WSR 13-17-066
[Filed August 16, 2013, 9:04 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 10-18-006.
Title of Rule and Other Identifying Information: Chapter 170-295 WAC, revising rules on communicable disease to align with recent department of health (DOH) changes to chapter 246-110 WAC.
Hearing Location(s): Department of Early Learning (DEL), State Office, 1110 Jefferson Street S.E., Olympia, WA 98501, on September 25, 2013, at 12 p.m.
Date of Intended Adoption: Not earlier than September 25, 2013.
Submit Written Comments to: Rules Coordinator, DEL, P.O. Box 40970, Olympia, WA 98504-0970, e-mail, fax (360) 586-0533, by September 25, 2013.
Assistance for Persons with Disabilities: Contact DEL rules coordinator by September 18, 2013, (360) 407-1962.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: To align chapter 170-295 WAC with DOH changes to chapter 246-110 WAC by replacing references to "communicable disease" and replacing them with "contagious disease" and revising DEL's definition of "communicable disease" to refer to WAC 246-110-010.
Reasons Supporting Proposal: Rule making is necessary for the preservation of public health because DOH has amended its definition of communicable disease to eliminate diseases and add new ones, and to substitute the term "contagious" for "communicable." Alignment of DEL's licensing rules with these changes is necessary in order to ensure that providers know what diseases are identified concerns based on the latest science, and to ensure they have clarity regarding terminology.
Statutory Authority for Adoption: RCW 43.215.060, 43.215.070, chapter 43.215 RCW.
Statute Being Implemented: Chapter 43.215 RCW.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: DEL, governmental.
Name of Agency Personnel Responsible for Drafting: Lynne Shanafelt, Licensing Administration, DEL State Office, P.O. Box 40970, Olympia, WA 98504, (360) 407-1953; Implementation and Enforcement: DEL licensing offices, statewide.
No small business economic impact statement has been prepared under chapter 19.85 RCW. The proposed rules are not expected to impose new costs on businesses that are required to comply. If the rules result in costs, those costs are not expected to be "more than minor" as defined in chapter 19.85 RCW.
A cost-benefit analysis is not required under RCW 34.05.328. DEL is not among the agencies listed as required to comply with RCW 34.05.328.
August 16, 2013
Elizabeth M. Hyde
AMENDATORY SECTION (Amending WSR 12-09-060, filed 4/17/12, effective 5/18/12)
WAC 170-295-0010 What definitions under this chapter apply to licensed child care providers?
"American Indian child" means any unmarried person under the age of eighteen who is:
(1) A member or eligible for membership in a federally recognized Indian tribe, or who is Eskimo, Aleut, or other Alaska native and a member of an Alaskan native regional corporation or Alaska native village;
(2) Determined or eligible to be found Indian by the Secretary of the Interior, including through issuance of a certificate of degree of Indian blood, or by the Indian health service;
(3) Considered to be Indian by a federally recognized or nonfederally recognized Indian tribe; or
(4) A member or entitled to be a member of a Canadian tribe or band, Metis community, or nonstatus Indian community from Canada.
"Anti-bias" is an approach that works against biases and recognizes when others are treated unfairly or oppressively based on race, color, national origin, marital status, gender, sexual orientation, class, religion, creed, disability, or age.
"Capacity" means the maximum number of children that a licensee is authorized to have on the premises of the child care at any one time.
"Center" means the same as "child care center."
"Certification" means department approval of a person, home, or facility that does not legally need to be licensed, but wants evidence that they meet the minimum licensing requirements (also see "Tribal certification").
"Child abuse or neglect" means the physical abuse, sexual abuse, sexual exploitation, abandonment or negligent treatment or maltreatment of a child by any person indicating the child's health, welfare, and safety is harmed.
"Child-accessible" means areas where children regularly have access such as: Entrances and exits to and from the center, classrooms or child care areas, playground area including equipment and fencing, parking areas, walkways, decks, platforms, stairs and any items available for children to use in these areas.
"Child care center" means the same as a "child day care center" or a facility providing regularly scheduled care for a group of children one month of age through twelve years of age for periods less than twenty-four hours.
"Clean" means to remove dirt and debris from a surface by scrubbing and washing with a detergent solution and rinsing with water. This process must be accomplished before sanitizing a surface.
"CACFP" means child and adult care food program established by congress and funded by the United States Department of Agriculture (USDA).
"Commercial kitchen equipment" means equipment designed for business purposes such as restaurants.
"((Communicable)) Contagious disease" means ((a disease caused by a microorganism (bacterium, virus, fungus, or parasite) that can be transmitted from person to person via an infected body fluid or respiratory spray, with or without an intermediary agent (such as a louse, or mosquito) or environmental object (such as a table surface))) as provided in WAC 246-110-010.
"Cultural relevancy" creates an environment that reflects home cultures, communities and lives of children enrolled in the program.
"Department," "we," "us," or "our" refers to and means the state department of early learning (DEL) and its predecessor agency the department of social and health services (DSHS).
"Developmentally appropriate practice":
(1) Means that the provider should interact with each child in a way that recognizes and respects the child's chronological and developmental age;
(2) Is based on knowledge about how children grow and learn; and
(3) Reflects the developmental level of the individual child, and interactions and activities must be planned with the needs of the individual child in mind.
"Director" means the person responsible for the overall management of the center's facility and operation, except that "DEL director" means the director of the department of early learning.
"Disinfect" means to eliminate virtually all germs from inanimate surfaces through the use of chemicals or physical agents.
"Domestic kitchen" means a kitchen equipped with residential appliances.
"External medication" means a medication that is not intended to be swallowed or injected but is to be applied to the external parts of the body, such as medicated ointments, lotions, or liquids applied to the skin or hair.
"I," "you," and "your" refer to and mean the licensee or applicant for a child care license.
"Inaccessible to children" means stored or maintained in a manner preventing children from reaching, entering, or using potentially hazardous items or areas. Examples include but are not limited to: Quantities of water, sharp objects, medications, chemicals, electricity, fire, mechanical equipment, entrapment or fall areas.
"Individual plan of care" means that the center's health policies and procedures do not cover the needs of the individual child so an individual plan is needed. Examples may include children with allergies, asthma, Down syndrome, tube feeding, diabetes care such as blood glucose monitoring, or nebulizer treatments.
"Infant" means a child one-month through eleven months of age.
"Lead teacher" means the person who is the lead child care staff person in charge of a child or group of children and implementing the activity program.
"License" means a permit issued by the department authorizing a licensee by law to operate a child care center and certifying that the licensee meets the minimum requirements under licensure.
"Licensee" or "you" means the person, organization, or legal entity responsible for operating the center.
"Maximum potential capacity based on square footage" is the maximum number of children a licensee can be licensed for based on the amount of useable space (square footage) in the licensee's center. The licensee may be licensed for less than the maximum potential capacity. A licensee may not be licensed for more than the maximum potential capacity.
"Moisture impervious" or "moisture resistant" means a surface incapable of being penetrated by water or liquids.
"Nonexpiring license" or "nonexpiring full license" means a full license that is issued to a licensee following the initial licensing period as provided in WAC 170-295-0095.
"Parent" means birth parent, custodial parent, foster parent, legal guardian, those authorized by the parent or other entity legally responsible for the welfare of the child.
"Pesticides" means chemicals that are used to kill weeds, pests, particularly insects.
"Potentially hazardous food" means any food or ingredient that requires temperature control because it supports rapid growth of infectious or toxin forming microorganisms.
"Potable water" means water suitable for drinking by the public as determined by the state department of health or local health jurisdiction.
"Premises" means the building where the center is located and the adjoining grounds over which the licensee has control.
"Preschool age child" means a child thirty months through five years of age not attending kindergarten or elementary school.
"Program supervisor" means the person responsible for planning and supervising the center's learning and activity program.
"Sanitize" means a surface must be clean and the number of germs reduced to a level that disease transmissions by that surface are unlikely. This procedure is less vigorous than disinfection.
"Satellite kitchen" means a food service establishment approved by a local health jurisdiction where food is stored, prepared, portioned or packaged for service elsewhere.
"School-age child" means a child not less than five years through twelve years of age who has begun attending kindergarten or elementary school.
"Staff" means a child care giver or group of child care givers employed by the licensee to supervise children served at the center who are authorized by DEL to care for or have unsupervised access to children under chapter 170-06 WAC.
"Supervised access" refers to those individuals at a child care center who have no responsibility for the operation of the center and do not have unsupervised access to children. These individuals are not required to submit a background check form. This includes those persons on the premises for "time limited" activities whose presence is supervised by a center employee and does not affect provider/child ratios or the normal activities or routine of the center. Examples include:
(1) A person hired to present an activity to the children in care such as a puppet show, cooking activity, and story telling;
(2) Parent participation as part of a special theme; or
(3) A relative visiting a child on the premises.
"The Washington state training and registry system (STARS)" means the entity approved by the department to determine the classes, courses, and workshops licensees and staff may take to satisfy training requirement.
"Toddler" means a child twelve months through twenty-nine months of age.
"Terminal room cleaning" means thorough cleaning of walls, ceiling, floor and all equipment, and disinfecting as necessary, in a room which has been used by a person having a ((communicable)) contagious disease before it is occupied by another person.
"Tribal certification" means that the department has certified the tribe to receive state payment for children eligible to receive child care subsidies.
"Unsupervised access" refers to those individuals at a child care center who can be left alone with children in the child care center. These individuals must have received a full background authorization clearance under chapter 170-06 WAC.
"Useable space" means the areas that are available at all times for use by the children that do not cause a health or safety hazard.
AMENDATORY SECTION (Amending WSR 06-15-075, filed 7/13/06, effective 7/13/06)
WAC 170-295-1080 What topics must my new staff orientation include?
You must have an orientation system in place to train each new employee and volunteer about program policies, practices, philosophies and goals. This training must include, but is not limited to, the program policies and practices listed in this chapter such as:
(1) Minimum licensing requirements;
(2) Planned daily activities and routines;
(3) Child guidance and behavior management methods;
(4) Child abuse and neglect prevention, detection, and reporting policies and procedures;
(5) Health policies and procedures;
(6) ((Communicable)) Contagious disease recognition and prevention;
(7) Bloodborne pathogens;
(8) Fire prevention, disaster plan and safety procedures;
(9) Special health and developmental needs of the individual child;
(10) Personnel policies, when applicable;
(11) Limited restraint techniques;
(12) Cultural relevancy; and
(13) Age and developmentally appropriate practices and expectations for the age group the staff will work with.
AMENDATORY SECTION (Amending WSR 06-15-075, filed 7/13/06, effective 7/13/06)
WAC 170-295-3010 What kind of health policies and procedures must I have?
(1) You must have written health policies and procedures that are:
(a) Written in a clear and easily understood manner;
(b) Shared with all new staff during orientation;
(c) Posted for staff and families to review; and
(d) Reviewed, signed and dated by a physician, a physician's assistant or registered nurse when you change your policies and procedures or type of care that you provide, or at least every three years when you are due for relicensing. (For example, if you go from caring for children from twelve months and older to caring for infants, you must update your health policies and procedures and have them reviewed and signed.)
(2) Your health policies and procedures must have information on how you plan to:
(a) Provide general cleaning of areas including but not limited to bathrooms, floors, walls, and doorknobs;
(b) Clean and sanitize areas including but not limited to food contact surfaces, kitchen equipment, diapering areas, toys, toileting equipment and areas, equipment that might be shared with several children such as sleep mats, cribs or high chairs;
(c) Prevent, manage and report ((communicable)) contagious diseases;
(d) Handle minor injuries such as nosebleeds, scrapes and bruises;
(e) Provide first aid;
(f) Screen children daily for illnesses;
(g) Notify parents that children have been exposed to infectious diseases and parasites;
(h) Handle minor illnesses;
(i) Handle major injuries and medical emergencies that require emergency medical treatment or hospitalization;
(j) Manage medication;
(k) Assist with handwashing and general hygiene including diapering and toileting;
(l) Handle food;
(m) Provide nutritious meals and snacks;
(n) Respond during any disasters;
(o) Care for children that may have special needs;
(p) Care for infants and obtain infant nurse consultation (if licensed for four or more infants); and
(q) Place infants to sleep on their backs to reduce the risk of sudden infant death syndrome (SIDS).
(3) Your health policies and procedures must have information on when you plan to:
(a) Require ill children to stay home and for how long;
(b) Allow the ill child to return; and
(c) Call a parent to pick up their child and how you will care for the child until the parent arrives.
AMENDATORY SECTION (Amending WSR 06-15-075, filed 7/13/06, effective 7/13/06)
WAC 170-295-3030 When is a child or staff member too ill to be at child care?
(1) Your staff must check all children for signs of illness when they arrive at the center and throughout the day.
(2) You must exclude children and staff with the following symptoms from care:
(a) Diarrhea (three or more watery stools or one bloody stool within twenty-four hours);
(b) Vomiting (two or more times within twenty-four hours);
(c) Open or oozing sores, unless properly covered with cloths or with bandages;
(d) For suspected ((communicable)) contagious skin infection such as impetigo, pinkeye, and scabies: The child may return twenty-four hours after starting antibiotic treatment;
(e) Lice or nits; and
(f) Fever of 100 degrees Fahrenheit or higher and who also have one or more of the following:
(i) Earache;
(ii) Headache;
(iii) Sore throat;
(iv) Rash; or
(v) Fatigue that prevents participation in regular activities.
(3) Children and staff who have a reportable disease may not be in attendance at the child care center unless approved by the local health authority.
(4) You must not take ear or rectal temperatures. Oral temperatures can be taken for preschool through school age if single use disposable covers are used over the thermometer.
(5) When a child becomes ill or injured while in your care, you must:
(a) Keep a confidential, individualized, written record in the child's file that includes the:
(i) Date of an illness or injury;
(ii) Treatment provided while in care; and
(iii) Names of the staff providing the treatment.
(b) Provide a copy of the illness or injury report to the parent; and
(c) Keep a current, written incident log listing date of illness or injury, the child's name, names of staff involved, and a brief description of the incident for tracking and analysis.
(6) You must notify parents in writing when their children have been exposed to infectious diseases or parasites. The notification may consist of either a letter to parents or posting a notification for parents in a visible location.
(7) You are a mandated disease reporter to the health department per WAC 246-101-415. You can obtain a list of reportable diseases, time frames for reporting and reporting phone numbers from your local health department.
AMENDATORY SECTION (Amending WSR 08-08-012, filed 3/19/08, effective 4/19/08)
WAC 170-295-7060 What injuries and illnesses or child abuse and neglect must I report?
You or your staff must report immediately:
(1) A death or a serious injury or illness that requires medical treatment or hospitalization of a child in care must be reported by telephone and in writing to the parent, licensor, and child's social worker, if the child has a social worker;
(2) Any instance when you or your staff have reason to suspect the occurrence of any physical, sexual, or emotional child abuse or child neglect, child endangerment, or child exploitation as required under described in chapter 26.44 RCW. You may make a report by calling the statewide number at 1-800-562-5624 or 1-866-ENDHARM; and
(3) An occurrence of food poisoning or reportable ((communicable)) contagious disease, as required by the state board of health to the local public health department and to the licensor, by telephone.