Section 251.09. Additional requirements for infant and toddler care.

 

(1)   Applicability and general requirements.

(a) Group child care centers providing care and supervision to infants and toddlers shall comply with the additional requirements of this section.

(am) Prior to admission, an interview shall be conducted with a child's parent or guardian to obtain written information which will aid child care workers in individualizing the program of care for the child. Information shall include all of the following:

1. Schedule of meals and feeding.

2. Types of food introduced and timetable for new foods.

3. Toileting and diapering procedures.

4. Sleep and nap schedule.

5. The child's way of communicating and being comforted.

6. Developmental and health history.

(b) Admission information for an infant or toddler shall be on file in the room or area to which the child is assigned and shall be known to the child care worker.

(c) Child care workers shall document changes in a child's development and routines every 3 months based on discussion with the parent.

(d) Each infant and toddler shall be cared for by a regularly assigned child care worker in a specific self-contained room or area. Infants and toddlers may not be transferred to the care of another child care worker or another group or room in order to adjust group sizes or staff-to-child ratios, except under one of the following circumstances:

1. During the first 2 hours and the last 2 hours of center operation.

2. When the number of children in a group is one or 2 children to one child care worker.

(e) The regularly assigned child care teacher and assistant child care teacher for each group of infants and toddlers shall have a minimum of 10 hours of training in infant and toddler care approved by the department within 6 months after assuming the position. If the training is not part of the required entry-level training under s. DCF 251.05 (1) (f) or (g) , it shall be obtained through continuing education.

(f) Infants and toddlers are restricted to first floors and ground floors having direct grade-level exits unless the building is in compliance with all applicable building codes that permit children to be cared for on other levels. The building inspection report on file with the licensing office shall indicate that children under 2 years of age may be cared for on other levels of the center.

(g) Safety gates shall be provided at open stairways.

(h) For centers licensed on or after January 1, 2009, the space occupied by cribs shall be deducted in determining the 35 square feet space requirement under s. DCF 251.06 (7) (a) for each child.

(i) The number of children under one year of age admitted at any one time may not exceed the number of cribs and playpens.

(j) Cribs and playpens shall contain a tight fitting mattress and any mattress covering shall fit snugly over the mattress. Water beds may not be used by children under age 2.

(k) Sheets or blankets used to cover the child shall be tucked tightly under the mattress and shall be kept away from the child's mouth and nose.

(L) Children under one year of age may not sleep in a crib or playpen that contains soft materials such as sheepskins, pillows, fluffy blankets, bumper pads or stuffed animals.

(2)   Daily program.

(a) Child care workers shall respond promptly to a crying child's needs.

(b) Each infant and each toddler shall be allowed to form and follow his or her own pattern of sleeping and waking.

(bm) Each child under one year of age shall be placed to sleep on his or her back in a crib unless otherwise specified in writing by the child's physician. The child shall be allowed to assume the position most comfortable to him or her when able to roll over unassisted.

(c) Emphasis in activities shall be given to play as a learning and growth experience.

(d) Throughout the day each infant and each toddler shall receive physical contact and attention such as being held, rocked, talked to, sung to and taken on walks inside and outside the center.

(e) Routines relating to activities such as taking a nap, eating, diapering and toileting shall be used as occasions for language development and other learning experiences.

(f) When a non-mobile child is awake, the child care worker shall change the child's body position and location in the room periodically. Non-mobile children who are awake shall be placed on their stomach occasionally throughout the day.

(g) The non-walking child who can creep or crawl shall be given opportunities during each day to move freely by creeping and crawling in a safe, clean, open, warm and uncluttered area.

(h) Child care workers shall encourage infants and toddlers to play with a wide variety of safe toys and objects.

(i) Infants and toddlers shall be taken outdoors for part of each day except during inclement weather or when this is not advisable for health reasons.

(j) Equipment shall be provided to take infants and toddlers out of doors for a walk.

(k) An adult-size rocking chair or other adult-size chair shall be provided for each child care worker for the purpose of holding and rocking children.

(3)   Feeding.

(a) Child care workers shall do all of the following:

1. Feed each infant and each toddler on the child's own feeding schedule.

2. Ensure that food and formula brought from home are labeled with the child's name and dated, and are refrigerated if required.

3. Ensure that formula prepared by the center is of the commercial, iron-enriched type and mixed according to the manufacturer's directions.

4. Except as provided in subd. 6. , provide formula or breast milk to all children under 12 months of age.

6. Provide a type of milk other than a type under subd. 4. , or a milk substitute, only on the written direction of the child's physician.

7. Discard leftover milk or formula after each feeding and rinse bottles after use.

8. Offer drinking water to infants and toddlers several times daily.

9. Hold a child unable to hold a bottle whenever a bottle is given. Bottles may not be propped.

10. Cover, date and refrigerate commercial baby food containers which are opened and foods prepared in the center which are stored. If not used within 36 hours, leftover food shall be discarded.

11. Hold or place a child too young to sit in a high chair in an infant seat during feeding. Wide-based high chairs, hook-on chairs or infant seats with safety straps shall be provided for children who are not developmentally able to sit at tables and chairs.

12. Encourage children to experiment with self-feeding with their hands and spoons. Eating utensils and cups shall be scaled to the size and developmental level of the children.

13. Offer a variety of nourishing foods to each child, such as cereal, vegetables, fruit, egg yolks and meat, according to the child's developmental level and the parent's feeding schedule.

14. Refrain from feeding a child directly from commercial food containers.

15. Refrain from heating breast milk in a microwave oven.

(b) Procedures for heating infant formula, milk and food in a microwave oven shall be posted near the microwave oven. Child care workers shall follow the posted procedures for heating food, milk and formula.

(4)   Diapering and toileting.

(a) Child care workers shall do all of the following:

1. Plan toilet training in cooperation with the parent so that a child's toilet routine is consistent between the center and the child's home, except that no routine attempts may be made to toilet train a child under 18 months of age.

2. Change wet or soiled diapers and clothing promptly.

3. Change each child on an easily cleanable surface which is cleaned with soap and water and a disinfectant solution after each use with a chlorine bleach solution of one tablespoon bleach to one quart of water, made fresh daily, or a quaternary ammonia product prepared in accordance with label directions.

4. If the diapering surface is above floor level, provide a barrier or restraint to prevent falling. A child may not be left unattended on the diapering surface.

5. Place disposable soiled diapers and gloves, if used, in a plastic-lined, hands-free, covered container immediately.

6. Place parent-supplied soiled cloth diapers in labeled plastic bags which are kept separate from other clothing.

7. Place center-supplied soiled cloth diapers in a plastic-lined, covered container for washing by a commercial diaper service.

8. Remove soiled diapers from containers as needed but at least daily for washing or disposal. Containers shall be washed and disinfected daily.

9. Wash hands with soap and running water before and after each diapering or assistance with toileting routines. For children under one year, hands may be washed with soap and a fabric or paper washcloth.

10. Apply lotions, powders or salves to a child during diapering only at the specific written direction of the child's parent or the child's physician. The directions on use shall be posted in the diaper changing area. Recording the use of lotions, powders or salves during diapering in the medical log book is not required.

11. Wash the child's diaper area before each diapering with a disposable or fabric towel used only once.

(b) Each self-contained classroom or area serving infants or toddlers who are diapered shall have a sink with hot and cold running water which is not used for food preparation or dishwashing within the room or area.

(c) There shall be a solid barrier between the diapering area and any food preparation area.

(d) There shall be a supply of dry and clean clothing and diapers sufficient to meet the needs of all the children at the center.

Cr. Register, January, 1997, No. 493 , eff. 8-1-97; CR 03-052 : renum. (1) (a) to be (am), am. (1) (title) and (intro.), (f), (2) (f) and (3) (a) 4., cr. (1) (j) to (L) and (2) (bm), r. (3) (a) 5. Register December 2004 No. 588 , eff. 3-1-05; corrections in (1) (e) and (h) made under s. 13.92 (4) (b) 7. , Stats., Register November 2008 No. 635 ; CR 07-102 : am. (1) (d) (intro.), 1., 2., (h), (4) (a) 3., 5. and 10. Register December 2008 No. 636 , eff. 1-1-09; 2015 Wis. Act 132 : am. (1) (e) Register February 2016 No. 722 , eff. 3-1-16.

Note

The licensee may use the department's form, Intake for Child Under 2 Years — Child Care Centers, or the licensee's own form to record information for individualizing the program of care for each child. Information on how to obtain the department's form is available on the department's website, http://dcf.wisconsin.gov , or from any regional licensing office in Appendix A. Microsoft Windows NT 6.1.7601 Service Pack 1 A quaternary ammonia product is any of a group of compounds in which a central nitrogen atom is joined to four organic radicals and one acid radical, used as antiseptics and disinfectants. Benzalkonium chloride, dimethyl benzyl ammonium chloride, and dodecyl dimethyl ammonium chloride are the names of some common ammonium compounds that might identify a product as a quaternary ammonium product. The chemical name for bleach is sodium hypochlorite. Microsoft Windows NT 6.1.7601 Service Pack 1