Chapter 12. Nutrition
Regulation .01 Food Service.LinkCopy Citation
A.
Food and Beverages.
(1)
Food and beverages that are furnished by an operator for meals or snacks, or both, shall comply with the guidelines of the Child and Adult Care Food Program of the U.S. Department of Agriculture, as indicated on a chart supplied by the office.
(2)
For children in care, unless provided by the child’s parent, the operator shall furnish:
(a)
All beverages, including beverages for meals and snacks; and
(b)
Milk with all meals.
(3)
A beverage furnished by the operator may not contain an added sweetener or caffeine, except for:
(a)
Infant formula: or
(b)
A beverage prescribed for a child by a health care provider.
(4)
If a child is:
(a)
Younger than 2 years old, milk furnished to the child shall be supplied or approved by the child’s parent; or
(b)
2 years old or older, milk furnished to the child by the operator shall be 1% fat milk or nonfat milk, unless otherwise ordered by a health care provider or requested by the child’s parent.
(5)
The operator may arrange with a child’s parent to furnish milk of a type that is different from the milk ordinarily furnished by the operator.
(6)
The operator shall keep a supply of nutritious food on hand in order to provide food to a child whose parent has not supplied:
(a)
Food for meals or snacks; or
(b)
Sufficient food to meet the standards of the Child and Adult Care Food Program of the U.S. Department of Agriculture.
B.
Hours of Operation. If a center operates:
(1)
4 or more consecutive hours a day, the operator shall furnish either:
(a)
All meals and snacks; or
(b)
Snacks; or
(2)
Less than 4 consecutive hours a day, the operator shall either:
(a)
Furnish food and beverages for meals or snacks, or both; or
(b)
Make arrangements with the parent of a child to provide food and beverages for meals or snacks, or both.
C.
Except during approved hours of overnight care, an operator shall serve meals and snacks at intervals of not more than 3 hours according to the following schedule:
D.
If an operator chooses not to provide meals, the operator shall make arrangements with the parent of each child to provide food for meals.
E.
Menus. An operator shall:
(1)
Post in a conspicuous place a weekly planned menu of foods and beverages furnished by the center for meals and snacks; and
(2)
Keep a dated record of food actually served in the center, and to each child on a modified diet, on file for at least 4 weeks, correcting the planned menu if necessary.
Regulation .02 Modified Diet.LinkCopy Citation
If an operator agrees to accept a child who requires a modified diet for:
A.
Medical reasons, the operator shall obtain from the child's parent a written prescription for the diet signed and dated by the child's licensed health practitioner within the previous 6 months; or
B.
Cultural or religious reasons, the operator shall obtain written, dated instructions for the diet signed by the child's parent.
Regulation .03 Food Sources.LinkCopy Citation
A.
An operator shall furnish food at the center only if it is wholesome and free from spoilage, filth, or other contamination and obtained from sources that comply with all laws relating to food, food processing, food handling, and food labeling.
B.
If an operator contracts to have food furnished from an outside source, such as a catering service, the operator shall ensure that the food:
(1)
Has been prepared and processed in a licensed food service facility or in a licensed food processing plant; or
(2)
Consists of a snack or party food which is not potentially hazardous and does not present a significant risk of transmitting food-borne disease.
C.
An operator may not provide to the children home-canned goods or any other hermetically sealed food prepared in a place other than a licensed food processing establishment.
D.
An operator:
(1)
Shall provide only fluid milk and fluid milk products that are:
(a)
Pasteurized Grade A;
(b)
Except as provided by §D(3) of this regulation, served from the original container; and
(c)
Not more than 4 days older than the expiration date marked on the original container;
(2)
Except as provided at Regulation .06D of this chapter, may use dry milk, dry milk products, or reconstituted dry milk only for cooking purposes; and
(3)
For meals and snacks, may serve milk family-style from a pitcher or similar container into which the milk has been poured from the original container.
Regulation .04 Food Storage and Preparation.LinkCopy Citation
A.
An operator shall:
(1)
Protect all food from contamination while it is being stored, transported, or displayed; and
(2)
Prepare and serve food, including infant formula, in a safe, sanitary, and healthful manner.
B.
There shall be sufficient storage areas for all food brought from home and all food held in reserve for service by the operator.
C.
Food shall be stored:
(1)
In an area that is dry, cool, well-ventilated, well-lighted, and equipped with easily cleanable shelving; and
(2)
At least 6 inches off the floor to facilitate cleaning.
D.
In a small center, food may be stored:
(1)
Separately from family food; or
(2)
With family food if the operator chooses to have the entire family food storage area inspected.
E.
If food is transferred for storage from its original container, the operator shall provide a secondary storage container that is:
(1)
Easily cleanable;
(2)
Nontoxic;
(3)
Nonabsorbent;
(4)
Tightly closed; and
(5)
Clearly labeled as to its contents.
F.
The operator:
(1)
May not store food below overhead waste lines;
(2)
Shall maintain cooked, potentially hazardous hot food at or above a temperature of 140° F;
(3)
Shall refrigerate potentially hazardous food at or below a temperature of 40° F;
(4)
Shall keep frozen food at or below 0° F; and
(5)
Shall restrict the movement of pets and other animals so that food and food contact surfaces are not contaminated.
G.
Single service items such as paper and plastic cups, containers, lids, plates, knives, forks, spoons, and placemats shall be:
(1)
Used only once; and
(2)
Stored, handled, and dispensed to protect them from contamination.
H.
During an activity in which the children prepare food, the activity shall be planned and carried out in a manner consistent with the safety and health practices required in this subtitle.
I.
The operator shall discard:
(1)
All spoiled fruits, vegetables, or other food;
(2)
Refrozen food;
(3)
Potentially hazardous frozen food that has been thawed and not immediately cooked and served;
(4)
Swelled, rusty, or leaky canned foods;
(5)
Foods exposed to fire, smoke, or water damage;
(6)
After a child finishes eating, any remaining food that has come into contact with:
(a)
The child's mouth; or
(b)
An eating utensil that has been used by the child; and
(7)
After being left out for consumption by children during a meal or snack, any milk remaining in an opened original container, a pitcher or similar container, or a drinking vessel.
J.
The operator shall send home or discard at the end of each day all opened containers of food brought from home for a child.
Regulation .05 Food Preparation Area and Equipment.LinkCopy Citation
A.
Appliances and equipment in the food preparation area shall be:
(1)
Cleaned and sanitized;
(2)
In good repair;
(3)
Capable of normal operation; and
(4)
Not conducive to the harboring of insects and rodents.
B.
Food contact surfaces shall be nontoxic, smooth, in good repair, and free of breaks, open seams, cracks, pits, and similar imperfections.
C.
Refrigeration shall be:
(1)
Of sufficient capacity to store all food and beverages that require refrigeration;
(2)
Operated at or below 40° F; and
(3)
Equipped with an indicating thermometer graduated at 2° F intervals.
D.
All frozen food units shall be operated at 0° F or less, and shall be provided with an indicating thermometer.
E.
Centers operating more than 4 consecutive hours shall provide refrigeration.
F.
Except in a small center or when only snacks are provided by the operator, a separate handwashing sink which is equipped with soap and paper towels shall be provided in or adjacent to each food preparation area. Food preparation and utensil washing sinks may not be used for handwashing.
G.
A cooking exhaust hood shall be provided when routine cleaning does not eliminate condensation or greasy film.
H.
Utensils and equipment used for the preparation and service of food and beverages shall be cleaned, sanitized, air dried, and stored in a manner approved by the office.
I.
Floors and walls in a food preparation area shall be easily cleanable and maintained in a clean condition.
Regulation .06 Infant Feeding.LinkCopy Citation
A.
The operator shall ensure that the written feeding schedule for an infant or toddler, as required by COMAR 13A.16.03.02D(1), is:
(1)
Followed; and
(2)
Updated as necessary or at least every 3 months while the child is in care.
B.
Infant Self-Feeding.
(1)
An infant shall be held for each bottle feeding except when the infant or toddler is developmentally able and insistent upon self-feeding.
(2)
When an infant or toddler holds the bottle, the infant or toddler may do so only:
(a)
When seated; and
(b)
If the bottle is made of unbreakable material.
C.
Except as specified by §D of this regulation, an operator may serve an infant or toddler only developmentally appropriate:
(1)
Commercially prebottled formula;
(2)
Breast milk, formula, juice, or water which has been prebottled for the child and provided by the child's parent;
(3)
Commercially processed baby food that is opened and used the same day;
(4)
Commercial infant formula, in concentrate, powder, or ready-to-feed form, if the:
(a)
Child's parent has provided prior written authorization for the use of the formula; and
(b)
Formula is prepared directly from a factory-sealed container and in accordance with the manufacturer's instructions; and
(5)
Other foods supplied by the operator or the parent that are consumed the same day.
D.
Only whole, pasteurized milk will be served to an infant or toddler who is not receiving formula or breast milk, except that skim milk, reconstituted nonfat dry milk, or 1—2 percent milk may be served upon the written prior approval of the child's parent and health care provider.
E.
An operator shall ensure that:
(1)
All infant foods and bottles are labeled with the infant's name, dated, and refrigerated at 40° F or below if potentially hazardous;
(2)
All nipples on bottles are protected;
(3)
Breast milk or formula which has been bottled for the child is:
(a)
Placed immediately in a refrigerator when brought to the center;
(b)
Warmed to the desired temperature immediately before feeding; and
(c)
Served to the child at a temperature that is safe and conducive to the child's comfortable feeding;
(4)
Foods that present a high risk of choking for infants and toddlers are not served to them; and
(5)
Reusable bottles and nipples are:
(a)
Reused only after they have been washed, rinsed, and sanitized; or
(b)
If supplied by the child's parent, rinsed after use and returned daily to the parent.
Chapter annotations
Authority: 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 Maryland
Agency 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)
Human Services Article, §1-202; Annotated Code of Maryland
Agency 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)
History: Effective date: October 20, 2008 (35:21 Md. R. 1826)
History: Regulation .01 amended effective July 20, 2015 (42:14 Md. R. 883)
History: Regulation .01A amended effective January 13, 2020 (47:1 Md. R. 14)
History: Regulation .03E repealed effective April 19, 2010 (37:8 Md. R. 618)