Section 406.22   Children Under 30 Months of Age

a)         Children under 30 months of age shall not be permitted in bathrooms, kitchens, or other hazardous areas without the caregiver or assistant present.

b)         To minimize the risk of Sudden Infant Death Syndrome, children shall be placed on their backs when put down to sleep.

1)         When the infant cannot rest or sleep on his/her back due to a disability or illness, the caregiver shall have written instructions, signed by a physician, detailing an alternative safe sleep position and/or special sleeping arrangements for the infant.  The caregiver shall put the infant to sleep in accordance with a physician's written instructions.

2)         When an infant can easily turn over from the back to tummy position, the infant shall be put down to sleep on his/her back, but allowed to adopt whatever sleeping position the infant prefers.

3)         Infants unable to roll from their stomachs to their backs, and from their backs to their stomachs, when found facedown, shall be placed on their backs.

4)         No infant shall be put to sleep on a sofa, soft mattress, car seat or swing.

5)         When an infant is awake, the infant shall be placed on his/her tummy part of the time and observed at all times.

c)         Children under 30 months of age shall be provided a daily program that is designed to meet their needs.

1)         The caregiver shall demonstrate warm, positive feelings toward each child through actions such as hugging, patting, smiling, and cuddling.

2)         Routines such as naps and feedings shall be discussed with the parents and shall be consistent with the child's routine at home.

3)         Non-mobile children who are awake shall be moved to different positions and shall be held, rocked, and carried about.

4)         The caregiver shall frequently change the place, position, and toys available for children who cannot move about the room.

5)         Consistent toilet training shall be undertaken at a time mutually agreed upon by parent and caregiver in accordance with the child's age and/or stage of development.

6)         Children shall be taken outdoors for a portion of every day, when weather permits, except when the child is ill or unless indicated otherwise by parent or physician.

d)         Feeding schedules and procedures shall meet the developmental needs of the children.

1)         Flexible feeding schedules of children shall be established to coordinate with parents' schedules at home and to allow for nursing.

2)         Infants shall either be held or be fed sitting up for bottle feeding. Infants unable to sit shall always be held for bottle feeding.  When infants are able to hold their own non-glass bottles, they may feed themselves without being held.  The bottle must be removed when the child has fallen asleep.  Bottle propping and carrying of bottles by young children throughout the day/night shall not be permitted.

3)         Bottles shall never be warmed or defrosted in a microwave oven.

4)         Children shall be allowed and encouraged to feed themselves when they indicate a readiness to do so.

5)         Safe finger foods such as those that dissolve in the mouth may be provided.

e)         Proper standards of hygiene shall be observed in the home.

1)         Hands shall be washed with soap and running water and dried before the feeding of each child.

2)         Formula brought in by the parent shall be labeled and placed in the refrigerator.

3)         All utensils shall be washed after each use.

4)         Foods stored or prepared in jars shall be served from a separate dish for each child. Any leftovers from the serving dish shall be discarded. Leftovers in the jar shall be labeled with the child's name, dated, refrigerated, and served within 24 hours or discarded.

5)         A toilet shall be easily accessible so that the contents of reusable diapers may be disposed of before placing the diapers in the diaper pail. Disposable diapers and their contents shall be disposed of in accordance with the manufacturer's instructions.

6)         Persons changing diapers shall wash hands under running water with soap after each change of diaper.  Hands shall be dried with single-use towels.  Additionally, disposable, non-permeable gloves shall be worn when changing a child who has watery or bloody stools.

7)         The child whose diaper is being changed is to be washed on the hands and anal area if there has been defecation or if irritation is present.

8)         Children who are not toilet trained shall be diapered in their own cribs, at a central diapering area on a surface that is disinfected after each use, or on a disposable paper sheet that is disposed of after each diapering.

9)         The toilet seat, if soiled, or potty shall be cleaned with germicidal solution (see subsection (f)) after every use.

10)         Soiled diapers shall be changed promptly.

11)         Sheets shall be changed when soiled, and all sheets shall be changed routinely 2 times per week.

12)         All beds shall be wiped clean as often as necessary.

13)         Toys and equipment shall be kept clean.

f)         A germicidal solution of ¼ cup household chlorine bleach to one gallon of water (or one tablespoon bleach to one quart of water) or other germicidal solution approved by the Centers for Disease Control and Prevention shall be used to clean surfaces soiled by blood or body fluids.  The bleach solution shall be made fresh daily.

g)         The equipment must be appropriate to the developmental needs of the children in care.

1)         Safe, sturdy, well-constructed individual cribs, playpens, or port-a-cribs for infants shall be equipped with good firm, fitting mattresses made of waterproof materials that can be washed.  Washable cots may be used for children 15 months of age and over.

2)         Sleeping equipment for children under 15 months must have protection to prevent falls.

3)         There shall be no more than 1½ inches of space between the mattress and bed frame when the mattress is pushed flush at one corner of the crib.

4)         No positioning device that restricts movement within the child's bed shall be used without written instructions from the child's physician.  Soft bedding, bumpers, pillows, quilts, comforters, sheepskins, stuffed toys, laundry and other soft products shall be removed from the crib when children are napping or sleeping.  If using a blanket, put the child with feet at the foot of the crib.  Tuck a thin blanket around the crib mattress, reaching only as far as the child's chest.

5)         Bed linens used on the cots, cribs, or playpens shall be safe, tightly fitting, and washable.

6)         Conveniently located, washable, plastic-lined covered receptacles shall be provided for soiled diapers and linens.

7)         A toilet seat or potty shall be provided.

h)         The materials must be appropriate to the developmental needs of the child in care.

1)         Provision shall be made for an adequate supply of individual diapers, clothing, powder, oil, etc.

2)         There shall be a variety of toys and art materials for children under 30 months of age to observe, grasp, pick up, and manipulate.

3)         Pull toys, pounding toys, large hollow blocks, or large balls shall be available for development of large muscles.

4)         Mobile walkers are prohibited.  Stationary exercisers may be used.

i)          Equipment and play materials shall be durable and free from characteristics that may be hazardous or injurious to children under 30 months of age.  Hazardous or injurious characteristics include sharp, rough edges; toxic paint; and objects small enough to be swallowed.

(Source:  Amended at 32 Ill. Reg. 9137, effective June 20, 2008)