Ariz. Admin. Code § 9-5-502

Current through Register Vol. 30, No. 40, October 4, 2024

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 sleeping and waking;

5. Develop, document, and implement tummy time policies and procedures that:

a. Provide an opportunity for a non-crawling infant to experience tummy time each day:

i. While the infant is awake, and

ii. On the infant's stomach;

b. Ensure a staff member who is supervising a non-crawling infant while the infant is flat on their stomach and on the floor:

i. Is within reach of the infant;

ii. Does not perform any other duties while supervising the infant;

iii. Does not allow the use of pillows, comforters, sheepskins, stuffed toys, or other soft products in the same floor space as the infant; and

iv. Does not allow any product specified in subsection (A)(5)(b)(iii) to be within reach of the infant;

c. Require continuous interaction between a non-crawling infant and the staff member who is supervising the non-crawling infant during tummy time;

d. Ensure, as an infant demonstrates ability and strength to control physical movement and greater sensory perception and social interaction, an assigned staff member provide a tummy-time period to:

i. A 2 - 3 month old infant of no more than 15 minutes;

ii. A 3 - 4 month old infant of no more than 20 minutes; and

iii. A 5 - 6 month old infant of 20 minutes; and

e. Ensure a non-crawling infant's tummy time period specified in subsection (A)(5)(d):

i. Is determined by the assigned staff member's assessment of the infant;

ii. Is gradually increased as the infant's ability, strength, and perception increases; and

iii. Does not exceed tummy time periods specified in subsection (5)(D)(i) through (iii).

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 children 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, crawling, 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 signals;

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

i. A description of any activities the infant participated in,

ii. The infant's food consumption,

iii. Diaper changes, and

iv. Tummy time;

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 otherwise;

l. Obtains written, current, and dated dietary instructions from a parent or health care provider regarding the method of feeding and types of foods to be prepared 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 nipple before reuse; and

4. When feeding an infant, a staff member:

a. Provides an infant with food for growth and development 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 written 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.

Ariz. Admin. Code § R9-5-502

Adopted effective December 12, 1986 (Supp. 86-6). Section 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). Amended by final rulemaking at 26 A.A.R. 1256, effective 6/3/2020.