ARC 8514C

ARC 8514C

Proposing rulemaking related to child care centers
and providing an opportunity for public comment

A Regulatory Analysis for this rulemaking was published in the Iowa Administrative Bulletin on October 16, 2024. A public hearing was held on the following date(s):

●November 6, 2024

Any persons who intend to attend a public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Department and advise of specific needs.

ITEM 1.Rescind 441—Chapter 109 and adopt the following new chapter in lieu thereof:

CHAPTER 109

CHILD CARE CENTERS

441—109.1(237A) Definitions.

“Adult” means a person 18 years of age or older.

“Child” means the same as defined in Iowa Code section 237A.1.

“Child care” means the same as defined in Iowa Code section 237A.1.

“Child care center” or “center” means the same as defined in Iowa Code section 237A.1. For the purposes of this chapter, the word “center” applies to a child care center or preschool unless otherwise specified.

“Child care facility” or “facility” means the same as defined in Iowa Code section 237A.1.

“Coaching” means a relationship-based process led by an expert to build capacity for specific professional dispositions, skills and behaviors and is focused on performance-based outcomes.

“Education” means formal coursework offered through a state-approved accredited secondary school, college or university.

“Facility” means a building or physical plant established for the purpose of providing child day care.

“Get-well center” means a facility that cares for a child with an acute illness of short duration for short enrollment periods.

“Involvement with child care” means the same as defined in Iowa Code section 237A.1.

“Parent” means parent or legal guardian.

“Person subject to an evaluation” means the same as defined in Iowa Code section 237A.5.

“Preschool” means the same as defined in Iowa Code section 237A.1.

“Professional development” means a continuum of learning activities designed to prepare and support individuals for work with children and families, including coaching, education, and training.

“Regulatory fee” means the amount payable to the department for licensure of a child care center based on the capacity of the center.

“Requesting entity” means an entity covered by these rules that is requesting an evaluation to determine if the person being evaluated can have involvement with child care. The requesting entity must be a child care facility as defined in Iowa Code section 237A.1.

“Serious injury” means the same as defined in Iowa Code section 702.18.

“Training” means a learning experience that addresses a specific topic of professional relevance that builds or enhances knowledge.

“Transgression” means the same as defined in Iowa Code section 237A.5.

441—109.2(237A) Licensure procedures.

109.2(1) Application for license.

a.Any adult or agency has the right to apply for a license. The application for a license must be made to the department on a department-provided application for a license to operate a child care center.

b.Requested reports, including the fire marshal’s report and other information relevant to the licensing determination, will be furnished to the department upon application and renewal.

c.A center must submit all required fingerprints to the department of public safety before the issuance or renewal of the center’s license.

d.When a center makes a sufficient application for an initial license, the center may operate for a period of up to 120 calendar days from the date of issuance of the form granting permission to open without a license, pending a final licensing decision. A center has made a sufficient application when it has had an on-site visit and has submitted the following to the department:

(1)An application for a license.

(2)An approved fire marshal’s report.

(3)A floor plan indicating room descriptions and dimensions, including location of windows and doors.

(4)Information sufficient to determine that the center director meets minimum personnel qualifications.

e.Applicants must submit the regulatory fee as specified in subrule 109.2(5) to the department.

f.Applicants must be notified of approval or denial of initial applications within 120 days from the date the application is submitted.

(1)If the applicant has been issued a form granting permission to open without a license, the applicant must be notified of approval or denial within 120 calendar days of the date of issuance of the form.

(2)No full or provisional license will be issued before payment of the applicable regulatory fee as determined pursuant to subrule 109.2(5).

g.The department will not act on a licensing application for 12 months after an applicant’s child care center license has been denied or revoked.

h.When the department has denied or revoked a license, the applicant or person is prohibited from involvement with child care unless the department specifically permits involvement through a record check decision.

109.2(2) License.

a.An applicant showing compliance with center licensing laws and these rules, including department approval of center plans and procedures and submission of the regulatory fee as specified in subrule 109.2(5) to the department by the date due, shall be issued a license for 24 months. In determining whether or not a center is in compliance with the intent of a licensing standard outlined in this chapter, the department will make the final decision.

b.A new license must be applied for when the center moves, expands, or the facility is remodeled to change licensed capacity.

c.A new license must be applied for when another adult or agency assumes ownership or legal responsibility for the center.

d.A provisional license may be issued or reduced pursuant to Iowa Code section 237A.2.

109.2(3) Denial. Initial applications or renewals will be denied when:

a.The center does not comply with center licensing laws and these rules in order to qualify for a full or provisional license.

b.The center is operating in a manner that the department determines impairs the safety, health, or well-being of children in care.

c.A person subject to an evaluation has transgressions that merit prohibition of involvement with child care and of licensure, as determined by the department.

d.Information provided either orally or in writing to the department or contained in the center’s files is shown to have been falsified by the provider or with the provider’s knowledge.

e.The center is not able to obtain an approved fire marshal’s certificate as prescribed by the state fire marshal or fails to comply in correcting or repairing any deficiencies in the time determined by the fire marshal or the fire marshal determines the facility is not safe for occupancy.

f.The regulatory fee as specified in subrule 109.2(5) is not received by the department within 60 calendar days from the due date on the invoice.

109.2(4) Revocation and suspension. A license will be revoked or suspended if corrective action has not been taken when:

a.The center does not comply with center licensing laws or these rules.

b.The center is operating in a manner that the department determines impairs the safety, health, or well-being of the children in care.

c.A person subject to an evaluation has transgressions that merit prohibition of involvement with child care and of licensure, as determined by the department.

d.Information provided to the department or contained in the center’s files is shown to have been falsified by the provider or with the provider’s knowledge.

e.The facility is not able to obtain an approved fire marshal’s certificate as prescribed by the state fire marshal, fails to comply in correcting or repairing any deficiencies in the time determined by the fire marshal or the fire marshal determines the facility is not safe for occupancy.

f.The regulatory fee as specified in subrule 109.2(5) is not paid in full due to insufficient funds to cover a check submitted to the department for the fee.

109.2(5) Regulatory fees. A fee based upon center capacity is due to the department at the time of issuance of the license in accordance with this subrule.

a.Fee structure. The amount of the fee is based on the capacity of the center as indicated below:

b.Determination of capacity. The licensing consultant must determine center capacity by dividing the amount of usable space by the amount of space required per child as specified in subrule 109.11(1). Upon approval by the department, the final determination of center capacity may include evaluation of other factors that influence capacity, as long as physical space requirements per child as defined in subrule 109.11(1) are maintained.

c.Notification. Upon final determination of center capacity by the licensing consultant, the licensing consultant or designee must sign and provide the child care center licensing fee invoice to the center.

d.Payment. The center must return the child care center licensing fee invoice to the department with the licensing fee payment within 60 calendar days from the date on the invoice. Regulatory fees are nonrefundable and nontransferable.

109.2(6) Adverse actions.

a.Notice of adverse actions for a denial, revocation, or suspension and the right to appeal the licensing decision will be given to applicants and licensees in accordance with 441—Chapter 7 and 441—subrule 16.2(3).

b.A letter received by an owner or director of a licensed center initiating action to deny, suspend, or revoke the facility’s license must be conspicuously posted at the main entrance to the facility. The letter will remain posted until resolution of the action to deny, suspend, or revoke the license. If the action to deny, suspend, or revoke is upheld, the center must return the license to the department.

c.If the center’s license is denied, suspended, or revoked, the department will notify the parent, guardian, or legal custodian of each child for whom the facility provides child care.

d.The center must cooperate with the department in providing the names and addresses of the parent, guardian, or legal custodian of each child for whom the facility provides child care.

441—109.3(237A) Inspection and evaluation. The department will conduct an unannounced on-site visit in order to make a licensing recommendation for all initial and renewal applications for licensure and will determine compliance with licensing standards imposed by licensing laws and these rules when a valid complaint is received.

109.3(1) At least one unannounced on-site visit will be conducted each calendar year.

109.3(2) After each visit and valid complaint, the department will document whether a center was in compliance with center licensing standards imposed by licensing laws and these rules.

109.3(3) The written documentation of the department’s conclusion as to whether a center was in compliance with licensing standards for all licensing visits and valid complaints will be available to the public. However, the identity of the complainant will be withheld unless expressly waived by the complainant.

441—109.4(237A) Administration.

109.4(1) Required written policies. The child care center owner, board or director shall:

a.Develop and implement policies for enrollment and discharge of children, field trips and noncenter activities, discipline/behavior, nutrition, health and safety policies and, if transporting children, transportation policy.

b.Develop a curriculum or program structure that uses developmentally appropriate practices and an activity program appropriate to the developmental level and needs of the children.

c.Develop and implement a written plan for staff orientation to the center’s policies and to the provisions of this chapter.

d.Make available for review a copy of the center policies and programs to all staff at the time of employment and each parent at the time a child is admitted to the center. A copy of the fee policies and financial agreements shall be provided to each parent at the time a child is admitted to the center.

e.When serving children under the age of three, develop and implement a policy for responding to incidents of biting.

f.Develop and implement a policy to ensure that people do not have unauthorized access to children at the center.

g.Develop and implement a policy for protection of each child’s confidentiality.

h.Develop and implement procedures for medical and dental emergencies, and ensure through orientation and training that all staff are knowledgeable of and able to implement the procedures.

109.4(2) Required postings. The following postings must be conspicuously posted in an area frequented by parents or the public:

a.Certificate of license at the main entrance of the center.

b.Notice of exposure of children to a communicable disease. The notice of exposure of children to a communicable disease will include the symptoms and the period of communicability.

c.Notice of decision to deny, suspend, or revoke the center’s license or reduce the center’s license to a provisional status, if applicable.

d.Mandatory reporter requirements.

e.Notice of availability of the handbook “Child Care Centers and Preschools Licensing Standards and Procedures (August 1, 2024).”

f.Name and contact information of the department’s child care licensing consultant.

g.Program activities and menu.

109.4(3) Mandatory reporters. Methods of identifying and reporting suspected child abuse and neglect shall be discussed with all staff within 30 days of employment.

441—109.5(237A) Parental participation. Parents must be afforded unlimited access to their children and to the provider caring for their children during the center’s hours of operation or whenever their children are in the care of a provider unless parental contact is prohibited by court order. The provider will inform all parents of this policy in writing at the time the child is admitted to the center.

441—109.6(237A) Personnel. The director of the center must develop policies for hiring and maintaining staff that demonstrate competence in working with children and that meet the following minimum requirements:

109.6(1) Center director requirements. Centers that have multiple sites must have a center director or on-site supervisor in each center. The center director is responsible for the overall functions of the center, including supervising staff, designing curriculum and program administration. The director must ensure services are provided for the children within the framework of the licensing requirements. The center director must have overall responsibility for carrying out the program and ensuring the safety and protection of the children. The following minimum qualifications must be submitted to the child care consultant for final approval prior to the start of employment. The center director:

a.Is at least 21 years of age.

b.Has obtained a high school diploma or passed a general education development test.

c.Has completed at least one course in business administration or 12 contact hours in administrative-related training related to personnel, supervision, recordkeeping, or budgeting, or has one year of administrative-related experience.

d.Has certification in infant, child, and adult cardiopulmonary resuscitation (CPR); infant, child, and adult first aid; and Iowa’s training for the mandatory reporting of child abuse.

e.Has achieved a total of 100 points obtained through a combination of education, experience, and child development-related training as outlined in the following chart:

(1)In obtaining the total of 100 points, a minimum of two categories must be used, no more than 75 points may be achieved in any one category, and at least 20 points shall be obtained from the experience category.

(2)Points obtained in the child development-related training category must have been taken within the past five years.

(3)For directors in centers predominantly serving children with special needs, the directors may substitute a disabilities-related or nursing degree for the bachelor’s degree in early childhood, child development or elementary education in determining point totals. In addition, experience in working with children with special needs in an administrative or direct care capacity must be equivalent to full-time experience in a child care center or preschool in determining point totals.

109.6(2) On-site supervisor. The on-site supervisor is required to be present when the program has multiple sites or when a director is not routinely present for six hours daily. The center director must identify a person in charge during the on-site supervisor’s absence. The on-site supervisor is responsible for the daily supervision of the center and must be on site daily either during the hours of operation that children are present or a minimum of six hours of the center’s hours of operation. The following minimum qualifications will be submitted to the child care consultant for final approval prior to the start of employment. The on-site supervisor:

a.Is at least 18 years of age.

b.Has obtained a high school diploma or passed a general education development test.

c.Has certification in infant, child, and adult CPR; infant, child, and adult first aid; and Iowa’s mandatory reporting of child abuse.

d.Has achieved a total of 75 points obtained through a combination of education, experience, and child development-related training as outlined in the chart and calculation described in subrule 109.6(1). A minimum of two categories must be used, no more than 50 points may be achieved in any one category, and at least 10 points must be obtained from the experience category.

109.6(3) Volunteers. A volunteer must be at least 16 years of age. All volunteers shall:

a.Sign a statement indicating whether or not they have one of the following:

(1)A conviction of any law in any state or any record of founded child abuse or dependent adult abuse in any state.

(2)A communicable disease or other health concern that could pose a threat to the health, safety, or well-being of the children.

b.Sign a statement indicating the volunteer has been informed of the volunteer’s responsibilities as a mandatory reporter.

c.Undergo the record check process when any of the following criteria are met:

(1)The volunteer is included in meeting the required child-to-staff ratio;

(2)The volunteer has direct responsibility for a child or children; or

(3)The volunteer has access to a child or children with no other staff present.

d.Have on file at the facility a record containing the statements required in paragraphs 109.6(3)“a” and “b” and documentation of any record check process. The record must be maintained as required in paragraph 109.9(1)“a.”

109.6(4) Record checks.

a.Criminal and child abuse record checks. Criminal and child abuse record checks shall be conducted for:

(1)Each owner, director, staff member, volunteer, or subcontracted staff person with direct responsibility for child care or with access to a child when the child is alone;

(2)Anyone living in the child care facility who is 14 years of age or older.

b.Authorization. A requesting entity shall request a record check evaluation prior to the employment of a person subject to record checks. The person subject to record checks shall complete the department’s criminal history record check form and any other forms required by the department of public safety to authorize the release of records.

c.Iowa records checks. Checks and evaluations of Iowa child abuse and criminal records, including the sex offender registry, must be completed before the person’s involvement with child care at the center. Iowa records checks must be repeated at a minimum of every two years and when the department or the center becomes aware of any possible transgressions. The department is not responsible for the cost of conducting the Iowa records check.

(1)The child care center may access the single-contact repository (SING) as necessary to conduct a criminal and child abuse record check of the person in Iowa. If the results of the check indicate a potential transgression, the center will send a copy of the results to the department for determination of whether or not the person may be involved with child care, regardless of the person’s status with the center.

(2)Unless a record check has already been conducted in accordance with subparagraph
109.6(4)“c”(1), the department must conduct a criminal and child abuse record check in Iowa for a person who is subject to a record check. The department may access SING to conduct the record check. The department may also conduct dependent adult abuse, sex offender, and other public or civil offense record checks in Iowa for a person who is subject to a record check.

d.National criminal history checks. National criminal history checks based on fingerprints are required for all persons subject to record checks. The national criminal history check must be repeated for each person every four years and when the department or center becomes aware of any new transgressions committed by that person in another state. The department is not responsible for the cost of conducting the national criminal history check.

(1)The child care center is responsible for obtaining the fingerprints of all persons subject to record checks.

(2)If the results of the Iowa records checks do not warrant prohibition of the person’s involvement with child care or otherwise present protective concerns, the person may be involved with child care on a provisional basis until the national criminal history check and evaluation have been completed.

(3)The child care center will provide fingerprints to the department of public safety prior to a person’s involvement with child care at the center. The center will submit the fingerprints on forms or in a manner allowed by the department of public safety.

(4)Centers that are required to submit fingerprint-based checks of the FBI national criminal database to comply with federal regulations may seek a waiver to substitute that record check for the procedure required in this subrule. Requests for a waiver must be submitted on a form prescribed by the department to the address listed on the form.

(5)A center considering involvement of a person who has had a national criminal history check at another center may request information from that center. That center may provide that information in writing upon a center’s request, using a form prescribed by the department. If the person being considered for employment has not had involvement with child care in the past six months, a new national criminal history check must be completed.

(6)If the results of the national criminal history check indicate that the person has committed a transgression, the center, if interested in continuing the person’s involvement in child care, must send a copy of the results to the department for evaluation. The department will determine whether or not the person may be involved with child care.

e.Mandatory and mandatory time-limited prohibition. A person with any convictions or founded abuse reports as defined in Iowa Code section 237A.5(2)“i” is prohibited from involvement with child care.

f.Evaluation required. For all other transgressions, and as requested under paragraph 109.6(4)“e,” the department will notify the requesting entity that an evaluation shall be conducted to determine whether prohibition of the person’s involvement with child care is warranted.

(1)The person with the transgression must complete the record check evaluation form. The requesting entity must provide the form and any other documents to the department within ten calendar days of the date on the form. The department will use the information the person with the transgression provides on this form to assist in the evaluation. Failure of the person with the transgression to complete and the requesting entity to return this form by the specified date will result in denial or revocation of the license or denial of employment. The department will not process evaluations that are not signed by the person subject to an evaluation.

(2)The department may use information from the department’s case records in performing the evaluation.

(3)The requesting entity may provide, or the department may request from the person subject to an evaluation or from the requesting entity, information to assist in performance of the evaluation.

(4)Any person or agency that might have pertinent information regarding criminal or abuse history and rehabilitation of the prospective employee may be contacted.

(5)In an evaluation, the department will consider all of the factors established in Iowa Code section 237A.5(2)“h.”

(6)When a person subject to a record check has a transgression that has been determined in a previous evaluation not to warrant prohibition of the person’s involvement with child care and has no subsequent transgressions, an exemption from reevaluation of the latest record check is authorized. The person may commence employment with another child care facility in accordance with the department’s previous evaluation. The exemption is subject to all of the provisions established in Iowa Code section 237A.5(2)“g.”

g.Evaluation decision. Within 30 days of receipt of a completed record check evaluation, the department will make a decision on the person’s involvement with child care. The department has final authority in determining whether prohibition of the person’s involvement with child care is warranted and in developing any conditional requirements and corrective action plan under this paragraph.

(1)The department will mail to the requesting entity and the person on whom the evaluation was completed the record check decision that explains the decision reached regarding the evaluation of the transgression.

(2)If the department determines through an evaluation of a person’s transgressions that the person’s prohibition of involvement with child care is warranted, the person will be prohibited from involvement with child care. The department may identify a period of time after which the person may request that another record check and evaluation be performed.

(3)The department may permit a person who is evaluated to maintain involvement with child care if the person complies with the department’s conditions and corrective action plan relating to the person’s involvement with child care.

(4)The department will send a letter to the employer that informs the employer whether the person subject to an evaluation has been approved or denied involvement with child care. If the person has been approved, the letter will inform the employer of any conditions and corrective action plan relating to the person’s involvement with child care.

h.Notice to parents. The department will provide notification of founded child abuse committed by an owner, director, or staff member of the child care center pursuant to Iowa Code section 237A.5(2)“k.” The center must cooperate with the department in providing the names and addresses of the parents, guardians, and legal custodians of each child for whom the facility provides child care.

109.6(5) Use of controlled substances and medications. All owners, personnel, and volunteers must be free of the use of illegal drugs and not be under the influence of alcohol or of any prescription or nonprescription drug that could impair their ability to function.

441—109.7(237A) Professional growth and development. Professional development will supplement the educational and experience requirements in rule 441—109.6(237A) and shall enhance the staff’s skill in working with the developmental and cultural characteristics of the children served. The center director, on-site supervisor, and staff counted as part of the staff ratio must meet the following minimum staff training requirements:

109.7(1) Required training within the first three months of employment. During their first three months of employment, all staff must receive the following training:

a.Iowa’s training for mandatory reporting of child abuse.

b.At least one hour of training regarding universal precautions.

c.Certification ininfant, child, and adult CPR. A valid certificate indicating the date of training and expiration date will be maintained.

d.Certification in infant, child, and adult first aid. A valid certificate indicating the date of training and expiration date must be maintained.

e.Essential child care pre-service or equivalent minimum health and safety training approved by the department in the following areas:

(1)Prevention and control of infectious disease, including immunizations.

(2)Prevention of sudden infant death syndrome and use of safe sleep practices.

(3)Administration of medication, consistent with standards for parental consent.

(4)Prevention of and response to emergencies due to food and allergic reactions.

(5)Building and physical-premises safety, including identification of and protection from hazards that can cause bodily injury, such as electrical hazards, bodies of water, and vehicular traffic.

(6)Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment.

(7)Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event.

(8)Handling and storage of hazardous materials and the appropriate disposal of biocontaminants.

(9)Precautions in transporting children.

(10)Child development.

Essential child care pre-service or equivalent minimum health and safety training may be required if content has significant changes that warrant that the training be renewed.

Child care staff employed in programs that only serve children over the age of three are exempt from taking health and safety trainings under subparagraphs 109.7(1)“e”(2) and 109.7(1)“e”(6).

109.7(2) Center directors and all staff.

a.During their first year of employment, all center directors and all staff will receive the following training:

(1)Ten contact hours of training from approved subject areas from the Council for Professional Recognition or approved content areas from the National Afterschool Association.

(2)Training received for CPR, first aid, mandatory reporting of child abuse, and universal precautions shall not count toward the ten contact hours.

(3)A provider shall not use a specific training or class to meet minimum continuing education requirements more than one time every five years.

b.Following their first year of employment, all center directors and all staff must:

(1)Maintain current certification for Iowa’s training for the mandatory reporting of child abuse; infant, child and adult CPR; and infant, child and adult first aid.

(2)Staff must receive six contact hours of professional development annually from one or more of the subject areas under subparagraph 109.7(2)“a”(1).

(3)Center directors and on-site supervisors must receive eight contact hours of training annually from one or more approved subject areas under subparagraph 109.7(2)“a”(1).

109.7(3) Staff employed in centers that operate summer-only programs. During their first three months of employment, all staff shall receive the following training:

a.Iowa’s training for mandatory reporting of child abuse.

b.At least one hour of training regarding universal precautions.

c.Certification in infant, child, and adult CPR. A valid certificate indicating the date of training and expiration date shall be maintained.

d.Certification in infant, child, and adult first aid. A valid certificate indicating the date of training and expiration date shall be maintained.

e.Essential child care pre-service or equivalent minimum health and safety training approved by the department in the following areas:

(1)Prevention and control of infectious disease, including immunizations.

(2)Prevention of sudden infant death syndrome and use of safe sleep practices.

(3)Administration of medication, consistent with standards for parental consent.

(4)Prevention of and response to emergencies due to food and allergic reactions.

(5)Building and physical-premises safety, including identification of and protection from hazards that can cause bodily injury, such as electrical hazards, bodies of water, and vehicular traffic.

(6)Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment.

(7)Emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event.

(8)Handling and storage of hazardous materials and the appropriate disposal of biocontaminants.

(9)Precautions in transporting children.

(10)Child development.

Child care staff employed in programs that only serve children over the age of three are exempt from taking health and safety trainings under subparagraphs 109.7(3)“e”(2) and 109.7(3)“e”(6).

109.7(4) Substitution. A provider who submits documentation from a child care resource and referral agency that the provider has completed the Iowa Program for Infant/Toddler Care (IA PITC) (August 1, 2024), or Early Childhood-Positive Behavior Interventions and Supports (EC-PBIS) training series (August 1, 2024) may use those hours to fulfill a maximum of two years’ professional developmentrequirements, not including preservice, first-aid, CPR and mandatory reporter training.

109.7(5) Approved professional development.

a.Professional development contact hours can be coaching, education, or training provided by a department-approved entity.

b.Coaching contact hours may only be used to meet up to half of an individual’s annual professional development requirement.

c.The department may randomly monitor any state-approved professional development for quality control purposes.

d.Professional development conducted with staff during the hours of operation of the facility, during staff lunch hours, or while children are resting must not diminish the required staff ratio coverage. Staff must not be actively engaged in care and supervision and simultaneously participate in training.

e.A professional development organization not approved by the department may submit for review to the department a request for child care training approval. All approvals unless otherwise specified shall be valid for five years. The department will issue its decision within 30 business days of receipt of a complete request.

f.Department-approved entities must provide participants a professional development certificate for approved professional development contact hours.

109.7(6) Professional development for supervisors and designees. The director, on-site supervisor, and any person designated as a lead in the absence of supervisory staff must have completed all preservice/orientation training outlined in subrule 109.7(1).

441—109.8(237A) Staff ratio requirements.

109.8(1) Staff requirements. Persons counted as part of the staff ratio must meet the following requirements:

a.Staff persons must be at least 16 years of age.

b.Those staff persons who are under the age of 18 shall meet the following requirements:

(1)May not be the sole provider on the premises of a child care facility.

(2)Shall not provide transportation to children in care.

(3)If staff persons under the age of 18 are providing child care services without an adult, they shall only provide care to school-aged children.

(4)May be utilized for brief periods of absence as identified in paragraph 109.8(2)“g” and scheduled nap periods of children over two years of age as identified in paragraph 109.8(2)“h.”

109.8(2) Staff ratio. The staff-to-child ratio shall be as follows:

a.Combinations of age groupings for children four years of age and older may be allowed and may have staff ratio determined on the age of the majority of the children in the group.

b.Combinations of age groupings for children three, four, andfive years of age may be allowed with a ratio of one staff member to every 12 children.

c.Children between 18 months and three years of age may be combined, if appropriate to the developmental needs of the child. If a child under two years of age is in a combined age group, the staff ratio of one to seven will be maintained. Otherwise, staff ratio may be determined by the age of the majority of the children in the group.

d.Combinations of age groupings that do not meet paragraphs 109.8(2)“a” through “c” may be approved by a child care licensing consultant when a program can show developmentally appropriate curriculum for all age groups and can provide sufficient supervision.

e.Combinations of age groupings for children five years of age and older must have a ratio consistent with the age of majority.

f.Upon the recommendation of a child’s physician or the area education agency serving the child, a child who is two years of age or older with a disability that results in significant developmental delays in physical and cognitive functioning who does not pose a threat to the safety of the infants may, if appropriate and for a limited time approved by the department, remain in the infant area.

g.Every child-occupied program room must have supervision present in the room. Brief absences of a staff member may be allowed for no more than five minutes when another staff person is present.

h.During nap time, at least one staff member must be present in every room where children are resting. Staff ratio requirements may be reduced to one staff member per room where children are resting and staff ratio coverage can be maintained in the center. The staff ratio must always be maintained for children under two years of age.

i.When more than eight children are present on the licensed premises, at least two staff members shall be present.

j.For a period of two hours or less at the beginning and end of the center’s hours of operation, one staff member may care for eight or fewer children, provided no more than four of the children are under two years of age and there are no more than eight children in the center.

k.When more than eight children are being transported in one vehicle, at least two staff members must be present, one of which is over 18 years of age.

(1)Only one adult is required when a center is transporting children in a center-owned vehicle with parent authorization for the sole purpose of transporting children to and from school.

(2)When a center contracts with another entity to provide transportation other than for the purpose of transporting children to or from school, at least one adult staff in addition to the driver must be present if at least eight children provided care by the center are transported.

l.Any child care center-sponsored program activity involving six or more children conducted away from the licensed facility shall provide a minimum of one additional staff over the required staff ratio for the protection of the children. At least one staff present on field trips must be over 18 years of age.

m.For centers serving school-age children, the ratio for school-age children may be exceeded for a period of no more than four hours during a day when school classes start late or are dismissed early or canceled due to inclement weather or structural damage provided the children are already enrolled at the center and the center does not exceed the licensed capacity.

109.8(3) Group size. Group size is determined in collaboration with the state fire marshal and will be assigned based on the review of health and safety requirements. Maximum capacity allowed shall be included on the certificate of license. Group sizes by age group must be included in annual inspection reports.

441—109.9(237A) Records.

109.9(1) Personnel records. The center will maintain personnel information sufficient to ensure that persons employed in the center meet minimum staff and training requirements and do not pose any threat to the health, safety, or well-being of the children. Each employee’s file must contain, at a minimum, the following:

a.Copies of all record checks kept in accordance with state and federal law regarding confidentiality of record checks. These records shall include:

(1)A copy of a department criminal history record check form or any other permission form approved by the department of public safety for conducting an Iowa or national criminal history record check.

(2)A copy of a request for child abuse information form, when applicable.

(3)Copies of the results of Iowa record checks conducted through the SING for review by the department upon request.

(4)Copies of national criminal history check results.

(5)Any department-issued documents sent to the center related to a record check, regardless of findings.

b.A physical examination report. As required in Iowa Code section 237A.5(1), personnel shall have good health as evidenced by a preemployment physical examination. Acceptable physical examinations shall be documented on a form prescribed by the department. The examination shall be performed within six months prior to beginning employment and shall be repeated at least every three years. A physical examination may be requested if the employer has reason to believe an employee would not be able to perform a job successfully or safely due to a medical condition.

c.Documentation showing the minimum staff training requirements as outlined in rule 441—109.7(237A) are met, including current certifications in first aid and CPR and Iowa’s training for the mandatory reporting of child abuse.

d.A photocopy of a valid driver’s license if the staff will be involved in the transportation of children.

109.9(2) Child’s file. Centers must maintain current and sufficient information in a file for each child that includes:

a.Child enrollment information, including name, age, date of birth, and address.

b.Parent/guardian contact information.

c.Emergency contacts and persons who can pick up the child as authorized by the parent.

d.Contact information and authorization of emergency medical and dental services.

e.Health and medical needs of a child, including any allergies or special health needs, a written emergency plan and prescribed treatment.

f.Incident reports of injuries, accidents, or other incidents, as applicable.

g.Parent authorization for a child to attend center-sponsored field trips and noncenter activities.

h.Signed and dated valid Certificate of Immunization, Certificate of Immunization Exemption, or Provisional Certificate of Immunization, provided by the department must be on file for each child enrolled as required by 641—Chapter 7.

i.For each child not yet enrolled in kindergarten, the child care center must require a physical examination submitted at enrollment but no later than within four weeks of admission.The physical should include a health history and status of present health, including allergies, medications, acute or chronic conditions, and care plan when needed.The physical should be completed and signed by the child’s primary health care provider (MD, DO, chiropractor, PA, or ARNP). The date of the physical examination shall be no more than 12 months prior to the first day of admission and annually thereafter until kindergarten entry.

j.For school-aged children, the child care center must have a statement of health signed by the parent indicating the child’s health status, allergies, medications, acute or chronic conditions and care plan when needed.

k.For a child who has a special health need, there must be a written care plan completed and signed by the child’s primary health care provider (MD, DO, chiropractor, PA, or ARNP) or parent or guardian.The care plan should include the care needed, when the care is to be given, and any possible complications or side effects, including required interventions.Documentation of special needs provided should be in a manner similar to documentation for medication administration.

109.9(3) Daily activities. For each child under two years of age, the center must make a daily written record. At the end of the child’s day at the center, the daily written record shall be provided verbally or in writing to the parent or the person who removes the child from the center. The record shall contain information on each of these areas:

a.The time periods in which the child has slept.

b.The amount of food consumed and the times at which the child has eaten.

c.The time of and any irregularities in the child’s elimination patterns.

d.The general disposition of the child.

e.A general summary of the activities in which the child participated.

441—109.10(237A) Health and safety policies. The child care center will establish definite health policies, including the criteria for excluding a sick child from a center. The child care center may be provided guidance from the child care center’s child care nurse consultant or the department regarding exclusion of an exposed child or staff during a communicable disease outbreak.

109.10(1) Medications. The center shall have written procedures for the dispensing, storage, authorization, and recording of all prescription medications, nonprescription medications, and nonmedicated topical products, including the following:

a.Staff must be over 18 to administer medication.

b.All medications must be stored in their original containers, with accompanying physician or pharmacist’s directions and label intact and stored so the medications are inaccessible to children and the public. Nonprescription medications must be labeled with the child’s name.

c.For every day an authorization for medication is in effect and the child is in attendance, there shall be a notation of administration, including the name of the medicine, date, time, dosage given or applied, and the initials of the person administering the medication or the reason the medication was not given.

d.In the case of medications that are administered on an ongoing, long-term basis, authorization must be obtained for a period not to exceed the duration of the prescription.

e.A child care staff member shall not provide medications to a child if the staff member has not completed preservice/orientation training that includes medication administration.

109.10(2) Daily contact. Each child shall have direct contact with a staff person upon arrival for early detection of apparent illness, communicable disease, or unusual condition or behavior that may adversely affect the child or the group.

109.10(3) Infectious disease control. Centers must establish policies and procedures related to infectious disease control and the use of universal precautions with the handling of any bodily fluids that include blood, bodily excrement or discharge. Soiled diapers shall be stored in containers separate from other waste. Sanitation and safety procedures for the center are developed and implemented to reduce the risk of injury or harm to children and reduce the transmission of disease.

109.10(4) Quiet area for ill or injured. The center will provide a quiet area under supervision for a child who appears to be ill or injured. The parents or a designated person will be notified of the child’s status in the event of a serious illness or emergency.

109.10(5) Staff hand washing. The center must ensure that staff demonstrate clean personal hygiene sufficient to prevent or minimize the transmission of illness or disease.

109.10(6) Children’s hand washing. The center shall ensure that staff assist children in personal hygiene sufficient to prevent or minimize the transmission of illness or disease. For each infant or child with a disability, a separate cloth for washing, one for rinsing, and one for drying may be used in place of running water.

109.10(7) First-aid kit. The center must ensure that a clearly labeled first-aid kit is available and easily accessible to staff at all times whenever children are in the center, in the outdoor play area, and on field trips. The kit must be sufficient to address first aid related to minor injury or trauma and stored in an area inaccessible to children.

109.10(8) Recording incidents.

a.Incidents involving a child, including minor injuries, minor changes in health status, or other minor behavioral concerns, shall be reported to the parents, guardians, and legal custodians on the day of the incident.

b.Incidents resulting in a serious injury, as defined in Iowa Code section 702.18, to a child in the child care facility or in the care of child care facility staff or incidents resulting in a significant change in the health status of a child must be verbally reported to the parents, guardians, and legal custodians immediately.

(1)Serious injuries must be reported to the department within 24 hours of the incident.

(2)Serious injuries must be documented and information maintained in the child’s file as required by subrule 109.9(2).

c.The parents, guardians, and legal custodians of any child included in incidents involving inappropriate, sexually acting-out behavior must be notified immediately after the incident. A written report fully documenting every incident will be provided to the parent or person authorized to remove the child from the center. The written report shall be prepared by the staff member who observed the incident, and a copy will be retained in the child’s file.

109.10(9) Smoking. Smoking and the use of tobacco products must be prohibited and nonsmoking signs must be posted pursuant to Iowa Code chapter 142D.

109.10(10) Transportation. Children must be transported pursuant to Iowa Code section 321.446.

109.10(11) Field trips. Emergency telephone numbers and emergency health plans, as applicable, for each child must be taken by staff when transporting children to and from school and on field trips and non-center-sponsored activities away from the premises.

109.10(12) Pets. Animals kept on site must be in good health with no evidence of disease, be of such disposition as to not pose a safety threat to children, and be maintained in a clean and sanitary manner. Documentation of current vaccinations shall be available for all cats and dogs. No ferrets; reptiles, including turtles; or birds of the parrot family can be kept on site. Pets are not allowed in the kitchen or food preparation areas.

109.10(13) Emergency plans.

a.The center shall have written emergency plans and diagrams for responding to fire, tornado, and flood (if area is susceptible to flood) and plans for responding to intoxicated parents and lost or abducted children. Emergency plans must include written procedures, including plans for the following:

(1)Evacuation to safely leave the facility.

(2)Relocation to a common, safe location after evacuation.

(3)Shelter-in-place to take immediate shelter when the current location is unsafe to leave due to the emergency issue.

(4)Lockdown to protect children and providers from an external situation.

(5)Communication and reunification with parents or other adults responsible for the children that includes emergency telephone numbers.

(6)Continuity of operations.

(7)To address the needs of individual children, including those with functional or access needs.

b.Emergency instructions; telephone numbers; and diagrams for fire, tornado, and flood (if area is susceptible to floods) must be visibly posted by all program and outdoor exits. Emergency plan procedures must be practiced and documented at least once a month for fire and for tornado. Records on the practice of fire and tornado drills must be maintained for the current and previous year.

c.The center must develop procedures for annual staff and volunteer training on these emergency plans and include information on responding to fire, tornadoes, intruders, intoxicated parents, and lost or abducted children in the orientation provided to new employees and volunteers.

d.The center must conduct a daily check to ensure that all exits are unobstructed.

109.10(14) Supervision and access.

a.The center director and on-site supervisor must ensure that each staff member or volunteer knows the number and names of children assigned to that staff member or volunteer for care. Assigned staff and volunteers must provide careful supervision.

b.Any person in the center who is not an owner, staff member, or volunteer who has a record check and department approval to be involved with child care must not have unrestricted access to children for whom that person is not the parent, guardian, or custodian.

c.A parent who is a registered sex offender under Iowa Code chapter 692A cannot be present upon the property of a child care center except for the time reasonably necessary to transport the offender’s own minor child or ward to and from the center. Under limited circumstances, a center director may give written permission to be on the property. Before giving written permission, the center director will consult with the center licensing consultant. The written permission must be signed and dated by the center director and the sex offender and kept on file for review by the center licensing consultant.

441—109.11(237A) Physical facilities.

109.11(1) Room size. The program room size must be a minimum of 80 square feet of useable floor space or sufficient floor space to provide 35 square feet of useable floor space per child. In rooms where floor space occupied by cribs is counted as useable floor space, there must be 40 square feet of floor space per child. Kitchens, bathrooms, halls, lobby areas, storage areas and other areas of the center not designed as activity space for children cannot be used as regular program space or counted as useable floor space.

109.11(2) Play equipment, materials and furniture.

a.The center will provide sufficient and safe indoor play equipment, materials, and furniture that conform with the standards or recommendations of the Consumer Product Safety Commission (CPSC) (August 1, 2024) or the American Society for Testing and Materials (ASTM) (August 1, 2024) for juvenile products. Play equipment, materials, and furniture must meet the developmental, activity, and special needs of the children.

b.Rooms must be arranged so as not to obstruct the direct observation of children by staff. Individual covered mats, beds, or cots and appropriate bedding will be provided for all children who nap. The center will develop procedures to ensure that all equipment and materials are maintained in a sanitary manner. Sufficient spacing must be maintained. The center shall provide sufficient toilet articles for each child for hand washing.

109.11(3) Indoor facility requirements.

a.The center shall ensure that:

(1)The facility and premises are sanitary, safe and hazard-free.

(2)The facility has sufficient:

1.Lighting.

2.Ventilation.

3.Heating and cooling.

(3)Equipment placed in a program area is maintained so as not to result in injury to children.

109.11(4) Outdoor facility requirements.

a.Centers must have a safe outdoor program area adjacent to the center, with sufficient square footage to accommodate at least 30 percent of the enrollment capacity at any one time at 75 square feet per child. The outdoor area must:

(1)Be free from litter and unsafe materials and free from contamination by the drainage or ponding of sewage or storm water.

(2)Include safe play equipment and an area of shade.

(3)Include fencing to protect from bodies of water and vehicular traffic.

b.The director or designated person must complete and keep a record of at least monthly inspections of the outdoor play area and equipment for the purpose of assessing and rectifying potential safety hazards. If the outdoor play area is not used for a period of time due to inclement weather conditions, the center shall document the reasons why the monthly inspection did not occur and must complete and document an inspection prior to resuming use of the area.

c.Approval may be given by the department to waive the outdoor space requirement for programs of three hours or less, provided there is suitable substitute space and equipment available.

d.Approval may be given by the department for centers operating in a densely developed area to use alternative outdoor play areas in lieu of adjacent outdoor play areas.

109.11(5) Bathroom facilities. At least one functioning toilet and one sink per 15 children two years of age and older must be provided in a room with natural or artificial ventilation. New construction after November 1, 1995, must provide for at least one sink in the same area as the toilet and, for centers serving children two weeks to two years of age, shall provide for at least one sink in the central diapering area. At least one sink must be provided in program rooms for infants and toddlers or in an adjacent area other than the kitchen. New construction after April 1, 1998, shall have at least one sink provided in the program rooms for infants and toddlers.

109.11(6) Telephone. A working nonpay telephone must be available in the center with emergency telephone numbers for police or 911, fire, ambulance, and poison control center posted in a conspicuous area. The street address and telephone number of the center must be included in the posting. A separate file or listing of emergency telephone numbers for each child shall be maintained.

109.11(7) Kitchen appliances. Gas or electric ranges or ovens shall not be placed in the program area. If kitchen appliances are maintained in the program area for food preparation activities, the area must be sectioned off and shall not be counted as useable floor space for room size.

109.11(8) Environmental hazards.

a.Within one year of being issued an initial or renewal license, centers operating in facilities built prior to 1978 shall conduct a visual assessment for lead hazards that exist in the form of peeling, cracking or chipping paint or painted surfaces in need of repair. If these lead hazards are found, it shall be assumed that lead-based paint is present on the surfaces, and the surfaces shall be repaired by an Iowa certified lead-safe renovator before a full license will be issued.

b.Within one year of being issued an initial or renewal license, centers operating in facilities that are at ground level, use a basement area as program space, or have a basement beneath the program area shall have radon testing following the National Consensus Standards as outlined in 641—Chapter 43.

c.To reduce the risk of carbon monoxide poisoning, all centers shall, on an annual basis, have a professional inspect all fuel-burning appliances, including oil and gas furnaces, gas water heaters, gas ranges and ovens, and gas dryers, to ensure the appliances are in good working order with proper ventilation. All centers shall install one carbon monoxide detector on each floor of the center that is listed with Underwriters Laboratory (UL) as conforming to UL Standard 2034 (August 7, 2024).

441—109.12(237A) Activity program requirements.

109.12(1) Activities. The center shall have a written curriculum that uses developmentally appropriate practices and a written program of activities planned according to the developmental level of the children. The center shall post a schedule of the program in a visible place. The child care program shall complement but not duplicate the school curriculum. The program shall be designed to provide children with:

a.A curriculum or program of activities that supports development of self-esteem, self-regulation, positive social interactions, communication skills, curiosity, problem-solving, creative expression, and gross motor and fine motor development.

b.A balance of active and quiet activities, individual and group activities, indoor and outdoor activities, and staff-initiated and child-initiated activities.

c.Experiences in harmony with the ethnic and cultural backgrounds of the children.

d.A supervised nap or quiet time for all children under six years of age not enrolled in school who are present at the center for five or more hours.

109.12(2) Discipline. The center shall have a written policy that shall be provided to staff at the start of employment and to parents at the time of admission. The center shall not use as a form of discipline:

a.Corporal punishment, including spanking, shaking, and slapping.

b.Punishment that is humiliating or frightening or that causes pain to the child. Children shall never be locked in a room or closet.

c.When restraints are part of a treatment plan for a child with a disability authorized by the parent and a psychologist or psychiatrist, staff shall receive training on the safe and appropriate use of the restraint.

d.Punishment or threat of punishment associated with a child’s illness, lack of progress in toilet training, or in connection with food or rest.

e.No child shall be subjected to verbal abuse, threats, or derogatory remarks about the child or the child’s family.

109.12(3) Children requiring special accommodations. Reasonable accommodations, based on the special needs of the child, must be made in providing care to a child with a disability.

109.12(4) Infant environment.

a.An area shall be provided that is properly and safely equipped for the use of infants and free from the intrusion of children two years of age and older.

b.Each infant and toddler shall be diapered in a sanitary manner as frequently as needed at a central diapering area. Diapering, sanitation, and hand-washing procedures shall be posted and implemented in every diapering area. There shall be at least one changing table for every 15 infants.

c.Highchairs or hook-on seats shall be equipped with a safety strap that shall be engaged when the chair is in use and shall be constructed so the chair will not topple.

d.Safe, washable toys, large enough so they cannot be swallowed and with no removable parts, shall be provided. All hard-surface toys used by children shall be sanitized daily.

e.The provider shall follow safe sleep practices for infants under one year of age.

(1)Infants shall always be placed on their backs for sleep.

(2)Infants shall be placed on a firm mattress with a tight fitted sheet that meets U.S. Consumer Product Safety Commission (August 1, 2024) and ASTM federal standards (August 1, 2024).

(3)Infants shall not be allowed to sleep on a bed, sofa, air mattress or other soft surface. No child shall be allowed to sleep in any item not designed for infant sleeping, including but not limited to an infant seat, car seat, swing, or bouncy seat.

(4)No toys, soft objects, stuffed animals, pillows, bumper pads, blankets, or loose bedding shall be allowed in the sleeping area with the infant.

(5)No co-sleeping shall be allowed.

(6)Sleeping infants shall be actively observed by sight and sound.

(7)If an alternate sleeping position is needed, a signed physician or physician assistant authorization with statement of medical reason is required and an expiration date.

f.A crib or crib-like furniture that has a waterproof mattress covering and sufficient bedding to enable a child to rest comfortably and that meets the current standards or recommendations from the U.S. Consumer Product Safety Commission (August 1, 2024) or ASTM International (August 1, 2024) for juvenile products shall be provided for each child under two years of age if developmentally appropriate. Crib railings shall be fully raised and secured when the child is in the crib. A crib or crib-like furniture shall be provided for the number of children present at any one time. The center shall develop procedures for maintaining all cribs or crib-like furniture and bedding in a clean and sanitary manner. There shall be no restraining devices of any type used in cribs.

g.Infant walkers cannot be used.

h.All items used for sleeping must be used in compliance with manufacturer standards for age and weight of the child.

441—109.13(237A) Food services. Centers participating in the USDA Child and Adult Care Food Program (CACFP) may have requirements that differ from those outlined in this rule in obtaining CACFP reimbursement and shall consult with a state CACFP consultant.

109.13(1) Nutritionally balanced meals or snacks. The center shall serve each child a full, nutritionally balanced meal or snack as defined by the CACFP guidelines (August 1, 2024) and shall ensure that staff provide supervision at the table during snacks and meals. Children remaining at the center two hours or longer shall be offered food at intervals of not less than two hours or more than three hours apart unless the child is asleep.

109.13(2) Menu planning. The center shall follow the minimum CACFP menu patterns for meals and snacks and serving sizes for children aged infant to 13 years (August 1, 2024). Menus shall be made available to parents and kept on file at the center. Substitutions in the menu, including substitutions made for infants, shall be noted and kept on file. Foods with a high incident rate of causing choking in young children should not be served per CACFP FNS-877 (August 1, 2024). Exceptions shall be allowed for special diets because of medical reasons in accordance with the child’s needs and written instructions of a licensed physician or health care provider.

109.13(3) Feeding of children under two years of age.

a.All children under 12 months of age shall be fed on demand unless the parent provides other written instructions. Meals and snacks provided by the center shall follow the CACFP infant menu patterns (August 1, 2024). Foods shall be appropriate for the infant’s nutritional requirements and eating abilities. Special formulas prescribed by a physician or health care provider shall be given to a child who has a feeding problem.

b.Bottles or containers of infant foods should be warmed under running, warm tap water or by placing them in a container of water that is no warmer than 120°F (49°C). Bottles and infant foods should never be warmed in a microwave oven.

c.All children under six months of age shall be held or placed in a sitting-up position sufficient to prevent aspiration during feeding. No bottles shall be propped for children of any age. A child shall not be placed in a crib or cot with a bottle or any other food item or left sleeping with a bottle or food item. Spoon feeding shall be adapted to the developmental capabilities of the child.

d.Single-service, ready-to-feed formulas, concentrated or powdered formula following the manufacturer’s instructions or breast milk shall be used for children 12 months of age and younger unless otherwise ordered by a parent or physician.

e.Whole milk for children under two years of age who are not on formula or breast milk unless otherwise directed by a physician shall be used.

f.Cleaned and sanitized bottles and nipples shall be used for bottles prepared on site. Prepared bottles shall be kept under refrigeration when not in use.

109.13(4) Food brought from home.

a.The center shall establish policies regarding food brought from home for children under five years of age who are not enrolled in school. A copy of the written policy shall be given to the parent at admission. Food brought from home for children under five years of age who are not enrolled in school shall be monitored and supplemented if necessary to ensure CACFP guidelines (August 1, 2024) are maintained.

b.The center may not restrict a parent from providing meals brought from home for school-age children or apply nutritional standards to the meals.

c.Perishable foods brought from home shall be maintained to avoid contamination or spoilage.

d.Snacks that may not meet CACFP nutrition guidelines (August 1, 2024) may be provided by parents for special occasions such as birthdays or holidays.

109.13(5) Food preparation, storage, and sanitation. Centers shall ensure that food preparation and storage procedures are consistent with the recommendations of the CACFPs (August 1, 2024) and provide:

a.Sufficient refrigeration appropriate to the perishable food to prevent spoilage or the growth of bacteria.

b.Sanitary and safe methods in food preparation, serving, and storage sufficient to prevent the transmission of disease, infestation of insects and rodents, and the spoilage of food. Staff preparing food who have injuries on their hands shall wear protective gloves. Staff serving food shall have clean hands or wear protective gloves and use clean serving utensils.

c.Sanitary methods for dish-washing techniques sufficient to prevent the transmission of disease.

d.Sanitary methods for garbage disposal sufficient to prevent the transmission of disease and infestation of insects and rodents.

109.13(6) Water supply. The center shall ensure that suitable water and sanitary drinking facilities are available and accessible to children. Centers that serve infants and toddlers shall provide individual cups for drinking in addition to drinking fountains that may be available in the center.

a.Private water supplies shall be of satisfactory bacteriological quality as shown by an annual laboratory analysis. Water for the analysis shall be drawn between May 1 and June 30 of each year. When the center provides care for children under two years of age, a nitrate analysis shall also be obtained.

b.When public or private water supplies are determined unsuitable for drinking, commercially bottled water certified as chemically and bacteriologically potable or water treated through a process approved by the health department or designee shall be provided.

441—109.14(237A) Extended evening care. A center providing extended evening care between the hours of 9 p.m. and 5 a.m. shall comply with the licensing requirements for centers contained in Iowa Code chapter 237A and this chapter, with the additional requirements set forth below.

109.14(1) Facility requirements.

a.The center shall ensure that sufficient cribs, beds, cots and bedding are provided appropriate to the child’s age and that sufficient furniture, lighting, and activity materials are available for the children. Equipment and materials shall be maintained in a safe and sanitary manner.

b.The center shall ensure that a separate space is maintained for school-age boys and girls to provide privacy during bathroom and bedtime activities. Bathroom doors used by children shall be nonlockable.

c.The center shall ensure that parents have provided the personal effects needed to meet their child’s personal hygiene and prepare for sleep. The center shall supplement those items needed for personal hygiene that the parent does not provide. The center shall obtain written information from the parent regarding the child’s snacking, toileting, personal hygiene and bedtime routines.

109.14(2) Activities.

a.Evening activities shall be primarily self-selected by the child.

b.Every child-occupied room except those rooms used only by school-age children for sleeping shall have adult supervision present in the room. Staff counted for purposes of meeting child-to-staff ratios shall be present and awake at all times. In rooms where only school-age children are sleeping, visual monitoring equipment may be used. If a visual monitor is used, the monitoring must allow for all children to be visible at all times. Staff shall be present in the room with the monitor and shall enter the room used for sleeping to conduct a check of the children every 15 minutes.

441—109.15(237A) School-based before- and after-school and summer programs. A building owned or leased by a school district or accredited nonpublic school that complies with rules adopted by the state fire marshal for school buildings is considered appropriate for use by a child care facility. Centers that operate in a school building shall comply with the licensing requirements for centers contained in Iowa Code chapter 237A and this chapter with the following considerations:

109.15(1) Infant-specific regulations outlined in paragraph 109.12(4)“e” and subrule 109.13(3) are not applicable.

109.15(2) Centers may receive limited exemption from a facility requirement at subrule 109.11(3), particularly relating to ventilation and bathroom facilities, if complying with the requirement would require a structural or mechanical change to the school building.

109.15(3) Centers shall ensure that the indoor and outdoor space occupied by the center is sanitary, safe, and hazard-free. Outdoor space used for recreation during the school day is sufficient for use by the child care program.

109.15(4) Centers that serve only school-age children and that operate in a school building are exempted from testing for lead and carbon monoxide.

109.15(5) Personnel. For director requirements set forth in subrule 109.6(1), for centers serving predominantly school-age children, the directors may substitute a degree in secondary education, physical education, recreation or related fields for the bachelor’s degree in early childhood, child development or elementary education in determining point totals. In addition, child-related experience working with school-age children shall be equivalent to full-time experience in a child care center or preschool in determining point totals.

109.15(6) Child’s file. All requirements under subrule 109.9(2) must be followed. For a center serving school-age children that operates in the same school facility in which the child attends school, documentation, including certificates of immunization, certificates of immunization exemption, or provisional certificates of immunization, shall be submitted to both locations in accordance with 641—Chapter 7.

441—109.16(237A) Get-well center. A get-well center shall comply with the licensing requirements for centers contained in Iowa Code chapter 237A and this chapter with the additional requirements and exceptions set forth below.

109.16(1) Staff requirements.

a.The center shall have a medical advisor for the center’s health policy. The medical advisor shall be a medical doctor or a doctor of osteopathy currently in pediatrics or family practice.

b.A center shall have a licensed LPN or RN on duty at all times that children are present. If the nurse on duty is an LPN, the medical advisor or an RN shall be available in the proximate area as defined in rule 655—6.3(152).

109.16(2) Health policies.

a.The center shall have a written health policy, consistent with the National Health and Safety Performance Standards (August 1, 2024), approved and signed by the owner or the chair of the board and by the medical advisor before the center can begin operations. Changes in the health policy shall be approved by the medical advisor and submitted in writing to the department. A written summary of the health policy shall be given to the parent when a child is enrolled in the center. The center’s health policy at a minimum shall address procedures in the following areas:

(1)Medical consultation, medical emergencies, triage policies, storage and administration of medications, dietary considerations, sanitation and infection control, categorization of illness, length of enrollment periods, exclusion policy, and employee health policy.

(2)Reportable disease policies as required by the department.

b.The child shall be given a brief evaluation by an LPN or RN upon each arrival at the center.

c.The parent shall receive a brief written summary when the child is picked up at the end of the day. The summary must include:

(1)Admitting symptoms.

(2)Medications administered and time they were administered.

(3)Nutritional intake.

(4)Rest periods.

(5)Output.

(6)Temperature.

109.16(3) Exceptions. The following exceptions to this chapter shall be applied to get-well centers:

a.A center shall maintain a minimum staff ratio of one-to-four for infants and one-to-five for children over two years of age.

b.All staff who have contact with children shall have a minimum of ten clock hours of special training in caring for mildly ill children.

c.There shall be 40 square feet of program space per child.

d.Outdoor space may be waived with the approval of the department if the program is in an area adjacent to the pediatrics unit of a hospital.

e.Grouping of children shall be allowed by categorization of illness or by transmission route without regard to age and shall be in separate rooms with full walls and doors.

These rules are intended to implement Iowa Code section 232.69 and chapter 237A.