# COMAR Title 13A — State Board of Education

## Subtitle 16 — Child Care Centers

### Chapter 13 — Centers for Children with Acute Illness

**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 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)

**Administrative History:** Effective date: October 20, 2008 (35:21 Md. R. 1826)

**Administrative History:** Regulation .02E amended effective April 19, 2010 (37:8 Md. R. 618); January 13, 2020 (47:1 Md. R. 14)

#### Regulation .01 Location of Center.

*COMAR 13A.16.13.01*

An office may issue a license for a room in a child care center or for an entire center offering care to children with acute illness.

#### Regulation .02 Applicability of Subtitle.

*COMAR 13A.16.13.02*

An applicant for a center offering care under this chapter shall meet the requirements of this subtitle with the exception of:

A. COMAR 13A.16.05.12 concerning outdoor activity areas;

B. COMAR 13A.16.09.01 concerning schedule of daily activities for all children;

C. COMAR 13A.16.09.03B(1) and (2) concerning activity materials and equipment;

D. COMAR 13A.16.09.05A concerning carriages and strollers, if care is provided to children younger than 2 years old;

E. COMAR 13A.16.10.01A(3)(c) concerning emergency evacuation and disaster drills for children; and

F. COMAR 13A.16.11.01 concerning exclusion for acute illness.

#### Regulation .03 Plan of Operation.

*COMAR 13A.16.13.03*

A. An applicant for a center offering care under this chapter shall:

  (1) Submit to and receive prior approval from the office, in consultation with the Maryland Department of Health and the health officer, of a written plan of operation for the center, including provision for health assessment of ill children; and

  (2) Operate according to the approved plan.

B. An applicant shall include in the written plan of operation:

  (1) Procedures to prevent the spread of disease, including general infection control procedures and methods of preventing the spread of airborne diseases, such as chicken pox and measles;

  (2) Staff training requirements in the areas of prevention and control of communicable diseases and care of ill children;

  (3) Staff education and experience in the health care field;

  (4) Staff orientation in pediatric first aid, infection control, and facility policies;

  (5) Staff/child ratios;

  (6) The identity of an on-call health consultant;

  (7) A definition of the population to be served and the criteria for admission, including exclusion policies;

  (8) Procedures for preparing a written plan of care for each child upon admission to include instructions for care in emergencies, medications, and special medical and nonmedical treatments;

  (9) Procedures for periodic reassessment of the child;

  (10) Methods for establishing an individualized program of daily activities for each child;

  (11) Staff information, including a staffing pattern;

  (12) A list of materials, equipment, and furnishings; and

  (13) Identification of buildings and rooms to be used for the program.

#### Regulation .04 Director Requirements.

*COMAR 13A.16.13.04*

The director in a center for children with acute illness shall:

A. Meet the requirements of COMAR 13A.16.06.05, .06, .07, or .08, as applicable; and

B. Have completed at least 40 hours of training in a college level course in prevention and control of communicable diseases and care of ill children.

#### Regulation .05 Use of Health Consultant.

*COMAR 13A.16.13.05*

An operator shall use a health consultant who is a registered nurse, a pediatric or family nurse practitioner, or a pediatrician to develop written policies and procedures and to supervise and instruct staff on performing procedures.