An operator shall provide a building for a center that is: Maintained in good repair; Free from health and safety hazards as identified by the office; and Clean and free from infestation of insects and rodents. Except as set forth in §C of this regulation, the operator shall ensure that the child care center complies with all applicable State and local codes, including but not limited to zoning, building, plumbing, gas, electrical, sewage disposal, drinking water, environment, health, and fire. A child care center for school age children which is located in a school building and operates before and after school hours is not required to comply with any regulation under this subtitle that relates to the physical plant of the center if the regulation exceeds requirements imposed by the county or the local board of education with respect to the school building. The operator shall ensure that an access road on center property permits passage by emergency vehicles during times when children are in care. A minimum of 35 square feet of floor space shall be provided for each child in care, except that: A minimum of 30 square feet of floor space shall be provided for each child in a: Child care center licensed before December 1, 1971; or Nursery school holding a certificate of approval to operate or a letter of exemption from approval that was issued by the State Board of Education before December 1, 1971, and is still in effect; and A child care program currently approved by the office to operate with less square footage per child than required by §A of this regulation may continue to operate with that reduced square footage as long as the: Operator demonstrates to the satisfaction of the office the impossibility of complying with the minimum square footage required by §A of this regulation while maintaining the economic viability of the program; and Office determines that the reduced square footage does not threaten the health, safety, or welfare of any child in care. In calculating the square footage of floor space provided for each child, the following may not be included: Any floor space, rooms, or areas that are not suitable or available for the daily program activities of the children, such as but not limited to columns, vestibules, and corridors, food preparation areas, kitchens, bathrooms, adult work areas, permanently equipped isolation areas or sleeping rooms, storage units, and storage space; and Furniture, except for: Children's chairs and tables which are nonfixed and multipurpose; Moveable equipment used for infant care, such as high chairs and swings; Moveable play equipment; An adult-size rocking chair or other adult-size comfortable chair; An adult-size couch; and Open shelves for children's daily activities. In centers that care for infants or toddlers: Diapering stations shall be included in calculating the square footage of floor space provided for each child; and The operator shall designate space for mothers to breastfeed or express breast milk that: Is not located in a bathroom; Has access to an electrical outlet; Has appropriate seating; and Has access to running water. In a center located in a residence, the space for children may include space within the family living area. Building maintenance, repair, or renovation activity may not occur while a child in care is on the premises if the activity may present a significant risk to child safety or health. A center operator may not use paint with lead content on any: Exterior or interior surface of the facility; or Material or equipment used for child care purposes. If the child care center is a residential rental property constructed before 1978, which is an affected property as defined by Environment Article, §6-801(b), Annotated Code of Maryland, the operator shall submit a copy of the current lead risk reduction or lead free certificate. If the facility was constructed before 1978 and is not certified lead free pursuant to Environment Article, §6-804(a)(2)(i), Annotated Code of Maryland, the operator shall: Ensure there is no chipping, peeling, flaking, chalking, or deteriorated paint on any surface of an interior or exterior area of the facility that is used for child care; If deterioration of a surface in an area used for child care is noted, or if renovation of the premises occurs that disturbs a painted surface, arrange to have a lead dust test: Conducted by an accredited visual inspector pursuant to COMAR 26.16.02.03B to meet the risk reduction standard, if the facility is an affected property; or Conducted in areas used for child care by an accredited risk assessor pursuant to COMAR 26.16.05.11, if the facility is not an affected property; and If a lead dust test is required under §C(2) of this regulation, obtain: A passing score on that test; and Verification from the lead inspector performing the test that the requirements of §C(2) and (3)(a) of this regulation have been met. In a facility constructed before 1978 and not certified lead free under Environment Article, §6-804(a)(2)(i), Annotated Code of Maryland, when performing renovation which disturbs the painted surface of an interior or exterior area used for child care, the operator shall ensure that the work is performed by an individual accredited to perform the lead paint abatement services using safe work practices as required by Environment Article, Title 6, Subtitle 10, Annotated Code of Maryland, and corresponding regulations. A room may be used for child care only if it: Has natural or mechanical ventilation that provides adequate exchange of air to protect a child's health and comfort; Is free of moisture and dampness; and Has a temperature at floor level of not less than 65° F. The center shall have hot and cold running water, with hot water temperature not exceeding 120° F. For each 40 children in care, or fraction thereof, there shall be at least one drinking water source that is: Safely accessible to children 2 years old or older without assistance from an adult; and Not located in a toilet room or in a sink used for handwashing. Drinking water shall be supplied by: An angle-jet drinking fountain with mouthguard; Licensed bottled water in the original container; Running water supply with individual single service drinking cups; or Another method or source approved by the office. During meals and snacks, water may be served family-style from a pitcher if the water is poured into the pitcher directly from one of the supply sources listed at §C of this regulation. For each group of infants or toddlers in a room, there shall be an approved diapering area with a sink that: Is used only for diapering and toileting purposes; and Permits continuous observation of, and immediate response to, each child in the group. For every 15 children who are 2 years old or older, an operator shall provide one toilet and one sink that are: Maintained in good operating condition and in a sanitary manner; Easily accessible to the children; and Equipped with water-resistant, nonabsorbent platforms which are safely constructed at a height that allows children to use the toilet and sink unassisted. An operator which holds a certificate of approval to operate, or a letter of exemption from approval, that was issued by the State Board of Education before July 1, 1991, and is still in effect may receive a variance from the requirements of §B of this regulation if the office determines that: The requirements can be met only with substantial physical modifications to the center; and Sanitary facilities are accessible to every child in the center. In each toilet facility accessible to a school age child, the operator shall provide at least one toilet in an enclosed stall or other space affording privacy to the child. In a small center approved for mixed age groups, only one toilet and sink are required. A center licensed for the first time shall provide at least one toilet facility restricted to use by adults that is equipped with a toilet, sink, and toilet supplies, except that this requirement does not apply to: Small centers; or Programs that operate 2-1/2 hours or less per session per day. Each toilet room shall have: A floor with a water-resistant, nonabsorbent finish; Smoothly finished walls with a hard surface; and Approved and functioning natural or mechanical ventilation. Portable toilets, also known as potty-chairs, may not be used in a child care center. Each toilet room shall contain individual paper towels, a trash receptacle, soap, and toilet paper. All sanitary supplies in a toilet room shall be available within reach of a child capable of using the toilet unassisted. Toiletry and grooming articles, drinking cups, towels, face cloths, brushes, and combs may not be shared. There shall be sufficient natural and artificial lighting in all approved areas of the center to allow proper child supervision and help ensure the safety of each child, employee, and visitor to the center. An operator shall use light fixtures with bulbs, lamps, and tubes that are shatter-proof or protected by shields to prevent shattering. In a room approved for child care that does not have windows, an operator shall provide an approved source of lighting that will operate in case of a power failure. An operator shall provide adequate outdoor lighting to ensure the safety of persons entering and leaving the center when it is dark outside. There shall be at least one operable telephone in the center that is freely and readily available to all center staff during the approved hours of operation. In a center with more than two rooms approved for child care, a staff member supervising a group of children in one room shall be able to communicate a request for assistance to a staff member in another room while maintaining continuous supervision of the group. In each room where care is provided to infants or toddlers, there shall be an operable telephone. The operator shall provide additional telephones or extensions in the center as may be required to: Summon emergency fire and rescue services promptly; and Transmit and receive other emergency communications. The entire center, including floors, walls, ceilings, fixtures, furnishings, materials, and equipment, shall be kept clean and free of infestation. In a center for fewer than 12 children located in a residence, the requirements of §A of this regulation apply only to space approved for child care. Cleaning may not be conducted while children are present except in emergencies or as clean up activities that are part of the daily activity program. Disposal of Refuse. Each room used for child care shall have a trash container with a disposable liner. In each area used for changing diapers, there shall be a separate trash container reserved for diaper discards that: Has a disposable liner and tightly fitting lid; Makes the contents of the container inaccessible to children in care. All trash containers in child care areas shall be emptied when full but at least daily. Refuse that is placed outdoors to await collection shall be stored in receptacles that are: Made of tight, nonabsorbent, easily washable materials; Covered with tightly fitting lids; and Washed and treated with disinfectant when necessary to combat odors and prevent infestation. Biocontaminants and biohazards shall be disposed of in a clean and sanitary manner. A center shall have an outdoor activity area on the premises of, adjacent to, or near and safely accessible to the center that provides adequate usable play space for the approved capacity of the center. A center for which a notice of intent, filed pursuant to COMAR 13A.16.02.02A(2), is received by the office on or after January 1, 2009, shall have an outdoor activity area that provides at least 75 square feet of usable play space for: One half of the approved capacity of the center; or Each child, if the center has an approved capacity of 20 or fewer children. Usable play space may include only the area and the activity equipment approved for use by children in care. The activity area shall be free from potential hazards to child health or safety. All outdoor activity equipment shall be safe, in good repair, clean, and nontoxic. Any pool on the premises of the facility shall be made inaccessible to children in care and have security features, including but not limited to a: Fence that surrounds the pool at least 4 feet in height; Self-closing and self-latching mechanism on the gate, door, or access to the pool; Lock that is operable and secured; and Sensor or alarm in the pool and on the access door. Only swimming facilities meeting applicable local standards of health, sanitation, and safety may be used. An above-ground swimming pool: May not be used for swimming activities; and Shall be made inaccessible to children in care. A child in care may not use a pool, such as a fill-and-drain molded plastic or inflatable pool. Education Article, §§9.5-401, 9.5-404—9.5-411 and 9.5-413—9.5-418; 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 .01A amended effective April 19, 2010 (37:8 Md. R. 618) Regulation .03C, D amended effective July 20, 2015 (42:14 Md. R. 883) Regulation .05B amended effective January 13, 2020 (47:1 Md. R. 14) Regulation .10A amended effective June 24, 2013 (40:12 Md. R. 1043) Regulation .11D amended as an emergency provision effective August 31, 2023 (50:20 Md. R. 885); amended permanently effective February 5, 2024 (51:2 Md. R. 76) Regulation .12F adopted effective January 13, 2020 (47:1 Md. R. 14) Regulation .13 amended effective January 13, 2020 (47:1 Md. R. 14)