To be approved as a family child care provider, an individual shall be 18 years old or older. Preservice Training. An individual who applies for an initial registration shall: Hold a current certificate indicating successful completion of training in approved: Basic first-aid through the American Red Cross, or a program with equivalent standards; and Cardiopulmonary resuscitation (CPR) through the American Heart Association, or a program with equivalent standards, appropriate for each age group approved for care in the home; Provide documentation of having successfully completed: Within 2 years before the application for initial registration is filed, at least 24 clock hours of approved training that includes 4 clock hours in each of the six core of knowledge competencies; The 90 clock hour course, or its approved equivalent, that satisfies the preservice training requirement for a child care teacher or child care center director under COMAR 13A.16.06.05B(4), COMAR 13A.16.06.09A(3), or COMAR 13A.16.06.10B(1)(a), as applicable; Department of Defense training modules for child care providers; The Child Development Associate Credential issued by the Council for Professional Recognition; An associate's degree that includes at least 15 semester hours of early childhood education or elementary education course work; A bachelor's or higher degree in early childhood education, elementary education, or other discipline approved by the office; or Other course work approved by the office; Complete approved training on emergency and disaster planning; Effective January 1, 2020, complete approved basic health and safety training within 90 days of initial registration; and Complete: Approved training in supporting breastfeeding practices; 3 clock hours of approved training in complying with the Americans with Disabilities Act; and Approved training in medication administration. Continued Training. A provider shall successfully complete: The health and safety training, as required by the office, by the end of each 12-month period measured each calendar year; During the first year of registration, 18 clock hours of approved training specified by the office; and By the end of each 12-month period after the first full year of registration, a total of 12 clock hours of approved continued training that consists of: At least 6 clock hours of core of knowledge training; and Not more than 6 clock hours of elective training. Professional Development Plan. The provider shall maintain a professional development plan. Training completed by the provider under §B of this regulation shall be: Consistent with the provider's professional development plan; and Documented by the provider on the professional development plan. Current certification in approved basic first aid and CPR training as specified in §A(1)(a) and (b) of this regulation shall be maintained at all times by: The provider; and If applicable, the additional adult. Infant-Toddler Training. The office may not approve a request by an applicant or a provider for an infant-toddler capacity of more than two children younger than 2 years old unless the individual has completed 3 semester hours or 45 clock hours of approved training, or the equivalent, related to the care of children younger than 2 years old. Sudden Infant Death Syndrome (SIDS) Training. The office may not approve a request by an applicant or a provider to provide care for a child younger than 24 months old unless the applicant or provider presents evidence of having successfully completed, within 5 years before the date of the request, approved SIDS training. SIDS training may not be used to satisfy the continued training requirements set forth in §B of this regulation. The office may not approve an application for an initial registration or a continuing registration unless the applicant has completed: Approved training in: Supporting breastfeeding practices; and Medication administration; and 3 clock hours of approved training in complying with the Americans with Disabilities Act. A currently registered provider shall have completed approved training as specified in §F of this regulation. The provider shall designate at least one substitute who is available on short notice to care for the children at the provider’s registered family child care home. Approval by Office. An individual designated as a substitute may not be used in that capacity unless the office has approved the individual. If information received by the office indicates that an individual designated as a substitute may present a risk to the health, safety, or welfare of children in care, the office may disapprove the use of that substitute. The office shall notify the provider of its decision to approve or disapprove a substitute within 30 days of the request being submitted. Use of Substitutes. A provider may use a substitute to: Provide care for children during a temporary absence of the provider; and Assist in providing care while the provider is present. Unless the office approves an additional number of days in advance, the use of substitutes to provide care in the provider's absence is limited to a total of not more than 20 working days in any 12-month period, counting only days on which substitute care is provided for more than 2 hours. A substitute shall: Be 18 years old or older; Be familiar with the requirements of this subtitle; Complete, sign, and submit to the office the required forms for substitutes, including: A medical evaluation completed within the past 12 months; and Permission to examine records of abuse and neglect of children and adults; Apply for a federal and State criminal background check at a designated law enforcement office in the State; If residing or having resided in a state other than Maryland within 5 years before being hired as a substitute: Apply for a state criminal background check to be performed by a duly authorized entity within that state; and Request the non-Maryland state entity performing the criminal background check to transmit the result of that background check directly to the Agency; and Present no risk to the health, safety, or welfare of children. Before allowing a substitute to provide or to assist in providing care, the provider shall orient the substitute to child health and safety matters, including, but not limited to: The location of the: Telephone and emergency telephone numbers; First aid supplies; and Child emergency forms; Medication administration information for each child authorized to receive medication; Modified diet information for each child placed on a modified diet; Emergency evacuation procedures; Permissible and appropriate child discipline procedures; Authorized child release procedures; and Procedures for documenting and reporting child injuries and accidents. During the provider's absence, a substitute is responsible for meeting the requirements of this subtitle regarding the: Supervision and protection of each child in care; and Operation of the family child care home. Except as set forth in §B of this regulation, before an individual may be used as an additional adult, the provider shall ensure that the individual: Is 18 years old or older; Attends an information session presented by the office concerning the requirements of this subtitle for the care of children younger than 2 years old; Files with the office: A completed additional adult application form; Signed and notarized release forms giving the office permission to examine records of abuse and neglect of children and adults for information about the applicant; Completed information, on a form supplied by the office, for each of the applicant's substitutes; and A medical report on the applicant based on a medical evaluation conducted within the previous 12 months by a practicing physician, certified nurse practitioner, or registered physician's assistant, and signed by the individual who conducted the evaluation; Applies for a federal and State criminal background check at a designated office in the State; If residing or having resided in a state other than Maryland within 5 years before being hired as an additional adult: Applies for a state criminal background check to be performed by a duly authorized entity within that state; and Requests the non-Maryland state entity performing the criminal background check to transmit the result of that background check directly to the Agency; Holds a current certificate indicating successful completion of approved basic first aid and CPR training applicable to children younger than 2 years old; and Presents evidence of having completed approved SIDS training within the previous 5 years. A provider may not use an individual as an additional adult unless the office has approved the individual in that capacity. Before permitting an individual to begin volunteer duties at the family child care home, the provider shall: Ensure that the individual presents no risk to the health, safety, or welfare of children; Conduct a child health and safety orientation for the individual that meets the requirements set forth in Regulation .03E of this chapter; Ensure that the individual has applied for a federal and State criminal background check at a designated office in the State; and Ensure that the individual, if residing or having resided in a state other than Maryland within 5 years before being hired as an additional adult: Applies for a state criminal background check to be performed by a duly authorized entity within that state; and Requests the non-Maryland state entity performing the criminal background check to transmit the result of that background check directly to the Agency. The provider, substitute, or additional adult shall accompany a volunteer whenever the volunteer is in the presence of an unrelated child in care. A volunteer who is younger than 18 years old may not be permitted to work with a child in care who is younger than 2 years old. Education Article, §§9.5-301—9.5-308, 9.5-310—9.5-312, 9.5-320, and 9.5-321;General Provisions Article, §4-333; Human Services Article, §1-202; Annotated Code of MarylandAgency Note: Federal Statutory Reference — Americans with Disabilities Act of 1990 (42 U.S.C. §12101 et seq.);Pro-Children Act of 1994 (20 U.S.C. §6081 et seq.);Child Care Development Block Grant (45 CFR Parts 98 and 99 and 42 U.S.C. 9858 et seq.);Social Security Act §418 (42 U.S.C. 618) Effective date: October 20, 2008 (35:21 Md. R. 1826) Regulation .02 amended effective April 19, 2010 (37:8 Md. R. 618); January 13, 2020 (47:1 Md. R. 12) Regulation .02A amended effective July 20, 2015 (42:14 Md. R. 882) Regulation .02H adopted effective July 20, 2015 (42:14 Md. R. 882) Regulation .03 amended effective January 13, 2020 (47:1 Md. R. 12) Regulation .03C, D amended effective April 19, 2010 (37:8 Md. R. 618) Regulation .04 amended effective April 19, 2010 (37:8 Md. R. 618) Regulation .04A amended effective January 13, 2020 (47:1 Md. R. 12) Regulation .04C repealed effective March 21, 2011 (38:6 Md. R. 396) Regulation .05A amended effective January 13, 2020 (47:1 Md. R. 12)