§ 110-91. Mandatory standards for a license.

§ 110‑91.  Mandatorystandards for a license.

All child care facilitiesshall comply with all State laws and federal laws and local ordinances thatpertain to child health, safety, and welfare. Except as otherwise provided inthis Article, the standards in this section shall be complied with by all childcare facilities. However, none of the standards in this section apply to theschool‑age children of the operator of a child care facility but do applyto the preschool‑age children of the operator. Children 13 years of ageor older may receive child care on a voluntary basis provided all applicablerequired standards are met. The standards in this section, along with any otherapplicable State laws and federal laws or local ordinances, shall be therequired standards for the issuance of a license by the Secretary under thepolicies and procedures of the Commission except that the Commission may, inits discretion, adopt less stringent standards for the licensing of facilitieswhich provide care on a temporary, part‑time, drop‑in, seasonal,after‑school or other than a full‑time basis.

(1)        Medical Care andSanitation. – The Commission for Public Health shall adopt rules whichestablish minimum sanitation standards for child care centers and theirpersonnel. The sanitation rules adopted by the Commission for Public Healthshall cover such matters as the cleanliness of floors, walls, ceilings, storagespaces, utensils, and other facilities; adequacy of ventilation; sanitation ofwater supply, lavatory facilities, toilet facilities, sewage disposal, foodprotection facilities, bactericidal treatment of eating and drinking utensils,and solid‑waste storage and disposal; methods of food preparation andserving; infectious disease control; sleeping facilities; and other items andfacilities as are necessary in the interest of the public health. TheCommission for Public Health shall allow child care centers to use domestickitchen equipment, provided appropriate temperature levels for heating,cooling, and storing are maintained. Child care centers that fry foods shalluse commercial hoods. These rules shall be developed in consultation with theDepartment.

TheCommission shall adopt rules for child care facilities to establish minimumrequirements for child and staff health assessments and medical careprocedures. These rules shall be developed in consultation with the Department.Each child shall have a health assessment before being admitted or within 30days following admission to a child care facility. The assessment shall be doneby: (i) a licensed physician, (ii) the physician's authorized agent who iscurrently approved by the North Carolina Medical Board, or comparablecertifying board in any state contiguous to North Carolina, (iii) a certifiednurse practitioner, or (iv) a public health nurse meeting the DepartmentsStandards for Early Periodic Screening, Diagnosis, and Treatment Program.However, no health assessment shall be required of any staff or child who isand has been in normal health when the staff, or the child's parent, guardian,or full‑time custodian objects in writing to a health assessment onreligious grounds which conform to the teachings and practice of any recognizedchurch or religious denomination.

Organizationsthat provide prepared meals to child care centers only are considered childcare centers for purposes of compliance with appropriate sanitation standards.

(2)        Health‑RelatedActivities. – The Commission shall adopt rules for child care facilities toensure that all children receive nutritious food and beverages according totheir developmental needs. After consultation with the State Health Director,nutrition standards shall provide for requirements appropriate for children ofdifferent ages.

Eachchild care facility shall have a rest period for each child in care after lunchor at some other appropriate time and arrange for each child in care to be out‑of‑doorseach day if weather conditions permit.

(3)        Location. – Eachchild care facility shall be located in an area which is free from conditionswhich are considered hazardous to the physical and moral welfare of thechildren in care in the opinion of the Secretary.

(4)        Building. – Eachchild care facility shall be located in a building which meets the appropriaterequirements of the North Carolina Building Code under standards which shall bedeveloped by the Building Code Council, subject to adoption by the Commissionspecifically for child care facilities, including facilities operated in aprivate residence. These standards shall be consistent with the provisions ofthis Article. A local building code enforcement officer shall approve anyproposed alternate material, design, or method of construction, provided thebuilding code enforcement officer finds that the alternate, for the purposeintended, is at least the equivalent of that prescribed in the technicalbuilding codes in quality, strength, effectiveness, fire resistance,durability, or safety. A local building code enforcement officer shall requirethat sufficient evidence or proof be submitted to substantiate any claim maderegarding the alternate. The Child Care Commission may request changes to theBuilding Code to suit the special needs of preschool children. Satisfactorilywritten reports from representatives of building inspection agencies shall berequired prior to the issuance of a license and whenever renovations are madeto a child care center, or when the operator requests licensure of space notpreviously approved for child care.

(5)        Fire Prevention. – Eachchild care facility shall be located in a building that meets appropriaterequirements for fire prevention and safe evacuation that apply to child carefacilities as established by the Department of Insurance in consultation withthe Department. Except for child care centers located on State property, eachchild care center shall be inspected at least annually by a local firedepartment or volunteer fire department for compliance with these requirements.Child care centers located on State property shall be inspected at leastannually by an official designated by the Department of Insurance.

(6)        Space and EquipmentRequirements. – There shall be no less than 25 square feet of indoor space foreach child for which a child care center is licensed, exclusive of closets, passageways,kitchens, and bathrooms, and this floor space shall provide during rest periods200 cubic feet of airspace per child for which the center is licensed. Thereshall be adequate outdoor play area for each child under rules adopted by theCommission which shall be related to the size of center and the availabilityand location of outside land area. In no event shall the minimum requiredexceed 75 square feet per child. The outdoor area shall be protected to assurethe safety of the children receiving child care by an adequate fence or otherprotection. A center operated in a public school shall be deemed to haveadequate fencing protection. A center operating exclusively during the eveningand early morning hours, between 6:00 P.M. and 6:00 A.M., need not meet theoutdoor play area requirements mandated by this subdivision.

Eachchild care facility shall provide indoor area equipment and furnishings thatare child size, sturdy, safe, and in good repair. Each child care facility thatprovides outdoor area equipment and furnishings shall provide outdoor areaequipment and furnishings that are child size, sturdy, free of hazards thatpose a threat of serious injury to children while engaged in normal playactivities, and in good repair. The Commission shall adopt standards toestablish minimum requirements for equipment appropriate for the size of childcare facility. Space shall be available for proper storage of beds, cribs,mats, cots, sleeping garments, and linens as well as designated space for each child'spersonal belongings.

TheDivision of Child Development of the Department of Health and Human Servicesshall establish and implement a policy that defines any building which iscurrently approved for school occupancy and which houses a public or privateelementary school to include the playgrounds and athletic fields as part of theschool building when that building is used to serve school‑age childrenin after‑school child care programs. Playgrounds and athletic fieldsreferenced in this section that do not meet licensure standards promulgated bythe North Carolina Child Care Commission shall be noted on the program'slicensure and rating information.

(7)        Staff‑ChildRatio and Capacity for Child Care Facilities. – In determining the staff‑childratio in child care facilities, all children younger than 13 years old shall becounted.

a.         The Commission shalladopt rules for child care centers regarding staff‑child ratios, groupsizes and multi‑age groupings other than for infants and toddlers,provided that these rules shall be no less stringent than those currentlyrequired for staff‑child ratios as enacted in Section 156(e) of Chapter757 of the 1985 Session Laws.

1.         Except as otherwiseprovided in this subdivision, the staff‑child ratios and group sizes forinfants and toddlers in child care centers shall be no less stringent than asfollows:

Age                   Ratio Staff/

                         Children                   GroupSize

0 to12 months                  1/5                             10

12 to24 months                1/6                             12

2 to3 years                       1/10                           20.

Nochild care center shall care for more than 25 children in one group. Child carecenters providing care for 26 or more children shall provide for two or moregroups according to the ages of children and shall provide separate supervisorypersonnel and separate identifiable space for each group.

2.         When any preschool‑agedchild is enrolled in a child care center and the licensed capacity of thecenter is six through 12 children, the staff‑child ratios shall be no lessstringent than as follows:

Age                                RatioStaff/Children

0 to 12 months             1/5 preschool children plus3 additional school‑aged children

12 to 24 months           1/6 preschool children plus2 additional school‑aged children.

Thefollowing shall also apply:

I.          There is nospecific group size.

II.         When only onecaregiver is required to meet the staff‑child ratio, the operator shallmake available to parents the name, address, and phone number of an adult whois nearby and available for emergency relief.

III.       Children shall besupervised at all times. All children who are not asleep or resting shall bevisually supervised. Children may sleep or rest in another room as long as acaregiver can hear them and respond immediately.

b.         Family Child CareHome Capacity. – Of the children present at any one time in a family child carehome, no more than five children shall be preschool‑aged, including theoperator's own preschool‑age children.

(8)        Qualifications forStaff. – All child care center administrators shall be at least 21 years ofage. All child care center administrators shall have the North Carolina EarlyChildhood Administration Credential or its equivalent as determined by theDepartment. All child care administrators performing administrative duties asof the date this act becomes law and child care administrators who assumeadministrative duties at any time after this act becomes law and untilSeptember 1, 1998, shall obtain the required credential by September 1, 2000.Child care administrators who assume administrative duties after September 1,1998, shall begin working toward the completion of the North Carolina EarlyChildhood Administration Credential or its equivalent within six months afterassuming administrative duties and shall complete the credential or itsequivalent within two years after beginning work to complete the credential.Each child care center shall be under the direction or supervision of a personmeeting these requirements. All staff counted toward meeting the required staff‑childratio shall be at least 16 years of age, provided that persons younger than 18years of age work under the direct supervision of a credentialed staff personwho is at least 21 years of age. All lead teachers in a child care center shallhave at least a North Carolina Early Childhood Credential or its equivalent asdetermined by the Department. Lead teachers shall be enrolled in the NorthCarolina Early Childhood Credential coursework or its equivalent as determinedby the Department within six months after becoming employed as a lead teacheror within six months after this act becomes law, whichever is later, and shallcomplete the credential or its equivalent within 18 months after enrollment.

Forchild care centers licensed to care for 200 or more children, the Department,in collaboration with the North Carolina Institute for Early ChildhoodProfessional Development, shall establish categories to recognize the levels ofeducation achieved by child care center administrators and teachers who performadministrative functions. The Department shall use these categories toestablish appropriate staffing based on the size of the center and theindividual staff responsibilities.

EffectiveJanuary 1, 1998, an operator of a licensed family child care home shall be atleast 21 years old and have a high school diploma or its equivalent. Operatorsof a family child care home licensed prior to January 1, 1998, shall be atleast 18 years of age and literate. Literate is defined as understandinglicensing requirements and having the ability to communicate with the familyand relevant emergency personnel. Any operator of a licensed family child carehome shall be the person on‑site providing child care.

Noperson shall be an operator of nor be employed in a child care facility who hasbeen convicted of a crime involving child neglect, child abuse, or moralturpitude, or who is an habitually excessive user of alcohol or who illegallyuses narcotic or other impairing drugs, or who is mentally or emotionallyimpaired to an extent that may be injurious to children.

TheCommission shall adopt standards to establish appropriate qualifications for allstaff in child care centers. These standards shall reflect training,experience, education and credentialing and shall be appropriate for the sizecenter and the level of individual staff responsibilities. It is the intent ofthis provision to guarantee that all children in child care are cared for byqualified people. Pursuant to G.S. 110‑106, no requirements may interferewith the teachings or doctrine of any established religious organization. Thestaff qualification requirements of this subdivision do not apply to religious‑sponsoredchild care facilities pursuant to G.S. 110‑106.

(9)        Records. – Eachchild care facility shall keep accurate records on each child receiving care inthe child care facility and on each staff member or other person delegatedresponsibility for the care of children in accordance with a form furnished orapproved by the Commission, and shall submit records as required by theDepartment.

Allrecords of any child care facility, except financial records, shall beavailable for review by the Secretary or by duly authorized representatives ofthe Department or a cooperating agency who shall be designated by the Secretaryand shall be submitted as required by the Department.

(10)      Each operator orstaff member shall attend to any child in a nurturing and appropriate manner,and in keeping with the child's developmental needs.

Eachchild care facility shall have a written policy on discipline, describing themethods and practices used to discipline children enrolled in that facility. Thiswritten policy shall be discussed with, and a copy given to, each child'sparent prior to the first time the child attends the facility. Subsequently,any change in discipline methods or practices shall be communicated in writingto the parents prior to the effective date of the change.

Theuse of corporal punishment as a form of discipline is prohibited in child carefacilities and may not be used by any operator or staff member of any childcare facility, except that corporal punishment may be used in religioussponsored child care facilities as defined in G.S. 110‑106, only if (i)the  religious sponsored child care facility files with the Department a noticestating that corporal punishment is part of the religious training of itsprogram, and (ii) the religious sponsored child care facility clearly states inits written policy of discipline that corporal punishment is part of thereligious training of its program. The written policy on discipline ofnonreligious sponsored child care facilities shall clearly state theprohibition on corporal punishment.

(11)      Staff Development. – TheCommission shall adopt minimum standards for ongoing staff development forfacilities but limited to the following topic areas:

a.         Planning a safe,healthy learning environment;

b.         Steps to advancechildren's physical and intellectual development;

c.         Positive ways tosupport children's social and emotional development;

d.         Strategies toestablish productive relationships with families;

e.         Strategies to managean effective program operation;

f.          Maintaining acommitment to professionalism;

g.         Observing andrecording children's behavior;

h.         Principles of childgrowth and development; and

i.          Learning activitiesthat promote inclusion of children with special needs.

Thesestandards shall include annual requirements for ongoing staff developmentappropriate to job responsibilities. A person may carry forward in‑servicetraining hours that are in excess of the previous year's requirement to meet upto one‑half of the current year's required in‑service traininghours.

(12)      DevelopmentallyAppropriate Activities. – Each facility shall have developmentally appropriateactivities and play materials. The Commission shall establish minimum standardsfor developmentally appropriate activities for child care facilities. Eachchild care facility shall have a planned schedule of developmentallyappropriate activities displayed in a prominent place for parents to review andthe appropriate materials and equipment available to implement the scheduledactivities. Each child care center shall make four of the following activityareas available daily: art and other creative play, children's books, blocksand block building, manipulatives, and family living and dramatic play.

(13)      Transportation. – Whena child care facility staff person or a volunteer of a child care facilitytransports children in a vehicle, each adult and child shall be restrained byan appropriate seat safety belt or restraint device when the vehicle is inmotion. Children may never be left unattended in a vehicle.

Theratio of adults to children in child care vehicles may not be less than thestaff/child ratios prescribed by G.S. 110‑91(7). The Commission shalladopt standards for transporting children under the age of two, includingstandards addressing this particular age's staff/child ratio duringtransportation.

(14)      Any effort to falsifyinformation provided to the Department shall be considered by the Secretary tobe evidence of violation of this Article on the part of the operator or sponsorof the child care facility and shall constitute a cause for revoking or denyinga license to such child care facility.

(15)      Safe Sleep Policy. – Operatorsof child care facilities that care for children ages 12 months or younger shalldevelop and maintain a written safe sleep policy, in accordance with rulesadopted by the Commission. The safe sleep policy shall address maintaining asafe sleep environment and shall include the following requirements:

a.         A caregiver in achild care facility shall place a child age 12 months or younger on the child'sback for sleeping, unless: (i) for a child age 6 months or younger, theoperator of the child care facility obtains a written waiver of thisrequirement from a health care professional, as defined in rules adopted by theCommission; or (ii) for a child older than 6 months, the operator of the childcare facility obtains a written waiver of this requirement from a health careprofessional, as defined in rules adopted by the Commission, a parent, or alegal guardian.

b.         The operator of thechild care facility shall discuss the safe sleep policy with the child's parentor guardian before the child is enrolled in the child care facility. Thechild's parent or guardian shall sign a statement attesting that the parent orguardian received a copy of the safe sleep policy and that the policy wasdiscussed with the parent or guardian before the child's enrollment.

c.         Any caregiverresponsible for the care of children ages 12 months or younger shall receivetraining in safe sleep practices.  (1971, c. 803, s. 1; 1973, c. 476, s. 128; 1975, c.879, s. 15; 1977, c. 1011, s. 4; c. 1104; 1979, c. 9, ss. 1, 2; 1981 (Reg.Sess., 1982), c. 1382, ss. 1, 2; 1983, c. 46, s. 2; cc. 62, 277, 612; 1985, c.757, ss. 155(h), (i), 156(c)‑(h); 1987, c. 543, s. 3; c. 788, s. 6; c.827, s. 234; 1989 (Reg. Sess., 1990), c. 1004, s. 56; 1991, c. 273, s. 5; c.640, s. 1; 1993, c. 185, s. 3; c. 321, s. 254(c); c. 513, s. 9; c. 553, s. 32;1995, c. 94, s. 32; 1997‑443, s. 11A.44; 1997‑456, s. 43.1(a); 1997‑506,s. 8(a); 1998‑217, s. 11; 1999‑130, s. 2; 2003‑407, s. 1;2007‑182, s. 2; 2009‑64, s. 1; 2009‑244, s. 1.)