214 R.I. Code R. 214-RICR-40-00-1.9

Current through December 3, 2024

Section 214-RICR-40-00-1.9 - Routine Care of Children

A. Feeding and Eating

1. Eating and feeding routines meet the individual needs of children in the program.

2. Staff do not force children to eat.

3. A feeding plan is established and followed for each Infant and Toddler prior to admission.

4. Infants who are not ready for self-feeding are held and fed by an individual staff member on a one-to-one basis.

5. Bottles are never propped up at any time or placed in a crib with a child.

6. A heating unit for warming bottles and food is readily accessible to staff. Microwaves are not used for heating bottles.

7. Only BPA free plastic or glass bottles are used.

8. Bottles provided by parents/guardians are labeled with the child's name.

9. If the program provides bottles and reusable nipples for community use, they are washed and sanitized in the dishwasher or boiled for at least five minutes prior to use.

10. All breast milk or formula is clearly labeled with the child's name.

11. The program prepares formula that is mixed and served according to manufacturer's instructions.

12. Prepared breast milk or formula is used immediately or stored in the refrigerator.

13. Un-served prepared breast milk or formula is returned to the parent/guardian at the end of each day.

14. Staff send home or discard any leftover breast milk, formula, and/or food that remains in bottles and/or containers after feeding. These items may not be reserved in the program.

15. Food is not used as an incentive unless specifically stated in the child's IEP/IFSP.

B. Diapering and Toileting

1. Diapering and Toileting routines meet the individual needs of children in the program.

2. Staff do not force children to use the bathroom.

3. Toilet training conforms to an individual plan based on each child's readiness and is carried out in conjunction with the parent/guardian.

4. Routine attempts to toilet train are made only when a child demonstrates readiness.

5. Children are changed and diapered regularly and are washed and dried with single use baby wipes.

6. No child is left unattended during diapering.

7. The diaper-changing surface is cleaned and sanitized after each use with a disposable towel, United States Environmental Protection Agency registered disinfectant, or disinfectant solution that is prepared daily.

8. Staff wash their hands thoroughly with liquid soap and warm running water after each diaper change, even if disposable gloves are used.

9. All soiled diapers are removed from the building daily.

10. If disposable diapers are used, they are placed in a covered receptacle that is:

a. lined with a plastic bag;

b. kept away from the children's activity and food service areas;

c. emptied as necessary to eliminate odors; and

d. cleaned and disinfected daily.

11. If cloth diapers are used, they are:

a. not rinsed or emptied at the child care program;

b. completely wrapped in a non-permeable material;

c. kept away from the children's activity and food service areas; and

d. given directly to the parent/guardian upon discharge of the child.

C. Sleeping

1. Sleeping routines meet the individual needs of children in the program.

2. Staff do not force children to sleep or stay awake.

3. There is a sleep plan appropriate to the needs of each child.

4. Staff may encourage children to rest, but children are not forced to stay in cribs or on cots.

5. Infants sleep in a safe sleep environment consistent with the American Academy of Pediatrics Safe Sleep Guidelines.

6. An Infant is placed on his/her back while sleeping.

7. Monitors or positioning devices are not used.

8. There are no restraining devices of any type, including swaddles.

9. Modifications to an Infant's safe sleep environment, regarding positioning, are not permitted unless the Infant's physician, physician's assistant or nurse practitioner has completed a signed waiver indicating that the child requires an alternate sleeping arrangement.

10. Infants must sleep in a crib approved by the United States Consumer Product Safety Commission Standards, equipped with a firm crib mattress and a tight fitting sheet.

a. Older Infants may sleep on a cot, at the discretion of the program.

11. Lighting must allow for staff to view the color of the child's skin and to check for breathing.

12. Children cannot sleep in a car safety seat, bean bag chair, bouncy seat, Infant seat, swing, jumping chair, highchair, or in comparable equipment/furniture.

13. If an Infant arrives at the facility asleep in a car safety seat, or falls asleep in comparable equipment, the Infant is immediately removed from the car seat or comparable equipment and placed in a safe sleep environment.

14. Clothing designed for safe sleep, including sleep sacks, are permitted.

15. No items are placed in the crib with an Infant except for a pacifier.

16. A pacifier clip is not permitted for use in a crib.

17. No additional items are placed on or above the crib.

18. Cribs are only used for rest or sleep.

214 R.I. Code R. 214-RICR-40-00-1.9