Section 7.12 - Nutrition and Food ServiceThe following requirements apply to all programs, including family child care, small group and school age and large group and school age child care. Additional requirements for small group and school age and large group and school age child care are found at 606 CMR 7.12(15).
(1) The licensee must design and implement a nutrition program that meets the U.S.D.A. guidelines for the nutritional and dietary needs and feeding requirements of each child, including those of children with disabilities.(2) All educators must receive basic training in the following: (a) in USDA recognized nutrition requirements for the healthy growth and development of children; and(b) in food choking hazards.(3) Educators must follow parents' or physicians' orders in the preparation and feeding of special diets to children.(4) Educators must follow the directions of the parents and /or the child's physician regarding any food allergies of a child.(5)Vitamin Supplements.(a) Educators must follow the direction of parents where the administration of over-the-counter vitamin supplements is required.(b) All over-the-counter vitamin supplements must be provided by parents in the original manufacturer's packaging.(c) Educators must not administer any vitamin supplement contrary to the directions on the original container, unless so authorized in writing by the child's licensed health care practitioner.(6) The licensee must have a method of providing nutritious meals and snacks to children whose parents fail to send meals and/or snacks from home.(7) If the licensee provides meals and snacks for children:(a) the nutrition program must serve a variety of nutritious foods;(b) the licensee must ensure that snacks and meals are prepared and served in a safe and sanitary manner;(c) the licensee must ensure that foods are not served to children beyond their recommended dates of use;(d) the licensee must store all food in clean, covered containers;(e) the licensee must properly wash and sanitize all bottles, eating utensils, drinking utensils, dishes, and preparation utensils after each use;(f) the licensee must prepare and make available to parents on request written menus, including snacks, for each week;(g) the licensee must keep previous menus on file for one year.(8) The licensee must provide refrigeration and storage for food at not less than 32°F, nor more than 40°F for all food requiring refrigeration. Meals and snacks provided by parents must be stored safely. Thermometers verifying temperatures must be maintained in all refrigerators.(9) Eating and drinking utensils must be free from defects, cracks and chips and appropriate to the ages and needs of the children, including children with disabilities. Disposable cups and plates may be used. If plastic utensils are used, they must be heavy-duty and if reused, must be designed for this purpose and dishwasher safe.(10) Meal schedules must be appropriate to the ages of the children served. (a) In programs serving infants and toddlers: 1. A current feeding schedule must be maintained, documenting use of either breast milk or formula, if applicable, new foods introduced, food intolerances and preferences, voiding patterns, and observations related to developmental changes in feeding and nutrition.2. Infants and toddlers must be fed according to their individual feeding schedules or needs.3. Infants must be held while fed a bottle.(b) In programs serving preschool and school age children:1. The licensee must provide regular, nutritious snacks for children in care for less than four hours;2. The licensee must schedule meals, in addition to snacks, for children in care four hours or longer;3. The licensee must offer a nutritious substitute to a child who misses a meal or snack due to deviations from his regular schedule (such as arriving late or leaving early).4. Children must be allowed to participate in menu planning in an age-appropriate manner.(11) During meal and snack times educators must:(a) be present interacting with and assisting children;(b) allow children to eat at a reasonable, leisurely rate;(c) encourage children to serve themselves, when appropriate;(d) ensure that each child receives an adequate amount and variety of food;(e) help children with disabilities to participate in meal and snack times with their peers;(f) encourage children to eat a well-balanced diet;(g) offer alternative activities for children who have finished their snack or meal.(12) Educators must dispose of, or return to the parent, milk, formula or food unfinished by a child, as directed by the parent.(13) The licensee must provide a source of sanitary drinking water located in or convenient to rooms occupied by children.(14) Educators must offer water to children at frequent intervals and upon request by children.(15)Additional Requirements for Small Group and School Age and Large Group and School Age Child Care. (a) The licensee must designate, according to Department of Public Health (DPH) requirements, one person to be responsible for the food program. This designated person shall review and approve menus.(b) If the licensee provides food prepared on-site, the licensee must have a Food Service permit or evidence of inspection from the local health department when required by DPH.(c) If the licensee provides food that is prepared off-site, the food must be prepared at a facility that has a Food Service permit or evidence of inspection from the local health department and must be transported to the program in appropriate sanitary containers and at appropriate temperatures.(d) If parents provide meals or snacks for children, the licensee must provide to parents, in writing at the time of admission, a list of nutritious items that may be part of a lunch or snack. The program must support parent choice regarding meals to the extent that such choice does not adversely affect a child's health.