An individual may not advertise a family child care service unless the individual holds a current certificate of registration issued by the office. An advertisement of the family child care service by a provider shall: Specify that the child care home is registered; and Include the registration number issued to the child care home by the office. A provider may not admit a child for care unless the provider has: Met the applicable requirements of this regulation; and Received the written records required by Regulation .04C—H of this chapter. At or before the child's admission to care, the provider shall obtain written information from the parent about the child's individual needs. Upon admission of an infant or a toddler, a provider shall determine with the parent: A schedule for feeding the child that includes: The amounts and kinds of food consumed daily; The sequence for introducing solid food when appropriate; and Any recommendations about feeding from the infant's physician; A written individual activity plan for the child; and If the child is 12 months old or older, the need for the child to use a crib for rest purposes. If a child is younger than 6 years old at the time of admission, the provider may not allow the child to remain in care if the parent does not, in accordance with COMAR 10.11.04, submit evidence to the provider on a form supplied or approved by the Office that the child has received an appropriate lead screening or test. As part of the admission process, the provider shall: Give the parent, or advise the parent how to obtain, consumer education information on child care that is supplied by the office; and Provide documentation that the requirements of §C(1) of this regulation have been met. The provider shall: Create and maintain, for at least 2 years after their creation, records of program: Enrollment, with each child's name, address, telephone number, date of birth, and dates and time periods for which enrolled; and Attendance that indicate: The dates of attendance of each child in the child care home; and Verification by each child's parent of that child's recorded daily attendance in care; Maintain: Procedures to ensure that the whereabouts of each child in attendance is known at all times; A written child discipline policy as required in COMAR 13A.18.07.03C; Records of food actually served by the provider for the most recent 4 weeks as required by COMAR 13A.18.12.01I(2); A written record of the dates and times at which emergency and disaster plan drills were conducted pursuant to COMAR 13A.18.10.01A(3)(c); Documentation that, at least once each calendar year, the parent of each child under the age of 3 years was given: Information about the Maryland Infant and Toddlers Program; and Contact information for the local lead agency responsible for the administration of the Maryland Infant and Toddlers Program; and A current copy of this subtitle at the home so that it is displayed and freely available for reference by parents and staff members; Negotiate and maintain a written agreement with the child's parent that specifies: The fees for and provision of care; The provider's child discipline policy; The presence at the home of any pet animals; If applicable, the use of volunteers in the child care program; and If overnight care is to be provided to the child, the sleeping arrangements approved by the parent; Give, or advise the parent how to obtain, information supplied by the office concerning: Consumer education on child care; and How to file a complaint with the office against a child care provider; and Document that the health and safety training, as required by the office, was updated by the end of each 12-month period, measured from the date of initial registration. The provider may provide the information required under §B(5) of this regulation by: A personal message to the parent, including an e-mail; A document for which the parent acknowledges receipt; or A text message. Unless a child is temporarily admitted to or retained in care pursuant to §L of this regulation, the provider shall maintain written records, on forms provided or approved by the office, that meet the requirements of this regulation for each child admitted to or continuing in care. Each child's written records shall be: Readily accessible to each staff member providing care to the child; and Kept on file at the child care home during the period of a child's enrollment and for 2 years after the child's disenrollment. The provider shall obtain and maintain emergency information from the child's parent that: Includes the child's name and date of birth; Includes the parent's full name, current address, and telephone contact information; Includes the name and telephone number of the individual who is authorized to pick up the child each day; Includes the name and telephone number of at least one individual who is authorized to pick up the child in an emergency; Includes the name, address, and telephone number of the child's physician or other health care provider; If the child has a special health condition, includes emergency medical instructions for that condition; Is signed and dated by the child's parent; Is updated as needed, but at least annually; and Is readily accessible to each staff member supervising the child, including during an off-site activity. 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: Includes a parental statement of the child's health status; If applicable, includes a statement of allergies; and 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: 2 months before admission for a child younger than 9 months old; 3 months before admission for a child between 9 and 24 months old; or 12 months before admission for a child 2 years old or older. As required by COMAR 10.11.04, there shall be evidence that the child has received: An appropriate lead screening for a child younger than 6 years old and born prior to January 1, 2015; or A lead test at age 12 months and again when the child is 24 months regardless of where the child resides, for any child born on or after January 1, 2015. A medical evaluation and, if applicable, documentation of an appropriate lead screening or test that are transferred directly from another registered child care home, a 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. There shall be an immunization record showing that: The child has had immunizations appropriate for the child's age which meet the immunization guidelines set by the Maryland Department of Health; 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; A registered physician or a health officer has determined that immunization is medically contraindicated according to accepted medical standards; or The parent objects to the child's immunization because it conflicts with the parent's bona fide religious beliefs and practices. 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, the provider 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. The provider shall record or maintain on file: Each incidence of acute illness requiring exclusion of the child from care pursuant to COMAR 13A.18.11.01B; Each injury or accident required by Regulation .06C and D of this chapter to be reported; Child medication records required by COMAR 13A.18.11.04D; 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.18.12.02; If program activities away from the child care home are provided, prior written permission from the child's parent to take the child to those activities; and If applicable, documentation that the parent of a child who is 12 months old or older, but younger than 2 years old, has requested a crib for the child's rest periods. 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 provider and the parent at least every 12 months after the child's admission to care. A provider shall maintain daily records of the amounts and kinds of liquids and solid food consumed by each child younger than 2 years old. These records shall be: Dated and kept on file for at least 4 weeks; Available in the area where children younger than 2 years old are fed; and Made available to the child's parent. Temporary Admission. A provider may temporarily admit or retain a child in care if the child’s parent or guardian is unable to provide the health-related records specified in §§D—H of this regulation. For a child to be temporarily admitted or retained in care, the parent or guardian shall present evidence of the child’s appointment with a health care provider or local health department to: Receive a medical evaluation to include, if applicable, a lead screening or test; Receive a required immunization; Acquire evidence of age-appropriate immunizations on a form approved by the office; or Reconstruct a lost record. The date of appointment, set pursuant to §L(2) of this regulation, may not be later than 20 calendar days following the date the child was temporarily admitted or retained in care. A provider shall exclude from care a child who has been temporarily admitted or retained in care if the parent fails to provide evidence of the required medical evaluation, immunization, or health record within 3 business days after the date of the appointment made pursuant to §L(2) of this regulation. The provider shall: Maintain and, upon request by the office, submit a current and complete list of personnel, on a form supplied or approved by the office, that includes each individual, whether paid or unpaid, who works at the child care home on a routine basis; For review by the office and by parents who have enrolled their children or are considering enrolling their children, post in a conspicuous location a current and complete staffing pattern, on a form supplied or approved by the office, that specifies: The number and ages of children enrolled; The staff/child ratio in relation to the daily schedule; and By staff member name, all child care assignments; During an individual's employment at the child care home and for 2 years after the date of the individual's last employment there, maintain a record for each individual that includes: The individual's: Training, if required under this chapter; Experience, if required under this chapter; and Function or position; Verification that the staff member's age complies with the minimum required for the position held; Employment medical evaluation; Criminal background check, except that the provider shall destroy the record of those results immediately after the last day of the individual’s employment; and Date on which the staff member received the written information required by COMAR 13A.18.06.02; Maintain documentation required for: Substitutes, pursuant to COMAR 13A.18.06.08B; and The adult available for emergencies, pursuant to COMAR 13A.18.08.02D; Maintain a calendar or other written record of the: Days on which a substitute provides care; and Staff member in whose place the substitute worked; and If using volunteers in the child care program, maintain a record for each volunteer that includes: The date on which the volunteer received the child health and safety orientation required by COMAR 13A.18.06.02; A brief statement of the volunteer's duties; and A medical evaluation of the volunteer that was completed within 12 months before the start of the volunteer's duties. The provider shall: Within 5 working day of its occurrence, provide written notification to the office about the: Addition of a new staff member that includes: The individual’s full name, date of birth, and date of hire; Information about the individual’s work assignment; Proof of compliance with the laws and regulations pertaining to criminal background checks; and Signed and notarized permission to examine records of abuse and neglect of children and adults for information about the individual; or Ending of employment, for whatever reason, of an individual that includes the: Individual’s full name; and Date of the individual’s last day of employment; Within 15 working days of adding the new employee, provide to the office complete documentation that the individual meets the requirements of this subtitle for the assignment, unless documentation already is on file in the office; Notify or require that a staff member notify the office within 24 hours of: The death of a child in care if the child died while at the child care home; The death of a child enrolled at the child care home if the child died of a contagious disease; and An injury to a child that occurs while the child is at the child care home or at an off-site activity which results in the child's being: Treated by a medical professional; or Admitted to a hospital; If a child has an injury or accident while in attendance, notify the child's parent: Immediately, if the child's injury is serious; or Within the same day, about any other injury and each accident which may result in injury; Immediately notify the office of: The provider, a resident of the home, or an employee who is under investigation for: A criminal charge; or An allegation of child abuse or neglect; or A change at the child care home that may affect the status of the registration, including but not limited to: Individuals living on the premises; Operation of the child care home; or Telephone number; Within 5 working days after there is a new resident who is 18 years old or older: Submit to the office a signed and notarized release form giving the office permission to examine records of abuse and neglect of children or adults for information about the resident pursuant to COMAR 13A.18.02.02D(1); and Ensure that the resident applies for a federal and State criminal background check pursuant to COMAR 13A.18.02.02C(1) and F; and Within 10 business days of receiving notice from the home’s supplier of water that the drinking water is contaminated, send a written notice of the contamination to the parent of each enrolled child that: Identifies the contaminants and their levels; and Describes the provider’s plan for dealing with the water contamination problem until the water is determined by the appropriate authority to be safe for consumption. If a provider wishes to make any changes from the current registration, such as use of rooms not previously approved for child care, capacity, hours of operation, or age groups served, the provider shall request and receive written approval of the change from the office before implementing the change. After determining whether the proposed change meets the requirements of this subtitle, the office shall approve or disapprove the proposed change. If the change is approved, the office shall issue a revised registration indicating the change. The office may grant a variance to a regulation under this subtitle: If the safeguards to a child's health, safety, or well-being are not diminished; When the provider presents clear and convincing evidence that the regulation is met by an alternative which complies with the intent of the regulation; and For a limited period of time as specified by the office, or for as long as the registration remains in effect and the provider continues to comply with the terms of the variance. Within 30 calendar days of receiving a completed request for a variance, the office shall notify the provider that the variance has been granted or denied. If a variance request is denied by a regional office of the Agency: The provider may appeal the denial to the Agency's central office; and The Agency's central office has the final determination of whether or not a variance is granted. Education Article, §§9.5-115, 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: February 6, 2012 (39:2 Md. R. 142) Regulation .02D amended effective January 13, 2020 (47:1 Md. R. 17) Regulation .03 amended effective January 13, 2020 (47:1 Md. R. 17) Regulation .03B amended effective June 24, 2013 (40:12 Md. R. 1043); March 17, 2025 (52:5 Md. R. 238) Regulation .03D amended effective July 20, 2015 (42:14 Md. R. 884) Regulation .03F adopted effective March 17, 2025 (52:5 Md. R. 238) Regulation .04 amended effective January 13, 2020 (47:1 Md. R. 17) Regulation .04A, F amended effective July 20, 2015 (42:14 Md. R. 884) Regulation .04L adopted effective July 20, 2015 (42:14 Md. R. 884) Regulation .05C amended effective July 20, 2015 (42:14 Md. R. 884) Regulation .05F amended effective January 13, 2020 (47:1 Md. R. 17) Regulation .06 amended effective July 20, 2015 (42:14 Md. R. 884); January 13, 2020 (47:1 Md. R. 17)