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CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS

TABLE OF CONTENTS

TITLE 22, DIVISION 12

CHAPTER 1. CHILD CARE CENTER GENERAL LICENSING REQUIREMENTS

SUBCHAPTER 1. (RESERVED)

SUBCHAPTER 2. INFANT CARE CENTERS

Article 1. General Requirements and Definitions

Section

General ............................................................................................................................................ 101351

Renumbered to Section 101152 by Manual Letter No. EAS-98-11, effective 11/1/98 ................... 101352

Limitations on Capacity and Ambulatory Status ............................................................................. 101361

Article 2. Licensing (Reserved)

Article 3. Application Procedures (Reserved)

Article 4. Enforcement Provisions (Reserved)

Article 5. Administrative Actions (Reserved)

Article 6. Continuing Requirements

Infant Care Center Director Qualifications and Duties .................................................................... 101415

Assistant Infant Care Center Director Qualifications and Duties ................................................. 101415.1

Infant Care Teacher Qualifications and Duties ............................................................................. 101416.2

Infant Care Aide Qualifications and Duties .................................................................................. 101416.3

Staff-Infant Ratio .......................................................................................................................... 101416.5

Staffing for Infant Water Activities .............................................................................................. 101416.8

Toddler Component in an Infant Care Center ................................................................................. 101417

Infant Needs and Services Plan .................................................................................................... 101419.2

Modifications to Infant Needs and Services Plan ......................................................................... 101419.3

Infant Care Discipline .................................................................................................................. 101423.1

Infant Care Transportation .............................................................................................................. 101425

Infant Care Isolation for Illness .................................................................................................... 101426.2

Infant Care Food Service ................................................................................................................. 101427

Infant Care Personal Services .......................................................................................................... 101428

Responsibility for Providing Care and Supervision for Infants ....................................................... 101429

Infant Care Activities ...................................................................................................................... 101430

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 151

CHILD CARE CENTER

GENERAL LICENSING REQUIREMENTS Regulations

Article 7. Physical Environment

Section

Infant Care General Sanitation ..................................................................................................... 101438.1

Outdoor Activity Space for Infants ............................................................................................... 101438.2

Indoor Activity Space for Infants ................................................................................................. 101438.3

Infant Care Center Fixtures, Furniture, Equipment, and Supplies ................................................... 101439

Infant Care Center Napping Equipment ....................................................................................... 101439.1

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 152

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101361

SUBCHAPTER 1. (RESERVED)

SUBCHAPTER 2. INFANT CARE CENTERS

Article 1. GENERAL REQUIREMENTS AND DEFINITIONS

101351 GENERAL 101351

(a) Child care centers providing group infant care shall be governed by the provisions specified in this

subchapter. In addition, such centers, except where specified otherwise, shall be governed by Chapter 1,

Child Care Center General Licensing Requirements.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73

and 1596.81, Health and Safety Code.

101352 DEFINITIONS 101352

Renumbered to Section 101152 by Manual Letter No. 98-11, effective 11/1/98.

101361 LIMITATIONS ON CAPACITY AND AMBULATORY STATUS 101361

(a) It shall be permissible for a child whose developmental needs require continuation in an infant care

center to remain in an infant care center up to a maximum age of three years.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

Article 2. LICENSING (Reserved)

Article 3. APPLICATION PROCEDURES (Reserved)

Article 4. ENFORCEMENT PROVISIONS (Reserved)

Article 5. ADMINISTRATIVE ACTIONS (Reserved)

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 153

CHILD CARE CENTER

101415 GENERAL LICENSING REQUIREMENTS Regulations

Article 6. CONTINUING REQUIREMENTS

101415 INFANT CARE CENTER DIRECTOR QUALIFICATIONS AND DUTIES 101415

(a) In addition to Section 101215.1, the following shall apply:

(b) The experience requirement specified in Sections 101215.1(h)(1), (2) and (3) shall be completed in an

infant care center or a comparable group child care program dealing with children under five years of

age.

and (h)(3) shall be related to the care of infants.

(d) When the director of an infant care center or the director of a combination center is temporarily away

from the center, the director has the authority to delegate his/her responsibilities as specified below:

(1) When an assistant director is required, arrangements shall be made for the assistant director to act

as a substitute.

(A) Arrangements shall be made for a fully qualified infant care teacher to act as a substitute

for the assistant director.

(2) When an assistant director is not required, arrangements shall be made for a fully qualified infant

care teacher to act as a substitute.

(3) If the absence is for more than 30 consecutive calendar days, the substitute director shall meet the

qualifications of a director.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.750, 1596.72

and 1596.81, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 154

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101415.1

101415.1 ASSISTANT INFANT CARE CENTER DIRECTOR QUALIFICATIONS 101415.1

AND DUTIES

(a) In addition to the director, an assistant director shall be present and on duty if the center has 25 or more

infants in attendance.

(b) The assistant infant care center director shall meet the following qualifications:

(1) Be a fully qualified infant care teacher.

(2) Have completed, with passing grades, at least three postsecondary semester or equivalent quarter

units in administration or employee relations at an accredited or approved college or university.

(A) The assistant director may complete the three units required in (b)(2) above within one

year following initial employment as assistant director.

(B) The assistant director shall work under the direction and supervision of the infant or child

care center director.

infant care center or the infant care component of a combination center.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 155

CHILD CARE CENTER

101416.2 GENERAL LICENSING REQUIREMENTS Regulations

101416.2 INFANT CARE TEACHER QUALIFICATIONS AND DUTIES 101416.2

(a) Notwithstanding Section 101216.1, the following shall apply:

(b) Prior to employment, an infant care teacher shall have completed, with passing grades, at least three

postsecondary semesters or equivalent quarter units in early childhood education or child development,

and three postsecondary semester or equivalent quarter units related to the care of infants, at an

accredited or approved college or university.

(1) After employment, a teacher who has not completed the course work required in (c)(1) below shall

complete, with passing grades, at least two units each semester or quarter until the education

requirements are met.

(1) Completion, with passing grades, of 12 postsecondary semester or equivalent quarter units in early

childhood or child development education at an accredited or approved college or university.

(A) At least three of the units required in (c)(1) above shall be related to the care of infants or

shall contain instruction specific to infants.

1. Examples of acceptable course work are pediatric nursing and postnatal care.

(2) At least six months of experience in a licensed infant care center or comparable group child care

program for children under five years of age.

(A) Experience shall be verified as having been performed satisfactorily, at least three hours

per day for a minimum of 50 days in a six-month period, as a paid or volunteer staff

member under the supervision of a person who would qualify as a teacher or director

under this chapter.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 156

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101416.3

101416.2 INFANT CARE TEACHER QUALIFICATIONS AND DUTIES (Continued) 101416.2

(d) A photocopy of each teacher's transcript(s) documenting successful completion of required course work

shall be maintained at the center.

(e) Under the direction and supervision of the director and the assistant director, the infant care teacher shall

provide direct care and supervision to infants at the center.

(f) Teachers shall visually observe aides whenever aides are working with infants, except as provided for in

Section 101416.5(d)(1).

(g) An infant care teacher shall complete 16 hours of health and safety training if necessary pursuant to

Health and Safety Code Section 1596.866.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.81 and 1597.05, Health and Safety Code.

101416.3 INFANT CARE AIDE QUALIFICATIONS AND DUTIES 101416.3

(a) In addition to Section 101216.2, the following shall apply:

(b) An infant care aide shall work under the direct supervision of the director, the assistant director or a fully

qualified teacher, except as provided for in Section 101416.5(d)(1).

Section 101216(e).

(d) An aide shall provide direct care and supervision to infants.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-18-02 Effective 4/11/18 Page 157

CHILD CARE CENTER

101416.5 GENERAL LICENSING REQUIREMENTS Regulations

101416.5 STAFF-INFANT RATIO 101416.5

(a) In addition to Sections 101216.3 (c), (e), (g) and (h), and notwithstanding Sections 101216.3 (a), (b), (d)

and (f), the following shall apply:

(b) There shall be a ratio of one teacher for every four infants in attendance.

(1) An aide may be substituted for a teacher when all of the following conditions are met:

(A) There is a fully qualified teacher directly supervising no more than 12 infants, and

(B) Each aide is responsible for the direct care and supervision of a group of no more than

four infants.

(2) When engaged in activities away from the center, there shall be a minimum of one adult to every

two infants in attendance.

(A) This ratio may include authorized representatives of infants in care and adult volunteers

to supplement the staff-infant ratio.

the staff-infant ratio when actually working with infants.

(d) There shall be one teacher to visually observe every 12 sleeping infants provided the remaining staff

necessary to meet the ratios specified in (b) above are immediately available at the center.

(1) An aide who is 18 years of age or older, and who meets the requirements of Sections 101216 and

101216.2(e), may visually observe 12 sleeping infants in place of a teacher if the conditions

specified in (d) above are met.

(e) There shall be provision for overlap of staff for different shifts so that continuity of care is assured.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.81 and 1597.05, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 158

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101416.8

101416.8 STAFFING FOR INFANT WATER ACTIVITIES 101416.8

(a) In addition to Sections 101216.6(a) and 101416.5(b), and notwithstanding Section 101216.6(b), the

following shall apply:

(b) A ratio of one adult to two infants shall be maintained during activities in or near any body of water

specified in Sections 101216.6(a)(1) and (3).

container of water that a child can get into and get out of unassisted. This shall include, but not be

limited to, wading pools, basins or water trays.

(1) This ratio may include authorized representatives of infants in care and adult volunteers to

supplement the staff-infant ratio.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 159

CHILD CARE CENTER

101417 GENERAL LICENSING REQUIREMENTS Regulations

101417 TODDLER COMPONENT IN AN INFANT CARE CENTER 101417

(a) Licensees serving infants may create a special program component for children who are between 18

months and 36 months of age. The provisions of Sections 101151 through 101239.2 and 101351

through 101439.1 shall apply to infant care centers operating a toddler component in addition to those

specified in Health and Safety Code section 1596.956.

(1) The infant care center shall obtain written permission from the child's authorized representative

for the placement of the child in the toddler program.

NOTE: Authority cited: Sections 1596.81 and 1596.956, Health and Safety Code. Reference: Section

1596.956, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-17-06 Effective 4/27/17 Page 160

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101419.2

101419.2 INFANT NEEDS AND SERVICES PLAN 101419.2

(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall

complete a needs and services plan for the infant.

(1) Such plan shall be completed with the assistance of the infant's authorized representative at the

personal interview specified in Section 101218.1.

(2) The authorized representative shall sign the plan to verify that he/she has participated in preparing

it.

(b) The needs and services plan shall be in writing and shall include the following:

(1) The individual feeding plan.

(2) The individual toilet-training plan, if applicable.

(3) Any services needed by the infant that are different from those provided by the center's normal

program. Such items shall include but not be limited to:

(A) Any special exercises for infants with physical disabilities.

(4) A plan for subsequent personal interviews with the authorized representative.

subsequent updates.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 161

CHILD CARE CENTER

101419.3 GENERAL LICENSING REQUIREMENTS Regulations

101419.3 MODIFICATIONS TO INFANT NEEDS AND SERVICES PLAN 101419.3

(a) The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to

assure its accuracy.

(1) The director, the assistant director or a teacher shall update the plan with the assistance of the

infant's authorized representative.

(2) The authorized representative shall sign the plan to verify that he/she has participated in updating

it.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

101423.1 INFANT CARE DISCIPLINE 101423.1

(a) In addition to Section 101223.2, the following shall apply:

(b) Confinement to cribs, high chairs, playpens or other similar furniture or equipment shall not be permitted

as a form of discipline or punishment.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

101425 INFANT CARE TRANSPORTATION 101425

(a) In addition to Section 101225, the following shall apply:

(b) Only licensed drivers 18 years old or older shall be permitted to operate any vehicle used to transport

infants.

specified in Section 101226(d).

(1) When public transportation is used to transport infants, center staff shall have on hand, and

available for use, a first-aid kit as specified in (c) above.

(d) When transporting infants in any motor vehicle, the licensee shall secure each infant in a child passenger

restraint system, i.e., a car seat designed for an infant. The child passenger restraint system shall be

secured in the vehicle in accordance with the manufacturer's instructions.

(1) The manufacturer's instructions shall be maintained in the center for as long as the infant car seat

is in use.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 162

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101425 (Cont.)

101425 INFANT CARE TRANSPORTATION (Continued) 101425

(2) Vehicle Code section 27360 requires that children as specified must be secured in a child

passenger restraint system.

HANDBOOK BEGINS HERE

Vehicle Code section 27315(c)(1) provides:

As used in this section, "motor vehicle" means a passenger vehicle, a motortruck, or a truck

tractor, but does not include a motorcycle.

Vehicle Code section 27360 provides:

(a) Except as provided in Section 27363, a parent, legal guardian, or driver shall not

transport on a highway in a motor vehicle, as defined in paragraph (1) of subdivision (c)

of Section 27315, a child or ward who is under eight years of age, without properly

securing that child in a rear seat in an appropriate child passenger restraint system

meeting applicable federal motor vehicle safety standards.

(b) Except as provided in Section 27363, a parent, legal guardian, or driver who transports a

child under two years of age on a highway in a motor vehicle, as defined in paragraph (1)

of subdivision (c) of Section 27315, shall properly secure the child in a rear-facing child

passenger restraint system that meets applicable federal motor vehicle safety standards,

unless the child weighs 40 or more pounds or is 40 or more inches tall. The child shall be

secured in a manner that complies with the height and weight limits specified by the

manufacturer of the child passenger restraint system.

also present in the motor vehicle and is not the driver.

Vehicle Code section 27363 provides:

(a) The court may exempt from the requirements of this article any class of child by age,

weight, or size if it is determined that the use of a child passenger restraint system would

be impractical by reason of physical unfitness, medical condition, or size. The court may

require satisfactory proof of the child's physical unfitness, medical condition, or size and

that an appropriate special needs child passenger restraint system is not available.

(b) In case of a life-threatening emergency, or when a child is being transported in an

authorized emergency vehicle, if there is no child passenger restraint system available, a

child may be transported without the use of that system, but the child shall be secured by

a seatbelt.

HANDBOOK CONTINUES

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-17-01 Effective 2/8/17 Page 163

CHILD CARE CENTER

101425 (Cont.) GENERAL LICENSING REQUIREMENTS Regulations

101425 INFANT CARE TRANSPORTATION (Continued) 101425

HANDBOOK CONTINUES

while wearing only a lap safety belt when the backseat of the vehicle is not equipped with

a combination lap and shoulder safety belt.

(d) Notwithstanding Section 27360, a child or ward under eight years of age who is four feet

nine inches in height or taller may be properly restrained by a safety belt, as defined in

paragraph (2) of subdivision (d) of Section 27315, rather than by a child passenger

restraint system.

(e) Notwithstanding Section 27360, a child or ward under eight years of age may ride

properly secured in an appropriate child passenger restraint system meeting applicable

federal motor vehicle safety standards in the front seat of a motor vehicle under any of the

following circumstances:

(1) There is no rear seat.

(2) The rear seats are side-facing jump seats.

(3) The rear seats are rear-facing seats.

(4) The child passenger restraint system cannot be installed properly in the rear seat.

(5) All rear seats are already occupied by children seven years of age or under.

(6) Medical reasons necessitate that the child or ward not ride in the rear seat. The

court may require satisfactory proof of the child’s medical condition.

(f) Notwithstanding subdivision (e), a child shall not be transported in a rear-facing child

passenger restraint system in the front seat of a motor vehicle that is equipped with an

active frontal passenger airbag.

HANDBOOK ENDS HERE

(e) The staff-infant ratio shall be maintained while transporting infants in motor vehicles.

(1) The required supervision ratios shall be maintained whether the vehicle is moving or parked.

(f) Infants in motor vehicles shall have constant adult supervision and shall not be left unattended under any

circumstances.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-17-01 Effective 2/8/17 Page 163.1

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101427 (Cont.)

101426.2 INFANT CARE ISOLATION FOR ILLNESS 101426.2

(a) In addition to Section 101226.2, the following shall apply:

(b) The isolation area shall be equipped with a crib, cot, mat or playpen for each ill infant.

director, a teacher or an aide.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.81 and 1597.05, Health and Safety Code.

101427 INFANT CARE FOOD SERVICE 101427

(a) In addition to Section 101227, the following shall apply:

(b) There shall be an individual feeding plan for each infant.

(1) The plan shall be completed and available for use prior to the infant's first day at the center.

(2) The director or the assistant director, and the infant's authorized representative and/or physician,

shall develop the plan.

(A) The authorized representative shall sign the plan to verify that he/she has participated in

developing and updating it.

(3) The plan shall include the following items:

(A) Instructions from the infant's physician relating to special diet or feeding.

(B) Feeding schedule.

(D) Schedule for introduction of solid and new foods.

(E) Food consistency.

(F) Food likes and dislikes.

(G) Food allergies.

(H) Schedule for introduction of cups and utensils.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-15-02 Effective 3/24/15 Page 164

CHILD CARE CENTER

101427 (Cont.) GENERAL LICENSING REQUIREMENTS Regulations

101427 INFANT CARE FOOD SERVICE (Continued) 101427

(4) The plan shall be updated as often as the authorized representative wants, or as necessary to reflect

changes in any of the areas specified above.

(5) The infant care center director or assistant director shall discuss current feeding theory with the

authorized representative. This discussion should cover the dangers of honey.

HANDBOOK BEGINS HERE

(A) Authorities recommend that honey not be fed to any infant for the first year of life. Honey

may carry botulism spores that can be harmful to young infants and has been known to

cause infant botulism.

(B) It is recommended that the discussion include the following "Recommendations for Infant

Feeding Practices" by the Department of Human Services concerning the sequence for the

introduction of solid foods to infants from birth to 12 months.

AGE FOODS

Birth-12 months Breast milk, iron-fortified formula, or evaporated milk formula

At 4-6 months Infant cereal (dry type)

At 5-7 months Vegetables, fruits and their juices

At 6-8 months Protein foods (cheese, yogurt; cooked beans, meat, fish, and

chicken; egg yolk)

At 10-12 months Whole egg

HANDBOOK ENDS HERE

(1) Bottle-fed infants shall be fed at least once every four hours.

(2) The infant care center shall have appropriate food available for the infant.

(A) Where the infant's authorized representative elects to provide food for the infant but

forgets to bring it, the center shall provide appropriate food for the infant.

(3) Introduction of solid foods shall be in accordance with the individual plan.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-15-02 Effective 3/24/15 Page 165

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101427 (Cont.)

101427 INFANT CARE FOOD SERVICE (Continued) 101427

(d) The infant care center shall provide only commercially prepared formulas for infants.

(1) Commercial formulas shall be stored and prepared in accordance with label directions.

(2) The specific brand of formula shall be specified in the feeding plan.

(3) Any change from one formula to another shall be reflected in advance on the feeding plan.

HANDBOOK BEGINS HERE

(4) Staff of the infant care center shall not prepare infant formula from basic ingredients.

HANDBOOK ENDS HERE

(e) The infant's authorized representative may provide formula or breast/mother's milk.

(1) Such formula or milk shall be bottled before being accepted by the center.

(A) Bottles shall be labeled.

(f) The infant care center may heat formula or breast/mother's milk.

(g) A supply of bottles and nipples shall be maintained at the infant care center. Bottles and nipples used by

one infant shall not be shared with or used by another infant unless sterilized.

(h) Infants who are unable to hold a bottle shall be held by a staff person or other adult for bottle feeding.

At no time shall a bottle be propped for an infant. An infant shall not be allowed to carry a bottle while

ambulatory. A bottle given to an infant able to hold his/her own bottle shall be unbreakable.

CALIFORNIA-DSS-MANUAL-CCL

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CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101427

101427 INFANT CARE FOOD SERVICE (Continued) 101427

(i) High chairs or other appropriate seating equipment shall be used to seat infants during feeding. Infants

who are unable to sit unassisted in a high chair or other seating equipment shall be held by a staff person

or other adult for feeding.

(j) Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled

with the infant's name and the current date.

(1) Formula in a partially consumed bottle shall be discarded at the end of each day.

(2) Food shall be discarded if not consumed within 72 hours of the date on the container label.

(3) Bottles and dishes provided by the authorized representative shall be rinsed and returned to the

authorized representative for sanitizing at the end of each day.

(k) The infant care center shall not serve honey or corn syrup to any infant.

(l) Commercially prepared baby food in jars shall be transferred to a dish before being fed to the infant.

(1) Any food left over in the dish at the end of the meal shall be discarded.

(m) If requested, arrangements for privacy shall be made for any mother who has reached an agreement with

the infant care center to nurse her infant in the center.

(n) Bottles and nipples maintained by the infant care center shall be sterilized using any of the following

methods after each use:

(1) Boiled for a minimum of five minutes and air-dried; or

(2) Soaked for a minimum of one minute in a sterilizing solution using 1/2 cup of bleach and five

gallons of water and air-dried; or

(3) Bottles may be washed and sterilized using a dishwasher.

(o) Infants shall not be bathed in, and diapers or clothing shall not be rinsed in, the food-preparation area.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.81 and 1597.05, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 167

CHILD CARE CENTER

101428 GENERAL LICENSING REQUIREMENTS Regulations

101428 INFANT CARE PERSONAL SERVICES 101428

(a) There shall be a written toilet-training plan for infants being toilet trained.

(1) The infant's authorized representative and the director or the assistant director shall develop the

plan.

(2) The plan shall include the following:

(A) Methods of toilet training;

(B) Introduction and use of appropriate training equipment; and

(3) Infants who are being toilet trained shall not be required to wear diapers unless specifically

indicated in the plan.

(4) The center shall follow the plan in toilet training the infant.

(5) Center staff shall have ready access to the toilet-training plan for infants in their care.

(b) The infant shall be kept clean and dry at all times.

(1) The infant care center shall ensure that the infant has sufficient changes of clothing and diapers so

that his/her clothing and diapers can be clean and dry at all times.

(2) Each infant's clothing and diapers shall be changed as often as necessary to ensure that the infant

is clean and dry at all times.

in an airtight container and returned to the authorized representative at the end of each day.

(1) The airtight container shall prevent the escape of fluids and odors and be portable enough to give

to the authorized representative.

(d) When changing an infant's diapers, the following shall apply:

(1) Each infant shall be diapered on a changing table.

(A) No infant shall be left unattended while on a changing table.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 168

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101428

101428 INFANT CARE PERSONAL SERVICES (Continued) 101428

(2) Infants may be diapered on a changing pad placed on the floor that meets the requirements of

Section 101439(h).

(3) Soiled disposable diapers shall either be disposed of as recommended on the packaging or placed

in an airtight container for daily disposal outside of the center.

(A) Containers shall be sanitized daily.

(4) Soiled cloth diapers shall be placed in an airtight container.

(5) Diapers provided by the center, when soiled, shall be rinsed, washed and sanitized on a daily

basis. If a diaper service is utilized, the diapers shall be placed in the diaper service company

container, as instructed, for pickup by the diaper service.

(6) Towels and washcloths used for cleaning infants shall not be shared with other infants or staff and

shall be washed after each use.

(7) The changing table and changing pads shall be disinfected after each use even when disposal

covers are used.

(A) Infant changing tables may be covered with disposable paper towels or a similar covering

that shall be discarded after each diaper change.

(B) The floor space used for diaper changing, if soiled, shall be disinfected after each use.

(e) Whenever a potty chair is used, the following requirements shall be met:

(1) The potty chair shall be placed on the floor and used in accordance with the manufacturer's

instructions.

(2) After each use, the potty chair shall be promptly emptied into a flushing toilet, and all surfaces

shall be thoroughly cleaned and disinfected.

(3) No infant shall be left unattended while on a potty chair or seat.

(f) As part of toilet training, each infant shall receive instruction and assistance in hand washing after use of

the toilet.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.81 and 1597.05, Health and Safety Code.

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MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 169

CHILD CARE CENTER

101429 GENERAL LICENSING REQUIREMENTS Regulations

101429 RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION 101429

FOR INFANTS

(a) In addition to Section 101229, the following shall apply:

(1) Each infant shall be constantly supervised and under direct visual observation and supervision by

a staff person at all times. Under no circumstances shall ANY infant be left unattended.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

101430 INFANT CARE ACTIVITIES 101430

(a) Notwithstanding Section 101230, the following shall apply:

(1) The infant care center shall develop, maintain and implement a written plan to ensure the

provision of indoor and outdoor activities designed to meet the needs of infants, including but not

limited to:

(A) Quiet and active play.

(B) Rest and relaxation.

(D) Toileting.

(E) Individual attention.

(F) Being held by a caregiver.

(2) The center shall ensure the participation of infants in the above activities.

(3) All infants shall be given the opportunity to nap/sleep without distraction or disturbance from

other activities at the center whenever the infant desires.

(A) No infant shall be forced to sleep, to stay awake or to stay in the napping area.

(i) The center is not prohibited from scheduling nap times for infants over 12

months old.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 170

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101438.1 (Cont.)

Article 7. PHYSICAL ENVIRONMENT

101438.1 INFANT CARE GENERAL SANITATION 101438.1

(a) All items used by pets and animals shall be kept out of the reach of infants.

(b) Each caregiver shall wash his/her hands with soap and water before each feeding and after each diaper

change.

(1) Only dispenser soap, such as liquid or powder in an appropriate dispenser shall be used.

(2) Only disposable paper towels in an appropriate holder or dispenser shall be used for hand drying.

infants have access to, are as follows:

(1) Floors, except those carpeted, shall be vacuumed or swept and mopped with a disinfecting

solution at least daily, or more often if necessary.

(2) Carpeted floors and large throw rugs that cannot be washed shall be vacuumed at least daily and

cleaned at least every six months, or more often if necessary.

(A) Small rugs that can be washed shall be shaken or vacuumed at least daily and washed at

least weekly, or more often if necessary.

Commercial-type cleaning machines commonly available through rental stores, grocery

stores, etc., may be used to clean carpets and large rugs. A professional cleaning service

may also be hired.

(3) Walls and portable partitions shall be washed with a disinfecting solution at least weekly, or more

often if necessary.

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MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 171

CHILD CARE CENTER

101438.1 (Cont.) GENERAL LICENSING REQUIREMENTS Regulations

101438.1 INFANT CARE GENERAL SANITATION (Continued) 101438.1

(4) The diaper-changing area, where residue is splashed from soiled diapers and items and surfaces

are touched by staff during the diaper-changing process, shall be washed and disinfected after

each diaper change. Such areas, items and surfaces shall include but not be limited to:

(A) Walls and floors surrounding the immediate diaper-changing area.

(B) Dispensers for talc, lotion, soap and paper towels.

(5) Sinks used to wash infants, or to rinse soiled clothing or diapers, shall be disinfected after each

use.

(d) Objects used by infants that are mouthed shall be washed and disinfected at least daily, or more often if

necessary. Such objects shall include, but not be limited to, toys and blankets.

(e) Linens laundered by the center shall be washed and sanitized at least daily, or more often if necessary.

Such linens shall include, but not be limited to, bedding, towels and washcloths used on or by infants.

(f) A disinfecting solution, which shall be used after surfaces and objects have been cleaned with a

detergent or other cleaner, shall be freshly prepared each day using 1/4 cup of bleach per gallon of water.

Commercial disinfecting solutions, including one-step cleaning/disinfecting solutions, may be used in

accordance with label directions.

(g) All disinfectants, cleaning solutions and other hazardous materials shall be removed immediately and

stored as specified in Section 101238.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.81 and 1597.05, Health and Safety Code.

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MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 172

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101438.3

101438.2 OUTDOOR ACTIVITY SPACE FOR INFANTS 101438.2

(a) In addition to Section 101238.2, the following shall apply:

(b) Outdoor activity space shall be physically separate from space used by children in the child care center

and school-age child care center components.

(d) The outdoor activity space shall be equipped with a variety of age-appropriate toys and equipment.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.81 and 1597.05, Health and Safety Code.

101438.3 INDOOR ACTIVITY SPACE FOR INFANTS 101438.3

(a) In addition to Section 101238.3, the following shall apply:

(b) Indoor activity space for infants shall be physically separate from space used by children in the child care

center and school-age child care center components.

(1) The center may use moveable walls or partitions to separate the above groups in the same room

provided that each group has the total amount of square footage in indoor activity space required

by this chapter.

(2) Moveable walls or partitions, if used, shall be at least four feet high; shall be constructed of sound-

absorbing material; and shall be designed to minimize the risk of injury to infants.

(1) The sleeping area for infants shall be physically separate from the indoor activity space. This

separation shall be accomplished as specified in (b) above.

(d) The various child care center components in a combination center may share office space, food-

preparation space, storage space and any other general-purpose space.

(e) The indoor activity space shall be equipped with a variety of age-appropriate washable toys and

equipment.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.81 and 1597.05, Health and Safety Code.

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MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 173

CHILD CARE CENTER

101439 GENERAL LICENSING REQUIREMENTS Regulations

101439 INFANT CARE CENTER FIXTURES, FURNITURE, EQUIPMENT 101439

AND SUPPLIES

(a) In addition to Section 101239, and notwithstanding Section 101239(h), the following shall apply:

(b) The infant care center shall be equipped with appropriate furniture and equipment including, but not

limited to, cribs, cots or mats; changing tables; and feeding chairs.

(d) Swings, playpens and all such equipment and furniture shall be assembled or installed according to the

manufacturer's instructions, and shall be maintained in good repair and safe condition.

(1) Equipment that is purchased already assembled shall not be modified.

(2) A baby walker shall not be allowed on the premises of a child care center in accordance with

Health and Safety Code Section 1596.846.

HANDBOOK BEGINS HERE

Health and Safety Code Sections 1596.846(b) and (c) state:

(b) A baby walker shall not be kept or used on the premises of a child day care facility.

Section 1500.86 of Part 1500 of Title 16 of the Code of Federal Regulations.

HANDBOOK ENDS HERE

(e) High chairs or low-wheeled feeding tables and any such equipment used for seating an infant shall have

broad-base legs.

(1) Seats and backrests shall be made of washable and moisture-resistant material.

(2) An infant shall not be permitted to pull on or climb on or into a high chair.

(3) Whenever an infant is in a high chair, the tray shall be properly latched on both sides.

(4) An infant shall not be permitted to stand up in a high chair.

(5) No infant shall be left unattended while in a high chair.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 174

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101439 (Cont.)

101439 INFANT CARE CENTER FIXTURES, FURNITURE, EQUIPMENT 101439

AND SUPPLIES (Continued)

(f) All such equipment or furniture shall be washed with a detergent/disinfectant after each use as specified

in Section 101438.1.

(g) Furniture shall be maintained in good repair and safe condition.

(h) Infant changing tables shall:

(1) Have a padded surface no less than one-inch thick and be covered with washable vinyl or plastic.

(2) Have raised sides at least three inches high.

(3) Be maintained in good repair and safe condition.

(4) While in use, be placed within arm's reach of a sink.

(5) Not be located in the kitchen/food-preparation area.

(i) There shall be a minimum of one hand washing sink to every 15 infants and one potty chair to every five

infants being toilet trained.

(1) If sufficient potty chairs are not available for the number of infants being toilet trained, a

combination of potty chairs and toilets with training seats may be used to meet the ratio specified

in (i) above.

(2) Infants shall not be permitted to play with potty chairs.

(j) Toilets and potty chairs and hand washing sinks for infants shall be in close proximity to indoor and

outdoor activity space.

(k) Toy storage containers shall meet the following requirements:

(1) Lids and the hardware used to hinge lids on boxes or chests shall be removed.

(2) All edges and corners shall be rounded and padded.

(3) The container shall be well ventilated.

(4) The container shall not be lockable.

(5) The container shall be maintained in good repair and safe condition.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 175

CHILD CARE CENTER

101439 (Cont.) GENERAL LICENSING REQUIREMENTS Regulations

101439 INFANT CARE CENTER FIXTURES, FURNITURE, EQUIPMENT 101439

AND SUPPLIES (Continued)

(A) Metal toy boxes shall not have rough or sharp edges, and wooden toy boxes shall not

have splinters and other rough areas.

(l) Toys shall be safe, and shall not have sharp points or edges or splinters, or be made of small parts that

can be pulled off and swallowed.

(1) The combination of toys shall provide and encourage:

(A) Auditory stimulation.

(B) Visual stimulation.

(D) Manipulative skills.

(2) Pacifiers shall have a shield or guard large enough so that infants cannot choke on them.

(3) Rattles shall be large enough so that they cannot become lodged in an infant's throat and

constructed so that they will not separate into small pieces.

HANDBOOK BEGINS HERE

(4) It is recommended that centers comply with the following U.S. Consumer Product Safety

Commission advice for the selection and safe use of children's toys:

(A) Avoid toys with small parts.

(B) Look for labels that give an age recommendation.

HANDBOOK ENDS HERE

(m) Fixtures, furniture, equipment, supplies and toys shall not be made of or contain toxic materials or

substances.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 176

CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101439.1 (Cont.)

101439.1 INFANT CARE CENTER NAPPING EQUIPMENT 101439.1

(a) In addition to Section 101239.1, the following shall apply:

(b) A standard size six-year crib or porta-crib meeting the following requirements shall be provided for each

infant who is unable to climb out of a crib:

(1) Stacking wall cribs or cribs stacked one on top of another, often referred to as tiered cribs, shall

not be permitted.

(2) Cribs shall not limit the ability of staff to see the infant.

(3) Cribs shall not limit the infant's ability to stand upright.

(4) Crib mattresses shall be:

(A) Covered with vinyl or similar moisture-resistant material.

(B) Wiped with a detergent/disinfectant daily and when soiled or wet.

(5) Cribs equipped with bumper pads shall be covered with vinyl or similar moisture-resistant

material. Each crib shall have a sheet to cover the mattress and, depending on the temperature, a

sheet and/or blanket to cover the infant.

(A) If bumper pads are used, they shall be installed around the entire inner portion of the crib

and tied or snapped into place in at least six places.

(B) The mattress shall be set at its lowest position and the side rail shall be locked in its

highest position.

CALIFORNIA-DSS-MANUAL-CCL

MANUAL LETTER NO. CCL-98-11 Effective 11/1/98 Page 177

CHILD CARE CENTER

101439.1 (Cont.) GENERAL LICENSING REQUIREMENTS Regulations

101439.1 INFANT CARE CENTER NAPPING EQUIPMENT (Continued) 101439.1

who have the ability to climb out of a crib.

(d) Each crib, mat or cot shall be occupied by only one infant at a time.

(e) Each infant's bedding shall be used for him/her only. Such bedding shall be replaced when wet or

soiled, or when the crib, mat or cot is to be occupied by another infant.

(1) Bedding shall be changed daily, or more often if required by (e) above.

(A) Soiled bedding shall be placed in a suitable container and made inaccessible to infants

until washed or picked up by a commercial laundering service.

(f) Cribs, mats or cots shall be arranged so as to provide a walkway and work space between the cribs, mats

or cots sufficient to permit staff to reach each infant without having to step over or reach over any other

infant.

(1) Placement of cribs, mats or cots shall not hinder entrance or exit to and from the napping space.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72 and

1596.81, Health and Safety Code.

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CHILD CARE CENTER

101538.3 (Cont.) GENERAL LICENSING REQUIREMENTS Regulations

101538.3 INDOOR ACTIVITY SPACE FOR SCHOOL-AGE CHILDREN 101538.3

(Continued)

(d) The capacity per room for a school-age child care program that meets the requirements of Health and

Safety Code Section 1596.806 shall not exceed the number of children for which a room of this size is

commonly approved for school use during the school day.

(e) The exemption from square-footage requirements for indoor activity space is only valid if the entire

program is operated in accordance with Health and Safety Code Section 1596.806.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.806 and 1596.81, Health and Safety Code.

101539 FIXTURES, FURNITURE, EQUIPMENT AND SUPPLIES 101539

(a) In addition to Section 101239, the following shall apply:

(b) Toilets used by school-age children shall provide individual privacy.

(1) Toilet facilities shall not be used simultaneously by children of both sexes.

are exempt from toilet requirements.

(1) Health and Safety Code Sections 1596.806(a), (a)(1), (a)(2), (b), (b)(1) and (d) pertain to the

exemption from toilet requirements for school-age child care programs that meet the requirements

of Health and Safety Code Section 1596.806.

HANDBOOK BEGINS HERE

Health and Safety Code Sections 1596.806(a), (a)(1), (a)(2), (b), (b)(1) and (d) state:

(a) A room used as a classroom by a schoolage child care program shall not be required to

meet the square footage or toilet requirements for child day care centers if the program is

operated on either of the following:

(1) A functioning schoolsite in the same facilities that have housed school children

during the day, before or after school hours, or before and after school hours.

HANDBOOK CONTINUES

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CHILD CARE CENTER

Regulations GENERAL LICENSING REQUIREMENTS 101539

101539 FIXTURES, FURNITURE, EQUIPMENT AND SUPPLIES 101539

(Continued)

HANDBOOK CONTINUES

(2) A functioning schoolsite in facilities certified as usable as a classroom for

instruction....

(b) School grounds, other than rooms used as classrooms, used by a schoolage child care

program operated on a functioning schoolsite pursuant to either paragraph (1) or (2) of

subdivision (a) shall be exempt from all of the following requirements imposed by the

department on child day care facilities:

(1) Fencing, outdoor activity space, toilet, and isolation space requirements....

(d) For purposes of this section, "schoolage child care program" means a program for

children who are four years and nine months or older and are currently enrolled in a

school or are dependent children living within the same household as a child attending a

school, operated by an entity that contracts with the school to provide staff and

program....

HANDBOOK ENDS HERE

(d) The exemption from toilet requirements is only valid if the entire program is operated in accordance with

Health and Safety Code Section 1596.806.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73,

1596.806 and 1596.81, Health and Safety Code.

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