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<regulation prefix="Regulation" num=".04" citation="COMAR 13A.16.03.04" title_num="13A" subtitle_num="16" chapter_num="03" heading="Child Records.">
  <paragraph num="A.">
    <text>For each child admitted to, or continuing in care, the operator shall maintain written records, on forms provided or approved by the office, that meet the requirements of this regulation.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Each child's written records shall be:</text>
    <paragraph num="(1)">
      <text>Readily accessible to all staff members providing care to the child; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Kept on file at the center during the period of a child's enrollment and for 2 years after the child's disenrollment.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The operator shall obtain and maintain emergency information from the child's parent that:</text>
    <paragraph num="(1)">
      <text>Includes the child's name and date of birth;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Includes the parent's full name, current address, and home and work telephone numbers;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Includes the name and telephone number of the individual who is authorized to pick up the child each day;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Includes the name and telephone number of at least one individual who is authorized to pick up the child in an emergency;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Includes the name, address, and telephone number of the child's physician or other health care provider;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>If the child has a special health condition, includes emergency medical instructions for that condition;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Is signed and dated by the child's parent;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Is updated as needed, but at least annually; and</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Is readily accessible to each staff member supervising the child, including during an off-site activity.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Unless a parent objects to a child's medical examination because of bona fide religious beliefs and practices, a health assessment of the child shall be provided by the child's parent that:</text>
    <paragraph num="(1)">
      <text>Includes a parental statement of the child's health status;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If applicable, includes a statement of allergies; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Includes a medical evaluation, signed and dated by a physician, that states the child is medically cleared to attend child care and is based on an examination completed by the physician within the last:</text>
      <paragraph num="(a)">
        <text>2 months before admission for a child younger than 9 months old;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>3 months before admission for a child between 9 and 24 months old; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>12 months before admission for a child 2 years old or older.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>The operator shall maintain documentation that, as required by COMAR 10.11.04, each child admitted to, or continuing in, care has received:</text>
    <paragraph num="(1)">
      <text>An appropriate lead screening, if the child is younger than 6 years old and was born before January 1, 2015; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A lead test when the child is 12 months old and again when the child is 24 months old, regardless of where the child resides, if the child was born on or after January 1, 2015.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>A medical evaluation and, if applicable, documentation of an appropriate lead screening or test that are transferred directly from a registered family child care home, another licensed child care center, or a public or nonpublic school in Maryland may be accepted as meeting the requirements of §§D(3) and E of this regulation.</text>
  </paragraph>
  <paragraph num="G.">
    <text>Unless a school-age child attends a school-age program located in the child’s school, the operator shall obtain, and maintain at the center, an immunization record showing that:</text>
    <paragraph num="(1)">
      <text>The child has had immunizations appropriate for the child's age which meet the immunization guidelines set by the Maryland Department of Health;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The child has had at least one dose of each vaccine appropriate for the child's age before entry and is scheduled to complete the required immunizations;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A licensed physician or a health officer has determined that immunization is medically contraindicated according to accepted medical standards; or</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The parent objects to the child's immunization because it conflicts with the parent's bona fide religious beliefs and practices.</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>If a parent objects to a child's immunization or medical examination, or both, because of the parent's bona fide religious beliefs and practices, an operator shall require the parent to provide a health history of the child and sign a statement indicating that to the best of the parent's knowledge and belief, the child is in satisfactory health and free from any communicable disease.</text>
  </paragraph>
  <paragraph num="I.">
    <text>The operator shall record or maintain on file:</text>
    <paragraph num="(1)">
      <text>Each incidence of acute illness requiring exclusion of the child from care pursuant to COMAR 13A.16.11.01;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Each injury or accident required by Regulation .06C and D of this chapter to be reported;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Child medication records required by COMAR 13A.16.11.04A(1) and D;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>If the child requires a modified diet, the prescription from the child's health practitioner or the written instructions from the child's parent, pursuant to COMAR 13A.16.12.02;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>If program activities away from the center are provided, prior written permission from the child's parent to take the child to those activities; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>If applicable, documentation that the parent of a toddler or an infant who is 12 months old or older has requested a crib for the child's rest periods.</text>
    </paragraph>
  </paragraph>
  <paragraph num="J.">
    <text>Written information about the child's individual needs that is supplied by the parent by the time of the child's admission to care shall be reviewed by the operator and the parent at least every 12 months after the child's admission to care.</text>
  </paragraph>
  <paragraph num="K.">
    <text>An operator shall maintain daily records of the amounts and kinds of liquids and solid food consumed by each infant and toddler. These records shall be:</text>
    <paragraph num="(1)">
      <text>Dated and kept on file for at least 4 weeks;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Available in the infant or toddler feeding area; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Made available to the child's parent.</text>
    </paragraph>
  </paragraph>
</regulation>