10-148-33 Me. Code R. § 12

Current through 2025-02, January 8, 2025

Section 148-33-12 - HEALTH AND MEDICAL

A.Immunization. Immunization records must be maintained to ensure proper medical treatment is determined and given in the event of a disease outbreak or public health emergency.

1. All Children in care must meet the following requirements:

a. The Provider must have a current record of immunization on file for each child, which clearly documents each child's present immunization status based on the Department's Day Care Immunization Standards (available at http://www.maine.gov/dhhs/mecdc/infectious-disease/immunization/family/ and published in September 2019), within 30 days of the child's first admission to the child care and updated as needed thereafter or,

b. A blood test documenting immunity to measles, mumps, rubella and varicella (chickenpox), placed in the Child's record and updated in a timely manner.

c. No Child may be required to be immunized if religious, philosophical or medical reasons are documented. Effective September 1, 2021, exemption from immunization requirements are limited to medical reasons. The Child's physician, nurse practitioner, or physician assistant must provide documentation that immunization is medically inadvisable.

2. Unimmunized Children, Provider and Staff Members. The Family Child Care Provider must maintain a list of all unimmunized persons, regardless of age. In the event of a disease outbreak as defined by CDC reporting standards, a Child not immunized must be excluded from the Family Child Care in accordance with CDC guidance or until the Child receives the necessary immunization or proof of immunity is on record.

3. Immunization records. The Family Child Care Provider must make immunization records available to the Department of Health and Human Services, Maine Center for Disease Control and Prevention, upon request.

B.Evaluation requirements. When the Department has reasonable cause to believe that an Applicant, Provider or Staff Member may be unable to provide safe care for Children, the Department may request a report from a qualified professional or an appropriate official that includes the evaluator's determination of the person's ability to safely care for Children.

1. A physical examination or other evaluation is not required if the Applicant, Provider, or Staff Member states in writing that it is contrary to the person's religious teachings and practice.

2. If the Applicant, Provider, or Staff Member refuses to be evaluated, the Department shall determine whether sufficient evidence exists to ensure that the person can safely care for Children.

C.Health care consultation.

1. The Provider must have a manual of written guidelines for the prevention and control of communicable diseases and other appropriate health practices for childcare.

2. The Provider must ensure that the manual be available to and read by all Staff Members.

D.Health monitoring. The Provider must observe Children in care each day at the time of arrival and throughout the Child's stay for obvious signs of illness such as fever, diarrhea, vomiting, or skin rashes. In the event of an apparent illness of a Child, the Provider must comply with the guidance in the manual described in Section 14(C)(1) below.

When a Provider knows or suspects that a Child has contracted a notifiable disease or condition, the Provider must notify the Maine Center for Disease Control and Prevention (MECDC). The Provider must notify the MECDC immediately by phone for Category 1 conditions, and within 48 hours for Category 2 conditions. MECDC contacts: Phone: 1-800-821-5821 (24 hours a day); FAX: 1-800-293-7534 (24 hours a day); or TTY: Maine relay 711 (24 hours a day). For a list of Category 1 and 2 notifiable diseases and conditions, see 10-144 CMR Chapter 258, Rules for the Control of Notifiable Conditions, Chapter 2(I). http://www.maine.gov/sos/cec/rules/10/144/144c258.doc

E.Dismissal of children due to illness. When a Child becomes ill, but does not require immediate medical help, the provider must determine if the Child should be sent home. The provider must notify the Parent/Legal Guardian of the Child who has symptoms that require exclusion.

F.Illness, serious injury, incidents, and accidents.

1. The Provider or a Staff Member must immediately notify the Child's Parent or Legal Guardian of any illness, serious injury, or Incident involving their Child. An Adult designated by the Parent or Legal Guardian must be notified immediately should the Parent or Legal Guardian be unavailable.

2. The Provider must document all Accidents, injuries, Incidents, or emergencies in the Child's record on the day of the occurrence and the Parent or Legal Guardian must review and sign the document within two business days.

G.First aid. The Provider must have a first aid kit and a current first aid manual.

1. A complete first-aid kit must be readily available to the Provider during all Field Trips, and while transporting Children. A complete first aid kit includes, but is not limited to, adhesive tape, band aids, gauze pads, gauze roller bandage, disposable gloves, instant cold pack, scissors, tweezers, thermometer, CPR mask, and antiseptic wipes. The first aid kit must not contain any expired materials.

2. The first aid kit must be kept in a clean and sanitary condition, be stored in an easily accessible, designated location known to all providers, and be kept out of the reach of Children.

H.Medication administration. A Provider may give a Child prescription medication only when the Provider has written, signed, and dated permission from a Parent.

1. The Provider must only give Medication prescribed for the specified Child, according to the label instructions on the original container.

2. The Provider must not give any nonprescription Medications to a Child without written permission from the Parent. Telephone, text, or email permission is allowed in emergencies, if the provider documents giving the Medication and obtains written permission from the Parent as soon as possible.

3. The provider must keep a written record, noting each time a prescription and nonprescription Medication is given to a Child.

4. All Medications, refrigerated or non-refrigerated, must be:

a. Completely inaccessible to Children,

b. Stored at the proper temperature, and

c. Discarded upon expiration.

I.Handwashing. Handwashing must be done with soap and running water. The provider must ensure that all Adults and all Children wash their hands in at least the following circumstances:

1. Immediately before and after eating snacks and meals, including washing the hands of all Infants and toddlers before all feedings;

2. After each diaper change or toileting;

3. Before and after handling food; and

4. Before and after administering Medication.

J.Prevention of exposure to blood and body fluids. The Provider must take measures to prevent exposure to blood and other potentially infectious fluids, which may include use of disposable gloves. When touching blood, body fluids, secretions, excretions, mucous membranes, or non-intact skin, providers must:

1. Wash their hands after contact, even if gloves are worn;

2. Ensure safe waste management by immediately discarding contaminated single use items; and

3. Immediately Clean and disinfect surfaces and reusable equipment.

K.Emergency procedures. Providers must have a procedure for responding to situations when an immediate emergency medical response is required. Staff-Child ratio must be maintained during all medical emergencies. Staff Members may be called in as necessary to maintain the required ratio. Every Staff Member must be trained to manage an emergency until emergency medical care becomes available.

10-148 C.M.R. ch. 33, § 12