Section R9-5-502. Supplemental Standards for Infants

A.      A licensee providing child care services for infants shall:

1.        Provide a wall-enclosed room for infants that provides exits required by R9-5-601(1);

2.        Provide age-appropriate active and quiet activities for each infant;

3.        Provide age-appropriate indoor and outdoor activities for each infant;

4.        Permit an infant to maintain the infant’s pattern of sleep- ing and waking;

5.        Develop, document, and implement policies and proce- dures that provide an opportunity for a non-crawling infant to spend time each day on the infant’s stomach while the infant is awake;

6.        Provide an outdoor activity area or an indoor activity area for large muscle development substituted for an outdoor activity area that is used by infants when enrolled chil- dren older than infants are not present;

7.        Provide space, materials, and equipment in an infant room that includes the following:

a.        An area with nonabrasive flooring for sitting, crawl- ing, and playing;

b.        Toys, materials, and equipment, that are too large for a child to swallow and free from sharp edges and points, in a quantity sufficient to meet the needs of the infants in attendance that include:

i.         Toys to enhance physical development such as toys for stacking, pulling, and grasping;

ii.        Soft toys;

iii.      Books;

iv.      Toys to enhance visual development such as crib mobiles and activity mats with an object or objects suspended above the infant’s head; and

v.        Unbreakable mirrors; and

c.        At least one adult-size chair for use by a:

i.         Staff  member   when  holding   or  feeding  an infant, or

ii.        Nursing mother when breastfeeding her infant;

8.        Provide a crib for each infant that:

a.        Has bars or openings spaced no more than 2 3/8 inches apart and a crib mattress measured to fit not more than 1/2 inch from the crib side;

b.        Has a commercially waterproofed mattress; and

c.        Is furnished with clean, sanitized, crib-size bedding, including a fitted sheet and top sheet or a blanket;

9.        Prohibit the use of stacked cribs;

10.     Ensure that an occupied crib with a crib side that does not have a non-porous barrier is placed at least 2 feet from another occupied crib side that does not have a non- porous barrier; and

11.     Label each food container received from the parent with the infant’s name.

B.       A licensee providing child care services for infants shall not:

1.        Allow an infant room to be used as a passageway to another area of the facility;

2.        Permit an infant who is awake to remain for more than 30 consecutive minutes in a crib, swing, feeding chair, infant seat, or any equipment that confines movement;

3.        Permit an infant to use a walker; or

4.        Allow screen time in an infant room.

C.      A licensee shall ensure that:

1.        A staff member providing child care services in an infant room:

a.        Plays and talks with each infant;

b.        Holds and rocks each infant;

c.        Responds immediately to each infant’s distress sig- nals;

d.        Keeps dated, daily, documentation of each infant including:

i.         A description of any activities the infant partic- ipated in,

ii.        The infant’s food consumption, and

iii.      Diaper changes;

e.        Maintains the documentation in subsection (C)(1)(d) on facility premises for 12 months after the date on the documentation;

f.         Provides a copy of the documentation in subsection (C)(1)(d) to the infant’s parent upon request;

g.        Does not allow bumper pads, pillows, comforters, sheepskins, stuffed toys, or other soft products in a crib when an infant is in the crib;

h.        Cleans and sanitizes each crib and mattress used by an infant when soiled;

i.         Changes each crib sheet and blanket before use by another infant, when soiled, or at least once every 24 hours;

j.         Cleans and sanitizes all sheets and blankets before use by another infant;

k.        Places an infant to sleep on the infant’s back, unless the infant’s parent submits written instructions from the infant’s health care provider that states other- wise;

l.         Obtains written, current, and dated dietary instruc- tions from a parent or health care provider regarding the method of feeding and types of foods to be pre- pared or fed to an infant at the facility;

m.      Posts the current written dietary instructions in the infant room and the kitchen and maintains the instructions on facility premises for 12 months after the date of the instructions; and

n.        Follows the current written dietary instructions of a parent when feeding the infant;

2.        A staff member providing child care services in an infant room does not:

a.        Place an infant directly on a waterproof mattress cover; or

b.        Place an infant to sleep using a positioning device that restricts movement, unless the infant’s health care provider has instructed otherwise in writing;

3.        When preparing, using, or caring for an infant’s feeding bottles, a staff member:

a.        Labels each bottle received from the parent with the infant’s name;

b.        Ensures that a bottle is not:

i.         Heated in a microwave oven;

ii.        Propped for an infant feeding; or

iii.      Permitted in an infant’s crib unless the written instructions required by subsection (C)(1)(l) state otherwise;

c.        Empties and rinses bottles previously used by an infant; and

d.        Cleans and sanitizes a bottle, bottle cover, and nip- ple before reuse; and

4.        When feeding an infant, a staff member:

a.        Provides an infant with food for growth and devel- opment that includes:

i.         Formula provided by the infant’s parent or the licensee or breast milk provided by the infant’s parent, following written instructions required by subsection (C)(1)(l); and

ii.        Cereal as requested by the infant’s parent or health care provider;

b.        If the staff member prepares an infant’s formula, prepares the infant’s formula in a sanitary manner;

c.        Stores formula and breast milk in a sanitary manner at the facility;

d.        Does not mix cereal with formula and feed it to an infant from a bottle or infant feeder unless the writ- ten instructions required by subsection (C)(1)(l) state otherwise;

e.        Except for finger food, feeds solid food to an infant by spoon from an individual container;

f.         Uses a separate container and spoon for each infant;

g.        Holds and feeds an infant under 6 months of age and an infant older than 6 months of age who cannot hold a bottle for feeding; and

h.        If an infant is no longer being held for feeding, seats the infant in a feeding chair or at a table with a chair that allows the infant to reach the food while sitting.

Historical Note

Adopted effective December 12, 1986 (Supp. 86-6). Sec- tion repealed; new Section adopted effective October 17, 1997 (Supp. 97-4). Amended by exempt rulemaking at 16

A.A.R. 1564, effective September 30, 2010 (Supp. 10-3).