Current through Register Vol. XLI, No. 50, December 13, 2024
Section 78-1-16 - Nutrition and Food16.1. A center shall have a nutrition program that provides children with meals and snacks that are consistent with the United States Department of Agriculture's (USDA) Child and Adult Care Food Program (CACFP), Meal and Snack Patterns (Appendix 78-1-C).16.2. Special Dietary Needs. When planning meals and snacks a center shall: 16.2.a. Consider information provided by the parent or a licensed health care provider about a child's special dietary needs, including special needs because of a medical condition, allergy, or religious prohibition;16.2.b. Obtain a written care plan from the parent stating any foods to be avoided, any foods to be substituted, and any need for special utensils; and16.2.c. Keep information about the child's special dietary needs in a location that is accessible to staff who prepare and serve food, while protecting a child's right to confidentiality.16.3. Frequency of Meals. A center shall offer food at intervals no more than three hours apart and ensure that no more than four hours elapse between meals and snacks for any child. A center shall provide meals and snacks according to the following requirements: 16.3.a. A center that is open from morning through afternoon shall serve a morning snack or breakfast, lunch, and afternoon snacks;16.3.b. A center that provides care before seven o'clock in the morning shall serve breakfast; and16.3.c. A center that provides care to the child whose planned attendance extends until after seven o'clock in the evening shall serve supper.16.4. Requirements for Milk and Juice. 16.4.a. When serving milk, a center shall serve the child only pasteurized, inspected, Grade A approved milk to drink, and shall not use powdered milk except for cooking.16.4.b. When serving juice, a center shall serve the child only commercially pasteurized, 100 percent, vitamin C fortified fruit juice to drink.16.4.c. A center shall avoid concentrated sweets, such as candy, sodas, sweetened drinks, and fruit nectars.16.5. Food Service. A center shall serve food according to the following: 16.5.a. A center shall provide a child with age-appropriate and developmentally suitable eating utensils;16.5.b. Staff members shall encourage a child to eat the food served, but shall not coerce or force feed a child;16.5.c. Staff members shall eat or participate in meals and snacks with a child 25 of months of age and over and shall model healthy eating habits;16.5.d. The meals shall be served in a setting that encourages socialization, where the children and staff members are seated when eating, and staff members provide supervision and model positive eating behaviors and social interactions;16.5.e. Food shall not be served directly on the table or chair tray; and16.5.f. The center shall give children time to eat their food without rushing.16.6. Menus. 16.6.a. A center shall post menus for all food served a minimum of one week in advance for the parent to see.16.6.b. A center shall follow written menus as planned and write any changes on the posted menus.16.6.c. A center shall date menus and keep them on file for a minimum of two months.16.7. Food Safety. A center shall ensure that:16.7.a. Food preparation areas, service areas, storage areas, and equipment and utensils are clean and in good repair;16.7.b. An off-site supplier of meals or snacks has a Food Service Permit;16.7.c. The Bureau for Public Health has approved the method of transporting and distributing the food not prepared at the center or which is served off-site;16.7.d. Leftover portions of food that have been served are discarded;16.7.e. Prior to serving milk to a child, except when its original container is a single service container, staff pours the milk from the original container into a clean, sanitized, and labeled bottle or a disposable, sterile bottle liner, or into a sanitized glass or single-service cup and shall not pour the milk back to its original container or store it for later use. Sanitized pitchers can be used for family style eating as long as any unused milk is discarded;16.7.f. Ice for consumption is made with drinking water; and16.7.g. Ice used for cooling is not consumed by the child, and water from melted ice used for cooling does not contaminate food to be served.16.8. Additional Nutrition and Feeding Requirements for a Child 12 Months of Age and Under.16.8.a. The center shall feed solid foods and fruit juices to a child four months of age and younger only upon receipt of and in accordance with a written plan of care signed by the child's licensed health care provider.16.8.b. A center caring for a child 12 months of age and under shall feed the child according to a plan developed in consultation with the parent and may include advice from the child's licensed health care provider. Due to the differences in development and nutritional needs of an infant, a center is not required to provide baby food to an infant not yet eating table food, but must ensure that the food provided by the parent meets nutritional guidelines as found in Appendix 78-1-C. The option to have parents supply the baby food must meet the requirements of subsection 16.9. of this rule.16.8.c. When a child is being breast fed, a center shall ensure that the child's plan makes a provision for the mother to provide sufficient portions of breast milk or an alternative to satisfy the child throughout the day, and a center shall not give commercial formula to the child receiving breast milk without written permission from the mother.16.8.d. For the child between six months and three years of age a center shall not replace formula or breast milk with water or juice.16.8.e. Until a child is able to hold a bottle securely, a staff member shall hold the child while bottle feeding. When a child is no longer being held for feeding, the staff shall ensure that seating is age-appropriate and shall not prop bottles or allow the child to carry a bottle while moving about or walking.16.8.f. For food safety a center shall: 16.8.f.1. Store perishable food, formula, and expressed breast milk in the refrigerator;16.8.f.2. Have the parent clearly label each bottle of formula with the child's name, contents, and the date received;16.8.f.3. Have the parent clearly label each bottle of breast milk with the child's name, date expressed, date frozen if applicable, and date received;16.8.f.4. Cap bottles of formula or breast milk during storage;16.8.f.5. Ensure each staff person follows the hand washing requirement found in section 17 of this rule prior to preparing a bottle;16.8.f.6. Thaw frozen breast milk in the refrigerator or under cold running water. The center must not refreeze breast milk;16.8.f.7. Not use a microwave oven to warm a bottle of formula or breast milk;16.8.f.8. Not give any formula or breast milk that is not labeled to a child;16.8.f.9. Discard any unused breast milk within two hours of feeding;16.8.f.10. Clean and sanitize bottles, bottle caps, and nipples by washing in a dishwasher and storing them in a sanitary manner, or by boiling them for five minutes immediately before filling them; and16.8.f.11. Handle baby food in the following manner:16.8.f.11.A. A center shall not accept previously opened baby food containers;16.8.f.11.B. A center shall remove commercially packaged baby food from its container and serve it in a clean bowl or cup;16.8.f.11.C. A center shall not place solid food in a bottle or feeder apparatus and shall use a spoon to feed solid food in a sanitary manner; and16.8.f.11.D. A center shall discard leftover food that has come into contact with the feeding spoon.16.8.f.12. A center shall handle breast milk and formula in the following manner: 16.8.f.12.A. A center shall store breast milk in breast milk storage bags or hard plastic or glass bottles with tight lids only;16.8.f.12.B. A center shall remove breast milk and bottles of formula from the refrigerator immediately before using only;16.8.f.12.C. A center shall discard formula when it remains at a temperature higher than 41 degrees Fahrenheit for more than one hour or within one hour after a child has finished feeding; and16.8.f.12.D. A center shall use freshly expressed or pumped breast milk, freshly refrigerated breast milk up to 4 days from the date the milk was expressed, or frozen breast milk stored in freezer for up to 12 months.16.8.g. In order to provide sufficient amounts of safe drinking water, the center shall ensure that: 16.8.g.1. Drinking water is available to children and staff members and is freely accessible at all times; and16.8.g.2. A single service drinking cup is discarded after one use, and a non-disposable cup or glass is washed and sanitized after each use.16.9. A center must offer a nutrition program, but may choose to allow a child to bring meals and snacks to the center if:16.9.a. The center has written policies that address:16.9.a.1. Providing parents and staff with nutritional guidelines in this rule;16.9.a.2. Providing to parents and staff guidelines on the proper preparation and storage of food so that foods do not present a cross-contamination threat;16.9.a.3. Providing to parents and staff a list of foods the center will not permit, including known food allergens to other children;16.9.a.4. An explanation to parents of how the center will address the issue if a child does not bring meals or snacks, or if the meals or snacks the child does bring are not within the nutritional guidelines or guidelines provided by the center;16.9.a.5. That the food prepared from an unapproved source is for consumption by the child and not to be shared with other children or the group.16.9.b. The center has safe storage and refrigeration of the food as needed. Storage must be approved by the Health Department;16.9.c. Each child's meal or snack is clearly labeled with the child's first and last names and the date it was brought to the center;16.9.d. No additional food preparation is required by the center;16.9.e. The center provides a meal or snack when the parent fails to provide a meal or snack from home;16.9.f. The center includes children with food allergies in the group during meal or snack time and closely supervises all children under school age during meal or snack time to prevent the cross-contamination of food or accidental ingestion of a food allergen; and16.9.g. The center has milk available at meal times in accordance with meal patterns described in Appendix 78-1-C of this rule.