactions with a child in accordance with (g) and (h) above occur.

 

(j)  The center director, site director, site coordinator, or family child care provider shall notify parents on the same day of an occurrence reported to them in accordance with (i) above.

 

(k)  All child care staff working with the child shall review and implement the behavior management plan in (h) above, and shall be trained on when and how to safely use any physical management techniques as specified, which shall be documented in the staff’s file.

 

(l)  The program shall ensure that parents have access to the program, the child care staff primarily involved with their children, and to their children, at any time children are in attendance and without prior notification. This requirement shall not prohibit the program from locking the doors for security purposes or checking parent’s identification.

 

(m)  The only exceptions to (l) above shall be if there is a court order or other legal documentation limiting parental access.

 

(n)  During the operating hours of the program, parents shall have an opportunity to communicate with the child care staff who care for their child.

 

(o)  Child care staff shall not:

 

(1)  Be impaired while on the job by any substances including, but not limited to, legally prescribed medication, alcohol, or illegal substances; and

 

(2)  Use alcohol or illegal substances while caring for children.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.20); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.19  Programming. 

 

(a)  Whenever programs are preparing a planned transition of a child to a new classroom or group, program staff shall:

 

(1)  Communicate with the child’s parents by notifying them of the intent to transition their child;

 

(2)  Collaborate and share information between each classroom or group; and

 

(3) Assist the child with the transition in a manner consistent with the child’s ability to understand.

 

(b)  Programs shall have available for review by the department and parents a written schedule or plan which details the daily activities offered to children.

 

(c)  Program staff shall:

 

(1)  On a daily basis provide children of all ages with opportunities for individual and group activities for each child including time for meals, snacks, sleep or rest, and indoor and outdoor activities;

 

(2)  Provide prompt attention to the individual physical needs of each child, such as diapering, toileting, feeding, sleeping, washing, and first aid;

 

(3) Regularly interact with children at their level, maintain eye contact, and, whenever appropriate, sit on the floor with them;

 

(4)  Protect younger or less mobile children from accident or injury which could be caused by older or more physically active children; and

 

(5)  Provide each child with developmentally appropriate opportunities and experiences that support cognitive, physical, social, and emotional development, creative expression, communication, and literacy.

 

(d)  Child care staff shall not allow children to provide care to other children, such as feeding infants, picking up infants or toddlers, changing diapers, assisting with toileting, or supervising children.

 

(e)  Programs shall provide opportunity for at least 60 minutes daily of gross motor activity for children age 18 months and older, except preschools operating 5 or fewer hours per day shall provide at least 20 minutes of gross motor activity daily.

 

(f)  In the absence of extreme weather conditions, child care staff may, and are encouraged to, bring children outside, taking into consideration the child's health and requests from a child's parent, provided the children shall be appropriately dressed and can move about safely in the outside play area, and staff shall monitor the children regularly for comfort in both hot and cold weather.

 

(g)  Child care staff shall not allow a child to go outside when the child has a health concern as documented on his or her allergy care plan or as documented by the child's health care practitioner limiting time outdoors.

 

(h)  Child care staff shall adhere to instructions from the child's parent related to protection from sun exposure, and apply sunscreen per manufacturer's instructions.

 

(i)  Other activity choices shall be available to children during use of television, video, or electronic devices.

 

(j)  All media shall be age and developmentally appropriate.

 

(k)  When in use, electronic devices shall be located in view of child care staff for monitoring purposes.

 

(l)  Any internet accessible electronic device used by the children shall be equipped with monitoring or filtering software or controls that limit children’s access to inappropriate web sites, e-mail, computer or mobile applications, or social media.

 

(m)  Child care staff shall not allow a child to view television or videos, or use electronic devices when the child’s parent has made such a request.

 

(n)  Center-based programs shall not combine children younger than 24 months in a mixed age group which includes children older than 47 months, except:

 

(1)  For time limited, specific activities, including but not limited to meals, snacks, nap or rest time, and special occasions such as birthday or holiday celebrations or visitor presentations;

 

(2)  When there are 17 or fewer children present in the program, including a maximum of 12 preschool children, and 4 or fewer of the 17 children are younger than 3 years of age; or

 

(3)  With a department approved plan for multi-age classrooms.

 

(o)  Child care staff shall not leave infants or toddlers unattended in seating, carrying or other devices placed on countertops, tables, or other elevated surfaces.

 

(p)  Child care staff shall:

 

(1)  Not confine awake infants and toddlers in restrictive equipment such as infant seats, seated infant carriers, car seats, swings, high chairs, stationary activity centers, strollers, cribs, or playpens for more than 15 minutes in any 2-hour period;

 

(2)  Allow infants and toddlers to remain in a high chair for more than 15 minutes when they are actively engaged in eating during snack or meals, in strollers for walks, or for non-ambulatory infants only, in cribs or playpens when outside; and

 

(3)  Provide stimulating activities such as age-appropriate toys or books to infants or toddlers while they are in equipment specified in (1) above.

 

(q)  Programs that are authorized by license or permit to care for children as young as 6 weeks of age may care for a child younger than 6 weeks of age for a maximum of 12 hours per week per child with prior approval from their local fire officer and notification to the department.

 

(r)  In a family or family group child care home licensed to care for children 6 weeks of age, the restriction specified in (q) above shall not apply to the family child care provider’s own biological or adopted infant younger than 6 weeks of age or an infant younger than 6 weeks of age who resides in the provider’s home.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.21); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.20  Prevention and Management of Injuries. 

 

(a)  Child care staff shall supervise every child in care at all times.

 

(b)  In center-based programs, staff shall position themselves to:

 

(1)  Be able to hear all children younger than school age at all times, continuously scan the entire environment to know where children are and what they are doing, and be able to physically respond immediately;

 

(2)  Know the whereabouts and activities of all school age children in their care at all times when children are briefly out of sight, such as when transitioning from one area to another or using the bathroom, and shall be able to physically respond immediately;

 

(3)  Allow for visual supervision of all children while children are eating, and shall be able to physically respond immediately to any child that may be choking; and

 

(4)  Know the number of and identity of children in their care.

 

(c)  Video monitors shall not replace the supervision of children, except as provided for in He-C 4002.26(l) and (m).

 

(d)  The only exception to (b)(1) above shall be children 4 years and older may leave the classroom to use a bathroom located on the same level as the classroom, provided that child care staff are aware of each child leaving the classroom to use the bathroom and the level of the building that the bathroom is located on is used exclusively by the child care program.

 

(e)  In family child care homes, family child care providers shall supervise children in accordance with the following:

 

(1)  The family child care provider or family child care worker may step away from the children to meet basic care needs throughout the day so long that:

 

a.  It shall be time limited; and

 

b.  The family child care provider or family child care worker shall be able to hear all children, preschool age and younger, at all times and be able to physically respond immediately, if necessary, with the exception of needing to step away to meet their own basic needs;

 

(2)  The family child care provider or family child care worker shall know the whereabouts and activities of all school age children at all times and shall be able to physically respond immediately;

 

(3)  The family child care provider or family child care worker may allow school-age children 6 years of age and older to play outside when the provider or worker are inside, with written parental permission; and

 

(4)  When children are eating, the family child care provider or family child care worker shall be positioned to allow for visual supervision of all children and shall be able to physically respond immediately to any child that may be choking. 

 

(f)  Child care staff shall not carry a child while stepping over a low wall, gate, or other similar barrier.

 

(g)  The program shall obtain the following documents from the parents of each child with a food allergy or other allergy, which results in a serious reaction:

 

(1)  A written care plan that includes instructions regarding food(s) or other allergens to which the child is allergic and steps for child care staff to take to avoid the allergens; and

 

(2)  A written treatment plan, detailing the treatment to be implemented in the event of an allergic reaction, which shall include:

 

a.  The names, doses, and methods of prompt administration of any medications, where the medication needs to be stored in relation to the child, taking into consideration the storage requirements in He-C 4002.21(o)(2), and instructions on how to administer the prescribed medication; and

 

b. Specific symptoms that would indicate the need to administer one or more medications.

 

(h)  At all times, at least one child care staff supervising a child with an allergy care plan shall have completed the training specified in He-C 4002.33(b)(5).

 

(i)  The program shall post each allergy care plan in accordance with the posting requirements in He-C 4002.14.

 

(j)   All child care staff responsible for food preparation and food service, and all child care staff responsible for supervising children with an allergy, including staff covering breaks, shall read and familiarize themselves with the care plans and treatment plans, to ensure that no child is accidentally exposed to an allergen.

 

(k)  Programs shall be equipped with a telephone that is operable and accessible to all child care staff during all operating hours for incoming and outgoing calls.  The phone may be a cellular phone or a landline.

 

(l)  Child care staff shall report any occurrence of a missing child to emergency services, as soon as child care staff have determined that the child cannot be promptly located on the premises of the child care program.

 

(m)  The center director, site director, family child care provider, and all staff used to meet staff to child ratios shall:

 

(1)  Be certified in pediatric cardiopulmonary resuscitation (CPR) and first aid within 90 days of the first date of employment;

 

(2)  Obtain certification in (m)(1) above by the American Red Cross, American Heart Association, Emergency Care and Safety Institute, National Safety Council, or other nationally recognized organization; and

 

(3)  Maintain current certifications required in (m)(1) above.

 

(n)  During all operating hours, on and off premises, there shall be at least one staff person who is trained and currently certified as specified in (m) above, with all children.

 

(o)  CPR and first aid training as specified in (m) above may be received via correspondence or on-line, provided a skill test is required to be performed prior to becoming certified.

 

(p)  Programs shall maintain on file, available for review by the department, copies of current CPR and first aid certificates and licenses.

 

(q)  Programs shall have on the premises and on all field trips, a selection of non-expired first aid supplies adequate to meet the needs of the children.

 

(r)  Programs shall store the first aid supplies required under (q) above in a portable container, in a location that is easily accessible by staff and out of the reach of children if the contents present a danger to children.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (He-C 4002.22); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.19)

 

He-C 4002.21  Administration and Storage of Medication.

 

(a)   Programs shall administer any medication, treatment, or other remedy to any child, as provided by the child’s parents and in accordance with this section. 

 

(b)  For the purposes of this section, “administer” means an act whereby a single dose of a medication is instilled into the body of, applied to the body of, or otherwise given to a child for immediate consumption or use.

 

(c)  Only authorized staff, a registered nurse (RN), licensed practical nurse (LPN), or licensed practitioner shall administer prescription and over-the-counter medications to children, in accordance with the child’s medication order.

 

(d)  Authorized staff shall administer only those medications for which there is a medication order provided by a licensed practitioner, and written permission from the parent.

 

(e)  Programs shall not accept any prescription medications that do not include a prescription label or medication order from a licensed professional.

 

(f)  Each medication order shall legibly display:

 

(1)  The child’s name;

 

(2)  The medication name, strength, the prescribed dose and method of administration;

 

(3)  The frequency of administration;

 

(4)  The indications for usage of all medications to be used pro re nata (PRN); and

 

(5)  The dated signature of the licensed practitioner for orders other than the prescription label.

 

(g)  Medication orders for PRN medication shall include:

 

(1)  The indications and any special precautions or limitations regarding administration of the medication;

 

(2)  The maximum dosage allowed in a 24-hour period;

 

(3)  The dated signature of the parent for topical substances or over-the-counter medication; and

 

(4) For other than the prescription label, the dated signature of the licensed health care practitioner for prescription medication.

 

(h)  In the event of a medication error in the administration of medication, the family child care provider, center director, site director, or designee shall notify the child’s parents immediately.

 

(i)  In the event of a medication error in the documentation of the administration of medication, the family child care provider, center director, or designee shall notify the child’s parents by the end of the day in which the error occurred.

 

(j)  Prior to administering prescription and over-the-counter medication to any child, child care staff shall complete and document training on medication administration, as required by He-C 4002.33(b)(4), delivered by the department, a physician, RN, or LPN practicing under the direction of an APRN, RN, or physician, or online training approved by the department.

 

(k)  Authorized staff shall complete training in medication safety and administration every 3 years.

 

(l)  Documentation of training in medication safety and administration shall be maintained on file at the child care program and be available for review by the department.

 

(m)  For each child receiving medication, child care staff shall maintain medication information on file and available for review by the department, including medication orders, parental authorization to administer medication, and information regarding a child’s allergies, if applicable.

 

(n)  Child care staff shall maintain a written record for each dose of medication administered to each child, which shall:

 

(1)  Be maintained on file in the program, available for review by the department;

 

(2)  Be completed by the authorized staff who administered the medication immediately after the medication is administered; and

 

(3)  For each administered medication, include at a minimum:

 

a.  The name of the child;

 

b.  The date and time the medication was taken;

 

c.  A notation of any medication error or the reason why any medication was not taken as ordered or approved;

 

d.  The dated signature of the authorized staff who administered the medication to the child; and

 

e. For administration of a PRN, documentation shall also include the reason for administration.

 

(o)  All medication shall be:

 

(1)  Inaccessible to children;

 

(2)  Stored at the temperature and conditions recommended by the manufacturer or as directed on the prescription label;

 

(3)  Stored in a secondary container separate from food if in a refrigerator; and

 

(4)  Labeled with the child’s name to ensure correct identification of each child's medication.

 

(p)  Medications such as insulin, inhalers, and epi-pens shall be readily accessible to child care staff caring for children requiring such medications, to assure timely administration when needed and in accordance with parental instructions in He-C 4002.20(g)(2)a.

 

(q)  Medications described in (p) above shall be permitted to be in the possession of a school-age child as long as the following are on file at the program:

 

(1)  Written authorization from the prescribing health care practitioner; and

 

(2)  Written permission from the child’s parents.

 

(r)  The only exception to (q) above shall be when a school-age child is with children younger than 6 years of age, insulin, inhalers, and epi-pens shall not be in the school-age child’s possession, but shall be readily accessible to staff.

 

(s)  All medications belonging to staff shall be stored separate from children’s medications in a locked area, or otherwise inaccessible to children.

 

(t)  All prescription or over-the-counter medication and topical substances shall be kept in the original containers or pharmacy packaging and properly closed after each use.

 

(u)  Any contaminated, expired, or discontinued medication, whether prescription or over-the-counter, and topical substances shall be returned to the child’s parents or, if belonging to the program, disposed of properly by authorized staff.

 

(v) Child care staff shall administer over-the-counter medications in accordance with the manufacturer’s instructions or written instructions from the child’s health care practitioner.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.23); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.18)

 

He-C 4002.22  Approval of Child Care Space and License Capacity: Indoors and Outdoors.

 

(a)  Prior to use for child care, all indoor and outdoor child care space shall be:

 

(1)  Inspected and approved by the local fire inspector, in accordance with RSA 170-E:6 and He-C 4002.02(d)(3);

 

(2)  Inspected and approved by the local health officer, in accordance with RSA 170-E:6 and He-C 4002.02(d)(2); and

 

(3)  Inspected by the department in accordance with RSA 170-E:8, III, and RSA 170-E:9, II; and these rules.

 

(b)  Prior to caring for children on any level of a building that does not exit to grade level, programs shall:

 

(1)  Obtain written approval from the local fire authority, which specifically grants approval for children to be cared for on any level that does not exit to grade level, including any restrictions on the number of children; and

 

(2)  Submit the approval in (1) above to the department.

 

(c)  Programs shall report any changes to indoor or outdoor child care space, or addition of new space, to the department:

 

(1)  Prior to the change; or

 

(2)  Within 24 hours of the change if, due to an emergency, approved child care space cannot be used due to reasons including, but not limited to, damages which make an area unsafe for children; and

 

(3)  When programs discontinue using space as specified in He-C 4002.02(q).

 

(d)  The licensee shall provide and maintain at least one toilet and one handwashing sink for every 20 children of their licensed capacity.

 

(e)  There shall be a minimum of 40 square feet of floor space per child, measured wall-to-wall, inside the rooms used by children.

 

(f) The department shall determine the license capacity by adding the number of children each room can accommodate based on 40 square feet per child, exclusive of common space, and in accordance with local fire, health and zoning approvals.

 

(g)  The department shall not consider common space, hallways, lockers, bathrooms, cooking areas of the kitchen, closets, or offices as child care space when determining license capacity.

 

(h)  There shall be a minimum of 35 square feet of floor space per child for programs licensed before November 23, 2008.

 

(i)  Programs referenced in (h) above shall be required to comply with the requirements in (e) above when:

 

(1)  The licensee or permittee lets the license lapse due to late submission of renewal application materials; or

 

(2)  The program relocates to new space or does major renovations to their current child care space, such as adding or removing walls or otherwise changing, reducing, or expanding space.

 

(j)  The program must have activity space of its own, apart from other groups that may be using the facility, during the time that it operates.

 

(k)  Programs which are located in the same building with other licensed entities or programs for children that are license exempt, pursuant to RSA 170-E:3, shall:

 

(1)  Not be responsible for or supervise any children not enrolled in the licensed program;

 

(2)  Not allow children from the license exempt program to mix with children enrolled in the licensed program; and

 

(3)  Not allow children from the license exempt program to share space that is being used by children enrolled in the licensed program.

 

(l)  Programs shall not overcrowd child care space with adult-sized furniture or other items for use only by adults or stored items.

 

(m)  For programs licensed before November 23, 2008 whose capacities included the use of common space as described in rules previous to that date shall be allowed to have no more than up to 2 children over the classroom capacity, regularly assigned to each classroom, provided the common space was approved by and is on file with the department.

 

(n)  For programs licensed before May 30, 1998 whose capacities included the use of common space as described in rules previous to that date shall be allowed to have no more than up to 4 children over the classroom capacity, regularly assigned to each classroom, provided the common space was approved by and is on file with the department.

 

(o)  Programs shall be equipped with an outside play area, which directly adjoins the indoor space of the facility and contains a minimum of 50 square feet of outdoor play area for each child based upon the program’s license capacity.

 

(p)  The only exceptions to (o) above are as follows:

 

(1)  Programs may utilize department approved outdoor play space which is located within ⅛ of a mile from the program, provided the program submits a written plan to the department showing that children can safely travel to and from the play area and the program;

 

(2)  Programs may operate with 50 square feet of outdoor play area per child for 1/3 of the program’s license capacity, provided that no more than 1/3 of the license capacity is in the play area at one time; and

 

(3)  Programs that operate 5 or fewer hours per day provided the curriculum includes at least 20 minutes of gross motor activities.

 

            (q)  For programs operating exclusively outdoors, the department shall determine the license capacity based on the area of outdoor space and the proposed staffing patterns as specified in these rules.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.24); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.23  Health and Safety Requirements for Indoor Space.

 

(a)  Programs shall provide child care only in space approved by the department.

 

(b) Child care staff shall ensure that the indoor space is:

 

(1)  Safe, clean, free of clutter, and in good repair;

 

(2)  Free from electrical hazards, such as overloaded outlets or extension cords, frayed, cracked or crimped cords, or unprotected outlets;

 

(3)  Well-ventilated by means of unobstructed mechanical ventilation system or open, screened window;

 

(4)  Well-lit to allow for the supervision of children and for child care staff and children to move about safely;

 

(5)  Free of damp conditions which result in visible mold, mildew, or a musty odor;

 

(6)  Free of heavy furnishings or items not secured to the wall or floor that could easily tip or are unstable;

 

(7)  Free of fumes from toxic or harmful chemicals or materials;

 

(8)  Free of tripping hazards; and

 

(9) Free of poisonous plants.

 

(c)  Child care staff shall ensure that potentially harmful items, including but not limited to matches, lighters, chemicals, materials labeled “harmful if swallowed,” flammable materials, sharp objects, and staffs’ personal belongings are locked or inaccessible to children.

 

(d)  All substances labeled “harmful if swallowed” or “flammable” and all containers storing cleaning materials shall be labeled as to the contents and stored separately from food and medications.

 

(e)  Non-toxic materials labeled “keep out of reach of children” shall only be used during a teacher-directed activity.

 

(f)  Cords or strings long enough to encircle a child’s neck, such as cords on window blinds, curtains or shades, shall be kept out of children’s reach.

 

(g)  Child care staff shall ensure that the presence of pets in the program does not present a hazard to the children, including but not limited to:

 

(1)  Reptiles, amphibians and birds, including baby chicks and ducklings, shall not be permitted in rooms or outdoor spaces regularly occupied by children;

 

(2)  When bringing animals into a child care, staff shall supervise children when the animals are available, designated areas shall be cleaned and sanitized after animal contact, and food or drink shall not be consumed in these areas;

 

(3)  Cages or other habitats shall be cleaned of all fecal material and sanitized on an as needed basis but no less than once per week;

 

(4)  Staff shall wear gloves while cleaning animal cages or habitats;

 

(5)  All staff and children shall wash hands with soap and warm running water after contact with animals or their cages or habitats; and

 

(6)  Dogs, cats, and ferrets shall be kept clean and free of parasites, fleas, ticks, mites, and lice, and vaccinated against rabies, with proof of current vaccination on site at the program and available for review by department staff.

 

(h)  Programs shall maintain bathroom facilities in accordance with the following:

 

(1)  Sinks, toilets, footstools, potty chairs, and adapters shall be cleaned and sanitized at least once a day and when visibly soiled;

(2)  Bathroom floors and other surfaces adjacent to toilets, including but not limited to walls, shall be cleaned and sanitized at least weekly, and when visibly soiled;

 

(3)  Toilet paper, individual cloth or paper towels, and liquid soap from a dispenser shall be available and accessible to children and staff; and

 

(4)  Bathrooms shall have a functional means of outside ventilation.

 

(i)  The program shall take prompt action to eliminate insects or rodents, and clean and sanitize all surfaces where there is visible evidence of their presence.

 

(j)  When using pesticides, programs shall:

 

(1)  Notify parents and staff in writing at least 2 days prior to the pesticide application, except in emergencies where pests pose an immediate threat to children; and

 

(2)  Document the date, time, and type of pesticide used for each time a pesticide is used.

 

(k)  Pesticides shall not be used in areas used by children while children are present, and any treated indoor area shall be aired out per manufacturers’ instructions prior to allowing children to return to that area.

 

(l)  Programs shall maintain the child care space free from non-compliance of Saf-FMO 300 and Saf-C 6000 by not blocking exits, or evacuation routes, including doorways, hallways, and stairs that are a means of egress, and by maintaining smoke detectors in working order.

 

(m)  The licensee shall prohibit smoking in the building anytime for center-based programs or during operating hours for family child care homes, with the following exceptions:

 

(1)  Child care staff who smoke during their breaks shall not smoke in view of children or while responsible for the care of children; and

 

(2)  Child care staff who smoke on their breaks shall wash their hands and change into fresh clothing, or remove smoke contaminated outerwear prior to returning to work to reduce exposure to second-hand smoke.

 

(n)  Child care staff shall:

 

(1)  Arrange space to provide clear pathways for movement from one area to another and to allow visual supervision by staff;

 

(2)  Arrange furnishings and fixtures safely, with sharp edges protected, and in such a way as to not present hazards to children; and

 

(3)  Store their personal belongings out of reach of children.

 

(o)  There shall be adequate space for each child’s possessions, such as individual cubbies, lockers, baskets, or bins.

 

(p)  Children’s toothbrushes shall be stored separately to air dry and be labeled with each child’s name.

 

(q)  All windows used for ventilation shall include screens in good repair, to prevent insects from entering the building. Windows and glass doors shall be constructed, adapted, or adjusted via the use of window guards or other means to prevent injury to children.

 

(r)  Garbage shall be disposed of in a lined and covered container and staff shall empty trash containers daily or sooner if contents create an odor or a health risk.

 

(s)  Stairways with more than 3 steps shall be equipped with handrails.

 

(t) In programs serving children younger than 3 years old, the licensee shall ensure that there are barriers placed at the top and bottom of stairwells opening into areas used by children younger than three years, unless prohibited by building or fire department regulations. Pressure gates at the top of stairs shall not be used.

 

(u)  Open stairways used by children younger than school age shall have railings or banisters installed along the open or unprotected side(s).

 

(v)  Programs shall:

 

(1)  Have a safe, functioning heating system;

 

(2)  Maintain a temperature of not less than 65 degrees Fahrenheit whenever children are present; and

 

(3)  Protect children from contact with exposed heat sources, including steam and hot water pipes, and radiators, via the use of permanent screens, guards, insulation or another suitable device that prevents children from coming in contact with them.

 

(w)  Prior to using portable space heaters or portable radiators in child care space, programs shall obtain written approval from the local fire inspector with documentation of the approval available for review by department staff during on-site visits.

 

(x)  All portable space heaters or radiators shall:

 

(1)  Be inaccessible to children;

 

(2)  Bear the safety certification of a recognized laboratory such as Underwriters Laboratory (UL) or Electro Technical Laboratory (ETL);

 

(3)  Be placed at least 3 feet from curtains, papers, furniture, or any other flammable object; and

 

(4)  Be installed and operated in accordance with the manufacturer’s specifications.

 

(y)  All fuel burning stoves, including but not limited to wood, coal, pellet, or gas, when used during child care, shall:

 

(1)  Meet applicable local and state codes with documentation of such approval available for review by department staff during on-site visits; and

 

(2)  Be maintained in a manner that ensures the safety of all children, by use of partitions, screens, guards, or other similar barricades, as approved by the local fire official;

 

(z)  Child care staff shall be in the room with children whenever a fireplace is in use.

 

(aa)  All working fireplaces in space used by children shall:

 

(1)  Have a secure child proof barrier in place at all times; and

 

(2)  Be equipped with padding or otherwise protected if the hearth presents a hazard to children.

 

(ab)  Guns, weapons, or live or spent ammunition shall be kept in locked storage with the key stored separately and out of the reach of children.

 

(ac)  Pursuant to 40 CFR 745, when interior surfaces of a building built prior to 1978 are in a deteriorating condition, including but not limited to flaking, chipping, and peeling paint, or are subject to renovations or construction, the licensee shall utilize a U.S. Environmental Protection Agency certified Renovation, Repair, and Painting (RRP) contractor, in accordance with 40 CFR 745.90(a) and (b) and He-P 1600.

 

(ad)  In addition to (ac) above, until the deteriorated surfaces can be made intact, the program shall provide the department with a plan, in writing, that ensures children will not have access to those surfaces and includes the expected date of completion of the work.

 

(ae)  Construction, remodeling, or alteration of structures during child care operations shall be done in a manner as to prevent exposure of children to hazardous or unsafe conditions including, but not limited to, fumes, dust, construction materials, and tools which pose a safety hazard.

 

(af)  When there is information or evidence indicating that the building may contain asbestos hazards, programs shall submit evidence that the building has been inspected by a licensed asbestos inspector and is free of asbestos hazards, or submit a plan of action to reduce or eliminate any existing contamination to be approved by the department.

 

(ag)  When there is information indicating that the building or water supply may contain radon hazards, programs shall submit evidence that the building has been inspected by a licensed radon inspector and is free of radon hazards or submit a plan of action to reduce or eliminate any existing contamination to be approved by the department.

 

(ah)  Child care staff shall immediately clean spills of bodily fluids, including urine, feces, blood, saliva, and discharges from the nose, eyes, or an injury, using soap and water and then disinfectant.  Surfaces requiring such action include tabletops, toys, floors, walls, toilets, potty chairs, and diaper changing surfaces.

 

(ai)  Child care staff shall:

 

(1)  Wear non-porous gloves when cleaning bodily fluid spills specified above;

 

(2)  Place soiled clothing in a plastic bag, tied securely and return the items to the child’s parent at pick up; and

 

(3)  Clean, rinse, disinfect, wring, and hang to dry mops used to clean bodily fluids.

 

(aj)  The fall zone under and around all indoor swings and climbing equipment, including slides or lofts, which would allow a fall from a height of more than 29 inches shall extend at least 39 inches and be covered with mats designed for gymnastics.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.25); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.14)

 

He-C 4002.24  Health and Safety Requirements for Outdoor Space.

 

(a)  The play area shall:

 

(1)  Be accessible to children with disabilities;

 

(2)  Be appropriate for each age group served, including use of toys and equipment that is age and developmentally appropriate to the needs of the children enrolled;

 

(3)  Provide for both direct sunlight and shade; and

 

(4)  Be free from hazards, including but not limited to:

a.  Water hazards such as unprotected pools, wells, or bodies of water;

b.  Animal feces; 

c. Poisonous plants;

d.  Broken toys, broken glass or other sharp items;

e.  Chipping, peeling, or flaking paint;

f.  Dangerous machinery or tools;

g.  Small objects that could present a choking hazard to young children; and

h.  Other dangerous items or substances.

 

(b)  Fencing shall enclose all play areas if the department determines the play area is unsafe because it is located adjacent to:

 

(1)  A street or road;

 

(2)  A swimming pool or other body of water, including a river, pond, or stream;

 

(3)  An active railroad track or crossing;

 

(4)  Sharp inclines or embankments; or

 

(5)  Any dangerous area.

 

(c)  All fencing required by the department or otherwise intended to limit children’s access to a defined area shall:

 

(1)  Have no gaps greater than 4 inches and be designed to restrain preschool children from climbing out of, over, under, or through the fence; and

 

(2)  Either:

 

a.  Be equipped with a child proof self-latching device on any gates leading to an entrance or egress; or

 

b.  Be equipped with a child proof lock if the area is determined to be hazardous to children.

 

(d)  The licensee shall protect outdoor play space located on a roof with a barrier at least 7 feet high, which children cannot climb.

 

(e)  The licensee shall install suitable barriers, including but not limited to bulkhead doors, to prevent falls into outdoor stair or window wells.

 

(f)  The department shall approve porches and decks before use as play areas.

 

(g)  Porches and decks shall comply with the following:

 

(1)  If they are more than three feet from ground level, there shall be protective railings in accordance with applicable building codes;

 

(2)  Railings shall be sturdy and constructed in a way that will prevent a young child from going underneath, over, or through them;

 

(3)  There shall be a child safety gate or other barricade on stairs whenever the porch or deck is in use by children younger than three years old; and

 

(4)  The family child care provider, center director, or site director shall monitor the condition of porches and decks to ensure that there are no splinters, cracks, protruding nails or screws, and discontinue use of the area until repairs are complete.

 

(h)   For outdoor play equipment that would allow a child to fall from a height of more than 29 inches, programs shall:

 

(1)  Equip and maintain the ground area under and extending at least 39 inches beyond the external limits of such equipment with an energy absorptive surface; and

 

(2)  Utilize an energy absorptive surface, required by (1) above, that:

 

a.  Does not present a choking hazard if used by children younger than 3 years;

 

b. Is checked and ranked regularly to remove any foreign matter, correct compaction, and increase absorption; and

 

c.  Is a unitary surface documented by the manufacturer  as being in compliance with the standards of ASTM International’s “ASTM F1292 Standard Specification for Impact Attenuation of Surfacing Materials Within the Use Zone of Playground Equipment” (2018 edition), available as noted in Appendix A, and installed per manufacturer’s instructions or conforms with Table 4.2.1 below:

 

Table 4.2.1 Energy Absorptive Surface

 

Fall Height

of Equipment

Wood

Chips

Bark

Mulch

Engineered

Wood Fibers

Fine

Sand

Coarse

Sand

Fine

Gravel

Medium

Gravel

Shredded

Tires

30 inches to 5 feet

6 inch

6 inch

6 inch

6 inch

6 inch

6 inch

6 inch

6 inch

6 feet

6 inch

6 inch

6 inch

12 inch

12 inch

6 inch

12 inch

6 inch

7 feet

6 inch

9 inch

9 inch

12 inch

N/A

9 inch

N/A

6 inch

8 feet

9 inch

9 inch

12 inch

12 inch

N/A

12 inch

N/A

6 inch

9 feet

9 inch

9 inch

12 inch

12 inch

N/A

12 inch

N/A

6 inch

10 feet

9 inch

9 inch

12 inch

N/A

N/A

12 inch

N/A

6 inch

11 feet

12 inch

12 inch

12 inch

N/A

N/A

N/A

N/A

6 inch

 

(i)  To prevent injury, programs shall not allow children to play on equipment or structures that require energy absorptive material pursuant to (h) above when the energy absorptive material is compacted and unable to be loosened, such as when frozen.

 

(j)  All fencing, balusters, handrails, and guardrails, or slats on lofts, stairways, decks, porches, or balconies that are accessible to children shall be constructed and maintained to prevent entrapment hazards.

 

(k)  All swimming pools on the premises of the child care program and used as part of the child care operations shall be clean and maintained in accordance with the manufacturer’s or installer’s printed instructions regarding cleaning, filtration, and chemical treatment.

 

(l)  All swimming pools on the premises of the child care program shall be inaccessible to children in accordance with the following:

 

(1)  In-ground pools shall be enclosed by a fence with a gate equipped with a child proof, self-latching device and a lock;

 

(2)  Above ground pools shall be enclosed by a fence with a gate which has a child proof, self-latching device and a lock, or equipped with a lockable gate, lockable swing up stairway, or other lockable barrier to prevent access to the stairs or ladders, or otherwise make the pool inaccessible to children;

 

(3)  A pool that is directly accessible from inside the building shall have a secure, lockable barrier that meets the requirements in (1) and (2) above to make the pool inaccessible to children;

 

(4)  Pool gates, fences, or other barriers as required in (1), (2), and (3) above shall be locked during all operating hours, except when the children are involved in a supervised water activity in the pool; and

 

(5)  The keys, combinations, or other means to open the locks required in (1) through (4) above shall not be accessible to children.

 

(m)  Each swimming pool shall be equipped with a ring buoy, and attached rope of sufficient length to reach the center of the pool from the edge of the pool and shall not be accessible to children.

 

(n)  Wading pools shall:

 

(1)  Be emptied and cleaned after each use;

 

(2)  Be stored so that water does not collect in them; and

 

(3)  Not contain water that is more than 10 inches deep.

 

(o)  Pursuant to 40 CFR 745 when exterior surfaces of a building built prior to 1978 are in a deteriorating condition, including but not limited to flaking, chipping, and peeling paint, or are subject to renovations or construction, a U.S. Environmental Protection Agency certified Renovation, Repair, and Painting (RRP) contractor shall be utilized, in accordance with 40 CFR 745.90(a) and (b) and He-P 1600.

 

(p)  In addition to (o) above, until such time as the deteriorated surfaces can be made intact, the program shall provide the department with a plan, in writing, that ensures children will not have access to those surfaces and includes the expected date of completion of the work.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.26); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.14)

 

He-C 4002.25  Learning Materials, Toys and Equipment.

 

(a)  Programs shall provide toys, equipment, furniture, and learning materials that are:

 

(1)  Age and developmentally appropriate;

 

(2)  Of sufficient quantity and variety to meet the needs of the children cared for in the program;

 

(3)  Available and accessible to children; and

 

(4)  Cleaned on a regular basis.

 

(b)  The program shall ensure that toys, equipment, furniture, and learning materials, are:

 

(1)  Sturdy and safely constructed and installed;

 

(2)  Easily cleaned; and

 

(3)  Maintained in a safe, secure, and workable condition, free from lead paint, protruding nails, rust, and other hazards that may be dangerous to children.

 

(c)  Toys that children routinely mouth, including but not limited to infant and toddler toys, shall be cleaned and sanitized after each use by a child and at the end of each day.

 

(d)  Child care staff shall not use any equipment, materials, furnishings, toys, or games identified by the U.S. Consumer Product Safety Commission as being hazardous.

 

(e) All play equipment, fences, and structures shall be free of entrapment hazards, including gaps that are between 3 ½ inches and 9 inches apart on balusters, handrails, guardrails, or slats on play structures, lofts, stairways, decks, porches, or balconies, that are accessible to children.

 

(f)  Child care staff shall not allow children younger than 3 years of age to have access to toys, toy parts, and other materials that pose a suffocation or choking risk or are small enough to be swallowed, including, but not limited to, coins, balloons, exposed foam padding, or empty plastic bags.

 

(g)  The only exception to (f) above for children age 30 months to 3 years shall be during teacher directed activities under direct supervision by child care staff, or when programs have the following documentation on file:

 

(1)  Observations of the children by program staff indicating that children do not put toys or objects in their mouths during play;

 

(2)  Parents statement that their child(ren) do not put toys or objects in their mouth(s) during play; and

 

(3)  Signed parent acknowledgment that they understand small parts are a choking hazard, and that the program will have small materials accessible as part of the curriculum.

 

(h)  Infants shall not be placed in any equipment, including but not limited to stationary activity centers that require them to support their heads on their own if they have not yet acquired that ability.

 

(i)  Baby walkers with wheels are prohibited in programs.

 

(j)  Toy boxes accessible to children used to store any child care materials and equipment shall have a safety lid support or not have a lid.

 

(k)  The fall zone under and around all indoor swings and climbing equipment, including slides or lofts, which would allow a fall from a height of more than 29 inches shall extend at least 39 inches and be covered with mats designed for gymnastics.

 

(l)  Infants shall only have access to toys with strings or cords up to 6 inches in length.

 

(m)  Toddlers shall only have access to toys with strings or cords up to 12 inches in length, or any length for an adult-directed activity.

 

(n)  Except for therapeutic equipment or small trampolines intended for individual use with direct adult supervision, the use of trampolines by child care children, whether indoors or outdoors, is prohibited.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.27); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.22)

 

He-C 4002.26  Rest and Sleep.

 

(a)  Child care staff shall arrange cribs, cots, beds, mats, or playpens in a manner that ensures that:

 

(1)  They do not block passageways and exit routes, to allow for emergency evacuation and access to each child by staff;

 

(2)  They are spaced at least 2 feet apart while in use or separated by a solid divider on one side only, allowing for adequate supervision by staff and air circulation; and

 

(3)  Children are placed head to toe.

 

(b)  Full day child care programs shall provide a sleeping bag, crib, cot, bed, or mat for each child requiring a rest. 

 

(c)  Each child 12 months of age and younger shall be placed on their back to sleep in an individual crib or play pen.

 

(d)  Child care staff shall discontinue using cribs or play pens with infants who have demonstrated the ability to climb out of them.

 

(e)  No crib shall be used unless manufactured on or after June 28, 2011, or if manufactured prior to that date, has a Children’s Product Certificate (CPC), or test report from a consumer product safety commission (CPSC) accepted third-party lab, provided by the manufacturer documenting the crib’s compliance with  16 CFR 1219 as required by 16 CFR 1219 and 1220.

 

(f)  Cribs and play pens required under (c) above shall:

 

(1)  Not be stacked;

 

(2) Be free of cracked or peeling paint, splinters, and rough edges;

 

(3) Have no more than 2⅜ inches between slats; 

 

(4)  Have no missing, loose, broken, or improperly installed parts, screws, brackets, baseboards, or other loose hardware, or damaged parts on the crib or mattress supports;

 

(5)  Not have corner posts that extend more than 1/16 of an inch above the end panels;

 

(6)  Not have holes or tears in the mesh walls or in the material that connects the walls to the bottom of the crib or play pen;

 

(7)  Have fitted sheets designed for the size mattress, including elastic corners so that there is no excess fabric with visible folds or bunching, and that do not compress the mattress;

 

(8) Not have bumper pads, blankets, flat sheets, pillows, quilts, comforters, sleep positioners, or any soft items or toys with infants up to 12 months of age; and

 

(9)  Have mattresses which are in good repair, free of rips or tears, and fit the crib or playpen so that the space between the mattress and crib or playpen is not more than 2 adult fingers wide and does not create a suffocation hazard. 

 

(g)  Pursuant to He-C 4002.33(b)(3), all child care staff in programs licensed for children 12 months and younger shall complete training on safe sleep practices prior to working with infants.

 

(h)  Infants up to 12 months shall not nap or sleep in a car safety seat, beanbag chair, bouncy seat, infant seat, swing, jumping chair, highchair, chair, futon, moses basket, or any other type of furniture or equipment that is not a play pen or crib that meets the requirements of (f) above.

 

(i)  If an infant up to 12 months falls asleep outside of their crib or play pen, including entering the program asleep in a car safety seat, staff shall immediately move the infant and place him or her on their back in a crib or play pen.

 

(j)  When child care staff place infants in their crib or play pen for sleep, they shall check to ensure that the temperature in the room is comfortable for a lightly clothed adult, check the infants to ensure that they are comfortably clothed and not overheated or sweaty, and that bibs and garments with ties or hoods are removed.

 

(k)  Children older than 3 months shall not be swaddled or placed in restrictive or weighted sleep suits or devices unless there are written medical orders from the child’s primary health practitioner.

 

(l)  In family and family group child care homes, use of an electronic monitor shall only be used to monitor sleeping children on the same level in lieu of direct supervision, in accordance with the following:

 

(1)  There is written authorization on file from the parents of the child, indicating that they are aware of and agree to the use of the monitor;

 

(2)  The child care staff responsible for their supervision can easily hear sounds from the monitor and respond; and

 

(3)  Every 15 minutes, the child care staff responsible for their supervision conduct in-person checks of infants and toddlers sleeping in a crib or playpen, to ensure that each child is safe and comfortable, including a check of their faces, viewing the color of their skin and to check on their breathing.

 

(m)  In center-based programs, use of an electronic monitor, whether only audio or both audio and visual, shall be permissible in lieu of having staff in the same room with infants and toddlers sleeping in cribs or playpens, in accordance with the following:

 

(1)  There is written authorization on file from the parents of the child, indicating that they are aware of and agree to the use of the monitor;

 

(2)  The child care staff responsible for their supervision are located in an adjoining room where they can easily hear sounds from the monitor and respond; and

 

(3)  Every 15 minutes, the child care staff responsible for their supervision conduct in-person checks of infants and toddlers sleeping in a crib or playpen, to ensure that each child is safe and comfortable, including a check of their faces, viewing the color of their skin and to check on their breathing.

 

(n)  Blankets, sleeping bags, bedding, cots, and mats shall be stored in a manner that ensures that sleeping surfaces are not touching, or the items shall be washed and sanitized before re-use if stored in a way that sleeping surfaces are touching.

 

(o)  All bedding shall be cleaned at least once a week and more frequently if soiled.

 

(p)  Programs shall provide children who attend for more than 5 hours with an opportunity for at least one hour of rest, relaxation, or sleep depending on the needs of each child.

 

(q)  Programs shall consult with the parents of each child and observe children on an ongoing basis to determine each child’s resting or napping needs.

 

(r)  Programs shall accommodate the individual sleeping patterns of infants and other children who are unable to adjust to a scheduled nap or rest time.

 

(s)  Programs shall allow children who are able to adjust to a scheduled nap or rest time to fall asleep and awaken at their own pace within a block of time set aside as nap or rest time.

 

(t)  Programs shall provide children who do not fall asleep after 30 minutes with an opportunity to do a quiet activity.

 

(u)  Child care staff shall not:

 

(1)  Require that children who are awake stay on mats, sleeping bags, cots, or beds for more than 60 minutes; or

 

(2)  Require children to sleep.

 

(v)  For children 24 months through 5 years, during naptime, a center-based program may have one less staff person in a classroom than required to meet ratios in accordance with He-C 4002.36 through He-C 4002.38 provided that:

 

(1)  The total number of child care staff required to maintain all ratios are on the premises of the program;

 

(2)  The ratio of awake children to staff in the classroom shall be no more than half the number of children as stated in He-C 4002.36 through He-C 4002.38;

 

(3)  Rooms in which staff is reduced shall be equipped with a two-way communication system to allow for immediate contact with other staff for assistance and response; and

 

(4)  There is a safety plan on file for review by the department, child care staff, and parents which includes plans or procedures for:

 

a.  Evacuation;

 

b.  Supervision;

 

c.  Environment;

 

d.  Schedule;

 

e.  Naptime policy; and

 

f.  Staff training and support;

 

(5)  The program provides parents with written notice of the reduction of staff; and 

 

(6)  Documentation of the written notice in (5) above, in the form of a posted document, a policy statement that is signed by each parent, or other method of documentation is kept in the child’s record for review by department staff during visits.

 

(w)  During rest and sleep, programs shall always maintain ratios for children under 24 months, in accordance with He-C 4002.36 and 4002.37, except as specified in (x) below.

 

(x)  Ratios for children under 24 months in mixed age groups with children 24 months and older shall be based on the average age of the children in each group during naptime, in accordance with (w) above.

 

(y)  Programs shall base the staff to child ratio on the average age of the children in each group in accordance with (x) above when there are mixed age groups in the same room.

 

(z)  No child shall wear a necklace during nap time or during sleep, unless the necklace is fused or has a fixed knot such that it cannot be removed.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.28); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22(formerly He-C 4002.22)

 

He-C 4002.27  Water Testing and Sewage Disposal.

 

(a)  Programs shall have a safe supply of water under pressure available for drinking and household use in accordance with the following:

 

(1)  Hot water under pressure, which measures at least 60 degrees Fahrenheit shall be available at all sinks during operating hours;

 

(2)  Hot water at taps which are accessible to children shall have an automatic control to maintain a temperature at the tap of not higher than 120 degrees Fahrenheit; 

 

(3)  In accordance with Env-Dw 501.04(c), a program that is considered to be a public water system as defined in RSA 485:1-a, XV, subject to regulation by the department of environmental services, shall have on file, available for review by the health officer and the department, a written document which lists the United States Environmental Protection Agency identification number of the system, assigned by the department of environmental services;

 

(4)  Programs that have their own independent water supply and are not considered to be public water systems as defined in RSA 485:1-a, XV and confirmed by DES, shall test their water supply in accordance with the following:

 

a.  Water testing shall be performed by a laboratory accredited under the environmental laboratory accreditation program in accordance with Env-C 300;

 

b.  For new applicants, not more than 90 days prior to the date the application is submitted to the department, water testing shall be conducted for arsenic,  bacteria,  nitrate, nitrite, lead, both stagnant and flushed, copper, both stagnant and flushed, and fluoride, and  results provided to the department with the application; and

 

c.  Ongoing water testing shall be conducted as follows and results maintained on file at the program, available for review by the health officer and the department:

 

1.  Once every 3 months for bacteria;

 

2.  Annually for arsenic, nitrate, and nitrite; and

 

3.  At least once every 3 years for stagnant lead, stagnant copper, and fluoride;

 

(5)  The results of water tests required by (a)(4)b. and c. above, and results of any other water tests shall be in compliance with the maximum contaminant levels established in Env-Dw 700 for bacteria, nitrates, nitrites, arsenic, and fluoride, and shall not exceed the action levels established in Env-Dw 714 for lead and copper;

 

(6)  Any program whose water test result has exceeded maximum contaminant levels or action levels shall:

 

a.  Immediately contact the department to report that finding, and provide the department with a plan for how it will ensure that children will not be at risk from exposure to the unsafe water; and

 

b.  Within 30 days of the date the program learns that they have failed a water test submit to the department an acceptable corrective action plan which details what action will be taken to correct the unsafe condition of the water and a date by which that action will be complete, unless the program requests, either verbally or in writing, and the department agrees, to extend that deadline, based on the following criteria:

 

1.  The program demonstrates that it has made a good faith effort to develop and submit the corrective action plan within the 30 day period but has been unable to do so; and

 

2.  The department determines that the health, safety, or well-being of children will not be jeopardized as a result of granting the extension; and

 

(7)  When a program fails to submit a written proposed corrective action plan within 30 days of receiving the unacceptable test result under (a)(6)b. above, the department shall initiate action to suspend the license or permit in accordance with He-C 4002.44(q) and (r), until such time as laboratory results meeting those requirements are received by the department.

 

(b)  During all hours of operation there shall be functional sewage disposal facilities designed to accommodate the license capacity of the program, in accordance with the following:

 

(1)  There shall be no visible sewage on the grounds; 

 

(2)  There shall be flush toilets in working order connected to a sewage disposal system; and

 

(3)  Any program whose septic system is showing signs of failure shall:

 

a.  Immediately make arrangements with a contractor licensed to evaluate and repair or replace septic systems to:

 

1.  Make temporary repairs to the septic system to correct the problem so that the program may continue to operate; or

 

2.  Make permanent repairs to the septic system or replace the septic system;

 

b.  Immediately contact the local health officer to inform him or her of the problem;

 

c.  Immediately contact the department to verbally report the problem, and give the department a plan for how it will immediately provide that:

 

1.  All required bathroom units function properly; and

 

2.  Children will not be exposed to any risks from the failed septic system;

 

d.  Within 10 days of the date that child care staff first notice signs indicating that the septic system is in failure, submit to the department a written plan, which includes:

 

1.  What action has been taken to correct the failed septic system;

 

2.  The date by which that action will be completed;

 

3.  An explanation of how the program will ensure that the requirements in c.1. and c.2. above will continue to be met until repair or replacements are completed; and

 

e.  Request an extension to d. above, which the department shall grant if additional time is necessary to develop a written plan and the safety and well-being of the children is maintained.

 

(c)  Privies are permissible in lieu of, or in addition to, (b)(2) above under the following conditions:

 

(1)  The licensee shall obtain approval by the town health officer for use of a privy;

 

(2)  The privy shall be constructed in accordance with Env-Wq 1022.01;

 

(3)  There shall be running water for handwashing available and accessible inside the privy area or immediately upon exiting the privy;

 

(4)   Privies shall be located:

 

a.  At least 100 feet from any place where food is prepared or served;

 

b.  At least 75 feet from any surface water; and

 

c.  At least 200 feet up-gradient of any well or spring;

 

(5)  Privy contents shall be:

 

a.  Removed as often as necessary to prevent the pit from being filled to within one foot of the top of the pit; and

 

b.  Disposed of in accordance with Env-Wq 1600;

 

(6)  The contents of the pit shall be covered daily with lime or other suitable agent to eliminate insects and odors;

 

(7)  The materials for liming and disinfection shall be kept:

 

a.  In proximity to the privy where they are readily available for use; and

 

b.  Stored in a manner where children cannot access the contents;

 

(8)  The privy and the pit shall be made fly-tight and provided with self-closing lids; and

 

(9)  Child care staff shall maintain the privy in clean and sanitary conditions at all times.

 

(d)  The licensee shall maintain chemical toilets in accordance with Env-Wq 1600, which shall be pumped by a septage hauler licensed by the department of environmental services.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.29); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.28  Bathroom Requirements. 

 

(a)  Bathrooms shall have a means of outside ventilation.

 

(b)  Prior to use, the local health officer or designee and the department shall approve portable sinks intended for use to meet any of the requirements of He-C 4002.

 

(c)  Toilet facilities shall afford adequate privacy appropriate to the ages of children enrolled in the program while allowing for age appropriate supervision of each child.

 

(d)  Programs licensed to care for children younger than 3 years of age shall:

 

(1)  Provide potty chairs or adult toilets with adapters at a ratio of one unit for every 10 children ages 18 months through 35 months, in addition to the requirements for toilets in He-C 4002.22(d);

 

(2)  Place potty chairs within easy access to a toilet and sink to allow child care staff to proceed to the toilet to empty the potty chair and proceed to the hand washing sink without having to open doors or gates, or have physical contact with other children;

 

(3)  Not place potty chairs in food preparation areas or food service areas; and 

 

(4)  Empty and sanitize each potty receptacle after each use.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.30); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22

 

He-C 4002.29  Diapering and Toilet Learning. 

 

(a)  Programs serving diapered children and children who are not toilet trained shall have a designated diaper changing area, which shall:

 

(1)  Be located adjacent to or in close proximity to a designated hand washing sink to allow access for hand washing without having to open doors or gates or have physical contact with other children;

 

(2)  Have a non-porous, washable surface, which shall be used exclusively for diaper changing and sanitized after each diaper change;

 

(3)  Contain a covered, hand-free receptacle, lined with a plastic bag, and located within reach of the diaper changing area for disposal of soiled disposable diapers and cleansing articles; and

 

(4)  Not be located in kitchens or in food preparation or food service areas, or on surfaces where food is prepared or served.

 

(b)  In addition to the requirements in (a) above, in center-based programs the diaper changing area shall be:

 

(1)  Located in the room where the children in diapers are cared for; and

 

(2)  Equipped with a sink adjacent to or in close proximity to the diaper changing area designated exclusively for adult and child hand washing before or after diaper changing or toileting.

 

(c)  Programs shall not use a sink for hand washing after diapering or toileting if food preparation or washing dishes or eating utensils occurs in the sink.

 

(d)  At least every 2 hours, child care staff shall check children in diapers and change diapers and clothing if they are soiled or wet.

 

(e)  During each diaper change, soiled areas of children shall be washed with disposable, single use cleansing articles such as baby wipes or soft paper towels that have been moistened with water.

 

(f)  If an elevated diaper changing surface is used child care staff shall remain at the elevated diaper changing surface and keep one hand on the child at all times while a child is on it.

 

(g)  For each child there shall be a supply of clean diapers, clothing, and bedding for use as needed.

 

(h)  When non-disposable diapers are used:

 

(1)  The diaper shall have an absorbent inner lining completely contained within an outer covering made of waterproof material that prevents the escape of feces and urine;

 

(2)  The diaper shall contain a waterproof cover that is adherent to the cloth material; or

 

(3)  The outer covering and inner lining shall be changed at the same time as a unit when a diaper with a separate lining is used.

 

(i)  Soiled disposable diapers and cleansing articles shall immediately be placed in a plastic bag lined, hands-free receptacle.

 

(j)  The plastic bag containing the soiled diapers and cleansing articles shall be removed daily, securely closed, and placed outside in covered garbage cans for collection or removal at regular intervals. 

 

(k)  Covered hands-free receptacles used to dispose of diapers and cleansing articles shall be cleaned and sanitized at least once each day.

 

(l)  Soiled non-disposable diapers shall:

 

(1)  Be immediately placed in an individual sealed plastic bag which shall be inaccessible to children and not in contact with other’s belongings; and

 

(2)  Be returned to the parent at the end of each day.

 

(m)  Programs using a commercial diaper service shall handle soiled diapers in accordance with written instructions from the service.

 

(n)  A copy of the written instructions required in (m) above shall be available for review by the department upon request.

 

(o)  Toilet learning shall be individualized, developmentally appropriate, conducted in accordance with a plan developed by each child’s parents and child care staff, and never forced.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.31); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22(formerly He-C 4002.28)

 

He-C 4002.30  Handwashing.

 

(a)  Child care staff shall wash their hands with liquid soap and running water as needed and:

 

(1)  After each diaper change or toileting;

 

(2)  After handling any bodily fluid;

 

(3)  After cleaning up or handling the garbage;

 

(4)  After playing outdoors;

 

(5)  Before and after eating;

 

(6)  Before and after administering medication; and

 

(7)  Before and during any food preparation or service as often as necessary to remove soil and contamination and prevent cross contamination when changing tasks or from raw to ready to eat foods.

 

(b)  Child care staff shall:

 

(1)  Teach children the importance of hand washing with liquid soap and running water; and

 

(2)  Instruct, encourage, remind, or assist infants and children as needed throughout each day to wash their hands as necessary to comply with (a)(1) through (5) above. 

 

(c)  Sinks that are used for food preparation or clean up, including sinks used for getting water for baby bottles, rinsing bottles, or dishes, and washing toys, shall not be used for hand washing after toileting or diaper changing.

 

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-97; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.26)

 

He-C 4002.31  Nutrition, Food Service and Food Safety.

 

(a)  Programs shall provide developmentally appropriate individual eating utensils, cups, and bottles, as applicable, for each meal and snack, which children shall not share.

 

(b) Eating and drinking utensils shall be free from defects, cracks, and chips.

 

(c)  Child care staff shall clean all dishes and cooking utensils in a dishwasher or manually wash them in clean hot water and detergent, rinse them in hot water, and allow manually washed dishes to air dry.

 

(d)  Child care staff shall serve all food items on a plate or napkin, except foods for infants and toddlers, which can be served on a chair tray or table that has been cleaned and sanitized before being used as an eating surface.

 

(e)  Child care staff shall sanitize all tables used for meals and snacks, both before and after serving meals or snacks.

 

(f)  Only food contact surfaces that are easily cleanable, smooth, free of cracks, breaks, open seams, or similar difficult to clean imperfections which are kept clean, shall be used for food preparation.

 

(g)  Children shall have access to drinking water and be encouraged to drink water throughout the day.

 

(h)  Child care programs that provide meals and snacks shall ensure they meet the daily meal patterns listed in the United States Department of Agriculture (USDA) “Child Meal Pattern” (11/26/2016) and USDA “Infant Meal Pattern” (11/29/2016) available as listed in Appendix B and copies of which are available in Appendix C.

 

(i)  Child care staff shall thoroughly wash all fruit and vegetables before cutting or serving those foods to children.

 

(j)  Except for the requirements in (k)(1) below, child care program personnel shall assure that no more than 3 hours elapse between meals and snacks offered to the children.

 

(k)  Child care program personnel shall:

 

(1) Follow individual feeding schedules provided by the parent of each child who has not reached a developmental level which enables them to eat on schedule; and

 

(2)  Comply with dietary restrictions as requested in writing by the parents of each child, due to food allergies, religious, or philosophical beliefs.

 

(l)  Notwithstanding (k) above, the center director, site director, or family child care provider may require the parents of any child to obtain and provide to the program a written note from the child’s licensed health care practitioner authorizing the dietary restrictions requested by a parent.

 

(m)  Child care staff shall not serve foods that can cause a choking hazard to children younger than 3 years of age or to children who have been identified as having chewing and swallowing difficulties, including, but not limited to:

 

(1)  Spoonsful of peanut butter;

 

(2)  Whole or rounds of hot dogs or sausage;

 

(3)  Whole grapes;

 

(4)  Hard candy and chewing gum;

 

(5)  Raw carrot rounds, peas, or celery;

 

(6)  Chips or hard pretzels;

 

(7)  Marshmallows;

 

(8)  Nuts or seeds;

 

(9)  Popcorn; or

 

(10)  Other hard or cylinder shaped foods that may pose a choking hazard.

 

(n)  Child care staff shall not serve low fat or non-fat milk, or other non-dairy milk products such as soymilk, oat milk, and almond milk, to children younger than 2 years of age unless authorized to do so in writing by the child’s parent and the child’s licensed health care practitioner.

 

(o)  Programs that provide formula or cereal shall provide iron fortified formula or cereal unless restricted in writing by a child’s parent and the child’s licensed health care practitioner.

 

(p)  Programs that provide meals and snacks for children shall:

 

(1)  Ensure that snacks and meals are prepared and served in a safe and sanitary manner, including washing fruits and vegetables before serving them;

 

(2)  Not serve food to children beyond the recommended dates of use, or beyond 3 days of storage in the refrigerator for perishable leftover food;

 

(3)  Store all food in the original containers or in a clean, covered container labeled with the date open and expiration date;

 

(4)  Store all unopened food at least 6 inches above the floor, separate from non-food items;

 

(5)  Store food items separate from non-food items that could contaminate food or be mistaken for food;

 

(6)  In addition to (c) above, properly wash and sanitize all infant bottles between each use;

 

(7)  Prepare and make available to parents on request written menus, including snacks, for each week; and

 

(8)  Keep previous menus on file for one year.

 

(q)  Child care program personnel shall store perishable food in accordance with the following:

 

(1)  Refrigeration and storage for food shall be at not less than 32°F, nor more than 40°F for all food requiring refrigeration;

 

(2)  There shall be a non-mercury, food service approved thermometers verifying temperatures maintained in all refrigerators; and

 

(3)  Refrigerators and freezers used to store foods intended for serving to children shall be maintained in clean condition.

 

(r)  Child care program personnel shall not serve to children any canned goods that are dented, bulging or rusted.

 

(s)  Programs shall have a method of providing nutritious meals and snacks to children whose parents fail to send meals or snacks from home.

 

(t)  During meals and snacks, child care personnel shall:

 

(1)  Encourage children to serve themselves, when appropriate;

 

(2)  Help children with disabilities to participate in meal and snack times with their peers; and

 

(3)  Encourage children to eat a well-balanced diet.

 

(u)  Children shall be encouraged to try all foods, but shall not be required to try or to eat any food before they are served other food components or additional servings, or before they are allowed to be done with their meal or snack.

 

(v)  In programs serving infants and toddlers, child care personnel shall:

 

(1)  Follow individual feeding schedules provided by the parent of each child who has not reached a developmental level, which enables them to eat on schedule;

 

(2)  Not introduce new or solid foods to any child without the consent of their parent(s), and as appropriate based upon their chewing and swallowing capability;

 

(3)  Hold infants younger than 6 months of age or who are unable to sit in feeding chairs while being fed;

 

(4)  Not hold more than one infant at a time to bottle-feed them;

 

(5)  Not prop bottles; and

 

(6)  Not feed infants or children while in a crib, or while on rest mats, beds, cots, or sleeping bags;

 

(w)  Child care personnel shall dispose of, or return to the parent, milk, formula, or food unfinished by a child, as directed by the parent.

 

(x)  Breast milk and prepared formula shall be stored in covered containers, labeled with the child’s name and, dated.

 

(y)  Breast milk shall be:

 

(1)  Used immediately or stored in the refrigerator no longer than 72 hours;

 

(2)  Labeled as used and returned to the refrigerator after each feeding if there is any left-over in the bottle, if being returned to the parent; and

 

(3)  Not fed to the child if left unrefrigerated for more than one hour.

 

(z)  Prepared formula shall be:

 

(1)  Used immediately or stored in the refrigerator no longer than 24 hours;

 

(2)  Discarded if not fed to an infant and left unrefrigerated for more than one hour; and

 

(3)  Discarded after each feeding, if there is any leftover in the bottle.

 

(aa)  Frozen breast milk shall be labeled and dated and stored in a freezer at 0 degrees Fahrenheit for no longer than 6 months.

 

(ab)  Thawed breast milk shall be used within 24 hours.

 

(ac)  To thaw breast milk, child care program personnel shall:

 

(1)  Place in refrigerator overnight; or

 

(2)  Defrost in a container of running cool tap water.

 

(ad)  To warm formula or breast milk, child care program personnel shall:

 

(1)  Hold under warm running water; or

 

(2)  Place in a bowl of warm water, a slow-cooking device, or a bottle warmer; and

 

(3)  Gently swirl bottle to recombine contents.

 

(ae)  If a slow-cooking device, such as a crock pot, is used for warming infant formula, breast milk, or infant food:

 

(1)  It shall be out of children’s reach;

 

(2)  The water temperature shall not exceed 120°F; and

 

(3)  It shall be emptied, cleaned, sanitized, and refilled with fresh water daily.

 

(af)  If a bottle warmer is used for warming infant formula, breast milk, or infant food, it shall be out of children’s reach and used according to manufacturer’s instructions.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.22)

 

He-C 4002.32  Field Trips, Water Activities and Transportation. 

 

(a)  Programs that opt to allow child care staff to take children on routine or unplanned local trips, such as walks in the neighborhood, trips to the local library, or other routine errands, shall obtain a signed and dated general permission slip from each child’s parent, which specifies all approved destinations and activities.

 

(b)  Child care staff who take the children off the premises for trips under (a) above shall call parents or post a notice at the program, informing parents of the destination and route of any unplanned trips, and the estimated time of return to the program.

 

(c)  The center director, site director, or family child care provider shall obtain a signed and dated authorization form from each child’s parents prior to allowing a child to participate in any water activities on or off the premises of the program, or any field trip off the premises of the program.

 

(d)  The parental authorization form required in (c) above shall be retained by the program and available for review by the department for a minimum of 6 months after the date of the last water activity or field trip covered by the permission slip, and include:

 

(1)  For water activities, the date(s) and destination(s) covered by the permission slip, whether the child can swim, and the child’s fear, or lack of fear about swimming, or being in, or near the water; and

 

(2) For all other field trips, the date(s), destination(s), and activities covered by the permission slip.

 

(e)  Whenever the program provides transportation, it shall ensure that:

 

(1)  Any vehicle used for transportation of children is registered and inspected in accordance with the laws of the state of New Hampshire;

 

(2)  The vehicle is maintained in a safe operating condition, and is clean and free of obstructions on the floors and seats, and any sharp, heavy, or potentially dangerous objects are placed in the trunk or cargo area and securely restrained;

 

(3)  The operator of any vehicle transporting children is at least 18 years old and holds a valid driver’s license;

 

(4)  The driver and any other attendants on the vehicle have received training in the safe transportation of children;

 

(5)  The driver of the vehicle is alert and not distracted by telephone, radio, or other communications; and

 

(6)  The driver of the vehicle takes attendance before and after each trip and conducts a complete vehicle inspection after every trip to ensure that no child is left alone in a vehicle at any time.

 

(f)  Child care staff shall not permit any child to remain in any vehicle unattended by staff of the child care program.

 

(g)  Any vehicle used to transport children, whether owned by the program, a child care staff member or by a parent who is transporting children other than his or her own, shall have proof of current liability insurance.

 

(h)  Child care staff shall ensure:

 

(1)  The number of children riding in any vehicle does not exceed the number of persons the vehicle is designed to carry;

 

(2)  Individual, age appropriate child restraints or seat belts are provided for and used by each child in accordance with RSA 265:107-a, and the driver and any other adults shall use their seatbelts when transporting children; and

 

(3)  All children remain seated when the vehicle is in operation.

 

(i)  Child care staff shall carry on all field trips:

 

(1)  A copy of each child’s registration and emergency information forms;

 

(2)  A first aid kit in the vehicle whenever children are present;

 

(3)  A copy of the parental permission slip for the field trip;

 

(4)  An attendance sheet documentation that staff accounted for each child every time they entered or exited the vehicle;

 

(5)  All emergency and currently prescribed child medications, as applicable; and

 

(6)  In each vehicle, a form that includes the program name, address, and phone number.

 

(j)  There shall be a working cell phone or other mechanism for making emergency telephone calls available in each vehicle during transport.

 

(k)  All swimming pools and wading pools on the premises of the child care program and used as part of the child care operations shall be supervised in accordance with the following:

 

(1)  Child care staff shall supervise children at all times when they have access to wading pools that have water in them;

 

(2) Child care staff shall not allow children inside the wading pool, swimming pool area, or in the swimming pool without adult supervision; and

 

(3) There shall be at least one staff person who is currently certified in CPR and who has completed a water safety training within the previous 3 years present with the children at all times during any water activity, and whenever children have access to swimming pools or other bodies of water.

 

(l)  When children are engaged in water activities, an adult who is able to swim shall be present with children at all times.

 

(m)  Child care staff who are responsible for children engaged in water activities shall be able and willing to immediately respond to any child in the water who needs assistance.

 

(n)  Lifeguards, swimming instructors, and similar individuals not employed by the program shall not be considered as staff to meet required staff to child ratios and supervision unless the lifeguard, swimming instructor, or other individual is responsible only for the children participating in the field trip.

 

(o)  In center-based programs, the center director or site director shall require that:

 

(1)  For routine daily transportation and other routine or unplanned trips such as walks in the neighborhood and trips to the local library, child care staff shall comply with the staff to child ratios and minimum staffing requirements specified in:

 

a.  He-C 4002.37 for infant and toddler programs;

 

b.  He-C 4002.39 for school-age programs; and

 

c.  He-C 4002.36 for all other center-based programs; and

 

(2)  For all other field trips and for all water activities:

 

a.  For each group of children specified in (p) and (q) below, at least one staff person shall meet the qualifications for the position of group leader for school-age programs and associate teacher for all other center-based programs as specified in He-C 4002.35 or be an assistant teacher or volunteer and at least 21 years of age;

 

b.  Notwithstanding a. above and with the exception of child care staff, other adults present to meet staff to child ratios shall be at least 18 years of age; and

 

c.  Center-based child care staff shall comply with the staff qualification requirements specified in He-C 4002.35.

 

(p)  Center-based programs shall staff water activities in accordance with the following:

 

(1)  For children ages 24 to 35 months the maximum group size shall be 8 children, with a ratio of one staff to 2 children;

 

(2)  For children ages 36 to 47 months the maximum group size shall be 12 children, with a ratio of one staff to 4 children;

 

(3)  For children ages 48 to 59 months the maximum group size shall be 18 children, with a ratio of one staff to 6 children; and

 

(4)  For children ages 56 months and older, if licensed as a school age program, the maximum group size shall be 24 children, with a ratio of one staff to 8 children.

 

(q)  Center-based programs shall staff field trips in accordance with the following:

 

(1)  For children 18 months and younger the maximum group size shall be 6 children, and the ratio shall be one staff to 3 children;

 

(2)  For children ages 19 to 35 months the maximum group size shall be 12 children, with a ratio of one staff to 4 children;

 

(3)  For children ages 36 to 47 months the maximum group size shall be 18 children, with a ratio of one staff to 6 children;

 

(4)  For children ages 48 to 59 months the maximum group size shall be 20 children, with a ratio of one staff to 8 children; and

 

(5)  For children ages 56 months and older, if licensed as a school age program, the maximum group size shall be 24 children, with a ratio of one staff to 10 children.

 

(r)  In a center-based program, the staff to child ratio and maximum group size for a mixed age group of children participating in any field trip or water activity shall be based on the age of the youngest child in the group.

 

(s)  Programs may exceed the maximum group size specified in (p) above for water activities and (q) above for all other field trips only:

 

(1)  During transportation to the field trip or water activity;

 

(2)  At snack or meal times during the field trip or water activity; and

 

(3)  During water activities where certified lifeguards or water safety instructors are present and exclusively supervising the water activities of the children in care of the program.

 

(t)  In a family or family group child care home, for all field trips and for water activities in swimming pools located on the licensed premises or off-site, such as the private residence of a friend or neighbor, child care staff shall comply with the staffing requirements specified in He-C 4002.34.

 

(u)  In a family or family group child care home, for all water activities on or off the premises of the program, other than water activities specified in (t) above, child care staff shall comply with the staffing requirements specified in He-C 4002.34, and the minimum staff to child ratios and staffing levels as follows:

 

(1)  There shall be one staff member for every 2 children, 35 months and younger, and the staff for this age group shall be responsible only for the children in this age group; and

 

(2)  For children age 36 months and older:

 

a.  There shall be one staff member for up to 6 children;

 

b.  There shall be 2 staff members for 7 to 12 children; and

 

c.  There shall be 3 staff members for 13 to 17 children.

 

(v)  Programs shall comply with the following:

 

(1)  Child care staff meeting the requirements of at least a group leader in a school-age program, associate teacher in all other center-based programs as specified in He-C 4002.35, or family child care worker in family based programs as specified in He-C 4002.34 shall be designated as in charge and present during any water activity or field trip;

 

(2)  All child care staff participating in any water activity or field trip shall be aware of the identity of the person designated in charge;

 

(3)  At least one staff person who has successfully completed a basic water safety course within 3 years prior to the water activity shall be present during any water activity for every 12 children; and

 

(4)  Each child care staff and other adult participating in any field trip or water activity shall:

 

a.  Be assigned primary responsibility for a specific group of children;

 

b.  Be provided with and bring with them during the field trip or water activity a written list of the names of the children for whom they have been assigned primary responsibility;

 

c.  Conduct head counts of children they are responsible for as often as is necessary to ensure that all children are present and accounted for at all times; and

 

d.  Be trained or instructed in supervision requirements and all requirements specified in this section.

 

(w)  Except during swimming activities conducted by a qualified swim instructor, a person certified in water safety and rescue, or a lifeguard, child care in all programs shall prohibit each child who cannot swim from going into water that reaches higher than his or her navel.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.29)

 

He-C 4002.33  Professional Development. 

 

(a)  All center directors, agency administrators, site coordinators, or site directors, and all other child care staff who are responsible for the supervision of children, or who are necessary for the staff to child ratios, shall keep on file documentation of completion of a minimum of 6 hours of professional development, which shall be completed in accordance with the following:

 

(1)  Within 90 days of the first date of employment;

 

(2)  Within 2 weeks for programs operating 3 months of the year or less; or

 

(3)  By providing documentation of previous completion.

 

(b)  The 6 hours of professional development required in (a) above shall include:

 

(1)  Child care licensing orientation;

 

(2)  Prevention and control of infectious diseases, including immunizations;

 

(3)  Prevention of SIDS and use of safe sleep practices;

 

(4)  Medication administration;

 

(5)  Prevention of and response to emergencies due to food and other allergic reactions;

 

(6)  Building and safety of physical premises, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic;

 

(7)  Prevention of shaken baby syndrome and abusive head trauma;

 

(8)  Emergency preparedness and response planning;

 

(9) Handling and storage of hazardous materials and the appropriate disposal of bio-contaminants;

 

(10)  Appropriate precautions in transporting children for child care personnel who will provide transportation or accompany children during transportation;

 

(11)  First aid and CPR;

 

(12)  Prevention, recognition, and reporting of child abuse and neglect;

 

(13)  Child development, including cognitive, physical, social, and emotional development; and

 

(14)  Training on all required components in the emergency operations plan as specified in He-C 4002.16(g)(3) and (h).

 

(c)  Prior to working with infants 12 months and younger, child care staff shall take training on prevention of SIDS and use of safe sleep practices.

 

(d)  Child care staff who have not completed the training in (1) through (4) below shall work under the direct supervision and observation of a staff member who has completed the following trainings:

 

(1)  Prevention and control of infectious diseases, including immunizations;

 

(2)  Prevention of shaken baby syndrome and abusive head trauma;

 

(3)  Handling and storage of hazardous materials and the appropriate disposal of bio-contaminants; and

 

(4)  First aid and CPR.

 

(e)  Child care staff employed in programs which are not licensed to care for children younger than 18 months of age shall be exempt from the requirements of (b)(3) and (b)(7).

 

(f)  The center director, agency administrator, site coordinator, site director, and all child care staff shall complete 18 hours of professional development within their first 12 months of hire, and annually thereafter, in accordance with the following:

 

(1)   A minimum of 3 hours shall be in health and safety topics listed in (b)(2)-(13) above; and

 

(2)  The remaining 15 hours shall be in any other areas listed in (k) below.

 

(g)   The only exceptions to (f) above shall be:

 

(1) Assistant teachers, associate teachers, group leaders, assistant group leaders, family child care workers, and family child care assistants who work fewer than 25 hours per week year round, or more than 25 hours per week during school vacations, or both, for the same licensee shall:

 

a.  Obtain 12 hours of professional development  within their first 12 months of hire, and annually thereafter; and

 

b.  Of the 12 hours, a minimum of three hours shall be in any of the health and safety areas listed in (b)(2)-(13) above, and the remaining hours shall be in any areas in (j) below;

 

(2)  Child care staff attending high school or college full time shall obtain 3 hours of professional development in health and safety areas listed in (b)(2)-(13) above annually; 

 

(3)  Full time college attendance in (2) above shall mean enrolled in a minimum of 12 credit hours per semester; and

 

(4)  Substitutes, as defined in He-C 4002.01(bi).

 

(h)  Professional development shall include trainings, workshops, technical assistance, self-study, or college courses.

 

(i)  Self-study projects shall:

 

(1)  Not exceed 6 of the required 18 hours of professional development; and

 

(2)  Not be utilized to obtain the professional development in health and safety requirements in (b)(2)-(13) above.

 

(j)  Self-study projects referenced in (i) above shall:

 

(1)  Be based on current research in child development or early childhood;

 

(2)  Demonstrate developmentally appropriate practice;

 

(3)  Support the knowledge and skills needed to care for young children; and

 

(4)  Be documented and include an evaluation component.

 

(k)  In addition to (b) above, professional development, as specified in (h) through (j) above, shall be in any of the following areas:

 

(1)  Health and safety;

 

(2)  Caring for children with exceptionalities;

 

(3)  Nutrition;

 

(4)  Any child care related courses sponsored or funded by the department;

 

(5)  Indoor and outdoor learning environments;

 

(6)  Behavior guidance;

 

(7)  Leadership, child care administration, or mentoring;

 

(8)  Financial management;

 

(9)  Working with families; or

 

(10)  Legal issues in child care.

 

(l)  The department shall accept the following toward meeting in-service professional development requirements:

 

(1)  Credit courses offered by a regionally accredited college or university with one credit equal to 12 hours;

 

(2)  Non-credit courses offered for continuing education units by a regionally accredited college or university;

 

(3)  Conference sessions or workshops presented by an individual who meets one of the following criteria:

 

a. Is credentialed by the department’s child development bureau, NH early childhood professional development system in accordance with RSA 170-E:50;

 

b. Has at least a bachelor’s degree in the subject area which she or he is providing professional development;

 

c.  Meets the minimum qualifications for the position of center director;

 

d.  Holds a professional license or certification through a professional organization relevant to the subject area which he or she is providing professional development; or

 

e.  Is employed or was previously employed in a position such as a trainer, instructor, or consultant by an organization specializing in one of the areas referenced in (k) above in which she or he is providing professional development;

 

(4)  Technical assistance provided by an individual who meets one of the criteria in (3) a. through e. above, provided they have at least 5 years’ experience as a center director if qualifying under c.

 

(5)  Provision of training or technical assistance developed and presented by an employee of the program or an individual hired by the program shall be in accordance with the following:

 

a.  The training is conducted when the trainees are not responsible for children;

 

b.  With the exception of classroom observations, technical assistance is provided when the subject(s) of the technical assistance are not responsible for children; and

 

c.  Information regarding credentials of the individual, their methods, content and objective, dates and times of trainings or technical assistance, and a list of participants is on file at the program and available for review by the department to assist the department in determining that:

 

1.  The individual meets the requirements specified in (3)a. through e. or (4) above; and

 

2.  The training or technical assistance is designed to increase the knowledge or skills of an individual in order to prepare him or her to more effectively work with children in a program; and

 

(6)  Online training and correspondence courses, provided documentation of completion includes:

 

a.  The title of the training;

 

b.  The completion date;

 

c.  The hours awarded; and

 

d.  A description which indicates the training is designed to increase the knowledge or skills of an individual in order to prepare him or her to more effectively work with children in a program.

 

            (m)  Unless otherwise specified on the training certificate or course description for more or fewer hours, training hours for recertification in first aid shall count as 2 hours and training for recertification in CPR shall count as 3 hours towards annual professional development requirements.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.33); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.30)

 

He-C 4002.34  Family and Family Group Child Care Programs.

 

(a)  Family and family group child care homes shall comply with He-C 4002.01 through He-C 4002.33 and this section.

 

(b)  Family child care shall:

 

(1)  Only be provided in a dwelling that provides complete independent living facilities for one or more persons including permanent provisions for living, sleeping, eating, cooking, and sanitation; and

 

(2)  Be occupied for living purposes on a full time basis by the family child care provider; or

 

(3)  Be located:

 

a.  Physically on the same property as the family child care provider’s permanent residence and such residence is a single family home; 

 

b.  In a duplex structure containing 2 independent side-by-side dwelling units and the family child care provider permanently resides in the other dwelling unit located in the duplex; or

 

c.  In a structure with a maximum of 3 stories, with no more than one dwelling unit located on each floor level, and the family child care provider permanently resides in one of the other dwelling units located in the 3 story structure.

 

(c)  A family child care provider may not hold more than one family child care license.

 

(d)  To qualify as a family child care provider, an individual shall be:

 

(1)  At least 21 years of age; or 

 

(2)  At least 18 years of age and submit with his or her application documentation that he or she has a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC), and at least one of the following:

 

a.  Successful completion of a 2 year child care curriculum approved by the department of education; or

 

b.  College courses, totaling 6 credits, in child development, early childhood, or elementary education, or other field of study focused on children, including at least one 3-credit course in child growth and development, from a regionally accredited college.

 

(e)  A family child care worker shall be 18 years of age or older.

 

(f)  A family child care assistant, whether paid or volunteer, shall:

 

(1)  Be 16 years of age or older; and

 

(2)  Work under the direct observation and supervision of the family child care provider or a family child care worker at all times.

 

(g)  A family based program may employ substitute staff who meet the age requirements of the staff position for whom they are substituting and assume the responsibilities of any child care staff on an emergency or temporary basis for not more than 90 consecutive days and not more than a maximum of 120 days in a 12-month period.

 

(h)  Family child care providers and family child care workers shall complete professional development requirements in accordance with He-C 4002.33.

 

(i)  Documentation of professional development requirements shall be maintained at the program and available for review by the department.

 

(j)  A junior helper in any family based program, whether paid or volunteer, shall:

 

(1)  Be at least 14 years of age;

 

(2)  Work with children only under the direct supervision and observation of a staff person who meets at least the minimum qualification of a family child care worker;

 

(3)  Not be calculated in staff to child ratios as specified in (o) through (q) below; and

 

(4)  Not be required to complete professional development hours as specified in He-C 4002.33.

 

(k)  Except in emergencies, a family or family group child care provider, worker, assistant or aide shall not provide family or family group child care services for more than 12 hours in any 24-hour period.

 

(l)  The license capacity for family or family group child care homes shall include the provider’s own, foster, and resident children up to 10 years of age, when they are present.

 

(m)  The department shall allow family and family group child care homes to fill vacant slots for preschool-age children with school-age children who are enrolled in and attending a full day school program, up to their maximum license capacities.

 

(n)  In a family child care home the maximum number of children that one family child care provider or family child care worker can care for shall be 6 preschool children plus 3 school-age children who are enrolled in and attending a full day school program, provided that:

 

(1)  Of the 6 preschool children, no more than 4 children are younger than 36 months of age; and

 

(2)  Of the 6 preschool children, no more than 2 children are younger than 24 months of age.

 

(o)  The maximum number of children that a family child care provider and a family child care worker or assistant can care for shall be 6 preschool children plus 3 school-age children who are enrolled in a full day school program, provided that, of the 6 preschool children, no more than 4 children are younger than 36 months of age.

 

(p)  Family group child care homes in which a family child care provider or family child care worker is working alone shall comply with the limits for a family child care home with one provider as specified in (o) above.

 

(q)  The maximum number of children that a family group child care provider and a family child care worker or assistant may care for shall be 12 preschool children plus 5 school-age children enrolled in a full day school program, provided that, of the 12 preschool children, no more than 4 children are younger than the age of 36 months.

 

(r)  Family based programs may care for a child in the foster care system who is younger than 6 weeks of age provided:

 

(1)  They have received prior approval from their local fire officer and notification to the department; and

 

(2)  In doing so, they will not exceed the limits in (n), (o), and (q) above.

 

(s)  The department shall not grant approval for (r) above if the program has not corrected citations identified on a statement of findings.

 

Source.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.31)

 

He-C 4002.35  Requirements for Child Care Staff in Center-Based Programs.

 

(a)  All center-based programs, other than those operating solely as a school-age program, shall have a center director who meets the following conditions:

 

(1)  The center director or qualified substitute director shall be on the premises for at least 60% of each day’s daytime operating hours; and

 

(2)  Programs operating as a night care program, the center director, qualified substitute director or lead teacher shall be on the premises for at least 60% of the program’s evening and nighttime operating hours.

 

(b)  School-age programs shall have a site director who meets the following conditions:

 

(1)  For school-age programs operating 5 or fewer hours per day, a site director or qualified substitute director shall be on the premises during all operating hours; or

 

(2)  For school-age programs operating more than 5 hours per day a site director or qualified substitute director shall be on the premises for at least 60% of each day’s daytime operating hours.

 

(c)  Center directors, agency administrators, site coordinators and site directors shall:

 

(1)  Be responsible for the daily operation of the program and ensure the program’s compliance with He-C 4002;

 

(2)  Designate a staff person who meets at least the minimum qualifications of group leader in school-age programs and associate teacher in all other center-based programs, in accordance with this section, who will be in charge and assume the responsibilities of the center director or site director as follows:

 

a.  During any unplanned or emergency absence of the center director or site director;

 

b.  In school-age programs operating more than 5 hours per day and all other center-based programs operating during daytime hours, for the remaining 40% of the daytime operating hours that the center director or site director is not required to be present under (a)(1) and (b)(2) above; and

 

c.  In night care programs, for the remaining 40% of the night time hours that the center director is not required to be present under (a)(2) above; and

 

(3)  Make all child care staff aware of the identity and scope of responsibility of the individual who will be in charge in the center director’s or site director’s absence.

 

(d)  With the exception of programs operating only as a school age program, there shall be at least one lead teacher on the premises during all operating hours, and one out of every 6 child care staff who are required to be on the premises in order to meet minimum staff to child ratios shall meet the minimum qualifications of a lead teacher.

 

(e) The only exception to (d) above shall be for the first and last hour of a center-based program operating more than 5 hours per day, provided an associate teacher as described in (l) below is on the premises.

 

(f)  Center-based programs that wish to apply for or have a single license for multiple buildings, and which choose not to have a center director in each building shall designate a staff person who qualifies as a lead teacher to be in charge in each building who reports to the center director.

 

(g)  School age programs that wish to apply for or have a single license for multiple buildings, and which choose not to have a site director in each building shall designate a staff person who qualifies as a group leader to be in charge in each building who reports to the site director.

 

(h)  The center director, agency administrator, site coordinator, site director or his or her designee shall have available for review at the program for all child care staff, documentation  to verify that the person qualifies for their position in accordance with this section.

 

(i)  Center-based programs may employ substitute staff for not more than 90 consecutive days for the same position only if the individuals:

 

(1)  Meet the age requirements of the staff position for whom they are substituting; and

 

(2)  Have completed the criminal background check process as described in He-C 4002.41.

 

(j)  A center director in a center-based program shall:

 

(1)  Be at least 21 years of age;

 

(2)  Have a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC);

 

(3)  Have 3 credits in management or supervision, awarded by an accredited college or university, a minimum of 2 years’ experience in a supervisory or management position in lieu of the 3 credits in management and supervision, or a written plan for completion of  3 credits in management or supervision from an accredited college or university;

 

(4)  Have a minimum of 1500 hours experience working with children in a licensed child care program or public or private elementary school;

 

(5)  Have one of the following:

 

a.  A minimum of an associate’s degree awarded by an accredited college in related coursework;

 

b.  An additional 3000 hours of experience working with children in a licensed child care program or in a public or private elementary school and documentation of a non-expired child development associates (CDA) in center-based programs awarded by the council for professional recognition;

 

c. Current certification in early childhood, elementary, or special education by the department of education;

 

d. Certification in a teacher preparation program accredited by the Montessori Accreditation Council for Teacher Education (MACTE) in infant and toddler, early childhood or elementary I, together with 60 credits, awarded by an accredited college or university; or

 

e.  Documentation of 60 credits, of which at least 24 shall be in related coursework, including at least 3 credits in each of the following core knowledge areas:

 

1.  Children with special needs;

 

2.  Child growth and development; and

 

3.  Curriculum for early childhood education; and

 

(6)  Be on file with the department as a center director working in that position on or before November 6, 2017.

 

(k)  A lead teacher in a center-based program shall have a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC), be at least 18 years old, and have one of the following:

 

(1)  A minimum of 18 credits in related coursework, including at least 3 credits in child or human growth and development, plus a minimum of 1000 hours experience working with children in a licensed child care program or public or private elementary school;

 

(2)  A minimum of 12 credits in related coursework, plus 3000 hours experience working with children in licensed child care program or public or private elementary school;

 

(3) Documentation of a non-expired child development associates (CDA) in center-based programs awarded by the council for professional recognition;

 

(4)  A credential from a teacher preparation program accredited by MACTE;

 

(5)  Five years as a licensed family child care provider with no enforcement actions imposed by the department;

 

(6)   Successful completion of the New Hampshire Early Childhood Apprenticeship Program;

 

(7)  A minimum of 1000 hours of supervised child care experience in a licensed child care program, documentation of successful completion of a 2-year vocational course in career and technical education with an additional 9 credits in related coursework; or

 

(8)  Documentation from or on file with the department that she or he was qualified for and employed in the position of lead teacher on or before November 6, 2017.

 

(l)  An associate teacher in a center-based program shall be at least 18 years old, have a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC), and have one of the following options:

 

(1)  Written documentation from or on file with the department that she or he was qualified and employed as an associate teacher on or before November 6, 2017;

 

(2)  A minimum of 9 credits in related coursework, including at least one 3 credit course in child or human growth and development;

 

(3)  Current certification as para II educator by the department of education; or

 

(4)  A minimum of 1000 hours of supervised child care experience in a licensed child care program, and knowledge of child growth and development obtained through one of the following:

 

a.  Completion of a high school level 2-year career and technical education course in teacher education;

 

b.  A 3 credit college course in child or human growth and development;

 

c.  Thirty hours of training in child growth and development, granted by an accredited college or university, an authorized provider of the International Association for Continuing Education and Training or obtained through documented life experience, including experience with the same age children the associate teacher supervises, such as a family child care provider, service as a foster parent, work as a school teacher, work as a camp counselor and experience as a group leader for children in sports or other activities, such as scouts or little league, or closely related experience.

 

(m)  Assistant teachers in a center-based program, whether paid or volunteer, shall:

 

(1)  Be at least 16 years of age; and

 

(2)  Work with children only under the direct supervision and observation of a staff person who meets at least the minimum qualifications of an associate teacher.

 

(n)  Notwithstanding (m)(2) above, assistant teachers shall only be alone with a child or group of children if the following conditions are met:

 

(1)  The center director has approved the specific assistant teacher to do this, with approval documented in the employee’s file;

 

(2)  The employee has been deemed eligible to work pursuant to RSA 170-E:7, III;

 

(3)  The employee has at least 3 months of experience at the program;

 

(4)  The employee has completed the required trainings pursuant to He-C 4002.33(a); and

 

(5)  The specific activities that the assistant teacher may be alone with children include:

 

a.  Walking children:

 

1.  To or from a bathroom;

 

2.  To or from receiving first aid treatment;

 

3.  To or from a bus stop; and

 

4.  From one classroom or area to another within the licensed premises;

 

b.  Supervising an ill child while waiting for pick-up by a parent;

 

c.  Supervising a group of children for up to 5 minutes when other child care staff leave the classroom to do a task that cannot be completed by the assistant teacher; or

 

d.  Supervising any children that may otherwise be without direct staff supervision pursuant to He-C 4002.20.

 

(o)  A junior helper in any center-based program, whether paid or volunteer, shall:

 

(1)  Be at least 14 years of age;

 

(2)  Work with children only under the direct supervision and observation of a staff person who meets at least the minimum qualification of an associate teacher;

 

(3)  Not be calculated in staff to child ratios as specified in He-C 4002.36, 4002.37, and 4002.39; and

 

(4)  Not be required to complete professional development hours as specified in He-C 4002.33.

 

(p)  A site director in a school-age program shall be at least 20 years of age, have a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC), and have at least one of the following:

 

(1)  Written documentation from or on file with the department that she or he was qualified and employed as a site director in a school-age program on or before the effective date of these rules in 2022;

 

(2)  A minimum of an associate’s degree in child development, education, recreation, or other field of study focused on children, awarded by an accredited college or university;

 

(3)  Certification of successful completion of training as a recreation director plus 1000 hours experience working with children in a licensed child care program, recreation program or a public or private elementary school;

 

(4)  A total of 12 credits in child development, education, recreation, or other field of study focused on children, from an  accredited college plus 1000 hours of experience working with children; 

 

(5)  Current certification as an educator by the department of education; or

 

(6)  Experience working with children totaling 2000 hours and:

 

a.  Current certification as a para II educator by the department of education; or

 

b.  Both of the following:

 

1.  Documentation of enrollment in a course for at least 3 credits in child development, education, recreation, or other field of study focused on children, through an accredited college or university and a written plan on file for completion of at least 3 additional credits as specified; and

 

2.  Within 12 months of the date the individual begins working as a site director, documentation of successful completion of at least 6 credits as specified in b.1. shall be on file for review by the department.

 

(q)  A group leader in a school-age program shall be at least 17 years of age, and have one of the following:

 

(1)  Experience working with school-age children, totaling 600 hours;

 

(2)  Documentation of at least 3 credits in child development, education, recreation, or other field of study focused on children, awarded by an accredited college or university;

 

(3)  Documentation that she or he is a certified coach;

 

(4)  Documentation of 5 years of parenting experience; or

 

(5)  Documentation from or on file with the department that she or he was qualified and employed as a group leader  in a school-age program on or before the adoption of these rules in 2022.

 

(r)  An assistant group leader in a school-age program, whether paid or volunteer, shall:

 

(1)  Be at least 15 years of age; and

 

(2)  Work with children only when under the direct supervision and observation of a site director or group leader as described in this section.

 

(s)  A project leader in a school-age program shall:

 

(1)  Be at least 15 years of age;

 

(2)  Be certified in CPR and first aid;

 

(3) Be recommended by an elementary school or established youth-related organization or agency; and

 

(4)  Have a written plan for the project she or he is leading, including:

 

a.  A description of the project;

 

b.  The objective and expected outcomes of the project;

 

c.  The location, time, and length of group meetings; and

 

d. The evaluation process of the project.

 

(t)  Project leaders shall not be required to complete in-service professional development hours as specified in He-C 4002.33.

 

(u)  Site directors in programs with a project leader shall:

 

(1)  Inform the project leader of program policies and child care licensing rules;

 

(2)  Require child care staff to observe or check on the project leader every 20 minutes;

 

(3)  Supervise, or require that the group leader supervise, the project leader; and

 

(4)  Have a consent form on file for review by the department that is signed by the parent of each child participating in an activity with a project leader.

 

(v)  Project leaders shall not be calculated in staff to child ratios as specified in He-C 4002.39.

 

 

Source.  #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.32)

 

He-C 4002.36  Group Child Care Centers.

 

(a)  Group child care centers shall comply with He-C 4002.01 through He-C 4002.33, He-C 4002.35, and this section, unless otherwise specified.

 

(b)  Programs shall staff group child care centers in accordance with the following:

 

(1)  For children ages 36 to 47 months, the maximum group size shall be 24 with the following minimum staffing levels:

 

a.  One associate teacher with up to 8 children;

 

b.  One associate teacher and one assistant teacher with 9 to 16 children; and

 

c.  One lead teacher and 2 assistant teachers with 17 to 24 children;

 

(2)  For children ages 48 to 59 months, the maximum group size shall be 24 with the following minimum staffing levels:

 

a.  One associate teacher with up to 12 children; and

 

b.  One associate teacher and one assistant teacher with 13 to 24 children; and

 

(3)  For children ages 60 months and over, the maximum group size shall be 30 with the following minimum staffing levels:

 

a.  One associate teacher with up to 15 children; and

 

b.  One associate teacher and one assistant teacher with 16 to 30 children.

 

(c)  Notwithstanding (b) above, a second staff person shall be in the building when 11 or more children are present.

 

(d)  In addition to the staffing requirements under (b) and (c) above, group child care centers shall:

 

(1)  Base the staff to child ratio and group size on the average age of the children in the group when there are mixed ages in the same group; and

 

(2)  Comply with staff to child ratios and requirements specified in He-C 4002.37 when the average age of children is younger than 36 months.

 

Source.  #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.33)

 

He-C 4002.37  Infant and Toddler Program.

 

(a)  Infant and toddler programs shall comply with He-C 4002.01 through He-C 4002.33, He-C 4002.35, and this section, unless otherwise specified.

 

(b)  Programs shall staff infant and toddler programs in accordance with the following:

 

(1)  For children ages 6 weeks to 12 months, the maximum group size shall be 12 with the following minimum staffing levels:

 

a.  One associate teacher with up to 4 children;

 

b.  One associate teacher and one assistant teacher with 5 to 8 children; and

 

c.  One lead teacher and 2 assistant teachers with 9 to 12 children;

 

(2)  For children ages 13 to 24 months, the maximum group size shall be 15 with the following minimum staffing levels:

 

 a.  One associate teacher with up to 5 children;

 

b.  One associate teacher and one assistant teacher with 6 to 10 children; and

 

c.  One lead teacher and 2 assistant teachers with 11 to 15 children;

 

(3)  For children ages 25 to 35 months, the maximum group size shall be 18 with the following minimum staffing levels:

 

a.  One associate teacher with up to 6 children;

 

b.  One associate teacher and one assistant teacher with 7 to 12 children; and

 

c.  One lead teacher and 2 assistant teachers with 13 to 18 children.

 

(c)  Notwithstanding (b) above, a second staff person shall be in the building when 5 or more children are present.

 

(d)  In addition to the staffing requirements under (b) and (c) above, programs licensed as infant and  toddler programs shall base the staff to child ratio and group size on the average age of the children in each group when there are mixed age groups in the same room.

 

(e)  To ensure that the emotional well-being and physical needs of infants between 6 weeks and 18 months of age are met, programs shall assign one child care staff as primary caregiver, based upon the staff-to-child ratio, who shall be responsible for meeting the children’s needs for the majority of time the children are in his or her care.

 

Source.  #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (formerly He-C 4002.38); ; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.34)

 

He-C 4002.38  Preschool Program. 

 

          (a)  Preschool programs shall comply with He-C 4002.01 through He-C 4002.33, He-C 4002.35, and this section.

 

          (b)  Preschool programs shall meet the staff to child ratio requirements specified in He-C 4002.36(b), as applicable.

 

          (c)  Preschool programs shall, in accordance with RSA 170-E:2, IV(f), operate 5 or fewer hours per day.

 

          (d)  The curriculum shall provide a variety of hands-on activities to foster:

 

(1)  Social and emotional development;

 

(2)  Language development and emergent literacy;

 

(3)  Cognitive development, including:

 

a.  Early numeracy;

 

b.  Science and social studies; and

 

c.  Approaches to learning;

 

(4)  Physical development and health; and

 

(5)  Creative expression and aesthetic appreciation.

 

Source.  #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.35)

 

He-C 4002.39  School-Age Program.

 

(a)  School-age programs shall comply with He-C 4002.01 through He-C 4002.33, He-C 4002.35, and this section, unless otherwise specified.

 

(b)  All school age programs shall be exempt from He-C 4002.08(a) only regarding recording birth dates on attendance records.

 

(c)  School-age programs that operate in a building which currently house a public or private school shall:

 

(1)  Identify and protect children from hazards such as vehicular traffic with direct supervision if the environment does not provide adequate protection; and

 

(2) Be exempt from modifying the environment to comply with He-C 4002.

 

          (d)  Programs that serve only children attending part day public kindergarten or full-day public school shall be exempt from:

 

(1)  He-C 4002.23(b)(2) regarding unprotected outlets only;

 

(2)  He-C 4002.23(c) regarding access to sharp objects such as scissors for arts and crafts or knives for cooking and access to non-cleaning materials or chemicals not labeled as “harmful if swallowed” or “flammable”, except that hand sanitizer may be available for use by children under staff supervision; and

 

(3)  He-C 4002.23(f) regarding long cords and strings.

 

          (e)  In lieu of He-C 4002.26(p), school-age programs operating for more than 5 hours per day shall provide children with an opportunity for at least 30 minutes of quiet activities, rest, or relaxation.

 

(f)  The staff to child ratios for school-age programs shall be one staff for 15 children age 56 months or older, with a maximum group size of 45, with the following minimum staffing levels:

 

(1)  One group leader with up to 15 children;

 

(2)  One group leader and one assistant group leader with 16 to 30 children; and

 

(3)  One site director and 2 assistant group leaders with 31 to 45 children.

 

          (g)  In addition to the staffing requirements in (f) above, programs licensed as school-age programs shall have a second staff person in the building when 13 or more children are present.

 

          (h)  School-age programs that hold combination licenses with multiple program types shall provide separate space for the school-age children during the hours of operation of the school-age program when 9 or more school age children are present.

 

          (i)  When 8 or fewer school-age children are present, programs shall have the option to combine school-age children with children 4 years of age and older.

 

          (j)  Programs shall have and maintain on file for review by parents and the department a written schedule of daily activities that ensures that the curriculum includes:

 

(1)  Opportunities for children to help in planning their own activities;

 

(2)  Time for structured and unstructured play, both indoors and outdoors;

 

(3)  Opportunities for active and quiet activities; and

 

(4)  Opportunities for individual and group experiences, both child-initiated and staff directed.

 

Source.  #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.36)

 

He-C 4002.40  Night Care Program.

 

(a)  Any program which intends to provide child care services during the evening or night time hours, between 7:00 PM and 5:00 AM shall be licensed to operate as a night care program.

 

(b)  Center-based night care programs shall comply with He-C 4002.01 through He-C 4002.33, He-C 4002.35, and the requirements applicable to the specific program type(s) for which they are licensed as well as the requirements in this section.

 

(c)  Night care programs operating in private homes that comply with all of the requirements for family and family group child care homes shall not be required to comply with the requirements specified in He-C 4002.35.

 

(d)  Child care staff shall not allow children attending a night care program to remain in the program for more than a total of 12 hours in any 24-hour period, except in an emergency.

 

(e)  Child care staff shall schedule activities in night care programs that address the basic and individual needs of children, including but not limited to relaxation, meals, play, and sleep.

 

(f)  Child care staff shall provide for privacy and separation by gender for bathing, toileting, and sleeping for all children.

 

(g)  Child care staff shall provide each child in a night care program with clean bedding and a bed or crib with a mattress, a cot, or sleeping bag on a rest mat.

 

(h)  Child care staff shall make sleeping arrangements that ensure that children who stay all night are not disturbed by the departure or arrival of those who stay only a portion of the night.

 

Source.  #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (formerly He-C 4002.38); ; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.37)

 

He-C 4002.41  Background Checks and Determination of Eligibility.

 

(a) Prior to employment or residency, as applicable, and every 5 years thereafter, all child care staff, substitutes, other employees, and volunteers who may be alone with children or are included in staff to child ratios, and household members age 10 years or older, shall submit for a background record check using NH Connections.

 

(b) Each individual age 18 and older completing a background record check in accordance with (a) above, shall submit a non-refundable fee for the issuance of the employment eligibility card, in accordance with RSA 170-E: 7, IV-a. and IV-d.

 

(c)  The following individuals shall not be required to obtain the employment eligibility card in (b) above:

 

(1) Family child care providers, household members, applicants, substitutes, and volunteers;

 

(2)  Child care staff determined eligible to work prior to October 1, 2017, who remain employed by the same licensee or at the same location if the licensee has changed at the time of submission of their background record check in (a) above;

 

(3)  High school and college students; or

 

(4) Other employees or individuals whose purpose is not related to the care or supervision of children in the program.

 

(d)  The background record check shall be completed in accordance with RSA 170-E:7, unless exempted from this requirement as permitted under RSA 170-E:7, II-a.

 

(e)  Pursuant to RSA 170-E:7, IV-b, individuals exempt in accordance with (d) above shall have on file at the program, a statement from the individual stating since the day the individual’s background check was completed, that he or she:

 

(1)  Has not been convicted of any crimes; and

 

(2)  Has not had a finding by the department or any administrative agency in this or any other state for abuse, neglect, or exploitation.

 

(f)  The unit shall make a determination regarding the individual’s eligibility in accordance with RSA 170-E:7, III and IV and notify the program and individual within 45 days of submission of all required information as required in this section and RSA170-E:7.

 

(g)  Individuals required to complete background record checks as specified in (a) above shall not have access to children or be present in the program until the program receives notice of eligibility from the unit.

 

(h)  When the unit receives the results of the fingerprint-based criminal background check for an individual that does not include any disqualifying information as described in RSA 170-E:7, III and IV, it shall notify the program that the individual may be present in the program, provided the individual is never alone with children and always under the direct supervision and observation of a staff member whom the unit has been deemed eligible. This direct supervision and observation shall continue until the unit receives all results from the background check required in RSA 170-E:7 and notifies the program and individual as described in (f) above.

 

(i)  When the department determines that an individual is ineligible to work in child care, in accordance with RSA 170-E:7, III or IV, it shall provide notice to the individual that includes:

 

(1)  The department’s determination of ineligibility;

 

(2)  The basis for the determination; and

 

(3)  The individual’s right to challenge his or her criminal record pursuant to Saf-C 5703.12.

 

(j)  When the department determines that an individual is ineligible to work in child care, in accordance with RSA 170-E:7, III or IV, it shall provide notice to the child care program that:

 

(1)  The department determined the individual to be ineligible to work in child care; and

 

(2)  The program shall take immediate action to prohibit the individual from being on the premises of the child care program and from having access to the children enrolled in the program.

 

(k)  The child care program shall inform the department in writing within 2 business days of receipt of the notice sent in (j) above of the specific action it has taken as required under (j)(2) above.

 

Source.   #13373, eff 4-22-22

 

He-C 4002.42  Complaints and Investigations.

 

(a)  In accordance with RSA 170-E:17, II, the department shall respond to any complaint that meets the following conditions:

 

(1)  The alleged non-compliance(s) occurred within 6 months of the date of the allegation(s);

 

(2) The complaint includes the complainant’s first-hand knowledge regarding the allegation(s) or on information reported directly to the complainant by a child who has first-hand knowledge regarding the allegation(s);

 

(3) There is sufficient specific information for the department to determine that the allegation(s), if proven to be true, would constitute non-compliance of any of the provisions of RSA 170-E or He-C 4002; or

 

(4)  The complaint is from any source and alleges non-compliance that occurred at any time if the complaint alleges:

 

a.  Physical injury or abuse;

 

b.  Verbal, or emotional abuse; or

 

c.  The danger of physical injury to one or more children.

 

(b)  When the complaint is determined to be substantiated, a statement of findings shall be issued to the program listing the citations found resulting from the investigation and any other citations found.

 

(c)  When the complaint is determined to be unfounded, the department shall send a notice to the program advising that the complaint was unfounded.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.08); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (from He-C 4002.07)

 

He-C 4002.43  Confidentiality.

 

(a)  Any information collected by the department pursuant to RSA 170-E:7 regarding criminal conviction records or founded cases of child abuse or neglect, which results in a department determination that the individual being investigated is ineligible to work with children, shall be kept confidential by the department, with the following exceptions:

 

(1)  The program in which the individual is employed shall be notified that the individual has been determined to be ineligible to work with children, in accordance with the provisions of RSA 170-E:7, III, or RSA 170-E:7, IV, so that the program can take corrective action; and

 

(2)  If a statement of findings is issued regarding the employment or presence in the program of an individual covered under (1) above, it shall not include the name of that individual on the statement of findings and shall only specify that the individual was determined by the department to be ineligible to work with children.

 

(b)  The department shall keep confidential information collected during the application process and any records in its possession regarding the admission, progress, health, and discharge of children, with the following exceptions:

 

(1)  Upon receipt of:

 

a.  A written request from the applicant, licensee, permittee, or his or her designated legal representative, the department shall release to the requester, information obtained during the application process; and

 

b.  Upon receipt of a written authorization to release information, signed by the applicant, licensee, or permittee, or in the case of personal information, signed by the individual who is the subject of the information, the department, shall release any information collected during the application process; or

 

(2)  During an administrative proceeding against the applicant or licensee.

 

(c)  Except for law enforcement agencies or in an administrative proceeding against the applicant or licensee, the department shall keep confidential any information collected during an investigation, unless it receives an order to release, destroy, or take any action relating to the information from a court of competent jurisdiction.

 

(d)  Applicants, licensees, permittees, and all child care staff shall keep confidential all records required by the department pertaining to the admission, progress, health, and discharge of children under their care and all facts learned about children and their families with the following exceptions:

 

(1   Child care staff shall allow the department access to all records that programs are required by department rule or state statute to keep, and to such records as necessary for the department to determine staffing patterns and staff attendance; and

 

(2)  Child care staff shall release information regarding a specific child only as directed by a parent of that child, or upon receipt of written authorization to release such information, signed by that child’s parent.

 

(e)  In addition to the confidentiality requirements in (d) above, child care staff shall discuss or share information regarding the admission, progress, behavior, health, or discharge of a child with the child’s parent(s) in a manner that protects and maintains confidentiality for both the child and the child’s parent(s).

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.08); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.08)

 

He-C 4002.44  Enforcement Action and Right to Appeal.

 

(a)  The department shall consider the following enforcement actions in response to non-compliance with licensing rules and laws:

 

(1)  Assessment of administrative fines;

 

(2)  Placement of conditions on a permit or license;

 

(3)  Suspension of a permit or license;

 

(4)  Denial of an application for a new or renewed license; or

 

(5)  Revocation of a permit or license.

 

(b)  The department shall place conditions on a license or permit when it determines that the applicant, licensee, or permittee is in violation of any of the provisions of RSA 170-E or any rule, and it determines that placement of those conditions shall:

 

(1)  Protect the health, safety, or well-being of children;

 

(2)  Assist the applicant, licensee, or permittee to achieve and maintain compliance with licensing rules or statute; or

 

(3)  Assist the applicant, licensee, or permittee to avoid suspension, revocation or denial of their license or permit.

 

(c)  When the department intends to place conditions on a license or permit, it shall send to the applicant, licensee, or permittee a notice setting forth:

 

(1)  The reason(s) for the intended action;

 

(2)  The specific condition(s) the department intends to place on the license or permit;

 

(3)  The effective date(s) of the proposed conditions;

 

(4)  Notice that, once the department places conditions on the license or permit, failure to comply with those conditions shall constitute failure to comply with the provisions of license; and

 

(5)  Information about the right to request an administrative hearing by submitting a written request for an administrative hearing to the commissioner no later than 10 calendar days from the date of receipt of the notice.

 

(d)  The conditions placed in accordance with (b) above:

 

(1)  Shall be determined by the department, based on the single or combination of options specified that will best address the specific issue or problem; and

 

(2)  Shall include, but not be limited to:

 

a.  Prohibiting a licensee or permittee from enrolling any additional children in a program;

 

b. Reducing the license capacity or the number of children for whom a licensee or permittee is authorized to care in a specific component of a program;

 

c.  Requiring an individual to obtain additional education other than that required for their position, or to complete additional in-service professional development activities, in excess of the annual requirement as specified under He-C 4002.33 in order to prepare them to more effectively work with children or assist them in achieving and maintaining compliance with He-C 4002;

 

d.  Requiring an applicant, licensee, or permittee to hire additional staff on a temporary or permanent basis;

 

e.  Restricting an administrator, or any other child care staff, or other individual’s access to enrolled children during child care hours as a result of a determination that the individual poses a threat to children and has been having, or may have, regular contact with the children enrolled in the program;

 

f.  Prohibiting a licensee or permittee from applying for an increase in the license capacity, or any addition of new program types to an existing license or permit, until they achieve and maintain compliance with He-C 4002;

 

g.  Prohibiting an applicant, licensee, or permittee from applying for additional child care program licenses; or

 

h.  Requiring the licensee to replace the center director, site director, or site coordinator.

 

(e)  The department’s decision to place conditions on a license or permit shall become final when:

 

(1)  The applicant, licensee, or permittee does not request an administrative hearing as specified in (c)(5) above; or

 

(2)  The department’s decision to place conditions on the license or permit is upheld after an administrative hearing.

 

(f)  The placement of conditions on a license or permit shall not prohibit the department from enforcing any conditions or any other enforcement action available to it under He-C 4002 or RSA 170-E.

 

(g)  When the department places conditions on a license or permit, the department shall issue a revised license or permit reflecting the conditions imposed.

 

(h)  Upon receipt of notice of the department’s intent to place conditions on a license, the applicant, licensee, or permittee receiving the notice shall immediately provide the department with evidence that the program notified all of the parents of enrolled children of the conditions imposed on the license by the department.

 

(i)  When a program has met the conditions placed on the license and has maintained compliance with all licensing rules and statutes related to the conditions for a period of one year or the time period reflected on the license or permit, whichever is greater, the department shall:

 

(1)  Provide written notice to the licensee or permittee of the department's intention to rescind the conditions; and

 

(2)  Issue a revised license or permit.

 

(j)  The department shall revoke a permit or license or deny an application for a new license, license renewal, or license revision in accordance with RSA 170-E:12 if:

 

(1)   The applicant, licensee, or permittee fails to provide or does not meet the requirements of He-C 4002.02;

 

(2)   The applicant, licensee, or permittee  refuses to submit or adhere to an agreement or corrective action plan which ensures that an individual determined ineligible for employment or as a household member is removed from employment or from the household and will not have access to the children in care during the operating hours of the program;

 

(3)  The applicant, licensee, or permittee has endangered, or continues to endanger one or more children, or otherwise caused one or more children to be physically or mentally injured;

 

(4)  The applicant, licensee, or permittee has a:

 

a.  Finding of abuse, neglect, or exploitation of any person;

 

b.  Conviction of child endangerment, fraud, or a felony against a person in this or any other state by a court of law;

 

c.  Conviction of any crime as referenced in RSA 170-E:7, III or IV; or

 

d.  Complaint investigation for abuse, neglect, or exploitation substantiated by the department or in any other state;

 

(5) The applicant, licensee, or permittee, or any representative or employee thereof knowingly provides false or misleading information to the department, including but not limited to information on the application or in the application attachments;

 

(6)  The applicant, licensee, or permittee, or any representative or employee thereof fails to cooperate with any inspection by the department or fails to submit any records or reports required by the department;

 

(7)  The applicant, licensee, or permittee violates any of the provision of RSA 170-E:1-23 or He-C 4002;

 

(8)  The applicant, licensee, or permittee has demonstrated a history or pattern of multiple or repeat citations of RSA 170-E or He-C 4002, that pose or have posed a threat to the safety of a child or children;

 

(9)  The applicant, licensee, or permittee fails to submit an acceptable corrective action plan or fully implement and continue to comply with a corrective action plan approved by the department in accordance with He-C 4002.06(f) through (i);

 

(10)  The applicant, licensee, or permittee fails to pay a fine assessed by the department as specified in He-C 4002.45; or

 

(11)  The applicant, licensee, or permittee fails to implement and comply with conditions placed on a license by the department as specified in He-C 4002.44(b).

 

(k)  If the department revokes a license or permit, or if a license or permit has expired due to the program’s failure to submit a timely application for renewal in accordance with He-C 4002, the program shall discontinue operations immediately.

 

(l)  The department shall notify applicants, licensees, or permittees of a decision of the department to deny, revoke, or suspend a license of their right to an administrative hearing in accordance with RSA 170-E:13.

 

(m)  If an applicant, licensee, or permittee fails to request an administrative hearing in writing within 10 days of the receipt of the notice required by RSA 170-E:13, I, the action of the department shall become final.

 

(n)  Administrative hearings under this section shall be conducted in accordance with RSA 170-E:13 and 14, RSA 541-A, and He-C 200.

 

(o)  Further appeals of department decisions under this section shall be governed by RSA 170-E:14.

 

(p)  Any licensee or permittee who has been notified of the department’s intent to revoke or suspend a license or deny an application for license renewal may continue to operate during the appeal process except as specified in (q) below.

 

(q)  When the department includes in its notice of revocation or suspension an order of immediate closure, pursuant to RSA 170-E:13, III, or RSA 541-A:30, III, the program shall immediately terminate its operation and not operate while an administrative hearing is pending except under court order or as provided by RSA 541-A:30, III.

 

(r)  The department shall initiate suspension of a license or permit rather than revocation when it determines that:

 

(1)  The program does not have a history of repeat citations of licensing rules or statute and the action is based on non-compliance or a situation that is:

 

a.  Related to a correctable environmental health or safety issue, including but not limited to a problem with a program’s water supply, septic system, heating system, or structure; and

 

b.  Documented by the program as being temporary in nature; or

 

(2)  The action is for one of the following and is under appeal:

 

a.  A criminal conviction; or

 

b.  A finding by the division for children, youth, and families, of child abuse, neglect, or endangerment.

 

(s)  Any suspension of a license or permit for which an administrative hearing has not been requested or any suspension of a license that has been upheld by an administrative hearing shall remain in effect until the department notifies the program whose license or permit was suspended that the suspension has been removed because:

 

(1)  The non-compliance which resulted in the suspension is corrected; or

 

(2)  The suspension was the result of loss of fire or health officer approval and the local fire or health officer has reinstated their previously rescinded approval.

 

(t)  Upon receipt of notice of the department’s intent to revoke, suspend, deny, or refuse to issue or renew a license or permit, the applicant, licensee, or permittee shall immediately provide the department with a list of the names, addresses, and phone numbers of the parents of enrolled children and staff employed by the program.

 

(u)  Based upon information provided under (t) above, the department shall notify the parents of children currently enrolled in the program, and staff employed by the program that the department has initiated action to revoke or suspend the license or deny an application for a license renewal.

 

(v)  When a program is allowed to continue operating pending appeal as provided in (p) above, the program shall provide the suspension or revocation notice to any new families prior to enrollment of their child or children or prospective staff prior to offer of employment.

 

(w)  The department shall send a notice equivalent to the notice specified in (u) above to the following entities:

 

(1)  The health officer and fire inspector serving the town in which the program is located;

 

(2)  The organization or entity who provides resource and referral services, pursuant to RSA 171-E:5-a, which covers the town in which the program is located; and

 

(3) The state office of the United States Department of Agriculture child and adult food program.

 

(x)   An applicant, licensee, center director, or site director shall be ineligible to reapply for a license, employment as a center director or site director, be a family child care provider, or hold any corporate office or controlling interest in any licensed program after revocation of a license or denial of an application. 

 

(y)  The period of ineligibility shall be at least 5 years from:

 

(1)  The date the decision to revoke or deny becomes final; or

 

(2) The date an order is issued upholding the action of the department, if an administrative hearing was requested.

 

(z)  When an individual enters into an administrative agreement with the department to surrender a license or withdraw an application that exceeds the 5 years in (y) above, the agreement shall supersede the rule.

 

(aa)  The department shall accept an application from an individual or consider an individual to be eligible to be employed as a center director, site director, or family child care provider after the 5 year period specified in (y) above only when it determines that the individual has, through education, training, or experience, acquired the knowledge and skills, and has the resources necessary to operate or direct a child care program in compliance with licensing rules and statute.

 

(ab)  Notwithstanding (aa) above, the department shall consider a request for a center director, site coordinator, or site director, prior to the expiration of the 5 years, to be considered eligible to be employed as a center director, site coordinator, or site director for another applicant or licensee, or to become an applicant for a license, only under the following circumstances:

 

(1) The revocation or denial was based on the center director’s, site coordinator’s, or site director’s inability to correct the non-compliance due to the applicant or licensee’s refusal or inability to correct; and

 

(2)  The center director, site coordinator, or site director employed by the applicant or licensee whose license was revoked or application was denied shows that circumstances have substantially changed such that the department now has a good cause to believe that the center director, site coordinator, or site director has the requisite degree of knowledge, skills, and resources necessary to maintain compliance with the provisions of RSA 170-E and He-C 4002.

 

(ac)  Notwithstanding (aa) above, the department shall consider an application submitted after the decision to revoke or deny becomes final, but before the expiration of the 5 years referenced in (y) above, provided revocation or denial was the result of non-compliance with RSA 170-E:4, II, RSA 170-E:12, I, RSA 170-E:12, V, RSA 170-E:12, VI, RSA 170-E:12, VII, RSA 170-E:12, VIII and RSA 170-E:12, XI, and only under the following circumstances:

 

(1)  The denial was based on the applicant or licensee’s inability or failure to correct non-compliance caused by a temporary condition which has been corrected; and

 

(2)  The licensee or applicant who was denied an initial application shows that circumstances have substantially changed such that the department now has a good cause to believe that the applicant has the requisite degree of knowledge, skills, and resources necessary to maintain compliance with the provisions of RSA 170-E and He-C 4002.

 

(ad)  No ongoing enforcement action shall preclude the imposition of any remedy available to the department under RSA 170-E, RSA 541-A, He-C 4002 or other law.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.10); ss by #9605, eff 11-26-09; ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.09)

 

He-C 4002.45  Administrative Fines.

 

(a)  The department shall assess administrative fines in accordance with RSA 170-E:11, VI and VII, and RSA 170-E:21-a as follows:

 

(1)  The department shall send the notice of intent to assess a fine by certified mail or by hand delivery to any person, applicant, licensee, or permittee;

 

(2)  The written notice required under (1) above shall include:

 

a.  The amount of the fine, the citation(s), and dates, if applicable, for which the fine is being assessed;

 

b.  Information regarding the right to request an administrative hearing, including the name, address, and phone number of the hearings unit, and deadline by which to request a hearing;

 

c.  Information about the option of reducing any assessed fine by 50% by submitting to the department, no later than 10 days from receipt of the notice, payment of the reduced fine, and a written statement waiving the right to request an administrative hearing regarding the fine, signed by the applicant, licensee, or permittee; and

 

d.  The name of a contact person within the office of operations support, bureau of licensing and certification;

 

(3)  If the applicant, licensee, or permittee does not request an administrative hearing as specified in (2)b. above, the department’s decision to assess a fine shall become final after the 10 day period specified in (2)c. above and the fine shall be paid to the department no later than 10 days from that date;

 

(4)  When an administrative hearing is conducted and the department’s decision to assess a fine is upheld, the fine shall be due and payable within 10 days of the date of the hearing officer's decision; and

 

(5)  The assessment of fines shall not prohibit the department from enforcing any conditions or any other enforcement action available to it under He-C 4002 or RSA 170-E.

 

(b)  The department shall assess fines in accordance with the following:

 

(1)  For failure to comply with the provisions of a license or permit, in violation of He-C 4002.05(a)(1), the fine shall be $200.00, plus $100.00 per day for each day for which the department has evidence that the program continues to fail to comply with the provisions of a license or permit, in violation of He-C 4002.05(a), after receipt of written notice of non-compliance from the department;

 

(2)  For a repeat citation for failure to comply with the provisions of a license or permit, in violation of He-C 4002.05(a)(1), the fine shall be $500.00, plus $100.00 for each day for which the department has evidence that the program continues to fail to comply with the provisions of a license or permit, in violation of He-C 4002.05(a), after receipt of written notice of non-compliance from the department;

 

(3)  For operating a child care program without a license or permit, in violation of RSA 170-E:4, I, the fine shall be $500.00, plus $100.00 per day for each day for which the department has evidence that the program continues to operate, in violation of RSA 170-E:4, I;

 

(4)  For continuing to operate a child care program after voluntarily closing, or for continuing to operate under an expired license after failing to submit a timely renewal application, in violation of RSA 170-E:4, I, the fine shall be $1,000.00, plus $100.00 per day for each day for which the department has evidence that the program continues to operate, in violation of RSA 170-E:4, I;

 

(5) For continuing to operate a child care program after suspension, revocation, or denial of a license or permit, in violation of RSA 170-E, I, the fine shall be $2,000.00, plus  $500.00 per day for each day for which the department has evidence that the former licensee or permittee continues to operate a child care program in violation of RSA 170-E:4, I;

 

(6)  For failure to submit any requested reports or failing to make available any records required by the department for investigation, monitoring, or licensing purposes in violation of   He-C 4002.05(k), (l), or (n)(4), the fine shall be $500.00, per offense, plus  $100.00 per day, per offense, for each day for which the department does not receive the requested documents;

 

(7)  For making false or misleading statements, either verbal or written, to the department, or for directing, requiring, or knowingly allowing any child care staff to make false or misleading statements to the department, or falsifying any documents, other written information, or reports issued by or required by the department, in violation of He-C 4002.05(m), the fine shall be $1000.00 per offense;

 

(8)  For failure by the applicant, licensee, or permittee, or by any child care staff at the direction of or on behalf of the applicant, licensee, permittee, center director, or site director, to cooperate during any visit authorized under RSA 170-E or He-C 4002, in violation of He-C  4002.05(n) the fine shall be $1000.00;

 

(9)  For failure to submit a corrective action plan, in violation of He-C 4002.06(f), the fine shall be $200.00;

 

(10)  For failure to implement or maintain the corrective action set forth in any corrective action plan that has been approved or issued by the department, in violation of He-C 4002.06(m) , the fine shall be $250.00 per citation;

 

(11)  For failure to supervise each child in care, in violation of He-C 4002.20(a), the fine shall be $750.00;

 

(12)  For abusing or neglecting a child or children, or failing to protect a child or children from abuse or neglect by any individual when the licensee, permittee, center director, or site director, either knew or should have known about the abuse or neglect, in violation of He-C 4002.18(e)(1) and (f), the fine shall be $1000.00;

 

(13)  For using corporal punishment, or failing to protect children from corporal punishment in the child care program by any child care staff, household member, or other individual, when the licensee, permittee, center director, or site director either knew or should have known about the corporal punishment, in violation of He-C 4002.18(e)(3) and (f), the fine shall be $1000.00;

 

(14)  For using inappropriate discipline or rough handling children, or failing to protect children from inappropriate discipline or rough handling when the licensee, permittee, center director, or site director either knew or should have known about the inappropriate discipline or mistreatment, in violation of He-C 4002.18(e)(2), the fine shall be $500.00;

 

(15)  For failure to comply with the qualifications for a center director or site director, in violation of He-C 4002.35(j) and (p) respectively, when the non-compliance is not corrected within 5 business days of written notice of non-compliance from the department, the fine shall be $100.00, plus $100.00 for each day that the non-compliance continues;

 

(16)  For failure to complete the criminal background check process, in violation of RSA 170-E:7 and He-C 4002.41, the fine shall be $500.00, plus $100.00 per day when the non-compliance is not corrected within 5 business days and the employee, household member, or other individual continues to work in the program without having completed the criminal background check process;

 

(17)  For non-compliance of any statute or any rule which results in  endangering one or more children, in violation of RSA 170-E:4, 2, the fine shall be $1000.00 for each citation, plus $200.00 per day for each day for which the department has evidence that the non-compliance continues after receipt of written notice of non-compliance from the department;

 

(18)  For a repeat citation of any rule not specified in (b)(3) through (17) above, the fine shall be $200.00;

 

 (19)  Except for (b)(5) above, when an inspection results in a determination that non-compliance of RSA 170-E or He-C 4002 is a repeat citation of any of the rules specified in (b)(3) through (19) above, the fine shall be twice the amount as the original fine assessed, not including any applicable daily rates;

 

(20)  For the purposes of (b)(18) through (19) above, each incident of non-compliance shall constitute a separate citation subject to a separate fine; and

 

(21)  For non-compliance of any statute, or rule which results in physical injury to one or more children, or places one or more children in jeopardy of physical harm, the department shall assess a fine of $2,000.00 for each non-compliance, plus $500.00 per day that the non-compliance exits.

 

Source.  #2664, eff 3-30-84, EXPIRED 3-30-90

 

New.  #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

 

New.  #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.11); ss by #12046, INTERIM, eff 11-19-16, EXPIRES: 5-18-17; ss by #12174, EMERGENCY RULE, eff 5-17-17, EXPIRES: 11-13-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.10)

 

PART He-C 4003  YOUTH RECREATION CAMPS

 

          He-C 4003.01  Purpose.

 

          (a)  The purpose of the rules in He-C 4003.01 through He-C 4003.41 is to provide an environment conducive to promoting and protecting the health and safety of all individuals who attend or provide services at a youth recreation camp (YRC).

 

          (b)  The purpose of the rules in He-C 4003.42 is to accommodate situations where strict compliance with all requirements established in this part may not be necessary for the protection of the safety and health of the individuals who attend or provide services at a YRC.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.02  Applicability.

 

          (a)  The definitions in He-C 4003.03 shall apply throughout this part.

 

          (b)  The rules in He-C 4003 shall apply to:

 

(1)  All YRCs as defined herein; and

 

(2)  Any organization or program exempt from licensing under RSA 170-E:3, I, that chooses to apply for and obtain a license under these rules.

 

          (c)  Except as provided in (b)(2), the rules in He-C 4003.03 through He-C 4003.41 shall not apply to:

 

(1)  Any child day care agency as defined in RSA 170-E:2, IV; or

 

(2)  Places, entities, and programs exempt from licensing under RSA 170-E:3, I.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.03  Definitions.

 

          (a)  “Activity leader”  means an individual who is not a regular staff member and is engaged by the YRC to oversee a specific activity, the purpose of which is to teach a skill, such as horseback riding, archery, or a craft.

 

          (b)  “Authorized staff” means a physician, a licensed health care practitioner, or YRC staff who has been trained as specified in He-C 4003.30.

 

(c)  “Camp facilities” means all of the structures at a youth recreation camp, whether temporary or

permanent, used by YRC staff or campers for sleeping, eating, personal hygiene, recreation, instruction, health care, or camp management, or any combination thereof.

 

(d)  “Camper” means any person enrolled in a YRC.

 

 (e) “Certified as an emergency medical responder” means certified as an emergency medical responder:

 

(1)  By the United States Department of Transportation (USDOT); or

 

(2)  Through a different nationally-recognized course whose standards are no less stringent than the certification standards of the USDOT.

 

          (f)  “Certified in first aid/CPR/AED” means certified in adult and pediatric first aid, cardiopulmonary resuscitation (CPR), and the use of an automated external defibrillator (AED):

 

(1)  By the American Red Cross; or

 

(2)  Through a different nationally-recognized course whose standards are no less stringent than the certification standards of the American Red Cross.

 

          (g)  “Certified in wilderness and remote first aid” means certified in wilderness and remote first aid:

 

(1)  By the American Red Cross; or

 

(2)  Through a different nationally-recognized course whose standards are no less stringent than the certification standards of the American Red Cross.

 

          (h)  “Communicable disease” means “communicable disease” as defined in RSA 141-C:2, VI.

 

(i)  “Contained YRC campus” means a parcel of land, with or without buildings thereon, that is:

 

(1)  Used for youth recreation camping;

 

(2)  Not open for use by the general public while the YRC is in operation; and

 

(3)  Typically, but not necessarily, in a rural location.

 

          (j)  “Counselor” means an individual who is responsible for the direct supervision of campers and the supervision and training of counselors-in-training or junior counselors, or both.

 

          (k)  “Counselor-in-training (CIT)” means an individual who works directly with campers only under the supervision of a counselor.

 

          (l)  “Day camp” means a YRC that operates for less than 24 hours per day.

 

          (m)  “Department” means the department of health and human services.

 

          (n)  “Director” means the individual in charge of the day-to-day operations of a YRC.

 

          (o)  “Emergency medical services” means “emergency medical services” as defined in RSA 153-A:2, VI.

 

          (p)  “Infirmary” means the area designated at a YRC for on-site medical care of campers or of campers and YRC staff.

 

          (q)  “In operation” means campers are in attendance at a youth recreation camp.

 

          (r)  “Junior counselor (JC)” means an individual who works directly with campers only under the supervision of a counselor.

 

          (s)  “Licensed health care practitioner” means an individual who:

 

(1)  Is authorized as provided in New Hampshire law to work as a registered nurse (RN), licensed practical nurse (LPN), advanced practice registered nurse (APRN), or physician’s assistant (PA); and

 

(2)  Has had training equivalent to or more intensive than that specified in He-C 4003.40(a).

 

          (t)  “Off-site overnight camping” means any venture that:

 

(1)  Involves a recreation activity, including but not limited to hiking, climbing, biking, canoeing, horseback riding, water activities, camping, and tenting;

 

(2)  Occurs for the duration of one night or longer; and

 

(3)  Occurs outside of the normal sleeping quarters of the youth recreation camp.

 

          (u) “Person” means any municipality, governmental subdivision, public or private corporation, individual, partnership, or other entity.

 

          (v)  “Physician” means any physician or health practitioner with the authority to write prescriptions.

 

          (w)  “Public water system (PWS)” means “public water system” as defined in RSA 485:1-a, XV.

 

          (x)  “Reportable disease” means a communicable disease, as defined in RSA 141-C:2, VI, required to be reported to the commissioner of the department of health and human services (DHHS) pursuant to RSA 141-C:7 and He-P 301.02.

 

          (y)  “Residence camp” means a YRC that operates for 4 or more consecutive 24-hour days.

 

          (z)  “Season” means the period(s) of time in the licensing year during which a seasonal YRC plans to operate and does operate.

 

          (aa)  “Seasonal camp” means a youth recreation camp that is not a year-round camp.

 

          (ab)  “State fire code” means “state fire code’” as defined in RSA 153:1, VI-a.

 

          (ac)  “Unit” means the child care licensing unit within the department of health and human services.

 

          (ad)  “Year-round camp” means a youth recreation camp that operates during each calendar quarter of the year.

 

          (ae)  “Youth” means individuals who are under 18 years of age.

 

          (af)  “Youth recreation camp (YRC)” means a program that operates for at least 10 days per license year for the purpose of providing recreational opportunities, or a combination of recreation and instruction, to 10 or more youth per day, at a place which is continuously or periodically used for such purposes.  The term includes camps, residence camps, and seasonal and year-round day camps.

 

          (ag) “YRC operator” means the individual that has primary responsibility for the day-to-day management of a YRC.

 

          (ah)  “YRC owner” means the person or entity that owns and is responsible for the operation and management of a YRC.

 

          (ai)  “YRC staff” means the individuals employed or otherwise engaged by a YRC, whether for pay or not, to:

 

(1)  Manage the camp, including office personnel, managers, and kitchen and maintenance staff; and

 

(2)  Work directly with campers, including counselors, counselors in training, junior counselors, activity leaders, instructors, and health care providers.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.04  License Required. 

 

          (a)  As specified in RSA 170-E:56, I:

 

(1)  No person shall for profit or for charitable purposes operate any youth recreation camp (YRC) without a license issued by the department; and

 

(2)  The license to operate a year-round camp required by RSA 170-E:56 shall be good only for the calendar year in which it is issued.

 

          (b)  A license shall be issued for one calendar year, beginning January 1 and ending December 31, unless otherwise requested on the application.

 

          (c)  The license to operate a seasonal camp required by RSA170-E:56, I shall be valid only between the opening and closing dates specified on the application.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.05  YRC License Application Requirements.

 

          (a)  Each applicant for a YRC license shall submit the following information to the unit:

 

(1)  The name of the YRC;

 

(2)  The location where the YRC operates in New Hampshire, by street address and municipality;

 

(3)  The name, primary mailing address, daytime telephone number, and emergency telephone number of the YRC owner and, if available, an e-mail address;

 

(4)  The name, primary mailing address, daytime telephone number, and emergency telephone number of the YRC operator, and if available, an e-mail address, if the operator is not the owner;

 

(5)  If the owner or operator, or both, is other than an individual, the name, daytime telephone number, and, if available, e-mail address for an individual representing the owner or operator, or both, as applicable;

 

(6)  Whether the YRC has operated previously in New Hampshire, and if so the following:

 

a.  A list showing the year(s) the YRC operated;

 

b.  For each year, the name under which the YRC operated, if different from the name in which the current application is being made; and

 

c.  Whether the YRC’s license has ever been suspended or revoked;

 

(7)  The capacity of the YRC, as follows:

 

a.  Maximum number of campers per camp session; and

 

b.  Number of YRC staff;

 

(8)  Whether the YRC is a seasonal camp or a year-round camp;

 

(9)  Whether the YRC is a day camp or a residential camp;

 

(10)  For a seasonal camp, the opening date and closing date for campers;

 

(11)  For a seasonal camp, the seasonal mailing address(es) and daytime telephone number(s) of the YRC owner, if different than the primary mailing address;

 

(12)  Whether the camp prepares or serves food to the campers or staff;

 

(13)  The name of each lake or river, if any, on which the YRC is located;

 

(14)  Whether the YRC is a public water system (PWS) or is connected to a PWS, and:

 

a.  If so, the name and PWS ID number of the public water system; and

 

b.  If not, the source of drinking water used by the YRC;

 

(15)  Whether the YRC is connected to a municipal sewer or other community, off-site sewage disposal system or is served by on-site sewage disposal system(s);

 

(16)  If the YRC is an entity that is required by RSA 292, RSA 293, RSA 293-A, or other applicable provision of New Hampshire law to register with the New Hampshire secretary of state:

 

a.  The business ID number assigned by the New Hampshire secretary of state; and

 

b.  An affirmation by the YRC owner that the YRC is registered and in good standing to do business in New Hampshire; and

 

(17)  The address of each YRC web site and social media network site, if any.

 

          (b)  With the application, the applicant shall submit as attachments the following to the department:

 

(1)   Results of a DCFY central registry name search completed by the YRC owner and operator, if different from the owner, if he or she is a current resident or has resided in New Hampshire within the previous 7 years;

 

(2)  The criminal history record check results of the YRC owner and operator, if different, from each state where the YRC owner and operator has lived, which may be done through a national database if the database includes all such states; and

 

(3)  A YRC checklist, consisting of a list of the operating standards that apply to the YRC that shall indicate the status of the YRC’s compliance with each standard specified in He-C 4003.11 through He-C 4003.41, as follows:

 

a.  A status of “YES” means the YRC complies with the standard;

 

b.  A status of “PENDING” means the YRC does not comply with the standard as of the application date but will be brought into compliance prior to the arrival of campers; and

 

c.  A status of “NO” means the YRC does not currently comply with the standard and does not have a plan to come into compliance prior to the arrival of campers.

 

          (c)  For any standard marked as “PENDING” or “NO” on the YRC checklist, the applicant shall provide a narrative explanation of the reason(s) for the non-compliance and:

 

(1)  A brief description of the plan(s) to bring the YRC into compliance; or

 

(2)  A request for a waiver of the requirement as specified in He-C 4003.43.

 

          (d)  For any YRC that is not served by a PWS that provides drinking water, other than water bottled as specified in RSA 143:16, RSA 485:3, XI and He-P 2100, to campers or YRC staff, or both, the YRC owner or designee shall submit results of a current water analysis for bacteria and nitrates with the application.

 

          (e)  For any YRC that is connected to a PWS during the season and that disconnects from the PWS at the end of the season and reconnects prior to the next season, the YRC owner or designee shall submit results of a current water analysis for bacteria with the application.

 

          (f)  For any YRC that is not connected to a municipal sewer or other off-site community sewage disposal system, the applicant shall provide the following additional information with the application:

 

(1)  The type(s) of toilet facilities and sewage disposal system(s) available;

 

(2)  For any system that has been approved by the department of environmental services, the approval number and date;

 

(3)  For any system that has not been approved by the department of environmental services and which includes a septic tank, a statement of the approximate age of the system and the approximate date of the most recent septic tank pumping or inspection; and

 

(4)  For any system that includes a lagoon, the number, date, and name of permittee as shown on the groundwater discharge permit or underground injection control (UIC) permit for the lagoon, as issued by the department of environmental services.

 

          (g)  The YRC owner or authorized representative shall sign and date the application and the YRC checklist. 

 

(h)  The signature on the application and YRC checklist shall constitute certification that:

 

(1)  The signer is the YRC owner or has been authorized by the YRC owner to sign the application;

 

(2)  The information provided in and with the application is true, complete, and not misleading to the knowledge and belief of the signer; and

 

(3)  The signer understands that any license granted based on false, incomplete, or misleading information shall be subject to suspension or revocation.

 

          (i)  The applicant shall file the complete application with attachments:

 

(1)  At least 30 days prior to the opening of the YRC, for a seasonal camp; or

 

(2)  No later than December 1 for the following calendar year, for a year-round camp.

 

          (j)  The applicant for a YRC license shall file a complete application with the department at the following address:

 

Department of Health and Human Services

Child Care Licensing Unit

129 Pleasant Street

Concord, NH 03301-3857

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.06  Application Processing.

 

          (a)  An application shall not be considered complete until all of the information requested in He-C 4003.05 and the attachments specified in this section are received, including any signatures required.

 

          (b)  A complete application for a YRC license shall include the following:

 

(1)  The information required in He-C 4003.05(a), signed as specified in He-C 4003.05(g);

 

(2)  Any additional required information as specified in He-C 4003.05(b)(1), (2) and (d)-(f);

 

(3)  A completed checklist as specified in He-C 4003.05(b)(3), signed as specified in He-C 4003.05(g);

 

(4)  Certification that the YRC owner has verified that the director meets the requirements specified in He-C 4003.11; and

 

(5)  The fee required by RSA 170-E:56, I, payable to “Treasurer State of NH.”

 

          (b)  Upon receipt of an application, the unit shall review the application to determine whether the application is complete.

 

          (c)  Except as provided in (f), below, if the application is not complete the unit shall notify the applicant in writing of what is required to complete the application.

 

          (d)  Upon notifying an applicant that the application is not complete, the unit shall suspend further processing of the application pending receipt of the information missing from the application.

 

          (e)  The computation of time for processing an application as specified in RSA 541-A:29 shall not begin until a complete application is received by the unit.

 

          (f)  The unit shall notify the applicant by telephone in lieu of providing a written notice pursuant to (c), above, if:

 

(1)  The anticipated time required of the applicant to supply the missing information is less than the anticipated time required of the unit to notify the applicant in writing; and

 

(2)  The unit is able to contact the applicant by telephone.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.07  Approval Criteria.

 

          (a)  The unit shall approve a YRC license application for a previously-licensed YRC if:

 

(1)  The applicant submitted a complete application;

 

(2)  The owner or operator is not on the central registry for abuse and neglect and the criminal record history for the owner and operator, if applicable, does not include any criminal conviction for any offense involving:

 

a.  Causing or threatening direct physical injury to any individual;

 

b.  Causing or threatening harm of any nature to any child or children; or

 

c. Unlawfully taking property of another, whether through force or threat of force or through deception;

 

(3)  The information supplied by the applicant shows that the YRC:

 

a.  Is in compliance with applicable standards specified in He-C 4003.03 through He-C 4003.41, or will be in compliance prior to campers arriving at the YRC; or

 

b.  Is being granted a waiver of the requirement pursuant to He-C 4003.42;

 

(4)  The test results show that the water meets applicable drinking water standards for bacteria and, if applicable, nitrates, as specified in Env-Dw 700, if the YRC is required to submit water test results pursuant to He-C 4003.05(d) or (e);

 

(5)  The YRC’s New Hampshire license has not been suspended or revoked or, if the license has been suspended or revoked, the condition(s) which resulted in the reason(s) for the suspension or revocation have been corrected or will be addressed as specified in (a)(3), above; and

 

(6)  The YRC has no outstanding deficiencies identified during an inspection conducted in accordance with this part. 

 

          (b)  The unit shall approve a YRC license application for a YRC that has not previously been licensed under these rules if:

 

(1)  The criteria specified in (a)(1)-(4) above, are met; and

 

(2)  The YRC passes a pre-season inspection in compliance with He-C 4003.15-4003.41, conducted by the unit.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

          He-C 4003.08  Issuance of YRC License.

 

          (a)  If the application is approved, the unit shall issue a YRC license to the applicant that contains the following information:

 

(1)  The YRC license number as assigned by the unit;

 

(2)  The name of the YRC owner;

 

(3)  Citations to department statutes and rules that apply to the YRC’s operation;

 

(4)  The name of the YRC;

 

(5)  The location of the YRC by street and municipality;

 

(6)  The date the department issued the license;

 

(7)  A statement that the license expires at the end of the calendar year of issuance; and

 

(8)  The signature of the department’s chief legal officer, or designee.

 

          (b)  The YRC owner or operator shall post the YRC license in a prominent place where it is visible to interested parties, such as state and local officials and parents or legal guardians of campers, such as the central YRC office or where official camp notices are posted.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.09  Inspection of YRC Facilities.

 

          (a)  As specified in He-C 4003.07(b)(2), unit staff shall inspect a YRC that has not previously been licensed in New Hampshire prior to the YRC receiving a license.

 

          (b)  Unit staff shall inspect each licensed YRC, while the YRC is in operation, to determine compliance with He-C 4003.11 through He-C 4003.42.

 

          (c)  The unit shall issue a written inspection report to the YRC owner or operator and director, which summarizes the inspection and identifies as a deficiency any condition that does not meet the applicable operating standard specified in He-C 4003.11 through He-C 4003.42, subject to the following:

 

(1)  If the YRC has received a waiver to an operating standard, such standard shall not be identified as a deficiency; and

 

(2)  If the YRC was inspected prior to the arrival of campers and the YRC identified the standard as “PENDING” pursuant to He-C 4003.05(b)(3)b., such standard shall not be identified as a deficiency if the YRC explains at the time of the inspection how the condition will be brought into compliance prior to the arrival of campers.  

 

          (d)  If the inspection report issued pursuant to (c) above identifies one or more deficiencies, the YRC owner or operator shall submit proof of compliance with the applicable standard(s) to the unit when compliance has been achieved.  Proof of compliance shall comprise of photographs, invoices, or such other documentation as is appropriate to demonstrate compliance with the particular standard(s) at issue.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.10 Suspension or Revocation of YRC License.

 

          (a)  Upon determining that conditions exist at a YRC that could adversely affect the health or safety of the campers or YRC staff, the unit shall initiate an action to suspend or revoke the YRC license in accordance with RSA 541-A:30, RSA 541-A:31, and the provisions of He-C 200 applicable to adjudicative proceedings.

 

          (b)  After a proceeding initiated pursuant to (a), above, the unit shall suspend the YRC license if the conditions:

 

(1)  Have adversely affected the health and safety of the campers or YRC staff or will adversely affect the health and safety of the campers or YRC staff if left uncorrected;

 

(2)  Resulted from accident or benign neglect; and

 

(3)  Can and will be corrected prior to further endangering the health and safety of the campers or YRC staff.

 

          (c)  After a proceeding initiated pursuant to (a), above, the unit shall revoke the YRC license if the conditions have adversely affected the health and safety of the campers or YRC staff or will adversely affect the health and safety of the campers or camp staff if left uncorrected, and:

 

(1)  Were created knowingly or with reckless disregard for camper or YRC staff health and safety; or

 

(2) Cannot be corrected prior to further endangering the health and safety of the campers or YRC staff.

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.11  Directors.

 

          (a)  Each YRC shall have a director who is at least 21 years of age.

 

          (b) The director of a residence camp shall have at least 2 seasons of previous administrative or supervisory experience in residential youth recreation camping.

 

          (c)  The director of a day camp shall have at least 2 seasons of previous administrative or supervisory experience in youth recreation camping, youth education and development, or other youth recreation programs.

 

          (d)  No individual shall be a director who has a criminal conviction for any offense involving:

 

(1)  Causing or threatening direct physical injury to any individual;

 

(2)  Causing or threatening harm of any nature to any child or children; or

 

(3)  Unlawfully taking property of another, whether through force or threat of force or through deception.

 

            (e)  No individual shall be a director who is listed on the central registry of founded reports of abuse and neglect.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.12  Counselors, Counselors-In-Training, and Junior Counselors.

 

          (a)  At least 80 percent of all counselors at a residence camp shall be 18 years of age or older.

 

          (b)  At least 80 percent of all counselors at a day camp shall:

 

(1)  Be 16 years of age or older; and

 

(2)  Be at least 2 years older than the campers with whom they are working.

 

          (c)  Each counselor, CIT, and JC shall attend a comprehensive training program provided by or through the YRC before commencing any activities with campers.

 

          (d)  No individual shall be a counselor, CIT, or JC who has any criminal conviction for any offense involving:

 

(1)  Causing or threatening direct physical injury to any individual;

 

(2)  Causing or threatening harm of any nature to any child or children; or

 

(3)  Unlawfully taking property of another, whether through force or threat of force or through deception.

 

            (e)  No individual shall be a counselor, CIT, or JC who is listed on the central registry of founded reports of abuse and neglect.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.13  Other YRC Staff. 

 

          (a)  A YRC shall not employ or otherwise engage as health care staff, kitchen staff, maintenance staff, special recreation staff, activity leader, instructor, volunteer, contractor, or otherwise, any individual who has a criminal conviction for any offense involving:

 

(1)  Causing or threatening direct physical injury to any individual;

 

(2)  Causing or threatening harm of any nature to any child or children; or

 

(3)  Unlawfully taking property of another, whether through force or threat of force or through deception.

 

          (b)  A YRC shall not employ or otherwise engage as health care staff, kitchen staff, maintenance staff, special recreation staff, activity leader, instructor, volunteer, contractor, or otherwise, any individual who is listed on the central registry of founded reports of abuse and neglect.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.14  Verification of Staff Qualifications.

 

          (a)  The YRC owner or operator shall verify that the director meets the qualifications specified in He-C 4003.11.

 

          (b)  Subject to (c) through (f), below, the YRC owner, operator, or director shall require all YRC staff, as defined in He-C 4003.03(aj), to:

 

(1)  Authorize or submit the results of a criminal background check in each state where the YRC staff member has lived, which may be done through a national database if the database includes all such states;

 

(2)  For each staff who has resided in New Hampshire for the past 7 years, complete and submit a notarized Form 2202A “DCYF Central Registry Name Search Authorization Release of Information to Third Party" (April 2014) certifying that:

 

“I acknowledge that the results of this search can only be released to myself or a Child-Placing Agency pursuant to NH RSA 170-E, the Department of Health and Human Services pursuant to RSA 170-G:8-c, or another state’s Child Welfare Agency or Private Adoption Agency pursuant to NH RSA 169-C:35. I understand and authorize the results of this search to be provided to the person/agency listed below if in compliance with the aforementioned laws. Any entity listed below that is not governed under these laws will not be sent the results”; and

 

(3)  Provide references and a listing of all previous employment and volunteer positions.

 

          (c)  Prior to employment, the YRC owner or operator shall conduct a check of the national sex offender public registry for all staff or, if the YRC staff has lived in a state that does not participate in the national registry, a check of the sex offender public registry of each state in which the individual has resided.

 

          (d)  Any counselor, CIT, or JC who is younger than 18 years old who will be left alone with a child or children, in lieu of the background check requirements specified in (b)(1) above, the individual shall provide at least 2 references to the YRC operator. 

 

(e)  One reference shall be from a non-relative, and attest to:

 

(1)  His or her knowledge of the minor’s character;

 

(2) Whether the minor has caused or threatened to cause direct physical injury to any other individual, or harm of any nature, to any child or children; and

 

(3)  His or her opinion on whether the minor is a good candidate to work directly with campers.

 

          (f)  The background check required to obtain a VISA for a counselor, CIT, or JC who enters the United States under the auspices of the International Camp Counselor Program (ICCP), Camp America, British University North America Club (BUNAC), Camp Leaders, or Camp Counselors USA (CC USA) shall meet the requirements of (b) above.

 

          (g)  The YRC shall accept the background check required for licensure for any licensed health professional who holds a current license as proof of compliance with (b)(1) above.  If the background check required for an applicant who is a licensed health professional does not include a check of the national sex offender public registry then the owner or designee shall check the person’s name against the national sex offender public registry prior to employing the applicant.

 

          (h)  For any YRC that is a certified provider under RSA 170-G:4, XVIII, the background check required for such certification may be used to satisfy the requirement of (b)(1) above.

 

          (i)  The YRC owner, operator, or director, shall:

 

(1)  Review the results of the background checks and certifications;

 

(2)  Review the submitted references and previous employment and volunteer information and check a sufficient number to become satisfied as to the individual’s suitability to work at the YRC; and

 

(3)  Conduct a personal interview with each individual hired or otherwise engaged as YRC staff.

 

          (j)  The YRC shall offer conditional employment to any applicant, pending the receipt of notice regarding the check of the New Hampshire central registry for child abuse and neglect, provided the applicant has passed all other required background checks specified in He-C 4003.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.15  Sleeping Areas; Privacy Areas.

 

          (a)  For purposes of this section, the following definitions shall apply:

 

(1)  “Privacy area” means a designated private or semi-private area at a camp, such as a room or other space that has permanent or temporary side walls, in which campers or YRC staff are expected to undress or change clothes.  The term includes sleeping areas and changing areas associated with showers or other bathing facilities, or with swimming, boating, or other athletic facilities;

 

(2)  “Session” means a period of time established by the camp owner for which a camper is enrolled at a camp;

 

(3)  “Sleeping area” means a tent, cabin, room, or other designated private or semi-private area at a residence camp in which a person is intended to sleep; and

(4) “Special needs camper” means a camper who, for any physical, psychological, or developmental reason, has one or more counselors assigned to work specifically with him or her.

 

          (b)  The YRC owner or designee shall develop a written policy to address transgender and gender non-conforming campers and staff, which may be as general or as specific as the YRC owner wants it to be.

 

          (c)  Subject to (d), below, no member of the YRC staff, including the director, counselors, activity leaders, instructors, health care providers, office personnel, managers, kitchen staff, and maintenance staff, shall enter a privacy area unless:

 

(1)  The privacy area is a sleeping area to which the YRC staff member is assigned;

 

(2)  Such entry is necessary to protect the health and safety of the occupants, such as in the case of a fire or a situation requiring urgent medical attention; or

 

(3)  The YRC staff member first announces his or her intent to enter and proceeds only after the occupants give audible approval.

 

          (d)  The provisions of (c), above, shall not apply to a camp attended by special needs campers if:

 

(1)  The YRC staff member enters the privacy area at the same time as the campers in order to assist a special needs camper;

 

(2)  The other campers are aware of the YRC staff member’s presence and have the opportunity to wait until the YRC staff member departs to disrobe or are otherwise provided privacy in which to disrobe; and

 

(3)  The camp has a written policy in place to ensure the safety of the campers in such situations and specifically covers the policy in the training provided pursuant to He-C 4003.12(c).

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.16  Camp Facilities.

 

          (a)  All camp facilities and grounds shall be maintained in good repair to ensure safe and sanitary conditions.

 

          (b)  Ventilation in camp facilities shall provide a movement of air to assure the comfort and protection of the occupants.

 

          (c)  Doors, windows, and other outer openings of camp facilities used for food storage, preparation, or consumption shall be equipped with screens with a mesh having at least 18 strands by 16 strands per square inch in all but the following circumstances:

 

(1)  First floor windows if designated for use as emergency egress;

 

(2)  Doors which are opened for normal or emergency ingress or egress; and

 

(3)  Any other time when such openings are ajar for a specific purpose at such times of the day or seasons of the year so as not to allow insects into the affected room(s).

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.17 Vehicles.  Any vehicle used to transport campers shall meet the applicable safety and operator requirements established by the New Hampshire department of safety.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.18  Sleeping Quarters.

 

          (a)  Each permanent building in which individuals sleep shall demonstrate compliance with applicable provisions of the state life safety code through an inspection undertaken pursuant to He-C 4003.28.

 

          (b)  Sleeping quarters in buildings shall meet the following criteria:

 

(1)  Sleeping units shall be arranged to provide a minimum floor area ratio of 40 square feet per single bunk and 60 square feet per double bunk;

 

(2)  Suitable protection shall be provided against insects;

 

(3)  A distance of at least 6 feet shall be provided between the heads of sleepers; and

 

(4)  A distance of at least 30 inches shall be provided between the sides of 2 adjacent beds.

 

          (c)  The number of campers in a tent shall not exceed the manufacturer’s rating for the tent.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.19  Assembly Areas.  Assembly areas shall comply with applicable provisions of the state life safety code.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.20  Drinking Water and Plumbing.

 

          (a)  Water used at the YRC for drinking, food preparation, and cleanup shall comply with the drinking water standards for bacteria and nitrates specified in Env-Dw 700.

 

          (b)  No cross-connection shall exist between approved and unapproved sources of water supply.  Fixtures shall be constructed as to involve no interconnections and no hazard of back-siphonage, as specified in Env-Dw 505.

 

          (c)  All plumbing , including drinking water fountains, shall conform to the applicable requirements of the state building code as established in RSA 155-A.

 

          (d)  If the YRC does not receive drinking water from a PWS, the YRC’s source of drinking water shall be:

 

(1)  Located to avoid contamination from buildings or wastewater disposal, if a surface water source; or

 

(2)  Constructed in accordance with the standards for drinking water wells established by the New Hampshire water well board in We 100-1000.

 

          (e)  Drinking water shall not be obtained from a source by dipping or drawing by a bucket.

 

          (f)  The distance between the YRC water supply and sanitary waste disposal shall meet the criteria set forth in Env-Wq 1000 unless the commissioner of the department of environmental services grants a waiver pursuant to Env-Wq 1001.03.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.21  Water Testing and Treatment.

 

          (a)  A YRC served by a PWS shall not be required to undertake separate testing under this chapter unless the PWS is in violation of its monitoring schedule for bacteria or nitrate, or both, established pursuant to Env-Dw 708 at the time the YRC application is submitted to the unit.

 

          (b)  If the PWS is in violation of its bacteria or nitrate monitoring schedule, the YRC shall have its drinking water analyzed for the contaminant for which the PWS is in violation within 7 days of being notified by the unit.

 

          (c)  A YRC that is not served by a PWS shall have its drinking water analyzed for bacteria and nitrates within 30 days prior to the opening date of the YRC season.

 

          (d)  The analyses required by (b) or (c), above, shall be conducted by a laboratory accredited for drinking water bacteria and nitrate analyses by the department of environmental services pursuant to Env-C 300.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.22  Natural Waters and Beaches.

 

          (a)  Natural waters used for swimming shall meet or exceed Class B criteria as specified in RSA 485-A:8 and Env-Wq 1700.

 

          (b)  A beach that is part of the YRC property shall meet the following health criteria:

 

(1)  The shore shall be free of litter;

 

(2)  Domestic animals shall be prohibited from the beach and swimming area; and

 

(3)  Detergents, personal bathing, and vehicle washing shall be prohibited in the water.

 

          (c)  Beach structures shall meet the following criteria:

 

(1)  Diving boards shall:

 

a.  Be firmly affixed to a dock or float; and

 

b.  Have a top surface that is slip-resistant; and

 

(2)  Docks, floats, and platforms shall be maintained in good repair so that they are free of splinters, cracks, sharp edges, or protruding hardware.

 

          (d)  Safety systems and procedures for use of the beach shall be as follows:

 

(1)  A first-aid kit shall be available at the beach, equipped with such items as lifeguard staff deem necessary to address emergency situations that are likely to occur at the waterfront;

 

(2)  All water activities shall be permitted only under the supervision of an American Red Cross certified lifeguard or another individual certified in an equivalent national recognized course having standards no less stringent than the life guard course offered by the American Red Cross;

 

(3)  There shall be one certified lifeguard for every 25 campers participating in water activities;

 

(4)  There shall be at least one YRC staff member or lifeguard for each 10 campers participating in water activities;

 

(5)  There shall be a safety accounting system in place for supervising and checking campers participating in water activities;

 

(6)  A check of campers participating in water activities shall be made at least every 15 minutes and referenced against the safety accounting system during non-instructional time;

 

(7) There shall be supervised entrances and exits and a lifeguard station providing an unobstructed view of the swimming area; and

 

(8) The YRC shall have a lost-swimmer plan detailing procedures to follow in an emergency.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.23  Swimming Pools.

 

          (a)  A swimming pool that is part of a YRC shall meet the criteria specified in Env-Wq 1100 for public swimming pools.

 

          (b)  Safety systems and procedures for use of each pool shall be as follows:

 

(1)  A first-aid kit shall be available at the pool, equipped with such items as lifeguard staff deem necessary to address emergency situations that are likely to occur at the pool;

 

(2)  All water activities shall be permitted only under the supervision of an American Red Cross certified lifeguard or another individual certified in an equivalent national recognized course having standards no less stringent than the life guard course offered by the American Red Cross;

 

(3)  There shall be one certified lifeguard for every 25 campers participating in water activities;

 

(4)  There shall be at least one YRC staff member or lifeguard for each 10 campers participating in water activities;

 

(5) There shall be a safety accounting system in place for supervising and checking campers participating in water activities;

 

(6)  A check of campers participating in water activities shall be made at least every 15 minutes and referenced against the safety accounting system during non-instructional time;

 

(7) There shall be supervised entrances and exits and a lifeguard station providing an unobstructed view of the swimming area; and

 

(8)  The YRC shall have a lost-swimmer plan detailing procedures to follow in an emergency.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.24  Toilet Facilities.

 

          (a)  Toilet facilities shall:

 

(1)  Include one toilet for every 10 campers in a resident camp;

 

(2)  Include one toilet for every 30 campers in a day camp;

 

(3)  Be located, constructed, and maintained to ensure safe and sanitary conditions; and

 

(4)  Contain at least one toilet for each gender with a door or curtain for privacy.

 

          (b)  Urinals may be substituted for up to 1/3 of the toilets in toilet facilities for males.

 

          (c)  Floors and walls in toilet facilities shall be sealed with polyurethane or paint up to a height of not less than 48 inches.

 

          (d)  Badly worn or chipped toilet seats shall be repaired or replaced.

 

          (e)  All toilet facilities shall be supplied with toilet paper at all times.

 

          (f)  A sink for hand washing with soap and single use towels shall be available within or immediately outside the toilet facility.

 

          (g)  Privies shall meet the following conditions:

 

(1)  The privy shall be constructed in accordance with Env-Wq 1022.01;

 

(2)  Privies shall be located:

 

a.  At least 100 feet from any place where food is prepared or served;

 

b.  At least 75 feet from any surface water; and

 

c.  At least 200 feet up-gradient of any well or spring;

 

(3)  Privy contents shall be:

 

a.  Removed as often as necessary to prevent the pit from being filled to within one foot of the top of the pit; and

 

b.  Disposed of in accordance with Env-Wq 1600.

 

(4)  The contents of the pit shall be covered daily with lime or other suitable agent to eliminate insects and odors;

 

(5)  The materials for liming and disinfection shall be kept in proximity to the privy so as to be readily available for use;

 

(6)  The privy and the pit shall be made fly-tight and provided with self-closing lids; and

 

(7)  Clean and sanitary conditions shall be maintained at all times.

 

          (h)  Chemical toilets shall be maintained and pumped by a septage hauler licensed by the department of environmental services in accordance with Env-Wq 1600.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.25  Sewage Disposal Facilities.  All on-site septic systems shall be designed, constructed, and maintained in accordance with Env-Wq 1000.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.26  Garbage and Waste Disposal; Toxic Chemical Storage.

 

          (a)  Garbage and refuse shall be disposed of in durable, easily cleanable, insect-proof, and rodent-proof containers that do not leak and do not absorb liquids.  Plastic bags or wet-strength paper bags shall be used to line such containers when maintained inside the areas used for food storage, preparation, or consumption.

 

          (b)  Garbage and refuse containers stored outdoors and dumpsters, compactors, and compactor systems shall be:

 

(1)  Easily cleanable;

 

(2)  Provided with tight fitting lids, doors, or covers; and

 

(3)  Kept covered when not in actual use.

 

          (c)  For any container equipped with a drain, the drain plug shall be in place at all times, except during cleaning.

 

          (d)  Cleaning materials, flammable materials, and toxic materials shall be:

 

(1)  Stored in properly labeled and safe containers;

 

(2)  Stored in an area separate from food; and

 

(3)  Used only by or under the supervision and direction of YRC staff.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.27  Notification to Emergency Responders.

 

          (a)  Subject to (d), below, the YRC owner or designee shall notify the local police, fire, and rescue departments regarding their operating dates in accordance with the following:

 

(1)  Annually for year-round camps; and

 

(2)  Immediately prior to opening for seasonal camps.

 

          (b)  The notification required by (a), above, shall:

 

(1)  Be in writing;

 

(2)  Include the opening and closing dates for seasonal camps; and

 

(3)  Be delivered in hand or sent via private delivery service, U.S. Postal Service, or email. 

 

          (c)  The YRC owner, or designee, shall:

 

(1)  Retain a paper copy of the notification; and

 

(2)  Provide it upon request to unit personnel.

 

          (d)  For any YRC located within an area that is served by full-time, non-volunteer emergency response personnel even when the YRC is not in operation, notice as specified in (a) above shall be required only if requested by the local emergency response agencies.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.28  Fire Safety Inspections and Compliance.

 

          (a)  The YRC owner, or designee, shall contact local fire officials to schedule such periodic fire safety inspections as are required by local ordinances or the state fire code.

 

          (b)  The YRC owner shall make the results of the inspection available to the department upon request.

 

          (c)  If the results of the inspection conducted by local fire officials show that the YRC did not pass the inspection, the YRC owner or designee shall provide a copy of the follow-up inspection report to the department within 10 days of receiving it.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.29  Storage, Handling, and Preparation of Food; Food Service; Kitchens.  The sanitary storage, handling, and protection of all food supplies, including refrigeration of perishable products and food preparation, as well as kitchen maintenance and dishwashing, shall comply with rules of the department of health and human services, division of public health services identified as He-P 2303.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.30  Required Health Care Staffing: Day Camps.

 

          (a)  A day camp that is not operated for campers who are physically or mentally disabled shall have, whenever campers are present at the camp, the following on-site medical staff:

 

(1)  A YRC staff member who is certified in age-appropriate first aid/CPR/AED; and

 

(2)  If the nearest emergency medical services are greater than 20 minutes from the camp by automobile, a YRC staff member who is:

 

a.  Certified as an emergency medical technician (EMT);

 

b.  Certified in wilderness and remote first aid;

 

c.  Certified as an emergency medical responder; or

 

d.  A licensed health care practitioner or physician.

 

          (b)  A day camp that is operated for campers who are physically or mentally disabled shall have, whenever campers are present at the camp, the following on-site medical staff:

 

(1)  A licensed health care practitioner or a physician licensed to practice in New Hampshire;

 

(2) A YRC staff member who is certified in age-appropriate first aid/CPR/AED; and

 

(3)  A YRC staff member who is:

 

a.  Certified as an EMT;

 

b.  Certified in wilderness and remote first aid; or

 

c.  Certified as an emergency medical responder.

 

          (c)  The YRC staff member who is certified in first aid/CPR/AED and the YRC staff member who qualifies under (a)(2) or (b)(1) or (3) may be the same individual.

 

          (d)  The YRC staff member certified in first aid/CPR/AED whose training is used to meet the requirements of (a)(1) or (b)(2) above shall have been certified or had such certification renewed within 24 months of the opening of the YRC for the season.

 

          (e)  The YRC staff member who qualifies under (a)(2) or (b)(3) above shall have been certified or had such certification renewed within 3 years of the opening of the YRC for the season.

 

          (f)  If a New Hampshire-licensed PA is used to satisfy the requirements of (b)(1)above, the PA shall provide a copy of the written agreement with the PA’s supervising New Hampshire-licensed physician to the YRC.

 

          (g)  Each health staff member shall post a copy of his or her New Hampshire license(s) in a conspicuous location in the camp office or infirmary.  For health care practitioners licensed in New Hampshire, a copy of the license verification as obtained through the New Hampshire board of nursing’s on-line license verification system may be substituted for a copy of the license.

 

          (h)  The YRC owner shall ensure that all health staff comply with Lab 1403.08, regarding reducing the risk of exposure to blood-borne pathogens.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.31  Required Health Care Equipment: Day Camps.

 

          (a)  A day camp shall have either:

 

(1)  A first aid cabinet as specified in He-C 4003.35(a)(1); or

 

(2)  At least one first aid kit containing such items as health staff deem necessary to address health issues likely to arise at the YRC.

 

          (b)  Excluding epinephrine auto-injectors or asthma inhalers possessed pursuant to RSA 170-E:59 through RSA 170-E:64, all medications or prescription drugs shall be kept in a container that is:

 

(1)  Inaccessible to campers and unauthorized YRC staff;

 

(2)  Stored in a secondary container separate from food if in a refrigerator; and

 

(3)  Labeled with the camper’s name to ensure identification of the medication.

 

          (d)  All medications belonging to YRC staff shall be stored separately from the campers’ medications in a container or area that is inaccessible to unauthorized individuals.

 

          (e)  The YRC shall comply with Env-Sw 904 relative to storage and disposal of infectious waste, including sharps.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.32  Required Health Care Staffing: Residence Camps.

 

          (a)  A residence camp that is not operated for campers who are physically or mentally disabled where the total number of campers and YRC staff is 75 or fewer shall have, whenever campers are present at the camp, the following on-site medical staff:

 

(1)  A YRC staff member who is certified in age-appropriate first aid/CPR/AED; and

 

(2)  A YRC staff member who is:

 

a.  Certified as an emergency medical technician (EMT);

 

b.  Certified in wilderness and remote first aid;

 

c.  Certified as an emergency medical responder; or

 

d.  A licensed health care practitioner or physician.

 

          (b)  A residence camp that is not operated for campers who are physically or mentally disabled where the total number of campers and YRC staff is at any time greater than 75 shall have, whenever campers are present at the camp, the following on-site medical staff:

 

(1)  A licensed health care practitioner or a physician licensed to practice in New Hampshire;

 

(2)  A YRC staff member who is certified in age-appropriate first aid/CPR/AED; and

 

(3)  If the nearest emergency medical services are greater than 20 minutes from the camp by automobile, a YRC staff member who is:

 

a.  Certified as an EMT;

 

b.  Certified in wilderness and remote first aid; or

 

c.  Certified as an emergency medical responder.

 

          (c)  A residence camp that is operated for campers who are physically or mentally disabled shall have, whenever campers are present at the camp, the following on-site medical staff:

 

(1)  A licensed health care practitioner or a physician licensed to practice in New Hampshire;

 

(2)  A YRC staff member who is certified in age-appropriate first aid/CPR/AED; and

 

(3)  A YRC staff member who is:

 

a.  Certified as an emergency medical technician (EMT);

 

b.  Certified in wilderness and remote first aid; or

 

c.  Certified as an emergency medical responder.

 

          (d)  The YRC staff member who is certified in first aid/CPR/AED and the YRC staff member who qualifies under (a)(2), (b)(1) or (3), or (c)(1) or (3), above, may be the same individual.

 

          (e)  The YRC staff member certified in first aid/CPR/AED whose training is used to meet the requirements of (a)(1), (b)(2), or (c)(2), above, shall have been certified or had such certification renewed within 24 months of the opening of the YRC for the season.

 

          (f)  The YRC staff member who qualifies under (a)(2), (b)(3), or (c)(3), above, shall have been certified or had such certification renewed within 3 years of the opening of the YRC for the season.

 

          (g)  If a New Hampshire-licensed PA is used to satisfy the requirements of (a)(2), (b)(1), or (c)(1), above, the PA shall provide a copy of the written agreement with the PA’s supervising New Hampshire-licensed physician to the YRC.

 

          (h)  Each health staff member shall post his or her New Hampshire license(s) in a conspicuous location in the camp office or infirmary.  For health care practitioners licensed in New Hampshire, a copy of the license verification as obtained through the New Hampshire board of nursing’s on-line license verification system may be substituted for a copy of the license.

 

          (i)  The YRC owner shall ensure that all health staff comply with Lab 1403.08, regarding reducing the risk of exposure to blood-borne pathogens.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.33  Medical Supervision at Residence Camps.

 

          (a)  All residence camps shall provide by contract for 24-hours per day, 7-days per week on-call medical service and supervision of all first aid and health services in the YRC by:

 

(1)  A physician or APRN licensed to practice in New Hampshire; or

 

(2)  A hospital emergency service.

 

          (b)  If a physician or APRN licensed to practice in New Hampshire and having at least one of the certifications listed in He-C 4003.30(a) or (b)(1)-(3) is in residence at and employed by a YRC, the requirements of (a) above shall be deemed to have been met.

 

          (c)  The physician or APRN under contract pursuant to (a) or (b) above shall issue written instructions, signed by the physician or APRN, to the individual responsible for providing first aid, to be followed in the absence of the physician or APRN.

 

          (d)  The YRC owner or director shall post the instructions prepared pursuant to (c), above, in a conspicuous place in the infirmary.

 

          (e)  The YRC owner shall provide a telephone or other means of emergency communication in the YRC, or ensure that such communication is available within 10 minutes travel time from the YRC.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.34  Required Health Care Equipment and Facilities: Residence Camps. 

 

          (a)  If the YRC is a residence camp, the director shall maintain the following first aid related items at the YRC at all times:

 

(1)  A first aid cabinet, which shall be:

 

a.  Kept fully equipped at all times with such items as health staff deem necessary to address health issues likely to arise at the YRC; and

 

b.  If containing prescription or non-prescription medications, locked when not in use; and

 

(2)  A backboard with head blocks and straps and proper immobilization equipment, such as straps, cervical collar, or blankets.

 

          (b)  Camp facilities shall include any needed isolation facilities.

 

          (c)  Where the YRC provides an infirmary building or room, such quarters shall:

 

(1)  Be isolated from the regular living and sleeping quarters to insure both quiet to the patient and safety to others; and

 

(2)  Not be used for any other purposes.

 

          (d)  Excluding epinephrine auto-injectors or asthma inhalers possessed pursuant to RSA 170-E:59 through RSA 170-E:64, all prescription and non-prescription medications shall be kept in a locked container that is:

 

(1)  Inaccessible to campers and unauthorized YRC staff;

 

(2)  Stored in a secondary container separate from food if in a refrigerator; and

 

(3)  Labeled with the camper’s name.

 

          (e)  All medications belonging to YRC staff shall be stored separately from the campers’ medications in a container or area that is inaccessible to unauthorized individuals.

 

          (f)  The YRC shall comply with Env-Sw 904 relative to storage and disposal of infectious waste, including sharps.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.35  Required Health Care Staffing: Off-Site Trips.

 

          (a) YRC staff supervising any off-site trip with campers shall carry a first aid kit equipped with such items as the YRC health staff deems necessary to address emergency situations that might occur.

 

          (b)  At least one YRC staff member on an off-site trip with campers shall be certified in:

 

(1)  First aid/CPR/AED; or

 

(2)  Wilderness and remote first aid.

 

          (c)  Subject to (d), below, on any off-site trip with campers involving boating or swimming, at least one YRC staff member shall be:

 

(1)  Certified as a lifeguard by the American Red Cross; or

 

(2)  Certified in an equivalent nationally-recognized course based on standards that are no less stringent than the lifeguard course offered by the American Red Cross.

 

          (d)  Having a YRC staff member be a certified lifeguard shall not be required if a certified lifeguard engaged by the owner or operator of the boating or swimming site or facility is on duty at the site or facility when the campers are boating or swimming, as applicable.

 

          (e)  Drinking water obtained during the trip from a source other than a public water system shall be considered as unsafe unless:

 

(1)  Disinfected by adding chlorine or iodine;

 

(2)  Filtered by the use of a drinking water filtration device intended to remove microorganisms; or

 

(3)  Disinfected by achieving a rolling boil for one minute.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.36  Communicable Diseases Isolation and Reporting.

 

          (a)  As required by He-P 301.03, any case or suspected case of a reportable disease, as listed in He-P 301.02, shall be reported by:

 

(1)  The physician or licensed health care practitioner who assessed, diagnosed, or treated the individual believed to have or suspected of having a reportable disease; or

 

(2)  When no physician or licensed health care practitioner is present, the director.

 

          (b)  The report identified in (a), above, shall include all of the information required by He-P 301.03, including the name and home address of the individual known to have or suspected of having the reportable disease.

 

          (c)  An individual with a communicable disease shall be placed in isolation and not leave or be removed from strict isolation without permission of the YRC health staff.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.37  Reporting of Other Illnesses.  When an outbreak of suspected food poisoning or other unusual prevalence of any illness occurs in which headache, muscle stiffness, general malaise, fever, diarrhea, sore throat, vomiting, or jaundice is a prominent symptom, the health staff or director shall immediately report the existence of such an outbreak or disease as required by He-P 300.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.38  Required Health Information.

 

          (a)  Each camper shall provide a health history and statement of health status to the director prior to entering the YRC.  As specified in RSA 170-E:58, the examination on which the statement of health status is based may be conducted by a physician, licensed advanced registered nurse practitioner, or PA.

 

          (b)  The health history and statement of health status required by (a), above, shall include the following:

 

(1)  A certification that the physical examination was completed within 2 years prior to YRC entrance;

 

(2)  A description of any camp activities from which the camper is exempt from for health reasons;

 

(3)  Unless exempted in accordance with RSA 141-C:20-c, documentation of immunization as specified in He-P 301.14.

 

(4)  A list of all known or suspected allergies;

 

(5)  If the YRC will provide food, identification of all dietary restrictions and any food allergies not listed under (4), above;

 

(6)  A list of all prescribed or over-the-counter medications being taken by the camper; and

 

(7)  To the extent not covered by (2) - (6) above, a description of any current physical, mental, or psychological conditions that require medication, treatment, or special restrictions or considerations while at the YRC.

 

          (c)  The YRC owner shall retain all documentation required by (b) above for 2 years, which shall be made available to the department upon request.

 

          (d)  The YRC owner or director shall:

 

(1)  Develop a written policy to establish what health information is required for YRC staff; and

 

(2)  Provide a copy of the policy to any parent or legal guardian of a camper or prospective camper upon request.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.39  Administration of Medication.

 

          (a)  The availability, use, and possession of epinephrine auto-injectors and asthma inhalers shall be as specified in RSA 170-E:59 through RSA 170-E:64.

 

          (b)  Prescription medications other than those listed in (a), above, and non-prescription medications other than topical substances shall be administered to campers only by authorized staff and only in accordance with the applicable medication order.

 

          (c)  If a camper’s parent or legal guardian provides written permission, YRC staff who have not been trained as specified in He-C 4003.40(a) may administer non-prescription topical substances to the camper.

 

          (d)  Authorized staff shall administer only those prescription medications for which there is a prescription label or written directions provided by a physician or APRN who is legally authorized to write the prescription, and written permission from the camper’s parent or legal guardian.

 

          (e)  Medication orders shall be valid for no more than one year.

 

          (f)  Each medication order shall legibly display the following information:

 

(1)  The camper’s name;

 

(2)  The name, strength, prescribed dose, and method of administration of the medication;

 

(3)  The frequency of administration of the medication, or if the medication is to be used on an as-needed basis (PRN), the information specified in (g), below; and

 

(4) The dated signature of the camper’s parent or legal guardian or a licensed health care practitioner for orders other than as shown on the prescription label.

 

          (g)  A medication order from a parent or legal guardian or a licensed health care practitioner regarding any medication to be administered as needed (PRN) shall include:

 

(1)  The indications and any special precautions or limitations regarding administration of the medication;

 

(2)  The maximum dosage allowed in a 24-hour period;

 

(3) The dated signature of the parent or legal guardian for topical substances and non-prescription medication; and

 

(4)  For orders other than as shown on the prescription label, the dated signature of the licensed health care practitioner for prescription medication.

 

          (h)  A written order regarding prescription medication shall not be changed except by a physician or a licensed health care practitioner having legal authority to prescribe.

 

          (i)  All prescription medications, including physician medication samples, shall:

 

(1)  Bear a label that legibly displays the information described in (f)(1)-(3), above; and

 

(2)  Be stored, dispensed, and administered in accordance with:

 

a.  RSA 318 and requirements adopted pursuant thereto by the New Hampshire board of pharmacy; and

 

b.  RSA 326-B and requirements adopted pursuant thereto by the New Hampshire board of nursing.

 

          (j)  All non-prescription medication and topical substances shall be kept in the original containers and properly closed after each use.

 

          (k)  The YRC may provide age-appropriate non-prescription topical substances, such as sunscreen, insect repellent, and over-the-counter anti-itch or anti-bacterial creams or ointments, and common non-prescription medications such as over-the-counter pain relievers and gastro-intestinal calming agents to a camper with the written permission of the camper’s parent or legal guardian.

 

          (l)  Any items provided pursuant to (k), above, shall be stored and administered as specified on the product label and in this section.

 

          (m)  The director shall return any remaining medication and topical substances provided by a camper’s parent or legal guardian to the parent or legal guardian when the camper departs the YRC.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.40  Training for YRC Staff.

 

          (a) Prior to administering prescription or non-prescription medication to any camper, YRC staff shall:

 

(1)  Complete and document training on medication safety and administration delivered by a physician, an APRN, an RN, or an LPN practicing under the direction of an APRN, RN, or physician; or

 

(2) Successfully complete a nationally-recognized course on medication safety and administration having standards that are no less stringent than the Academy of Pediatrics on-line course, Medicine Administration in Early Education and Child Care.

 

          (b)  Health staff shall complete training in medication safety and administration every 3 years.

 

          (c)  The YRC owner shall:

 

(1)  Maintain all documentation of training in medication safety and administration on file; and

 

(2)  Make such documentation available for review by state or local health officials upon request.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.41  Recordkeeping and Reporting.

 

          (a)  For each camper receiving medication, YRC health staff shall maintain the following information on file:

 

(1)  For each medication prescribed for a camper, the written medication order as specified in He-C 4003.39 and any special considerations for administration of the medication;

 

(2) Written authorization from the camper’s parent or legal guardian to administer the medication, which includes a statement that the camper has received the specific medication prior to entering the YRC;

 

(3)  The name and contact information of the camper’s parent or legal guardian who is to be notified if required by (d), below; and

 

(4)  Any allergies the camper is known to have or is suspected to have.

 

          (b)  The record required by (a), above, shall be updated with a written record of each dose of medication, excluding topical substances, administered to the camper.

 

          (c)  The written record required by (a), above, shall:

 

(1)  Be maintained on file and made available for review by state or local health officials;

 

(2) Be completed by the YRC staff who administered the medication immediately after the medication is administered; and

 

(3) For each administered medication, include:

 

a.  The name of the camper;

 

b.  The date and time the medication was taken;

 

c.  A notation of any deviation from the medication order provided pursuant to He-C 4003.40 in the administration of a medication and the reason why the medication was not taken as ordered or approved;

 

d. The dated signature of the authorized staff who administered the medication to the camper;

 

e.  For administration of an as-needed medication, the reason for administration; and

 

f.  Any other information that is relevant to the administration of the medication.

 

          (d)  In the event of any deviation from the administration of medication as described in (3)c., above, the director or designee shall:

 

(1)  Note the deviation in the record required by (c), above; and

 

(2)  Notify the camper’s parent or legal guardian immediately.

 

          (e)  In the event of an error in the documentation of the administration of medication, the director or designee shall identify the error and provide correct information in the record as soon as the error is identified.

 

          (f)  The director shall make the records required by this section available for review by state and local health officials upon request.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4003.42  Waivers.

 

          (a)  The unit shall grant a waiver to accommodate situations and circumstances at YRCs where strict compliance with all requirements established herein may not be necessary for the protection of the safety and health of the individuals who attend or provide services at such camps.

 

          (b)  A request for a waiver shall be filed with the application for a YRC license or as soon thereafter as the need for the waiver is identified.

 

          (c)  The person requesting the waiver shall include the following information with each such request:

 

(1)  A specific reference to the section of the rule for which a waiver is being sought;

 

(2)  A full explanation of why a waiver is necessary;

 

(3)  A full explanation of the alternative(s) proposed to be implemented if a waiver is granted, if any;

 

(4)  Whether the waiver is needed for a limited time and, if so, what that time period is; and

 

(5)  A full explanation of why granting the waiver will not jeopardize the health and safety of the individuals who attend or provide services to the YRC, as applicable.

 

          (d)  Subject to (e), below, the unit shall grant a waiver if it determines that granting a waiver will not jeopardize the health and safety of the individuals who attend or provide services to the YRC, as applicable.  In granting a waiver, the unit shall impose such conditions, including time limitations, as the unit deems necessary to ensure that the health and safety of the individuals who attend or provide services to the YRC, as applicable, are protected.

 

          (e)  No waiver shall be granted if the effect of the waiver would be to waive or modify a statutory requirement, unless the statute expressly provides that the requirement may be waived or modified.

 

          (f)  If a waiver is granted, the waiver shall be made part of the license.

 

          (g)  If the waiver request is denied, the unit shall notify the person requesting the waiver in writing of the decision and the reason(s) for the decision.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

PART He-C 4004  CERTIFICATION REQUIRED FOR YOUTH SKILL CAMPS

 

          He-C 4004.01  Purpose.  The purpose of this part is to implement the requirements in RSA 170-E:56, II relative to conducting background checks for youth skill camps (YSCs).

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4004.02  Applicability.

 

          (a)  These rules shall apply to all youth skill camps as defined in He-C 4004.03(h)

 

          (b)  These rules shall not apply to:

 

(1)  Any recreation camp as defined in RSA 170-E:55, I , and regulated under He-C 4003;

 

(2)  Any child day care agency as defined in RSA 170-E:2, IV;

 

(3)  Any private home in which a skill is taught to a child pursuant to an agreement between the child’s parent or guardian and the instructor; and

 

(4)  Any class or program that otherwise would qualify as a youth skills camp as defined in He-C 4004.03(h) that is conducted or offered by an educational institution regulated under Title XV of New Hampshire’s codified statutes, including public and nonpublic institutions, provided that:

 

a.  A criminal history records check as described in RSA 189:13-a is completed on each employee and volunteer of the public or nonpublic institution who might be left alone with a child or children during the class or program; and

 

b.  A check of the national sex offender public registry is completed for each employee and volunteer covered by a. above.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4004.03  Definitions.  For purposes of this part, the following definitions shall apply:

 

          (a)  “Background check policy” means the policy required by RSA 170-E:56, II relative to background checks for all camp staff who might be left alone with any child or children;

 

          (b)  “Camp staff” means the owner and operator of a youth skill camp and any employee, volunteer, or other individual employed or otherwise associated with the youth skill camp, whether for pay or not, to interact directly with youths in a setting where a single staff member might be left alone with any child or children;

 

          (c)  “Child” mean an individual under 18 years of age;

 

          (d)  “Minor” means an individual under 18 years of age;

 

          (e)  “Program” as used in the definition of “youth skill camp” means a specific curriculum that:

 

(1)  Has been developed by individuals knowledgeable and experienced in the field to impart a specific skill over a period of 3 or more consecutive days; and

 

(2)  Is taught by at least one instructor who is knowledgeable and experienced in the skill being imparted;

 

          (f)  “State of residence” means a state in which an individual who is subject to the background check required by RSA 170-E:56, II currently lives or has lived, whether on a permanent or temporary basis, after attaining the age of 18 years;

 

          (g)  “Youth” means a minor who attends a youth skill camp;

 

          (h)  “Youth skill camp (YSC)” means “youth skill camp” as defined in RSA 170-E:55, II,  that is not also a recreation camp as defined in RSA 170-E:55, I;

 

          (i) “YSC operator” means the person that has primary responsibility for the day-to-day operation and management of a YSC.  The YSC operator might also be the YSC owner;

 

          (j) “YSC owner” means the person that owns and is ultimately responsible for the operation and management of a YSC.  The YSC owner might also be the YSC operator; and

 

          (k)  “Validated database” means a database that includes:

 

(1)  Felonies and misdemeanors in each state other than New Hampshire; and

 

(2)  Felonies in New Hampshire.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4004.04  Required Background Check Policy.

 

          (a)  The background check policy required by RSA 170-E:56, II(a) shall be adequate to ensure that no camp staff has a criminal conviction for any of the offenses listed therein, specifically:

 

(1)  Causing or threatening direct physical injury to any individual; or

 

(2)  Causing or threatening harm of any nature to any child or children.

 

          (b)  A background check policy shall be deemed to meet the requirement of (a), above, if it:

 

(1)  Requires all camp staff who might be left alone with a child or children to be subject to a background check, as described in He-C 4004.05, prior to initially being left alone with a child or children and not less than once in each calendar year thereafter;

 

(2)  Prohibits any staff member who has not been subject to the required background check from working directly with any youth(s) unless a staff member for whom the background check has been completed is also present;

 

(3)  Requires the YSC operator to review:

 

a.  The results of the background checks and certifications, for compliance with the established YSC policy and RSA170-E:56, II(a); and

 

b.  Any references, employment history, and volunteer history submitted by or for each camp staff member, to determine whether to allow the individual to work directly with youths at the YSC;

 

(4)  As required by RSA 170-E:56, II(e), identifies the frequency of the background checks and the sources used to conduct the background checks; and

 

(5)  Requires the YSC operator to maintain an up-to-date listing of all staff members who are in a position such that it is possible they could be left alone with children, together with the status of their background checks.

 

          (c)  As specified in RSA 170-E:56, II(d), a background check policy may include more stringent requirements for background checks than specified in (b), above, provided:

 

(1)  The requirement of (a), above, is met; and

 

(2)  The more stringent requirements are explicitly identified in the policy and in the certification explained in He-C 4004.07.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4004.05  Background Checks.

 

          (a)  Subject to (b) through (d), below, the background check required by each YSC’s background check policy shall comprise:

 

(1)  A criminal background check in each state of residence of the potential staff member, which may be done through a validated database that includes current information for each such state of residence or through the state identification bureau of each state of residence; and

 

(2)  A check of the national sex offender public registry.

 

          (b)  For any volunteer or employee who is younger than 18 years old who will be left alone with a youth, the background check policy shall require the minor to provide a minimum of 2 written references to the YSC operator. 

 

(c)  One reference shall be from a non-relative, and attest to:

 

(1)  Their knowledge of the minor’s character;

 

(2)  Whether the minor has caused or threatened to cause direct physical injury to any other individual, or harm of any nature, to any child or children; and

 

(3)  Their opinion on whether the minor is a good candidate to work directly with campers.

 

          (d)  The YSC may accept the background check required for licensure for any licensed health professional who holds a current license as proof of compliance with (a)(1) above.  If the background check required for an applicant who is a licensed health professional does not include a check of the national sex offender public registry then the owner or designee shall check the person’s name against the national sex offender public registry prior to employing the applicant.

 

          (e)  The YSC operator may rely on the background check required to obtain a visa for any camp staff who enters the country to be a camp counselor through organizations such as the International Camp Counselor Program (ICCP), Camp America, British University North America Club (BUNAC), Camp Leaders, or Camp Counselors USA (CC USA).

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4004.06  Release of Information Regarding Background Checks.

 

          (a)  Each YSC owner and each YSC operator, if different from the owner, shall maintain the information received as a result of performing background checks as confidential information.

 

          (b)  The YSC operator shall provide information as to whether a background check has been completed on camp staff to any parent or guardian of a youth who requests the information.

 

          (c)  The YSC operator shall provide a copy of the listing required by He-C 4004.04(b)(5) to the department for review upon request. 

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4004.07  Required YSC Certification.

 

          (a)  The YSC operator shall make the certification required by RSA 170-E:56, II(a) by providing the following information to the unit:

 

(1)  The calendar year for which the certification is being made;

 

(2)  The complete legal name of the YSC, including any trade name or other name used by the YSC;

 

(3)  The municipality of each location in New Hampshire where the YSC operates or will operate;

 

(4)  The name, primary mailing address, physical address if different, and daytime telephone number, including area code, of the YSC operator and an e-mail address, if any;

 

(5)  If the YSC operator is other than an individual, the name, title, daytime telephone number, and, if available, e-mail address for an individual authorized by the YSC operator to act on the operator’s behalf;

 

(6)  If the YSC operator is not the YSC owner, the name, primary mailing address, and daytime telephone number, including area code, of the YSC owner and an e-mail address, if any;

 

(7)  The YSC web or social media network site addresses, if any; and

 

(8)  The anticipated number of sessions to be offered, the anticipated length of each session, and the general area in which a skill will be taught, such as computer programming, music, or a specific sport.

 

          (b)  The YSC operator or authorized representative shall sign and date the completed certification and print or type his or her name on the certification  prior to submitting it to the unit.

 

          (c)  The signature required by (b), above, shall constitute certification that:

 

(1)  The signer is the YSC operator or has been authorized by the YSC operator to sign the certification;

 

(2)  A background check policy that meets the requirements of RSA 170-E:56, II and He-C 4004 is in place;

 

(3)  Background checks for the camp staff who might be left alone with a child or children have been conducted and reviewed as required by RSA 170-E:56, II and He-C 4004;

 

(4)  Background checks will be conducted and reviewed for all new camp staff brought on after the date of the initial certification as required by RSA 170-E:56, II and He-C 4004;

 

(5)  The information provided is true, complete, and not misleading to the knowledge and belief of the signer; and

 

(6)  The signer understands that he or she is subject to the penalties for unsworn falsification specified in RSA 641:3 or any subsequent statute if the information is false, incomplete, or misleading.

 

          (d)  If any camp staff is added subsequent to filing the required certification, the YSC operator shall conduct a background check for such staff prior to the staff working directly with any youth(s) unless a staff member for whom the background check has been completed is also present.

 

          (e)  The YSC operator shall submit the certification information required in He-C 4004.07(a):

 

(1)  Prior to any youth arriving at the YSC in each calendar year that the YSC operates; and

 

(2)  Subject to (f), below, with the fee required by RSA 170-E:56, II(b), which if paid by check or money order shall be made payable to “Treasurer - State of New Hampshire”.

 

          (f)  No fee shall be required if the YSC operator is a political subdivision.

 

          (g)  The required certification shall be valid only for the calendar year in which it is submitted.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

          He-C 4004.08  Review and Availability of YSC Policies.  The YSC owner or operator shall:

 

          (a)  Review the background check policy each year prior to the opening of the YSC camp and make adjustments if needed;

 

          (b)  Make the policy available through the YSC’s web or social media network site, if the YSC has a web presence; and

 

          (c)  Provide the unit with the policy, which shall be posted on the unit’s website.

 

Source.  #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

 

New.  #13073, eff 7-23-20

 

 


APPENDIX A

 

Rule

Specific State Statute the Rule Implements

 

 

He-C 4001.01

RSA 170-E:24; RSA 170-E:25; RSA 170-E:34

He-C 4001.02

RSA 170-E:28; RSA 170-E:29-a

He-C 4001.04

RSA 541-A:29

He-C 4001.07

RSA 170-E:29; RSA 170-E:29-a; RSA 170-E:34, I(e); RSA 170-E:40; RSA 170-E:49

He-C 4001.10

RSA 170-E:33, II; RSA 170-E:34, I(a)(1), (7); RSA 170-E:34, I(c)

He-C 4001.12

RSA 170-E:34, I(a)(4); RSA 170-E:34, I(a)(5); RSA 170-E:42; RSA 141-C

He-C 4001.13

RSA 170-E:34, I(a)(4); RSA 170-E:34, I(a)(5)

He-C 4001.14

RSA 170-E:34, I(a)(4); RSA 170-E:34, I(b); RSA 126-U:7, II

He-C 4001.15

RSA 170-E:34, I(a)(4),(5),(6); RSA 170-E:42

He-C 4001.16

RSA 170-E:34, I(a)(4); RSA 126-U:5-b

He-C 4001.17

RSA 170-E:34, I(a)(4)

He-C 4001.18

RSA 170-E:34, I(a)(4)

He-C 4001.19

RSA 170-E:34, I(a)(2)

He-C 4001.20

RSA 170-E:34, I(a)(2); RSA 170-E:34, I(b)

He-C 4001.21

RSA 170-E:34, I(a)(5), (7)

He-C 4001.22

RSA 170-E:34, I(a)(9); RSA 126-U; RSA 126-U:7

He-C 4001.23

RSA 170-E:34, I(a)(7); RSA 126-U:7; RSA 126-U:10

He-C 4001.24

RSA 170-E:34, I(a)(5)

He-C 4001.25

RSA 170-E:34, I(a)(5); RSA 265:107-a

He-C 4001.29

RSA 170-E:25, II(c); RSA 170-E:34, I(b)

He-C 4001.30

RSA 170-E:25, II(c); RSA 170-E:34, I(b)

He-C 4001.31

RSA 170-E:29-a, I and I-a; RSA 170-E:34, I.(a)(2)

 

 

He-C 4002.01

RSA 170-E:2

He-C 4002.02

RSA 170-E:6; RSA 170-E:8; RSA 170-E:9; RSA 170-E:11, I(1); RSA 541-A:30, I

He-C 4002.03

RSA 541-A:29

He-C 4002.04

RSA 170-E:11, I (m)

He-C 4002.05

RSA 170-E:7, I; RSA 170-E:6-b; RSA 170-E:11, I(a) & (b); and RSA 170-E:11, I(h)

He-C 4002.06

RSA 170-E:8, II; RSA 170-E:10; RSA 170-E:11,I(h)

He-C 4002.07

RSA 170-E: 10-a; RSA 170-E:11, IV; RSA 541-A:30-a

He-C 4002.08

RSA 170-E:11, I (d), (e)

He-C 4002.09

RSA 170-E:11, I(b)

He-C 4002.10

RSA 170-E:11, I(a), (d) & (g); 45 C.F.R. § 98.41(a)(1)(i)(C)

He-C 4002.11

RSA 170-E:11, I(a), (d) & (g); 45 C.F.R. §98.41(a)(1)(i)

He-C 4002.12

RSA 170-E:11, I(a), (d), (g), & (h); 45 CFR 98.[§98.16(aa)]

He-C 4002.13

RSA 170-E:11, I(e) & (f)

He-C 4002.14

RSA 170-E:11, I(a), (d), & (g); 45 C.F.R. § 98.41(a)(1)(iv) or (vii)

He-C 4002.15

RSA 170-E:11, I(a), (d), (g), (h), (i); 45 CFR  98.41(a)(1)(i)(C); CFR 98.[§98.16(aa)]

He-C 4002.16

RSA 170-E:11, 1(a), (b), (c), (e), & (i); 45 CFR 18

He-C 4002.17

RSA 170-E:11, I(a), (d), (g), & (h); 45 CFR 98.[§98.16(aa)];

He-C 4002.18

RSA 170-E:11, I(a) - (e) & (i); 45 CFR 98

He-C 4002.19

RSA 170-E:11, I(a), (d), & (e)

He-C 4002.20

RSA 170-E:11, I(a), (d), (g), & (h) and 45 CFR 98.[§98.16(aa)]

He-C 4002.21

RSA 170-E:11, I(a), (d), (e) & (g)

He-C 4002.22

RSA 170-E:11, I (d)

He-C 4002.23

RSA 170-E:11, I(d) & (e); 40 CFR 745.90(a) and (b)(2011)

He-C 4002.24

RSA 170-E:11, (d) & (e)

He-C 4002.25

RSA 170-E:11, I (d) & (e); 16 C.F.R. § 1500

He-C 4002.26

RSA 170-E:11, I (c), (d), & (e); 45 C.F.R. § 98; 16 C.F.R. § 1219 and 1220

He-C 4002.27

RSA 170-E:11, I(d), (e), (h); RSA 170-E:6

He-C 4002.28

RSA 170-E:11, I(d), (e), (h); RSA 170-E:6

He-C 4002.29

RSA 170-E:6; RSA-170-E:11, I(d), & (e)

He-C 4002.30

RSA-170-E:11, I(d) & (e)

He-C 4002.31

RSA-170-E:11, I(d) & (e)

He-C 4002.32

RSA-170-E:11, I(a) - (e) and RSA 265:107-a

He-C 4002.33

RSA-170-E:11, I(b) & (e) and 45 C.F.R. §98.44

He-C 4002.34

RSA 170-E:11, I(b) & (e)

He-C 4002.35

RSA 170-E:11, I(b), (d) & (e)

He-C 4002.36

RSA 170-E:11, I(a) & (c)

He-C 4002.37

RSA 170-E:11, I(a), (c) & (e)

He-C 4002.38

RSA 170-E:11, I(a), (c) & (e)

He-C 4002.39

RSA 170-E:11, I(a), (c) & (e)

He-C 4002.40

 RSA 170-E:11, I(a) & (c)

He-C 4002.41

RSA 170-E:7; RSA 170-E:11,I(h); 45 C.F.R. § §98.43

 He-C 4002.42

RSA 170-E: 11, IV; RSA 170-E:17, II & III

He-C 4002.43

RSA 170-E:11, I(a) & (h); RSA 170-E:11, II & III

He-C 4002.44

RSA 170-E:11, I(a) & (h); RSA 170-E:11, IV & V; RSA 170-E:12; RSA 170-E:13

He-C 4002.45

RSA 170-E:11, II, VI & VII; RSA 170-E:21-a

He-C 4003

RSA 170-E:53-a; RSA 170-E:54; and RSA 170-E:56, I

He-C 4004

RSA 170-E:53-a; RSA 170-E:54; and RSA 170-E:56, II(a)

 


APPENDIX B

 

Location of Incorporated by Reference Document

Title of Document to be Incorporated by Reference

Cost and How to Obtain the Document

He-C 4001.15(al)

U.S Environmental Protection Agency’s, “How to Dispose of Medicines Properly” (April 2011)

Publisher: U.S. Environmental Protection Agency

Cost: Free of Charge

The incorporated document is available at:

https://nepis.epa.gov/Exe/ZyPDF.cgi/P100ZW8A.PDF?Dockey=P100ZW8A.PDF

 

He-C 4002.24(h)(2)c.

ASTM International’s, “ASTM F1292 Standard Specification for Impact Attenuation of Surfacing Materials Within the Use Zone of Playground Equipment” (2018 Edition)

Publisher: ASTM International

 

Cost: $60.00

 

The incorporated document is available at:

https://www.document-center.com/standards/show/ASTM-F1292

 

 

He-C 4002.27(ah)

“Infant Meal Pattern” USDA (11/29/2016)

Available as a pdf. Free of charge at: https://www.fns.usda.gov/sites/default/files/cacfp/CACFP_infantmealpattern.pdf,  and as attached in Appendix C

He-C 4002.27(ah)

“Child Meal Pattern” USDA

Available as a pdf. Free of charge at: https://www.fns.usda.gov/sites/default/files/cacfp/CACFP_childmealpattern.pdf, and as attached in Appendix C

He-C 4001.29(d)(5)a.

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Evidence-Based Practices Resource Center”

Publisher: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration

Cost: Free of Charge

The incorporated document is available at:

https://www.samhsa.gov/ebp-resource-center

 

He-C 4001.29(d)(6)a.

The American Society of Addiction Medicine’s “The ASAM Criteria” (Third Edition)

Publisher: The American Society of Addiction Medicine

Cost: Member: $85.00/ Non-Member $95.00

The incorporated document is available for purchase at:

https://www.asam.org/resources/the-asam-criteria

 

He-C 4001.29(d)(6)b.

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s “Knowledge Application Program (KAP) Resource Documents and Manuals” (July 2020)

Publisher: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration

Cost: Free to the Public

The incorporated document is available at:

https://www.samhsa.gov/kap/resources

 

He-C 4002.31(h)

United States Department of Agriculture’s, “Infant Meal Pattern” (11/29/2016)

Publisher: United States Department of Agriculture

 

Cost: Free of Charge

 

The incorporated document is available as attached in Appendix C or at:

https://www.fns.usda.gov/sites/default/files/cacfp/CACFP_infantmealpattern.pdf

 

He-C 4002.31(h)

United States Department of Agriculture’s, “Child Meal Pattern” (11/29/2016)

Publisher: United States Department of Agriculture

 

Cost: Free of Charge

 

The incorporated document is available as attached in Appendix C or at: 

https://www.fns.usda.gov/sites/default/files/cacfp/CACFP_childmealpattern.pdf

 

 

 


Appendix C