kdheks Our Vision – Healthy Kansans living in safe and sustainable environments.

1. http://www.kdheks.gov Our Vision – Healthy Kansans living in safe and sustainable environments.

2. Guidance for New Child Care Providers: Application and Survey Process Kansas Department of Health & Environment Early Care & Youth Programs SectionRev. 2/2012 Disclaimer: This presentation serves as a brief overview of the child care licensing process and regulation review. It is the ultimate responsibility of the applicant/provider to review the regulations that apply to the type of care offered.

3. Background • The original licensing law was passed in 1919; the licensing authority was later placed with the Kansas Department of Health and Environment. • The Department administers the licensing law as a preventive program to assure that out-of-home care for children and maternity patients will not be exploitive, unsafe, or unhealthy. • The main purpose of the law is to protect the health, safety, and welfare of children receiving care away from their parents and home. It also provides consumer protection, assuring parents that the care meets minimum standards. • The Kansas Department of Health and Environment contracts with local health departments through the Aid-To-Local Process. This contract specifies regulatory services to be provided by the local contractor. Most local health departments supplement their KDHE funds to meet service needs.

4. Types of Day Care Licenses and Capacity Information • Licensed Day Care Home • Maximum of up to 10 children with one adult, depending on the number and ages of children in care (refer to KAR 28-4-114(e)(1) Table I) • Group Day Care Home • Maximum of up to12 children 2 ½ to 11 years with one adult (refer to KAR 28-4-114(f)(1) Table II) OR • Maximum of up to 12 children with 2 adults, depending on the number and ages of children in care (refer to Table III and IV) • Note: When only one adult is present, licensee must revert back to maximum capacity under Table I

5. Child Care Atmosphere • Business Oriented • offering services • preparation time is required • provider/customer contract often facilitates clear expectations • check for local ordinances or codes which may apply • Personal Oriented • developing a daily schedule and plan for child care allows you to provide safe, nurturing care in the best interest of children but also allows you the time and energy you need to maintain your well being and meet your own needs • if using a residence, determine which areas will be used for child care and which areas will be non-child care areas (made inaccessible to children); review the supervision requirements to ensure the child care areas can be supervised (visually and hearing) at all times; the child care surveyor will inspect ALL areas of the facility

6. Child Care Atmosphere Continued • Environment Oriented • providing a safe, healthy, and nurturing setting • providing developmentally and age appropriate materials, equipment, and activities to support children’s growth • facility should be arranged and structured to have a minimum of 25 square feet of available play/nap space per child in care • each applicant with a temporary permit and each licensee shall ensure that supervision is provided as necessary to protect the health, safety, and well-being of each child in care • prior to use of use of a basement or second level in a facility, Kansas State Fire Marshal approval must be obtained; a third floor shall not be used

7. Overview Effective July 1, 2010, all new applicants must be a high school graduate or the equivalent such as having a GED Effective February 3, 2012, all new applicants must complete orientation prior to submitting an application (contact the child care surveyor in the county where the facility will be located to complete orientation) Complete the application packet (refer to instructions for guidance) Application KBI/SRS Background Check Form State License Application Fee – $85 for a LDCH and $87 for GDCH (local fees may apply) Submit application according to application instructions Make copies for your file before mailing! Application Process

8. Definitions for Guidance • KAR 28-4-113(c) “Care provider” and “provider” mean an individual who cares for and supervises children in a facility and has responsibility for the health, safety, and well-being of children, including the following: • A primary care provider; • an individual who is at least 16 years of age and who is working in the facility; and • a substitute. • KAR 28-4-113(q) “Primary care provider” means an applicant with a temporary permit, a licensee, or the designee of an applicant with a temporary permit or a licensee. Each applicant with a temporary permit, each licensee, and each designee shall be at least 18 years of age and shall meet the requirements for a primary care provider specified in K.A.R. 28-4-114a. • KAR 28-4-113(r) “Professional development training” means training approved by the secretary that is related to working with children in care. • KAR 28-4-113(s) “Substitute” means an individual who supervises children in the temporary absence or extended absence of the primary care provider and who meets the following requirements: • In the temporary absence of the primary care provider, the substitute shall be at least 16 years of age and shall meet all of the requirements for a provider specified in K.A.R. 28-4-114a (a)(2), (b)(4)(C) and (c). • In the extended absence of the primary care provider, the substitute shall be at least 18 years of age and shall meet all of the requirements for a primary care provider specified in K.A.R. 28-4-114a. • KAR 28-4-113(t) “Temporary absence” means time away from a facility for a period not to exceed three hours in a day.

9. Required Initial Professional Development Training for Licensed and Group Day Care Homes Within 30 days of submitting an application: • Pediatric First Aid Certification • Pediatric Cardiopulmonary Resuscitation (CPR) Certification • At least 2 hrs in Recognizing and Reporting the Signs of Child Abuse or Neglect (must include prevention of head trauma) • At least 2 hrs in Basic Child Development • At least 2 hrs in Safe Sleep/Sudden Infant Death Syndrome (SIDS) • Initial Professional Development Requirements under KAR 28-4-114a(d) are required to be met no later than 30 calendar days after submitting an application. • Training detailed in 1-6 above is required for all applicants and providers (see definition of provider under KAR 28-4-113); note requirements for substitutes based on working hours. • Training hours for orientation and all courses completed may be applied to requirements for initial training under KAR 28-4-114a(d).

10. Supervision and Safe Sleep • Review all general supervision, indoor, outdoor, and napping supervision requirements. Especially consider: • Supervision Plan KAR 28-4-115a(a): A copy of the plan shall be available for review by the parents or legal guardians and by the department. Note what the regulation specifies must be addressed in the plan. • Napping and Sleeping KAR 28-4-116a: Each applicant and each licensee shall develop and implement safe sleep practices.

11. Required Paperwork and Forms Children’s Files: All blanks must be complete • Medical Record (use KDHE form only); includes immunization records – CCL 029 • Health Assessment (physical/well check) – CCL 029a • Authorization for Emergency Care – CCL 010 • Off-Premise Forms (signed when needed) – CCL 034, 035 • Medication Record (short and long term) – CCL 026, 027 • Critical Incident Report (when needed) – CCL 028

12. Paperwork and Forms continued… Adult Files • Adult Health Assessment (KDHE form) – CCL 009 • Negative TB Test Documentation • Professional Development Training Documentation • Copy of Current KBI/SRS Background Check Form – CCL 002 Additional Paperwork if Transporting • Mechanical Safety Checklist – CCL 005 • Car Insurance (declaration) • Copy of Driver’s License All forms can be found at: http://www.kdheks.gov/bcclr/forms.html (Click on the licensed/group day care home link)

13. Regulations Commonly Overlooked It is the child care provider’s responsibility to review and become familiar with the regulation book. A copy must be kept on file at the facility. • KAR 28-4-115 (g)(1) Household cleaning supplies and bodily care products with warning labels or which contain alcohol are in locked storage or out of reach of children under 6 years of age. NOTE: Out of reach is considered around 5 ft or in a place where a child cannot climb to reach them. • KAR 28-4-115 (i) The outdoor play area. The designated area for outdoor play and large motor activities shall meet all the requirements outlined in the regulation. NOTE: Use of a trampoline shall be prohibited during the hours of operation (refer to KAR 28-4-115 (i)(3) for complete details). • KAR 28-4-115 (j) Each facility on and after March 1, 2012, shall have a designated area for outdoor play and large motor activities as part of the licensed premises (outdoor play area that meets requirements must be on site).

14. Regulations continued… • KAR 28-4-116 (a) Daily activities. The provider shall offer each child the opportunity to participate in daily activities which promote healthy growth and development. Refer to KAR 28-4-116 (a)(1-7) for specific details. • Napping and sleeping. Refer to KAR 28-4-116a (a)-(e) • On or after December 28, 2012, no crib purchased before June 28, 2011, is in use in the facility. • KAR 28-4-116 (e)(13) A washable or disposable individual cup, towel, and washcloth shall be provided for each child. A common hand towel is not acceptable. • KAR 28-4-131(a-c) Pet area(s) should be clean and sanitary, out of the kitchen, immunizations must be current and on file, dangerous animals may not be around children, feces must be picked up, and parents must be informed when children have access to animals on the premises. Animal food and water should be maintained so children cannot access them.

15. Regulations continued… • KAR 28-4-129 Swimming and wading pools. Above ground pools must be at least 4 feet high (steps/ladders removed) or must be enclosed with a fence at least 5 feet high. Below ground pools must be enclosed with a fence at least 5 feet high. All fences must have 4 sides. Wading pools must be dumped daily. A house cannot serve as the fourth side of a fence if there is an exit which makes the pool accessible to children. • KAR 28-4-116(a)(7) Children shall be taken outdoors daily and receive at least 1 hour of play unless extreme weather conditions. Children under 12 months shall be taken outdoors daily. • For each child under five years of age, the provider shall be outdoors at all times and remain within sight of and in proximity to each child, watching and directing the activities of the child per KAR 28-4-115a(d)(1). • For each child five years of age and older refer to KAR 28-4-115a(d)(2). • KAR 28-4-115(c)(10-11) Stairs (indoor, outdoor and leading to tornado shelter) with more than two steps shall be railed, balusters must not be more than 4 inches apart, and steps must be guarded when children under 2 ½ years are in care.

16. Survey ProcessFour Types of Surveys: Initial, Annual, Compliance and Complaint The Initial Survey is the only scheduled visit. • Prepare the indoor and outdoor environment using the self evaluation checklist. • The entire premises is surveyed, including all levels and the outside. • Posted paperwork • Temporary Permit or License • Completed Fire/Life Safety Agreement (KSFM or local representative will sign off when the facility is inspected) • Emergency phone numbers • Disaster Plans • Diapering and Toileting Procedures for Group (though all must follow procedures) • Paperwork on file • Well-Child Information (may be posted or provided to parents) • Supervision Plan (may be posted or provided to parents) • Written Discipline Policy (may be posted or provided to parents) • Recorded Fire Drills (monthly) & Tornado Drills (April-Sept.) • Vehicle Records (if transporting) • Professional Development Training Documentation • Incident/Illness Reports

17. Survey Process Continued • A survey is not just a time to review your child care environment and files. It is an opportunity for surveyors to observe interactions with children and child care practices such as nap time, lunch preparation, outdoor play, diapering, and supervision. • Surveyors make request or ask questions such as, “Show me where children nap.” “Tell me about your sleeping policies.” “What activities do you offer school age children vs. toddlers?” “Tell me what you do outside.” “Where are the children when you are preparing lunch? Are they within hearing distance ? How often do you check on the children when they are out of sight?” • Written documentation of findings are recorded on a Notice of Survey Findings form. Findings are reviewed with the provider at the conclusion of the survey and a copy is left. The provider may ask questions for clarification. This is considered the exit interview.

18. Next Steps An unannounced compliance check may be conducted. All violations must be verified as corrected before a permanent license can be issued.

19. Resources and Partners • Child and Adult Care Food Program • Resource and Referral Agency • Department of Social and Rehabilitation Services (SRS) – Child Care Subsidy Program • Local Association and Provider Groups The child care facility surveyor can provide you with more information.

20. Withdrawing the Application If at any time you wish to withdraw your application to provide child care, please do the following: • Submit your request in writing to the child care surveyor or KDHE. You can also contact KDHE at 785.296.1270 and request to withdraw by telephone. • If you have a Temporary Permit, return the original to KDHE. NOTE: The application fee is non-refundable.

21. What paperwork do I need to submit?

22. Required Paperwork – Application Look for an Application with 08/2011 Revision Date! Check what is applicable for a new application Select category All information must be provided. If the facility is in a commercial building (non-residential; refer to application instructions for additional requirements.

23. Application Cont. Must be completed. Must be completed.

24. Application Cont. Must be completed. Contact your local surveyor for orientation. Orientation must be completed prior to submitting an application. I/We understand that I/we are not authorized to provide services to children and youth prior to receiving a Temporary Permit or License from KDHE. Don’t forget to sign the application! If there are two applicants, both must sign.

25. Final page of application

26. KBI/SRS Child Abuse Registry Check Select this category Must be completed Must be completed Must be completed

27. KBI/SRS Child Abuse Registry Check Include anyone over 10 years of age living, working, regularly visiting/volunteering at the facility, including yourself.

28. Fire Life Safety AgreementDownload at – http://www.ksfm.ks.gov/daycare-home/ The Agreement must be posted next to your license. Please ensure this is completed. Read the entire agreement prior to posting. This is page 1 of 2

29. Fire Life Safety Agreement • Prior to use of use of a basement or second level in a facility, Kansas State Fire Marshal approval must be on file. This will be completed by the KSFM or your local fire inspector (not all areas do this inspection). Please post even if the inspection has not been completed and signed.

30. FOR MORE INFORMATION Contact your child care facility surveyor. If you do not have contact information for your surveyor, please call KDHE at 785.296.1270.

31. http://www.kdheks.gov Our Vision – Healthy Kansans living in safe and sustainable environments.