An individual may not have responsibility for supervising a child in care unless the individual meets the requirements of this subtitle pertaining to a provider, substitute, or additional adult, as applicable. Except as provided in Regulation .02C and D of this chapter, when a child is in attendance, the individual responsible for supervising the child shall at all times: Be alert and responsive; Know where the child is; Be able to see or hear the child; Be near enough to the child to render immediate assistance; and Provide supervision that is appropriate to the individual age, needs, capabilities, activities, and location of the child, which may include, but not be limited to: Making reasonable accommodations for a child with a disability; and If applicable, allowing an adult who provides specialized services to a child in care to provide those services at the home in accordance with the child’s individualized education plan, individualized family services plan, or written behavioral plan. The provider or substitute shall: Remain inside the home while a child in care younger than 6 years old is present inside the home; and Accompany a child in care who is younger than 6 years old whenever the child is outside of the home. Supervision of Resting Children. If a resting or napping child is younger than 2 years old, the provider or substitute shall: Remain within sight and sound of the child; and Observe the child at least every 15 minutes to determine that the child is safe, breathing normally, and in no physical distress. If a resting or napping child is 2 years old or older, the child: May be on a different level of the home from the provider or substitute if: That level is approved by the office for child care use; and The provider has informed the child's parent that the child is permitted to be on a different level of the home; and Shall be observed by the provider or substitute to ensure the child’s safety and comfort at intervals of at least every 15 minutes. If a resting or napping child is in a different room from the provider or substitute and that room can be closed off from the rest of the home by a door, screen, or similar furnishing, the provider or substitute shall ensure that the door, screen, or similar furnishing remains open so that the view into the room is unobstructed. The provider may use a video and sound monitoring system to meet the sound and sight requirement in §D(1)(a) of this regulation. A child may not be left unattended on the premises of the home, in a motor vehicle, or during an off-site activity. During an off-site activity, the provider or substitute shall exercise reasonable care to protect children from potentially hazardous areas and situations. If the outdoor activity space is not on the premises, the provider or substitute shall accompany and supervise a child of any age in transit to and from the space and while at the space. Before a child may participate in a supervised activity out of the home without the provider or substitute, responsibility for the child's whereabouts and supervision shall be clearly assigned throughout the period of the activity. A child in care may not travel to or from school or a school transportation site without adult supervision unless the child is in the first or a higher grade. A child engaged in swimming or wading shall be under immediate supervision by the provider or substitute at all times. Whenever children are engaged in a swimming activity, at least two adults permitted to have child care responsibilities under this subtitle shall be present during the activity. When water is over a child's chest and the child cannot swim, the provider or substitute shall be in the water with the child to provide one-to-one supervision. When water is more than 4 feet deep, an individual 16 years old or older who holds a current certificate of approval for lifeguarding from the American Red Cross, YMCA, or other organization acceptable to the office or the local health department shall be present and on duty at all times while a child is in the water. A provider, substitute, or approved additional adult with the requisite certification may fulfill this requirement. A child engaged in swimming or wading shall be under immediate supervision by the provider or substitute at all times. If overnight care is provided, the provider or substitute shall, throughout the period of care: Remain on the premises; Remain on the same level of the home as the children in care; and Respond to the feeding schedule, sleep habits, sleep disturbances, and age-appropriate bedtime routine of each child in care. If overnight care is provided to four or more children at the same time, the provider or substitute shall remain alert and awake at all times. 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 .01 amended effective April 19, 2010 (37:8 Md. R. 618); July 20, 2015 (42:14 Md. R. 882) Regulation .02C, D amended effective April 19, 2010 (37:8 Md. R. 618) Regulation .03 repealed effective July 20, 2015 (42:14 Md. R. 882) Regulation .04 amended effective April 19, 2010 (37:8 Md. R. 618) Chapter revised effective January 13, 2020 (47:1 Md. R. 12)