Sec.19a-79-10. Under three endorsement

(a) The operator of a program caring for children under three (3) years of age shall comply with section 19a-79-1a to section 19a-79-10, inclusive, and section 19a-79-13 of the Regulations of Connecticut State Agencies.

(b) A program caring for children under three (3) years of age is required to have a separate endorsement by the department.

(c) Infants and toddlers

(1) Age. Children from six (6) weeks to thirty six (36) months of age shall be considered infants and toddlers.

(2) Ratio. There shall be at least one (1) program staff qualified under section 19a-79-4a(d) of the Regulations of Connecticut State Agencies for every four (4) children or fraction thereof in attendance.

(3) Group size. The group size shall not exceed eight (8) children.

(4) There shall be a physical barrier separating each group of eight (8) children, indoors and outdoors.

(d) Special equipment

Each child day care center and group day care home shall have equipment and furniture to meet the developmental needs of the children served.

(1) Sinks

(A) In child day care centers there shall be a sink with hot and cold running water designated for diaper changing and hand washing of staff and children. This sink shall be located in the program space. Visual contact with all other children shall be maintained while changing diapers or using the sink. Child day care centers which staff three (3) adults to a group size of eight (8) infants or toddlers may use an accessible diaper changing facility if it is immediately adjoining the program area.

(B) Separate sinks shall be available for purposes other than hand washing after diaper changing within child day care centers.

(C) Group day care homes shall have a sink accessible for hand washing other than the sink used for food preparation.

(2) Furniture shall include:

(A) well constructed free standing cribs, not stacked cribs, each of which has slats no more than two and three-eighths (2 ⅜) inches apart and a fully waterproofed, firm, snug-fitting mattress for infants;

(B) washable cots for toddlers;

(C) chairs for feeding, each of which has a stable base, safety straps on all high chairs attached to the chair and a tray which locks securely;

(D) low tables and chairs according to children's size and development; and

(E) a refrigerator and facilities to store and heat food and bottles.

(3) Furniture may include but not be limited to:

(A) strollers, each of which has a stable base, firmly attached safety straps and tightly locking brakes;

(B) play pens, each of which has either small weave mesh netting or slats no more than two and three-eighths (2 ⅜) inches apart, a firm floor with a secured foam pad and hinges that lock tightly; and

(C) an adult rocking chair.

(e) Diapering and toileting

(1) The diapering area shall be an elevated sturdy table or counter equipped with a safety rail.

(2) Infants and toddlers shall be diapered at a diapering area used only for this purpose and located in the program area.

(3) Each diapering area shall have a non-porous surface and be kept in good repair.

(4) Diapering areas shall be washed and disinfected after each use.

(5) Disposable paper sheets shall be used and discarded immediately after each diapering.

(6) A covered washable lined waste receptacle shall be available and located in a convenient place for soiled waste material. These materials shall be removed to an exterior waste storage area at least daily.

(7) The hands of the staff and the children shall be washed before and after each diaper change.

(8) Diapering and hand washing policies and procedures shall be posted in each diapering area.

(9) Disposable diapers shall be discarded in a covered receptacle immediately after diapering.

(10) When cloth diapers or training pants are used, a plan for their use and care shall be submitted to and approved by the department prior to implementation of the plan. This plan shall include, but not necessarily be limited to, these procedures:

(A) placing soiled clothing and diapers in a sealed air tight container,

(B) removing soiled clothing and diapers from the child day care center or group day care home daily, and

(C) cleaning and sanitizing the container daily.

(f) Linens and clothing and bedding

(1) A supply of linen and emergency clothing shall be available for each child in the child day care center or group day care home at all times.

(2) All children's linens shall be washed at least weekly and as needed.

(3) Each child's linens and clothing shall be stored individually. Plastic bags shall not be accessible to infants and toddlers.

(4) When cribs and cots are shared, they must be washed and disinfected and linens changed between children.

(g) Sleep arrangements

(1) Infants under twelve (12) months of age shall be placed in a supine (back) position for sleeping in a well constructed, free standing crib or bed designed for infant sleeping, with a snug fitting mattress unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for an alternative sleep position.

(2) When infants can easily turn over from the supine to the prone position, they shall be put down to sleep on their back, but allowed to adopt whatever position they prefer for sleep.

(3) Soft surfaces and gas-trapping objects such as pillows, quilts, sheepskins, soft bumpers or stuffed toys shall not be placed under or with an infant for sleeping and shall be kept out of the infant's crib or bed.

(4) No infant shall be put to sleep on a sofa, soft mattress, waterbed or other soft surface. No infant shall be put to sleep in a child restraint system intended for use in a vehicle, an infant carrier, a swing or any place that is not specifically designed to be an infant bed unless the child has written documentation from a physician, physician assistant or advanced practice registered nurse specifying a medical reason for their use.

(h) Toys and other objects

(1) Toys used for infants shall be kept separate, washed and disinfected at least daily. Toys for toddlers, including floor and riding toys, shall be washed and disinfected at least weekly and as needed.

(2) Toys and other objects with a diameter of less than one and one-quarter (1 ¼) inches, objects with removable parts that have a diameter of less than one and one-quarter (1 ¼) inches, plastic bags, balloons and Styrofoam objects shall not be accessible to children under three (3) years of age.

(i) Health consultant

(1) A health consultant shall visit the program on the days and times children under the age of three (3) are present. The scheduled times of the visits shall be arranged so that all children under the age of three (3) are observed. The health consultant shall prepare and maintain signed documentation of visits which shall be kept on the licensed premises.

(2) The health consultant shall visit the program according to the following schedule:

(A) once a week for children up to twenty-four (24) months of age,

(B) once a week for children two (2) to three (3) years of age attending a full day, and

(C) once a month for children two (2) to three (3) years of age attending part day programs.

(j) Infants shall be removed from their cribs and held for all bottle feedings. They may be placed in chairs for all other feedings. Infants and toddlers shall be removed from their cribs or playpens at other intervals during the day for individual cuddlings and for verbal communication. They shall be allowed to crawl and toddle as age and development permit. Each infant shall be placed in a prone (front) position part of the time when awake.

(k) Foods and Liquids. When food and liquids are served:

(1) a written statement specifying the formula, breast milk or other liquids and the feeding schedule for infants shall be obtained from the parent(s),

(2) unused portions of formula, breast milk or other liquids shall be discarded after each feeding,

(3) clean bottles shall be provided by the parent(s) unless the facility uses disposable bottles or has a dishwasher or dishwashing system approved by the local health director to wash bottles,

(4) baby food shall be served from a dish unless the whole contents of the jar will be served, and

(5) each child's bottle shall be individually identified with the child's name.

(l) Outdoor play space

(1) All infant toddler play space shall be fenced.

(2) The equipment available to the infants and toddlers shall be developmentally appropriate for the ages of the children.

(Effective July 27, 1993; Amended August 8, 1995; Amended November 6, 2008)