Administrative Code

Virginia Administrative Code
6/28/2022

Part VII. Special Care Provisions and Emergencies

8VAC20-780-490. Preventing the spread of disease.

A. A child shall not be allowed to attend the center for the day if he has:

1. A temperature over 101°F;

2. Recurrent vomiting or diarrhea; or

3. A communicable disease.

B. If a child needs to be excluded according to subsection A of this section, the following shall apply:

1. Arrangements shall be made for the child to leave the center as soon as possible after the signs or symptoms are noticed; and

2. The child shall remain in the designated quiet area until leaving the center.

C. When children at the center have been exposed to a communicable disease listed in the Department of Health's current communicable disease chart, the parents shall be notified within 24 hours or the next business day of the center's having been informed unless forbidden by law, except for life threatening diseases, which must be reported to parents immediately.

D. The center shall consult the local department of health if there is a question about the communicability of a disease.

E. When any surface has been contaminated with body fluids, it shall be cleaned and sanitized.

Statutory Authority

§§ 22.1-16 and 22.1-289.046 of the Code of Virginia.

Historical Notes

Former 22VAC15-30-570 derived from VR175-08-01 § 7.1, eff. November 1, 1993; amended, Virginia Register Volume 12, Issue 4, eff. March 1, 1996; Volume 14, Issue 21, eff. September 1, 1998; Volume 21, Issue 12, eff. June 1, 2005; amended and renumbered as 22VAC40-185-490, Virginia Register Volume 29, Issue 1, eff. November 1, 2012; renumbered Volume 37, Issue 24, eff. July 1, 2021.

8VAC20-780-500. Hand washing and toileting procedures.

A. Hand washing.

1. Children's hands shall be washed with soap and running water or disposable wipes before and after eating meals or snacks.

2. Children's hands shall be washed with soap and running water after toileting and any contact with blood, feces, or urine.

3. Staff shall wash their hands with soap and running water:

a. Before and after helping a child use the toilet;

b. Before and after a diaper change;

c. After the staff member uses the toilet;

d. After any contact with body fluids;

e. Before feeding or helping children with feeding; and

f. Before preparing or serving food or beverages.

4. If running water is not available, a germicidal cleansing agent administered per manufacturer's instruction may be used.

B. Diapering; soiled clothing.

1. The diapering area shall be accessible and within the building used by children.

2. There shall be sight and sound supervision for all children when a child is being diapered.

3. The diapering area shall have the following:

a. A sink with running warm water not to exceed 120°F;

b. Soap, disposable towels, and single use gloves such as surgical or examination gloves;

c. A nonabsorbent surface for diapering or changing shall be used. For children younger than three years, this surface shall be a changing table or countertop designated for changing;

d. The appropriate disposal container as required by subdivision 6 of this subsection; and

e. A leakproof covered receptacle for soiled linens.

4. When a child's clothing or diaper becomes wet or soiled, the child shall be cleaned and changed immediately.

5. Disposable diapers shall be disposed in a leakproof or plastic-lined storage system that is either foot-operated or used in such a way that neither the staff member's hand nor the soiled diaper touches an exterior surface of the storage system during disposal.

6. When cloth diapers are used, a separate leakproof storage system as specified in subdivision 5 of this subsection shall be used for each individual child.

7. The diapering surface shall be used only for diapering or cleaning children, and it shall be cleaned with soap and at least room temperature water and sanitized after each use. Tables used for children's activities or meals shall not be used for changing diapers.

8. Individual disposable barriers may be used between each diaper change. If the changing surface becomes soiled, the surface shall be cleaned and sanitized before another child is diapered.

9. Staff shall ensure the immediate safety of a child during diapering.

C. Toilet training. For every 10 children in the process of being toilet trained, there shall be at least one toilet chair or one child-sized toilet, or at least one adult sized toilet with a platform or steps and adapter seat.

1. The location of these items shall allow for sight and sound supervision of children in the classroom if necessary for the required staff-to-children ratios to be maintained.

2. Toilet chairs shall be emptied promptly and cleaned and sanitized after each use.

Statutory Authority

§§ 22.1-16 and 22.1-289.046 of the Code of Virginia.

Historical Notes

Former 22VAC15-30-575 derived from Virginia Register Volume 14, Issue 21, eff. September 1, 1998; amended, Virginia Register Volume 21, Issue 12, eff. June 1, 2005; Errata, 21:13 VA.R. 1941 March 7, 2005; amended and renumbered as 22VAC40-185-500, Virginia Register Volume 29, Issue 1, eff. November 1, 2012; renumbered Volume 37, Issue 21, eff. July 1, 2021; Volume 38, Issue 2, eff. October 13, 2021.

8VAC20-780-510. Medication.

A. The decision to administer medicines at a facility may be limited by center policy to administer:

1. Prescribed medications;

2. Over-the-counter or nonprescription medications; or

3. No medications except those required for emergencies or by law.

B. Prescription and nonprescription medication shall be given to a child:

1. According to the center's written medication policies; and

2. Only with written authorization from the parent.

C. Medication shall be administered by a staff member who is 18 years of age or older.

D. Nonprescription medication shall be administered by a staff member or independent contractor who meets the requirements in 8VAC20-780-245 J 1 or J 2.

E. The center's procedures for administering medication shall:

1. Include any general restrictions of the center.

2. For nonprescription medication, be consistent with the manufacturer's instructions for age, duration, and dosage.

3. Include duration of the parent's authorization for medication, provided that it shall expire or be renewed after 10 work days. Long-term prescription drug use and over-the-counter medication may be allowed with written authorization from the child's physician and parent.

4. Include methods to prevent use of outdated medication.

F. The medication authorization shall be available to staff during the entire time it is effective.

G. Medication shall be labeled with the child's name, the name of the medication, the dosage amount, and the time or times to be given.

H. Nonprescription medication shall be in the original container with the direction label attached.

I. The center may administer prescription medication that would normally be administered by a parent or guardian to a child provided:

1. The medication is administered by a staff member or an independent contractor who meets the requirements in 8VAC20-780-245 J;

2. The center has obtained written authorization from a parent or guardian;

3. The center administers only those drugs that were dispensed from a pharmacy and maintained in the original, labeled container; and

4. The center administers drugs only to the child identified on the prescription label in accordance with the prescriber's instructions pertaining to dosage, frequency, and manner of administration.

J. When needed, medication shall be refrigerated.

K. When medication is stored in a refrigerator used for food, the medications shall be stored together in a container or in a clearly defined area away from food.

L. Medication, except for those prescriptions designated otherwise by written physician's order, including refrigerated medication and staff's personal medication, shall be kept in a locked place using a safe locking method that prevents access by children.

M. If a key is used, the key shall not be accessible to the children.

N. Centers shall keep a record of medication given children, which shall include the following:

1. Child to whom medication was administered;

2. Amount and type of medication administered to the child;

3. The day and time the medication was administered to the child;

4. Staff member administering the medication;

5. Any adverse reactions; and

6. Any medication error.

O. Staff shall inform parents immediately of any adverse reactions to medication administered and any medication error.

P. When an authorization for medication expires, the parent shall be notified that the medication needs to be picked up within 14 days or the parent must renew the authorization. Medications that are not picked up by the parent within 14 days will be disposed of by the center by either dissolving the medication down the sink or flushing it down the toilet.

Statutory Authority

§§ 22.1-16 and 22.1-289.046 of the Code of Virginia.

Historical Notes

Former 22VAC15-30-580 derived from VR175-08-01 § 7.2, eff. November 1, 1993; amended, Virginia Register Volume 12, Issue 4, eff. March 1, 1996; Volume 14, Issue 21, eff. September 1, 1998; Volume 21, Issue 12, eff. June 1, 2005; Volume 23, Issue 20, eff. July 11, 2007; amended and renumbered as 22VAC40-185-510, Virginia Register Volume 29, Issue 1, eff. November 1, 2012; amended and renumbered Volume 37, Issue 24, eff. July 1, 2021; Volume 38, Issue 2, eff. October 13, 2021.

8VAC20-780-520. Over-the-counter skin products.

A. All nonprescription drugs and over-the-counter skin products shall be used in accordance with the manufacturer's recommendations. Nonprescription drugs and over-the-counter skin products shall not be kept or used beyond the expiration date of the product.

B. If sunscreen is used, the following requirements shall be met:

1. Written parent authorization noting any known adverse reactions shall be obtained;

2. Sunscreen shall be in the original container and labeled with the child's name;

3. Sunscreen does not need to be kept locked but shall be inaccessible to children under five years of age or those children in a therapeutic child day program or special needs child day program;

4. Any center-kept sunscreen shall be hypo-allergenic and have a minimum SPF of 15;

5. Staff members without medication administration training may apply sunscreen, unless it is prescription sunscreen, in which case the storing and application of sunscreen must meet medication-related requirements; and

6. Children nine years of age and older may administer their own sunscreen if supervised.

C. If diaper ointment or cream is used, the following requirements shall be met:

1. Written parent authorization noting any known adverse reactions shall be obtained;

2. These products shall be in the original container and labeled with the child's name;

3. These products do not need to be kept locked but shall be inaccessible to children;

4. A record shall be kept that includes the child's name, date of use, frequency of application and any adverse reactions; and

5. Staff members without medication administration training may apply diaper ointment, unless it is prescription diaper ointment, in which case the storing and application of diaper ointment must meet medication-related requirements.

D. If insect repellent is used, the following requirements shall be met:

1. Written parent authorization noting any known adverse reactions shall be obtained;

2. Insect repellent shall be in the original container and labeled with the child's name;

3. Insect repellent does not need to be kept locked but shall be inaccessible to children;

4. A record shall be kept that includes the child's name, date of use, frequency of application and any adverse reactions;

5. Manufacturer's instructions for age, duration and dosage shall be followed; and

6. Staff members without medication administration training may apply insect repellent, unless it is prescription insect repellent, in which case the storing and application of insect repellent must meet medication-related requirements.

Statutory Authority

§§ 22.1-16 and 22.1-289.046 of the Code of Virginia.

Historical Notes

Former 22VAC15-30-585 derived from Virginia Register Volume 21, Issue 12, eff. June 1, 2005; amended and renumbered as 22VAC40-185-520, Virginia Register Volume 29, Issue 1, eff. November 1, 2012; renumbered Volume 37, Issue 24, eff. July 1, 2021.

8VAC20-780-530. First aid training and cardiopulmonary resuscitation (CPR).

A. At least one staff in each classroom or area where children are present shall have, within 90 days of October 13, 2021:

1. Current certification in cardiopulmonary resuscitation (CPR) as appropriate to the age of the children in care from an organization such as the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council. The training shall include an in-person competency demonstration; and

2. Current certification in first aid from an organization such as the American Red Cross, American Heart Association, American Safety and Health Institute, or National Safety Council.

B. CPR and first aid certification training may count toward the annual training hours required in 8VAC20-780-245.

C. There shall be at least two staff members who meet the requirements of subsection A of this section present on the premises during the center's hours of operation, on fieldtrips, and wherever children are in care.

D. Primitive camps shall have a staff member on the premises during the hours of operation who has at least current certification in first responder training.

E. Staff who is a registered nurse or licensed practical nurse with a current license from the Board of Nursing shall not be required to obtain first aid certification.

Statutory Authority

§§ 22.1-16 and 22.1-289.046 of the Code of Virginia.

Historical Notes

Former 22VAC15-30-590 derived from VR175-08-01 § 7.3, eff. November 1, 1993; amended, Virginia Register Volume 12, Issue 4, eff. March 1, 1996; Volume 14, Issue 21, eff. September 1, 1998; Volume 21, Issue 12, eff. June 1, 2005; amended and renumbered as 22VAC40-185-530, Virginia Register Volume 29, Issue 1, eff. November 1, 2012; amended and renumbered Volume 37, Issue 24, eff. July 1, 2021; Volume 38, Issue 2, eff. October 13, 2021.

8VAC20-780-540. First aid and emergency supplies.

A. A first aid kit shall be:

1. On each floor of each building used by children;

2. Accessible to outdoor play areas;

3. On field trips; and

4. Wherever children are in care.

B. Each first aid kit shall be easily accessible to staff but not to children.

C. The required first aid kits shall include at a minimum:

1. Scissors;

2. Tweezers;

3. Gauze pads;

4. Adhesive tape;

5. Band-aids, assorted types;

6. An antiseptic cleansing solution /pads;

7. Thermometer;

8. Triangular bandages;

9. Single use gloves such as surgical or examination gloves; and

10. The first aid instructional manual.

D. The following emergency supplies shall be required at the center and be available on field trips:

1. Activated charcoal preparation (to be used only on the direction of a physician or the center's local poison control center); and

2. An ice pack or cooling agent.

E. The following nonmedical emergency supplies shall be required:

1. One working, battery-operated flashlight on each floor of each building that is used by children; and

2. One working, battery-operated radio in each building used by children and any camp location without a building.

Statutory Authority

§§ 22.1-16 and 22.1-289.046 of the Code of Virginia.

Historical Notes

Former 22VAC15-30-600 derived from VR175-08-01 § 7.4, eff. November 1, 1993; amended, Virginia Register Volume 12, Issue 4, eff. March 1, 1996; Volume 14, Issue 21, eff. September 1, 1998; Volume 21, Issue 12, eff. June 1, 2005; amended and renumbered as 22VAC40-185-540, Virginia Register Volume 29, Issue 1, eff. November 1, 2012; renumbered Volume 37, Issue 24, eff. July 1, 2021.

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