Issue 29 - 07-18-2024 | Kansas Department of Health and Environment | Permanent Administrative Regulations

Volume 43 - Issue 29 - July 18, 2024

State of Kansas

Department of Health and Environment

Permanent Administrative Regulations

Article 4.—MATERNAL AND CHILD HEALTH

28-4-113. Definitions. (a) “Applicant” means a person who has applied for a license but who has not yet been granted a license to operate a facility.

(b) “Applicant with a temporary permit” means a person who has applied for a license and who has been granted a temporary permit to operate a facility.

(c) “Care provider” and “provider” mean an individual who cares for and supervises children in a facility and has responsibility for the health, safety, and well-being of children, including the following:

(1) A primary care provider;

(2) an individual who is at least 16 years of age and who is working in the facility; and

(3) a substitute.

(d) “Department” means Kansas department of health and environment.

(e) “Disinfect” means full surface application of a disinfectant solution of fragrance-free, environmental protection agency (EPA)-registered chlorine bleach mixed according to the directions on the label or an alternate fragrance-free, EPA-registered disinfectant used according to the directions on the label to any inanimate object.

(f) “Evening care” means care after 6:00 p.m. and before 1:00 a.m. the following day for children enrolled at a facility and present during operating hours.

(g) “Extended absence” means time away from a facility for a period of more than three hours in a day.

(h) “Facility” means a family child care home, a day care home, or a group day care home.

(i) “Family child care home,” “day care home,” or “group day care home” means the premises on which care is provided for a maximum of 12 children under 16 years of age, with a limited number of children under five years of age as specified in K.A.R. 28-4-114(e).

(j) “Fire inspector” means a person approved by the state fire marshal to conduct fire safety inspections.

(k) “Large motor activity” means any movement involving the arms, legs, feet, or entire body, including crawling, running, and jumping.

(l) “License capacity” means the maximum number of children who are authorized to be on the premises at any one time.

(m) “Licensed physician” means an individual who is licensed to practice either medicine and surgery or osteopathy in Kansas by the Kansas state board of healing arts or who practices either medicine and surgery or osteopathy in another state and is licensed under the licensing statutes of that state.

(n) “Licensee” means a person who has been granted a license to operate a facility.

(o) “Medical record” means the immunization record, health assessment, and medical history of each child.

(p) “Overnight care” means care after 1:00 a.m. and before 6:00 a.m. the same day for children enrolled at a facility and present during operating hours.

(q) “Primary care provider” means an applicant with a temporary permit, a licensee, or the designee of an applicant with a temporary permit or a licensee. Each applicant with a temporary permit, each licensee, and each designee shall be at least 18 years of age and shall meet the requirements for a primary care provider specified in K.A.R. 28-4-114a.

(r) “Professional development training” means training approved by the secretary that is related to working with children in care.

(s) “Sanitize” means full surface application of an EPA regulated food-safe sanitizing solution or heat treatment of any inanimate object used for food preparation or service.

(t) “Small motor activity” means any movement involving the hands or fingers, including using scissors, brushing teeth, and threading beads.

(u) “Substitute” means an individual who supervises children in the temporary absence or extended absence of the primary care provider and who meets the following requirements:

(1) In the temporary absence of the primary care provider, the substitute shall be at least 16 years of age and shall meet all of the requirements specified in K.A.R. 28-4-114a.

(2) In the extended absence of the primary care provider, the substitute shall be at least 18 years of age and shall meet all of the requirements specified in K.A.R. 28-4-114a.

(v) “Temporary absence” means time away from a facility for a period not to exceed three hours in a day.

(w) “Tobacco product” means any product that is made or derived from tobacco, or that contains nicotine, that is intended for human absorption, inhalation, or ingestion, including by consuming or using a cigarette, cigar, pipe, chewing tobacco, snuff, snus, or vape device.

(x) “Use zone” means the surface under and around a piece of equipment onto which a child falling from or exiting the equipment would be expected to land.

(y) “Visual motor activity” means any movement involving the coordination of hand or body movements with vision, including drawing, throwing items, or catching items.

(z) “Weapons” means any of the following:

(1) Firearms;

(2) ammunition;

(3) air-powered guns, including BB guns, pellet guns, and paint ball guns;

(4) hunting and fishing knives;

(5) archery equipment; or

(6) martial arts equipment. (Authorized by K.S.A. 65-508; implementing K.S.A. 65-503 and K.S.A. 65-508; effective, E-80-18, Oct. 17, 1979; effective May 1, 1980; amended May 1, 1981; amended May 1, 1983; amended May 1, 1984; amended May 1, 1985; amended Feb. 26, 1990; amended Feb. 3, 2012; amended Aug. 2, 2024.)

28-4-114. Applicant; licensee. (a) Application process.

(1) Any person desiring to operate a facility shall apply for a license on forms provided by the department.

(2) Each applicant and each licensee shall submit the fee specified in K.A.R. 28-4-92 for a license or for the renewal of a license. The applicable fee shall be submitted at the time of license application or renewal and shall not be refundable.

(3) The granting of a license to any applicant or applicant with a temporary permit may be refused by the secretary if the applicant or applicant with a temporary permit is not in compliance with the applicable requirements of the following:

(A) K.S.A. 65-504 through 65-506, and amendments thereto;

(B) K.S.A. 65-508, and amendments thereto;

(D) K.S.A. 65-530 and 65-531, and amendments thereto; and

(E) all regulations governing facilities.

(4) Failure to submit the application forms and fee for renewal of a license shall result in an assessment of a late fee pursuant to K.S.A. 65-505, and amendments thereto, and may result in closure of the facility.

(b) Applicant and licensee requirements. Each applicant, if an individual, and each licensee, if an individual, shall meet the following requirements:

(1) Be at least 18 years of age;

(2) not be involved in child care or a combination of child care and other employment for more than 18 hours in a 24-hour period; and

(3) not be engaged in either business or social activities that interfere with the care or supervision of children.

(1) Each applicant with a temporary permit and each licensee who operates more than one child care facility, as defined in K.S.A. 65-503, and amendments thereto, shall maintain each child care facility as a separate entity.

(2) A license for an additional child care facility shall not be granted until all existing child care facilities for which the licensee has been granted a license are in compliance with licensing regulations.

(d) Multiple licenses. No licensee shall be licensed concurrently for or provide more than one type of child care or child and adult care on the same premises.

(e) Maximum group size for family child care homes. Each applicant with a temporary permit and each licensee shall ensure that the requirements of this subsection are met.

(1) The maximum group size for a family child care home shall be the following:

TABLE I – MAXIMUM GROUP SIZE, ONE PROVIDER
Maximum Number of Children Under 12 Months	Maximum Number of Children at Least 12 Months but Under 5 Years of Age	Maximum Number of Children at Least 5 Years but Under 10 Years of Age	Maximum Group Size
0	8	2	10
1	6	3	10
2	5	2	9
3	3	2	8

TABLE II – MAXIMUM GROUP SIZE, ONE PROVIDER
Ages of Children Enrolled	Maximum Group Size
At Least 2.5 Years but Under 10 Years of Age	10
At Least 3 Years but Under 10 Years of Age	11
At Least 5 Years but Under 10 Years of Age	12

TABLE III – MAXIMUM GROUP SIZE, TWO PROVIDERS*
Maximum Number of Children Under 12 Months	Maximum Number of Children at Least 12 Months but Under 5 Years of Age	Maximum Number of Children at Least 5 Years but Under 10 Years of Age	Maximum Group Size*
0	10	2	12
1	9	2	12
2	8	2	12
3	7	2	12
4	5	3	12
5	4	3	12
*A second provider shall be present when the number of children exceeds the maximum number allowed for one provider. See Table I.

(2) If the ages of children enrolled are at least 2.5 years but under 10 years of age, the maximum group size for two providers is 12.

(3) Children at least 10 years of age but under 16 years of age unrelated to the provider on the premises for the purpose of receiving child care in the facility shall be included in the maximum group size if child care for this age group as a whole exceeds five hours a week.

(f) Developmental levels. Any child who does not function according to age-appropriate expectations shall be counted in the age group that reflects the developmental age level of the child.

(g) License capacity not exceeded. Each applicant with a temporary permit and each licensee shall ensure that the total number of children on the premises, including children under 10 years of age related to the applicant with a temporary permit, the licensee, or any other provider, does not exceed the license capacity, except for additional children permitted in subsection (i).

(h) Group size not exceeded. Except as provided by subsection (i), each applicant with a temporary permit and each licensee shall ensure the following requirements are met:

(1) The maximum number of children in each age category, including children under 10 years of age related to the applicant with a temporary permit, the licensee, or any other provider, does not exceed the maximum number of children in each age category as specified in subsection (e), except as specified in paragraph (h)(3).

(2) The total number of children on the premises, including children under 10 years of age related to the applicant with a temporary permit, the licensee, or any other provider, does not exceed the maximum group size based on the age of the youngest child present and the number of providers present as specified in subsection (e).

(3) For each child under five years of age not in attendance, the maximum number of children ages five and older may be increased by one. The total number of children in attendance shall not exceed the maximum group size.

(i) Additional children on the premises. In addition to the number of children permitted under the terms of the temporary permit or the license and specified in subsection (e), other children may be permitted on the premises.

(1) Not more than two additional children 2.5 years of age or older who attend part-day preschool or part-day kindergarten may be present at any time between the hours of 11:00 a.m. and 1:00 p.m. for the noon meal on days that school is in session.

(2) Not more than two additional children at least five years of age but under 10 years of age may be present between the hours of 6:00 a.m. and 6:00 p.m. The additional children may be present as follows:

(A) During the academic school year before and after school, in-service days, school holidays, scheduled or emergency closures, and school breaks not to exceed two consecutive weeks; and

(B) during the two consecutive weeks before the opening of the academic school year in August or September and following the end of the academic school year in May or June.

(3) Not more than two additional children 10 years of age or older, unrelated to the applicant with a temporary permit or the licensee, may be present for not more than two hours a day during child care hours if all of the following conditions are met:

(A) The additional children are not on the premises for the purpose of receiving child care in the facility.

(B) The additional children are visiting the applicant’s or the licensee’s own child or children.

(j) Substitute. Each applicant with a temporary permit and each licensee shall arrange for a substitute to care for children in the event of a temporary absence or extended absence of the primary care provider.

(k) Posting of temporary permit or license and availability of regulations. Each applicant with a temporary permit and each licensee shall post any temporary permit or license conspicuously as required by K.S.A. 65-504, and amendments thereto. A copy of the current regulations governing facilities shall be kept on the premises and shall be available to all providers at all times.

(l) Closure. Any applicant may withdraw the application for a license. Any applicant with a temporary permit and any licensee may submit, at any time, a request to close the facility. If an application is withdrawn or a facility is closed, any temporary permit or license granted to the applicant or licensee for that facility shall become void. (Authorized by K.S.A. 65-508; implementing K.S.A. 65-504, K.S.A. 65-505, and K.S.A. 65-508; effective, E-80-18, Oct. 17, 1979; effective May 1, 1980; amended May 1, 1981; amended May 1, 1983; amended May 1, 1984; amended May 1, 1985; amended Feb. 26, 1990; amended Feb. 3, 2012; amended Aug. 2, 2024.)

28-4-114a. Initial and ongoing professional development training. If an applicant, an applicant with a temporary permit, or a licensee is not an individual, the applicant, applicant with a temporary permit, or licensee shall designate an individual to meet the requirements of this regulation.

(a) Orientation.

(1) Each person shall, before applying for a license, complete an orientation program on the requirements for operating a facility, provided by the secretary’s designee that serves the county in which the facility will be located.

(2) Each applicant, each applicant with a temporary permit, and each licensee shall provide orientation to each provider about the policies and practices of the facility, including duties and responsibilities for the care and supervision of children enrolled. Each provider shall complete the orientation before the provider is given sole responsibility for the care and supervision of children. The orientation shall include the following:

(A) Licensing regulations;

(B) the policies and practices of the facility, including emergency procedures, behavior management, and discipline;

(D) care and supervision of children in care, including any special needs and known allergies;

(E) health and safety practices; and

(F) confidentiality.

(b) Health and safety training. Each applicant, each applicant with a temporary permit, each licensee, and each provider shall complete health and safety training approved by the secretary.

(1) Each applicant and each applicant with a temporary permit shall complete the training not later than 30 calendar days after submitting an application for a license.

(2) Each provider shall complete the training before the date of employment or not later than 30 calendar days after the date of employment. Each provider shall complete the training before being given sole responsibility for the care and supervision of children.

(3) The health and safety training shall include the following subject areas:

(A) Recognizing the signs of child abuse or neglect, knowledge on the prevention of child maltreatment, shaken baby syndrome and abusive head trauma, and the reporting of suspected child abuse or neglect;

(B) basic child development, including:

(i) supervision of children;

(ii) cognitive, social, emotional, physical development; and

(iii) approaches to learning;

(D) recognizing when a child is ill and prevention and control of infectious diseases, including immunizations;

(E) prevention of and response to emergencies due to food and allergic reactions;

(F) building and premises safety, including identification of and protection from hazards that could cause bodily injury, including electrical hazards, bodies of water, and vehicular traffic;

(G) emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event, including violence at a facility;

(H) handling and storage of hazardous materials and the appropriate disposal of bio-contaminants, including blood and other bodily fluids or waste;

(I) precautions when transporting children, if transportation is provided; and

(J) medication administration training.

(c) Pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) certifications. Each applicant, each applicant with a temporary permit, each licensee, and each provider shall obtain certification in pediatric first aid and pediatric CPR as specified in this subsection.

(1) Certifications shall include a practical application component and be demonstrated in front of an instructor certified by a nationally recognized first aid and CPR training organization.

(2) Each applicant and each applicant with a temporary permit shall obtain the certifications not later than 30 calendar days after submitting an application for a license.

(3) Each provider shall obtain the certifications before the date of employment or not later than 30 calendar days after the date of employment.

(4) Each individual required to obtain the certifications shall maintain current certifications.

(5) Each applicant with a temporary permit and each licensee shall ensure that at least one provider who has current certification in pediatric first aid and current certification in pediatric CPR is present at all times.

(d) Annual professional development training requirements.

(1) For purposes of this subsection, “licensure year” shall mean the period beginning on the effective date and ending on the expiration date of a license.

(2) In each licensure year, each provider shall complete 16 clock-hours of professional development training. Four of the 16 clock-hours shall include the subject areas specified in paragraphs (b)(3)(A), (b)(3)(C) through (J), or subsection (c).

(e) Documentation. Documentation of all orientation, training, and certifications for each individual shall be kept in that individual’s file in the facility. (Authorized by and implementing K.S.A. 65-508; effective Feb. 3, 2012; amended May 12, 2017; amended Aug. 2, 2024.)

28-4-115. Facility. (a) Water supply and sewerage systems. Each applicant, each applicant with a temporary permit, and each licensee shall ensure that public water and sewerage systems, where available, are used. If a nonpublic source for the water supply is used, the water shall be safe for drinking and shall be tested annually by a department-certified laboratory. If a well is used, the well shall be approved by the local authority for private well permitting, the department, or a licensed water well contractor. A copy of the test results and the approval shall be kept on file at the facility. Each private sewerage system shall be maintained in compliance with all applicable state and local laws.

(b) Drinking water for children under 12 months of age. If children under 12 months of age are enrolled in a facility using water from a nonpublic source, including private well water, commercially bottled drinking water shall be purchased and used until a laboratory test confirms that the nitrate content of the private well water is not more than 10 milligrams per liter (10 mg/l) as nitrogen.

(c) General environmental requirements. Each facility shall have 25 square feet of available play space per child and shall be constructed, arranged, and maintained to provide for the health and safety of children in care. Each applicant, each applicant with a temporary permit, and each licensee shall ensure that the facility meets the following requirements:

(1) Has walls that are in good condition;

(2) is skirted and anchored if a mobile home;

(3) has a 2A 10B:C fire extinguisher;

(4) has a working smoke detector on each level of the facility;

(5) is uncluttered, visibly clean, and free from any evidence of vermin infestation and any objects or materials that constitute a danger to children in care;

(6) has kitchen and outdoor trash and garbage in covered containers or in tied plastic bags;

(7) meets all of the following requirements for each heating appliance:

(A) Has a protective barrier for each freestanding heating appliance to protect from burns; and

(B) has each heating appliance using combustible fuel vented to the outside;

(8) has each electrical outlet covered or inaccessible to prevent easy access by a child when the outlet is not in use;

(9) has any power strip or extension cord positioned in a manner that prevents a tripping or shock hazard;

(10) has each stairway with more than two stairs railed;

(11) if any children under 2.5 years of age are in care, meets all of the following requirements:

(A) Has each stairway equipped with balusters not more than four inches apart or guarded to prevent a child’s head or body from falling through;

(B) has each stairway guarded by a secured door or gated to prevent unsupervised access by the child, including a latching device that an adult can open readily in an emergency;

(D) does not have a pressure gate at the top of any stairway;

(12) has a readily available second means of escape from the first floor;

(13) has each lockable interior door designed to permit the door to be unlocked from either side in case of an emergency;

(14) is maintained at a temperature of not less than 65 degrees Fahrenheit and not more than 85 degrees Fahrenheit in the play area;

(15) does not have any window coverings with strings or cords accessible to children in care;

(16) has at least one bathroom with at least one sink and one flush toilet. All fixtures shall be in working order at all times. An individual towel and washcloth or disposable products shall be provided for each child. The use of common towels shall be prohibited. Hand soap shall be readily accessible in each bathroom; and

(17) has interior and exterior surfaces of the facility that are free from peeling, chipping, cracking, scaling, and loose paint.

(d) Fire safety. Each facility shall be approved for fire safety by a fire inspector.

(e) Basements and other floors. A basement or a second floor used for child care in a facility shall be approved for fire safety by a fire inspector before use. A third floor shall not be used for child care.

(f) Refrigerator. A refrigerator shall be available for the storage of perishable foods. Refrigerated medications shall be in a locked box.

(g) Storage, handling, and disposal of hazardous items. The following hazardous items shall be safely stored, handled, and disposed:

(1) All household supplies, cleaning supplies, dangerous chemicals, and all bodily care products containing alcohol or bearing warning labels to keep out of reach of children shall be in locked storage or stored out of reach of children under six years of age. Soap used for hand washing may be kept unlocked and placed on the back of the counter by a sink.

(2) All medications shall be in locked storage or stored out of the reach of children under 10 years of age.

(3) Chemicals and cleaning supplies shall be used and disposed of in accordance with the product safety label.

(4) Sharp instruments shall be stored in drawers or cabinets equipped with childproof devices to prevent access by children or stored out of reach of children.

(5) Tobacco products, ashtrays, lighters, and matches shall be stored out of reach of children.

(h) Storage of weapons. No child in care shall have access to weapons. All weapons shall be stored in a locked room, closet, container, or cabinet. Ammunition shall be kept in locked storage separate from other weapons.

(i) Outdoor play area. The designated area for outdoor play and large motor activities on the premises shall meet all of the following requirements:

(1) The outdoor play area shall be fenced if the play area adjoins that of another child care facility, as defined in K.S.A. 65-503, and amendments thereto, or if the area surrounding, or the conditions existing outside, the play area present hazards that could be dangerous to the safety of the children, which may include any of the following:

(A) A fish pond or a decorative pool containing water;

(B) railroad tracks; or

(2) Outdoor play equipment that is safely constructed and in good repair shall be available and placed in an area free of health, safety, and environmental hazards.

(3) The use of a trampoline shall be prohibited during the hours of operation of the facility. If a trampoline is on the premises, the trampoline shall be made inaccessible to children during the facility’s hours of operation.

(4) Climbing equipment and swings shall be either anchored in the ground with metal straps or pins or set in cement, to prevent movement of the equipment and swings.

(5) All surfaces under and around climbing equipment and swings shall meet the following requirements:

(A) Impact-absorbent surfacing material shall be installed in each use zone under and around anchored equipment over four feet in height, including climbing equipment, slides, and swings.

(B) Impact-absorbent surfacing material shall consist of material intended for playground use, including shredded bark mulch, wood chips, fine sand, fine gravel, shredded rubber, unitary surfacing material, or synthetic impact material.

(C) Hard-surfacing materials, including asphalt and concrete, shall not be used in any use zone. Hard-packed dirt shall be covered with an impact-absorbent surfacing material as specified in paragraph (i)(5)(B). This requirement shall apply regardless of the height of the climbing equipment, slides, and swings.

(D) Surfaces made of loose material shall be maintained by replacing, leveling, or raking the material.

(6) Swings shall not have wooden or metal seats.

(7) Teeter-totters and merry-go-rounds designed for school-age children shall not be used by children under five years of age.

(j) Each facility licensed on and after March 1, 2012 shall have a designated area for outdoor play and large motor activities as part of the licensed premises. (Authorized by K.S.A. 65-508; implementing K.S.A. 65-508 and K.S.A. 65-530; effective, E-80-18, Oct. 17, 1979; effective May 1, 1980; amended May 1, 1981; amended May 1, 1983; amended May 1, 1984; amended May 1, 1986; amended May 1, 1987; amended Feb. 26, 1990; amended Feb. 3, 2012; amended Aug. 2, 2024.)

28-4-116. Daily care of children. (a) Daily activities.

(1) Each applicant with a temporary permit and each licensee shall provide daily activities that promote healthy growth and development, take into consideration the cultural background and traditions that are familiar to the children, and incorporate both indoor and outdoor activities that are appropriate for the ages and developmental levels of the children in care.

(2) Each child shall be offered a choice of activities and the opportunity to participate. Age-appropriate toys, play equipment, books, and other learning materials shall be available in sufficient quantities to allow each child a choice of activities.

(3) The activities, supplies, and equipment shall be designed to promote the following:

(A) Large, small, and visual motor development, which may include running, climbing, jumping, grasping objects, drawing, buttoning, and tying;

(B) creative expression, which may include dramatic play, music, and art;

(D) language development and literacy, which may include reading, singing, finger plays, writing, and stories.

(4) Each child shall be given the opportunity for at least one hour of physical activity daily, either outdoors as described in paragraph (a)(7) or indoors.

(5) Each applicant with a temporary permit and each licensee shall ensure that the following requirements are met if the daily activities include any media viewing:

(A) Each media program shall be age-appropriate and, if rated, shall have a rating appropriate for the ages and developmental levels of the children who view the program.

(B) No child shall be required to participate in media viewing. Each child not engaged in media viewing shall be offered a choice of at least one other activity for that time period.

(6) Toys and other items used by children shall meet the following requirements:

(A) Be clean, of safe construction, and in good repair;

(B) be washed and sanitized daily when used by children under 18 months of age; and

(7) Unless prohibited by the child’s medical condition or extreme weather conditions, each child in care shall be taken outdoors daily. Each child 12 months of age or older shall have the opportunity for at least one hour of outdoor play daily.

(b) Self-help and personal care. Each provider shall ensure that each child is assisted as needed with hand washing, toileting, dressing, and other personal care.

(c) Tobacco products. No provider shall use tobacco products while providing direct physical care to children. Smoking in any room, enclosed area, or other enclosed space on the premises shall be prohibited when children are in care pursuant to K.S.A. 65-530, and amendments thereto.

(d) Nutrition and food service. Each applicant with a temporary permit and each licensee shall develop and implement menu plans for meals and snacks that contain a variety of healthful foods, including fresh fruits, fresh vegetables, whole grains, lean meats, and low-fat dairy products.

(1) If children under 18 months of age are in care, the following requirements shall be met:

(A) Each child shall be held when bottle-fed until the child can hold the child’s own bottle.

(B) No child shall be allowed to sleep with a bottle in the child’s mouth.

(i) Each bottle that contains prepared formula shall be stored in the refrigerator with the nipple covered.

(ii) Each bottle shall be labeled with the child’s name, the contents, and the time and date prepared, and shall be used within 24 hours of the time of preparation on the label.

(iii) If a child does not finish a bottle, the contents of the bottle shall be discarded within one hour from when the feeding from that bottle started.

(D) If breast milk is used, the following requirements shall be met:

(i) All breast milk shall be labeled with the child’s name and the time and date expressed.

(ii) Unfrozen breast milk shall be stored in a refrigerator and shall be used within 96 hours from the time it was expressed.

(iii) Frozen breast milk shall be stored in a freezer and shall be used within six months

from the time it was expressed and within 24 hours from the time it was thawed.

(iv) If a child does not finish the bottle of breast milk within two hours from when the feeding from that bottle started, the contents shall be discarded.

(v) Accommodations shall be provided that enable the child’s parent to breastfeed their child.

(E) No formula or breast milk shall be heated in a microwave oven.

(F) Solid foods shall be offered when the provider and the parent or legal guardian of the child determine that the child is ready for solid foods. Opened containers of solid foods shall be labeled with the child’s name, the contents, and the date opened. Containers shall be covered and stored in the refrigerator.

(2) Each applicant with a temporary permit and each licensee shall serve nutritious meals and snacks based on the amount of time a child is in care.

(A) Each child who is in care at least 2.5 hours but under four hours shall be served at least one snack.

(B) Each child who is in care at least four hours but under eight hours shall be served at least one snack and at least one meal.

(C) Each child who is in care at least eight hours but under 10 hours shall be served at least two snacks and one meal or at least one snack and two meals.

(D) Each child who is in care for 10 or more hours shall be served at least two meals and at least two snacks.

(3) Each applicant with a temporary permit and each licensee shall include the following items in meals and snacks:

(A) Breakfast shall include the following:

(i) A fruit, vegetable, full-strength fruit juice, or full-strength vegetable juice;

(ii) bread or grain product; and

(iii) milk.

(B) Noon and evening meals shall include one item from each of the following:

(i) Meat or a meat alternative;

(ii) two vegetables or two fruits, or one vegetable and one fruit;

(iii) bread or a grain product; and

(iv) milk.

(i) Milk;

(ii) fruit, vegetable, full-strength fruit juice, or full-strength vegetable juice;

(iii) meat or a meat alternative; or

(iv) bread or grain product.

(D) For snacks, juice shall not be served when milk is served as the only other item.

(4) A sufficient quantity of food shall be prepared for each meal to allow each child to have a second portion of bread, milk, and either vegetables or fruits.

(5) Drinking water shall be available to each child at all times when the child is in care.

(6) All milk products served shall be pasteurized.

(7) If a fruit juice or a vegetable juice is served, the juice shall be pasteurized and full-strength.

(8) If any child has a food allergy or special dietary need, the provider and the parent or legal guardian of the child shall make arrangements for the provision of alternative foods or beverages.

(9) If meals are catered or delivered from an off-site location, the following requirements shall be met:

(A) Food provided from a central kitchen or vendor and delivered to the facility shall be obtained from a source licensed or inspected by the Kansas department of agriculture or equivalent food safety licensing agency in another state.

(B) Food shall be transported in covered and temperature-controlled containers and shall not be allowed to stand. Hot foods shall be maintained at not less than 140 degrees Fahrenheit, and cold foods shall be maintained at 45 degrees Fahrenheit or less.

(10) Meals and snacks shall be served to each child using individual tableware that is appropriate for the food or beverage being served. Food shall be served on tableware appropriate for that food and shall not be served directly on a bare surface, including a tabletop.

(11) Tableware shall be washed, rinsed, and air-dried or placed in a dishwasher after each meal.

(12) Sanitary methods of food handling and storage shall be followed.

(13) A washable or disposable towel and washcloth shall be provided for each child. (Authorized by K.S.A. 65-508; implementing K.S.A. 65-508 and K.S.A. 65-530; effective, E-80-18, Oct. 17, 1979; effective May 1, 1980; amended May 1, 1981; amended May 1, 1983; amended May 1, 1985; amended May 1, 1987; amended Feb. 26, 1990; amended Feb. 3, 2012; amended Aug. 2, 2024.)

28-4-116a. Napping and sleeping. (a) Rest period. Each child shall have a daily, supervised rest period as needed. Each child who does not nap or sleep shall be given the opportunity for quiet play.

(b) Safe sleep practices for children in care.

(1) Each applicant with a temporary permit and each licensee shall develop a written plan for safe sleep practices and implement safe sleep practices for children in care who are napping or sleeping.

(2) Each applicant with a temporary permit and each licensee shall ensure that the safe sleep practices are shared with the parent or legal guardian of each child before the first day of care.

(3) Each provider shall follow the safe sleep practices of the facility.

(4) Each child who is 12 months of age or older shall nap or sleep on a bed, a cot, the lower bunk of a bunk bed, or a pad over a carpet or area rug on the floor.

(5) Children under 12 months of age. Each applicant with a temporary permit and each licensee shall ensure that all of the following requirements are met for each child in care who is under 12 months of age:

(A) The child shall nap or sleep in a crib or a playpen. Stacking cribs or bassinets shall not be used. Cribs with water-bed mattresses shall not be used.

(B) If the child falls asleep on a surface other than a crib or playpen, the child shall be moved to a crib or playpen.

(C) A crib or playpen shall be provided and used for each child in attendance at any one time. The child shall not nap or sleep in the same crib or playpen occupied by another child at the same time.

(D) The child shall be placed on the child’s back to nap or sleep.

(E) When the child is able to turn over independently from front to back and back to front, the child shall be placed on the child’s back but then shall be allowed to remain in a position preferred by the child. Wedges or infant positioners shall not be used.

(F) The child shall sleep in a crib or a playpen that is free of any soft items, including pillows, quilts, blankets, bumpers, comforters, sheepskins, flat sheets, cloth diapers, bibs, stuffed animals, and toys.

(G) The child may nap or sleep in sleep clothing, including sleepers and sleep sacks. Swaddling shall not be permitted.

(c) Napping or sleeping surfaces. Each applicant with a temporary permit and each licensee shall ensure that the following requirements are met for all napping or sleeping surfaces:

(1) Clean, individual bedding shall be provided for each child.

(2) Each surface used for napping or sleeping shall be kept clean, of safe construction, and maintained in good repair.

(3) Each crib and each playpen shall be used only for children who meet the manufacturer’s recommendations for use, including any age, height, or weight limitations. The manufacturer’s instructions for use, including any recommendations for use, shall be kept on file at the facility.

(4) Each crib and each playpen shall have a firm, tightfitting mattress and a fitted sheet.

The mattress shall be set at its lowest point when any child using the crib or playpen becomes able either to sit up or to pull up to a standing position inside the crib or playpen, whichever occurs first, to ensure that the child cannot climb out of the crib or playpen.

(5) If a crib or playpen is slatted, the slats shall be spaced not more than 2.375 inches apart.

(6) Each applicant, each applicant with a temporary permit, and each licensee shall ensure that no crib purchased before June 28, 2011 is in use in the facility.

(7) Each pad used for napping or sleeping shall be at least 0.5 inch thick, washable or enclosed in a washable cover, and long enough so that the child’s head and feet rest on the pad. Clean, individual bedding, including a bottom and a top cover, shall be provided for each child.

(8) Cribs, cots, playpens, and pads, when in use for napping or sleeping, shall be separated by at least 24 inches in all directions except when bordering on the wall.

(9) When not in use, cribs, cots, playpens, pads, and bedding shall be stored in a clean and sanitary manner.

(10) There shall be a complete change of bedding after each five uses, immediately when wet or soiled, and always upon a change in the child utilizing the sleeping surface.

(d) Consumer warning or recall. Each applicant with a temporary permit and each licensee shall make any necessary changes to follow the recommendations of any consumer warning or recall of a crib or a playpen as soon as the warning or recall is known.

(e) Transition from crib or playpen. The determination of when a child who is 12 months of age or older is ready to transition from a crib or a playpen to another napping or sleeping surface shall be made by the parent or legal guardian of the child and by either the applicant with a temporary permit or the licensee. The requirements of paragraphs (c)(3) and (4) for a child using a crib or playpen shall apply. (Authorized by and implementing K.S.A. 65-508; effective Feb. 3, 2012; amended Aug. 2, 2024.)

28-4-117. Health care requirements for children under 16 years of age and recordkeeping. (a) A completed medical record on the form provided by the department shall be on file for each child under 10 years of age enrolled for care and for each child under 16 years of age living in the child care facility and shall include the following:

(1) The results of a health assessment conducted by a nurse approved to perform health assessments, a licensed physician, or physician assistant. The health assessment shall be conducted not more than twelve months before and obtained not later than 60 calendar days after the child’s initial enrollment in a child care facility and;

(2) a medical history obtained from the parent or legal guardian. Each applicant with a temporary permit and each licensee shall review with each child’s parent or legal guardian that child’s medical history at least once every 12 months.

(b) A child under 16 years of age shall not be required to have routine tuberculin tests.

(c) Immunizations for each child, including each child of the provider under 16 years of age shall be current as medically appropriate and shall be maintained current for protection from the diseases specified in K.A.R. 28-1-20(d). A record of each child’s immunizations shall be obtained not later than 60 calendar days after the child’s initial enrollment in a child care facility and shall be maintained on the child’s medical record.

(d) Exceptions to the requirements for immunizations shall be permitted as specified in K.S.A. 65-508, and amendments thereto. Documentation of each exception shall be maintained on file at the facility.

(e) If an infant who has not been immunized against measles, mumps, rubella, and varicella because of the age of that child is enrolled and there are children in care who have not had measles, mumps, rubella, and varicella immunizations due to an exception, including the children of the provider, the parents of the infant at risk shall sign a statement that the parents have been informed of the risk to their child. This statement shall be in the infant’s file at the facility.

(f) If a child is moved to a different child care facility, a new health assessment shall not be required if the previous health assessment is available.

(g) Each applicant with a temporary permit and each licensee shall provide information to parents of children about the benefits of annual well-child health assessments for children under the age of six years and biennial health assessments for children six years of age and older. Each applicant with a temporary permit and each licensee shall also provide information about the importance of seeking medical advice when children exhibit health problems. This information shall be given on a form provided by the department to the parent when the child is enrolled or be posted in a conspicuous place, with copies of the form available to parents on request.

(h) Recordkeeping. Each applicant with a temporary permit and each licensee shall ensure that a file is maintained for each child. Each file shall include the following information:

(1) The full name, home and business addresses, and telephone numbers of the child’s parent or parents or legal guardian and the name, address, and telephone number of the individual to notify in case of emergency;

(2) the full name and telephone number of each individual authorized to remove the child from the facility;

(3) a medical record as required by K.A.R. 28-4-117(a); and

(4) written permission from the parent or legal guardian for emergency medical care and for the child to go off the premises as required by K.A.R. 28-4-124 and 28-4-127(b)(1)(A) and (B). (Authorized by K.S.A. 65-508; implementing K.S.A. 65-507 and 65-508; effective, E-80-18, Oct. 17, 1979; effective May 1, 1980; amended May 1, 1981; amended, T-83-27, Sept. 22, 1982; amended May 1, 1983; amended May 1, 1984; amended May 1, 1985; amended May 1, 1986; amended Feb. 26, 1990; amended July 11, 2008; amended Aug. 2, 2024.)

28-4-118. Reporting suspected child abuse or neglect. Each provider shall report to the Kansas department for children and families or to law enforcement any suspected child abuse or neglect within 24 hours. (Authorized by and implementing K.S.A. 65-508; effective, E-80-18, Oct. 17, 1979; effective May 1, 1980; amended May 1, 1981; amended May 1, 1983; amended May 1, 1986; amended Feb. 26, 1990; amended May 12, 2017; amended Aug. 2, 2024.)

28-4-122. Requirements and definitions for general regulations. (a) Requirements. The requirements of K.A.R. 28-4-123 through 28-4-133 shall apply to the following:

(1) Family child care home, day care home, or group day care home as defined in K.A.R. 28-4-113;

(2) preschool and child care center as defined in K.A.R. 28-4-420; and

(3) residential center and group boarding home as defined in K.A.R. 28-4-268.

(b) Definitions. For the purposes of K.A.R. 28-4-123 through K.A.R. 28-4-133, the following definitions shall apply:

(1) “Animal” means any living creature, other than a human being, that has the ability to move voluntarily, including any mammal, rodent, fish, reptile, spider, insect, and bird.

(2) “Applicant” means a person who has applied for a license but has not yet been granted a license to operate a facility, residential center, or group boarding home.

(3) “Applicant with a temporary permit” means a person who has applied for a license and who has been granted a temporary permit to operate a facility, residential center, or group boarding home.

(4) “Department” means Kansas department of health and environment.

(5) “Disinfect” means full surface application of a disinfectant solution of fragrance-free, environmental protection agency (EPA)-registered chlorine bleach mixed according to the directions on the label or an alternate fragrance-free, EPA-registered disinfectant used according to the directions on the label to any inanimate object.

(6) “Facility” means a family child care home, day care home, group day care home, a preschool, or a child care center, but shall not include a residential center or group boarding home.

(7) “Licensee” means a person who has been granted a license to operate a facility, residential center, or group boarding home.

(8) “Pool” means any fixture or structure designed or utilized to hold water for swimming, wading, recreation, exercise, therapeutics, bathing, or any other purpose. The definition of pool shall not include indoor bath tubs or fully enclosed containers used to store water.

(9) “Primary care provider” means an applicant with a temporary permit, a licensee, or the designee of an applicant with a temporary permit or a licensee. Each applicant with a temporary permit, each licensee, and each designee shall be at least 18 years of age and shall meet the requirements for a primary care provider specified in K.A.R. 28-4-114a.

(10) “Program director” means an individual in a child care center or preschool who meets the requirements specified in K.A.R. 28-4-429(b) or (c) and who is responsible for implementing and supervising the program.

(11) “Provider” means an individual who cares for and supervises children in a family child care home and has responsibility for the health, safety, and well-being of children, including the following:

(A) A primary care provider;

(B) an individual who is at least 16 years of age and who is working in the family child care home; and

(12) “Regularly volunteering” means working in a facility without compensation on a recurring basis. This term shall not apply to guest speakers or to individuals who make one or more presentations on a specific subject.

(13) “Sanitize” means full surface application of an EPA regulated food-safe sanitizing solution or heat treatment of any inanimate object used for food preparation or service.

(14) “Secretary” means secretary of the Kansas department of health and environment or the secretary’s designee.

(15) “Shelter-in-place area” means a designated location in the facility to which children and others may relocate in an emergency.

(16) “Staff member” means an employee, a substitute, or a volunteer in a facility, a residential center, or a group boarding home.

(17) “Substitute” means an individual who supervises children in the temporary or extended absence of an employee or volunteer.

(18) “Tobacco product” means any product that is made or derived from tobacco, or that contains nicotine, that is intended for human absorption, inhalation, or ingestion, including by consuming or using a cigarette, cigar, pipe, chewing tobacco, snuff, snus, or vape device.

(19) “Volunteer” means an individual 14 years of age or older who is working in the facility without compensation. (Authorized by and implementing K.S.A. 65-508; effective, T-86-46, Dec. 18, 1985; effective May 1, 1986; amended March 28, 2008; amended Aug. 2, 2024.)

28-4-123. Parental access. (a) Each parent and each legal guardian of a child enrolled in a facility shall have access to the premises during all hours of operation. Each residential center and group boarding home shall develop a plan for parental visitation in cooperation with the legal custodian if different from the parent.

(b) If video cameras are used in a facility for the purpose of monitoring children’s activities or to provide remote visual access to parents and legal guardians, each applicant with a temporary permit and each licensee shall ensure that the following requirements are met:

(1) The parent or legal guardian of each child in care shall be informed in writing that cameras are used in the facility.

(2) All staff members shall be informed if cameras are used.

(3) The use of cameras shall not replace any requirements for supervision of children in care.

(4) Each applicant with a temporary permit and each licensee shall give the secretary’s designee access to video camera recordings and viewing privileges for the purpose of investigating compliance. (Authorized by K.S.A. 65-508; implementing K.S.A. 65-508 and K.S.A. 65-512; effective, T-86-46, Dec. 18, 1985; effective May 1, 1986; amended Aug. 2, 2024.)

28-4-124. Parental permission for children to go off-premises. Each applicant with a temporary permit and each licensee shall ensure that the requirements of this regulation are met.

(a) Residential centers and group boarding homes shall be exempt from the requirements of this regulation.

(b) Written permission on a form supplied by the department shall be obtained from the parent or legal guardian of each child who will be transported or allowed to participate in any off-premises field trip.

(c) For each location a child is transported and for each off-premises trip, the destination, the time children leave the facility, the adults responsible for the children, and the estimated time of return shall be provided to parents and legal guardians.

(d) The child’s emergency medical treatment form and medical record shall be accessible when any child is participating in any off-premises trip or activity.

(e) Written permission on a form supplied by the department shall be obtained from the parent or legal guardian of each school age child who will be biking or walking without adult supervision to or from activities away from the facility. (Authorized by and implementing K.S.A. 65-508; effective, T-86-46, Dec. 18, 1985; effective May 1, 1986; amended Feb. 26, 1990; amended Aug. 2, 2024.)

28-4-126. Health of individuals at least 16 years of age. Each applicant with a temporary permit and each licensee shall ensure that the requirements of this regulation are met.

(a) Health requirements.

(1) Each individual caring for children shall be free from any physical, mental, or emotional conditions that prevent the individual’s ability to protect the health, safety, and welfare of the children, shall be qualified by temperament and emotional maturity, demonstrate an understanding of children, and shall act with sound judgment.

(2) No individual in contact with children shall be in a state of impaired ability due to the use of alcohol, prescription or nonprescription drugs, or other substances.

(b) Health status forms. Each individual at least 16 years of age who is caring for children shall attest to that individual’s health status on a form supplied by the department or approved by the secretary.

(1) The health status form shall indicate if the individual has been exposed to an active case of tuberculosis or has been diagnosed with suspected or confirmed active tuberculosis.

(2) Each individual shall update the health status form annually or more often if there is a change in the health status or if the individual has been exposed to an active case of tuberculosis.

(1) Each individual at least 16 years of age who is living, working, or regularly volunteering in the facility shall have a record of a negative tuberculosis test or x-ray obtained not more than two years before the date of employment or initial application for a license or not later than 30 days after the date of employment or initial application.

(2) Compliance with the tuberculosis prevention and control program of the department shall be required following each exposure to active tuberculosis disease.

(d) Records. The health status form and each tuberculosis test shall be recorded on forms provided by the department and shall be kept in each individual’s record at the facility.

(e) In addition to meeting the requirements in K.A.R. 28-4-126(c) and (d), each resident 16 years or older in a residential center or group boarding home shall have a health assessment conducted by a licensed physician, a physician assistant, or by a nurse trained to perform health assessments. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1986; amended Feb. 26, 1990; amended Aug. 2, 2024.)

28-4-127. Telephone; emergency medical treatment; reporting requirements. Each applicant with a temporary permit and each licensee shall ensure that the requirements of this regulation are met.

(a) Telephone. A working telephone shall be on the premises and available for use at all times. Emergency telephone numbers shall be readily accessible or be posted next to the telephone for the police, fire department, ambulance, hospital or hospitals, and poison control center.

(b) Emergency medical treatment.

(1) The following documentation shall be on file at the facility, residential center, or group boarding home for each child:

(A) Written permission of the parent or legal guardian for emergency medical treatment on a form that meets the requirements of the hospital or clinic where emergency medical care will be given; and

(B) the name and telephone number of a physician and hospital preference.

(2) Residential centers and group boarding homes providing emergency care shall be exempt from K.A.R. 28-4-127(b)(l)(A).

(3) Provisions shall be made at a hospital or medical clinic for emergency treatment for children in care.

(4) The medical record and emergency medical treatment form shall be taken to the hospital or medical clinic with any child needing emergency medical treatment.

(5) When a staff member accompanies a child to emergency medical treatment, that individual shall remain with the child until the child’s parent or legal guardian assumes responsibility for the child. The individual’s absence shall not compromise the supervision of the other children in the facility.

(1) Residential centers and group boarding homes. Each applicant with a temporary permit and each licensee for each residential center or group boarding home shall:

(A) Have on file at the residential center or group boarding home written policies on reporting of illnesses and injuries of adults and children. The policies shall be approved by the Kansas department for children and families.

(B) Report any injury or illness which results in the death of a child in care to the Kansas department for children and families by the next working day.

(2) Facilities. Each applicant with a temporary permit and each licensee for each facility shall:

(A) Report by the end of the same day to the parent or legal guardian of each injury of a child which requires any first aid provided by an individual caring for children.

(B) Immediately notify the parent or legal guardian if a child becomes ill while attending the program.

(C) Report if an applicant with a temporary permit, a licensee, a staff member, or a child in care contracts an infectious or contagious disease listed in K.A.R. 28-1-2. The report shall be made by the next working day to the secretary’s designee who serves the county in which the facility is located.

(D) Fully cooperate with any investigation, disease control, or surveillance procedures initiated by the local health department or the department. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1986; amended May 1, 1987; amended Feb. 26, 1990; amended Aug. 2, 2024.)

28-4-128. Safety and emergency procedures. (a) Emergency plans; drills.

(1) Each applicant, each applicant with a temporary permit, and each licensee shall develop and implement a written emergency plan to provide for the safety of children and staff members in emergencies. The emergency plan shall include the following information:

(A) Procedures for emergencies likely to occur on or near the premises, including a fire, a weather-related event, a missing or runaway child, a chemical release, a utility failure, an intruder, an act of terrorism, a lockdown, and an unscheduled closing;

(B) a designated shelter-in-place area, a designated off-premises relocation site, and evacuation routes for each area and for each site;

(C) procedures to meet the needs of individual children, including each child with special needs and chronic medical conditions;

(D) procedures for responding to and preventing allergic reactions of individual children;

(E) procedures for notifying each parent or adult responsible for a child of any off-premises relocation;

(F) procedures for reuniting each child with each parent or adult responsible for the child;

(G) procedures for continuity of operations, including backing up or retrieving health and other required records; and

(H) procedures designating the tasks to be followed by each staff member in an emergency, including the following:

(i) As appropriate, contacting 911 or other emergency response entities;

(ii) assisting the children, including children with special needs, to move to a designated shelter-in-place area and to a designated off-premises relocation site; and

(iii) ensuring that emergency supplies are readily available.

(2) Each emergency plan shall be kept on file on the premises. Each applicant with a temporary permit and each licensee shall ensure that the plan is reviewed with parents or legal guardians of children enrolled.

(3) Each staff member shall be informed of and shall follow the emergency plan.

(4) Each licensee shall review the emergency plan at least annually and update it as needed.

(5) Each licensee shall ensure that each staff member practices, at least annually, the procedures for assisting the children to move to a designated shelter-in-place area and to a designated off-premises relocation site. The date and time of each practice and a list of all participating staff members shall be recorded and kept on file on the premises.

(6) Each licensee shall ensure that each staff member and child participate in the following drills:

(A) A fire drill shall be conducted monthly. A record of the date and time of each fire drill and a record of each evacuation time shall be kept on file on the premises for one year.

(B) A tornado drill shall be conducted monthly. A record of the date and time of each tornado drill and a record of each evacuation time shall be kept on file on the premises for one year.

(b) Standard precautions for handling blood and other bodily fluids or waste. Each applicant, applicant with a temporary permit, and each licensee shall ensure that each staff member complies with the following standard precautions when handling blood and other bodily fluids or waste:

(1) Each staff member shall avoid coming into direct contact with blood and other bodily fluids or waste.

(2) Each staff member shall wear single-use gloves in the following situations:

(A) When cleaning contaminated surfaces or areas;

(B) before dressing a cut or sore that is leaking body fluids; and

(3) Each contaminated surface or area on which a spill occurs shall be cleaned by removing any visible spill from the surface or area with a water-saturated disposable paper towel or wipe. After the surface or area has been cleaned, the surface or area shall be sanitized by wetting the entire surface or area with a disinfectant solution of chlorine bleach mixed according to the directions on the label, or an appropriate commercial disinfectant used according to the directions on the label.

(4) Each mop used to clean up a contaminated area shall be cleaned and rinsed in a disinfecting solution, wrung as dry as possible, and hung to dry.

(5) Each paper towel, sponge, or other material used for cleaning up a contaminated area shall be placed in a plastic bag with a secure tie and thrown away in a covered container.

(c) Each applicant with a temporary permit and each licensee shall maintain first-aid supplies in a first-aid kit, carrying case, box, or other container. The first-aid supplies shall include the following:

(A) First-aid manual;

(B) single-use gloves;

(D) adhesive tape;

(E) a roll of sterile gauze;

(F) sharp scissors;

(G) sterile gauze squares at least four inches by four inches in size;

(H) a cleansing agent or liquid soap;

(I) an elastic bandage;

(J) tweezers; and

(K) a bottle of water for washing and cleansing. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1986; amended Feb. 26, 1990; amended Aug. 2, 2024.)

28-4-129. Swimming and wading activities. Each applicant, each applicant with a temporary permit, and each licensee shall ensure that the requirements of this regulation are met.

(a) Pools, hot tubs, and spas on the premises.

(1) No child shall have unsupervised access to a pool, a hot tub, or a spa.

(2) If a pool, a hot tub, or a spa is on the premises, it shall be constructed, maintained, and used in such a manner as to safeguard the lives and health of the children.

(3) Required staff-child ratios shall be maintained at all times that children are involved in swimming or wading activities.

(4) The number and ages of children using a pool shall be limited to allow supervision by each individual caring for children.

(5) Legible safety rules for the use of each pool shall be posted in a clearly visible location near the pool area.

(6) Each individual responsible for the supervision of any child using a pool shall review the safety rules with each child before the child participates in the activity.

(b) Pools on the premises. Pools containing less than 12 inches of water and not permanently affixed to the premises shall be exempt from this subsection. If a pool is on the premises, the following requirements shall be met:

(1) Each inground pool shall be enclosed by a fence at least five feet high, with openings no greater than 3.5 inches, and constructed and maintained in good repair to discourage children and unwanted visitors from accessing the pool area. The wall of a building may be used as one side of the fence if the wall has no openings, including windows and doors, capable of providing direct access to the pool area.

(2) Each gate in the fence shall be at least five feet high, self-closing, self-locking, and kept closed and locked.

(3) Each aboveground pool shall have non-climbable sidewalls that are at least four feet high, or shall be enclosed by a fence at least five feet high to prevent chance access by children. The fence and the gate shall meet the requirements in paragraphs (b)(1) and (b)(2). Steps and ladders shall be removed and stored away from the pool when the pool is not in use. Each aboveground pool with a deck or berm that provides a ground-level entry on any side shall be treated as an inground pool.

(4) Sensors shall not be used in lieu of a fence.

(5) Water in the pool shall be maintained between pH 7.2 and pH 7.8. The water shall be disinfected by free available chlorine between 1.0 parts per million and 3.0 parts per million, by bromine between 1.0 parts per million and 6.0 parts per million, or by an equivalent agent approved by the local health department.

(6) If a stabilized chlorine compound is used, the pH shall be maintained between 7.2 and 7.7 and the free available chlorine residual shall be at least 1.5 parts per million.

(7) The pool shall be cleaned and the chlorine or equivalent disinfectant level and pH level shall be tested every two hours during periods of use. The results of these tests shall be recorded and available for review by the secretary’s designee.

(8) Each pool more than six feet in width, length, or diameter shall be provided with a ring buoy and rope or with a shepherd’s hook. The equipment shall be of sufficient length to reach the center of the pool from each edge of the pool. The equipment shall be available at all times, including times when the pool is not in use.

(9) The water temperatures shall be maintained at no less than 82 degrees Fahrenheit and no more than 88 degrees Fahrenheit while the pool is in use.

(1) Each hot tub and each spa shall be covered with an insulated, rigid cover secured by straps or locks or surrounded by a fence and gate that meets the requirements of paragraphs (b)(1) and (b)(2).

(2) Children in facilities shall not be permitted to use a hot tub or a spa. Children in residential centers and group boarding homes shall be permitted to use hot tubs when medically indicated.

(d) Ponds and lakes. Ponds and lakes may be used for wading or swimming only by children over six years of age, and shall be approved for swimming by the local health department, the department, or the designated authority in the state in which the wading or swimming site is located. Required staff-child ratios shall be maintained at all times, and a certified life guard shall be on duty. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1986; amended Feb. 26, 1990; amended Aug. 2, 2024.)

28-4-130. Transportation. Each applicant with a temporary permit and each licensee shall ensure that the requirements of this regulation are met when the facility, residential center, or group boarding home arranges for or provides transportation for children in care.

(a) Each driver shall be at least 18 years of age.

(b) Each driver shall hold a valid driver’s license that meets the requirements of the Kansas motor vehicle drivers’ license act, K.S.A. 8-234a et seq. and amendments thereto.

(d) Each transporting vehicle shall be maintained in safe operating condition.

(e) Each transporting vehicle owned or leased by the facility, residential center, or group boarding home shall have an annual mechanical safety check. The safety check shall be documented on a form provided by the department. A record of the date of the safety check and corrections made shall be kept on file at the facility, residential center, or group boarding home.

(f) Trailers, camper shells, or truck beds shall not be used for transportation of children.

(g) Fifteen-passenger vans shall not be used to transport children. Any 15-passenger van purchased or leased before December 31, 2023, shall be exempt from this requirement.

(h) Each vehicle shall be covered by accident and liability insurance in an amount of not less than $100,000 for personal injury or death in any one accident, $300,000 for injury or death to two or more persons in any one accident; and $50,000 for loss to property of others.

(i) Emergency release forms and health assessment records shall be in the vehicle when children enrolled in residential centers or group boarding homes are transported more than 60 miles from the residential center or group boarding home, or if children are in emergency medical care.

(j) Each transporting vehicle owned or leased by the facility, residential center, or group boarding home shall have a first-aid kit that meets the requirements in K.A.R. 28-4-128.

(k) The following requirements regarding the use of seat belts and child safety seats shall apply:

(1) Each individual shall be secured by the use of a seat belt or a child safety seat when the vehicle is in motion.

(2) No more than one individual shall be secured in any seat belt or child safety seat.

(3) Each seat belt shall be properly anchored to the vehicle.

(4) When a child safety seat, including a booster seat, is required, the seat shall meet the following requirements:

(A) Has current federal approval;

(B) has a label with the date of manufacture, date of expiration, and model number;

(D) has not been recalled;

(E) has no missing parts or cracks in the frame;

(F) has not been in a crash;

(G) is installed according to the manufacturer’s instructions and vehicle owner’s manual;

(H) is appropriate to the height, weight, and physical condition of the child, according to the manufacturer’s instructions and state statutes and regulations; and

(I) is properly maintained.

(5) The manufacturer’s instructions for use shall be kept on file at the facility, residential center, or group boarding home.

(l) For each child younger than five years of age after August 31 of the current school year, each facility, residential center, or group boarding home shall utilize an age and size-appropriate child safety restraining system when transporting a child in a school bus or a bus operated by a common carrier.

(m) The safety of each child riding in each vehicle shall be protected as follows:

(1) All doors shall be locked while the vehicle is in motion.

(2) Discipline shall be maintained at all times.

(3) All parts of each child’s body shall remain inside the vehicle at all times.

(4) No child shall either enter or exit the vehicle into a lane of traffic.

(5) No child shall be left in a vehicle unattended by an adult.

(6) When the vehicle is vacated, the driver shall make certain no child is left in the vehicle.

(7) Tobacco product use in the vehicle shall be prohibited while children are being transported.

(8) No cell phone or other electronic device shall be used by the driver when the vehicle is in motion. If a cell phone or electronic device is used for navigation, it shall be in hands-free mode only.

(9) Each facility shall maintain applicable staff-child ratios in the vehicle when children are being transported.

(10) Residential centers and group boarding homes shall maintain applicable staff-child ratios when children under six are being transported.

(n) A copy of the requirements in subsection (m) shall be posted in each vehicle or given to each driver.

(o) Each child shall be transported directly to the location designated by the applicant with a temporary permit or the licensee. No unauthorized stops shall be made along the way, except in an emergency. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1986; amended May 1, 1987; amended Feb. 26, 1990; amended Aug. 2, 2024.)

28-4-131. Animals. Each applicant with a temporary permit and each licensee shall ensure that the following requirements are met for any animals on the premises.

(a) If any animal is kept on the premises, each area in which the animal is permitted shall be maintained in a sanitary manner. There shall be no evidence of disease, flea, tick, or worm infestation.

(b) No animal shall be in the kitchen while food is being prepared.

(d) Each domesticated dog and each domesticated cat shall have a current rabies vaccination given by a licensed veterinarian or a person acting under the direct supervision of a veterinarian as specified in K.S.A. 21-1213, and amendments thereto. A record of vaccinations shall be kept on file at the facility.

(e) When animals that represent a possible risk of harm to children are on the premises, children shall be protected from them.

(f) Any non-domesticated or aggressive animal, including animals that have a history of inflicting injury or have shown signs of aggression, shall be prohibited, unless the animals are in an animal exhibit and are under the control of professional animal care personnel presenting the exhibit.

(g) Before handling any animal, each child in care shall be taught safety procedures to follow when handling them.

(h) Each contact between a child and an animal shall be supervised by an adult who is close enough to intervene immediately if either of the following circumstances occurs:

(1) The animal shows signs of distress or aggression; or

(2) the child shows signs of treating the animal inappropriately.

(i) Each individual shall wash that individual’s hands after feeding or handling any animal. Each individual caring for children shall ensure each child washes that child’s hands or be assisted in washing that child’s hands after feeding or handling any animal. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1986; amended Feb. 26, 1990; amended Aug. 2, 2024.)

28-4-132. Child care practices. (a) Supervision. Each applicant, each applicant with a temporary permit, and each licensee shall ensure that supervision is provided by a person 16 years of age or older who is responsible for the health, safety, and well-being of each child in care.

(b) Behavior management practices.

(1) Behavior management practices shall be consistent with the goals and purposes of the program and appropriate to the age and developmental level of the child.

(2) Each individual caring for children shall practice methods of behavior management that are designed to help each child develop inner controls and manage the child’s own behavior in a socially acceptable manner. No individual caring for children shall use prohibited methods of punishment.

(3) Each applicant, each applicant with a temporary permit, and each licensee shall develop and implement a written discipline policy indicating the methods of guidance appropriate for the ages of the children in care. Parents and legal guardians shall be informed of the policy.

(c) Prohibited punishment. Punishment that is humiliating, frightening, or physically harmful to any child shall be prohibited.

(1) Prohibited methods of punishment. Prohibited methods of punishment shall include the following:

(A) Corporal punishment, including hitting with the hand or any implement, slapping, swatting, shaking, pulling hair, yanking the arm, excessive exercise, exposure to extreme temperatures, and any other measure that produces physical pain or threatens the child’s health or safety;

(B) mental and emotional cruelty, including verbal abuse, threats, derogatory remarks about the child or the child’s family, or statements which tend to shame, humiliate, or frighten the child;

(D) confining the child in a high chair, a play yard, a crib, a closet, a locked room or area, a box, or a similar enclosure;

(E) withholding or forcing foods, toilet use, or rest; and

(F) placing soap or any other substances that stings, burns, or has a bitter taste in the child’s mouth, on the tongue or on or in any other part of the child’s body.

(2) Each individual who cares for children shall be prohibited from giving any child any medications, herbal or folk remedies, or drugs to control or manage behavior, unless prescribed by a licensed physician, physician assistant, or advanced practice registered nurse.

(d) Hand washing. Hands shall be washed using soap and warm running water and dried with an individual towel or disposable product. When cloth towels and washcloths are used, they shall be labeled with the child’s name, and shall be laundered at least weekly. When soap and running water are not readily available, an alcohol-based hand sanitizer may be used only by adults and, under adult supervision, by children two years of age and older.

(1) Each individual caring for children shall wash that individual’s hands as needed when hands are soiled and when each of the following occurs:

(A) At the start of the hours of operation or when first arriving at the facility;

(B) returning from being outdoors;

(D) before preparing each snack and each meal and before and after eating each snack and each meal;

(E) before and after administrating any medication; and

(F) after feeding or handling any animal.

(2) Each individual caring for children shall ensure each child washes that child’s hands or be assisted in washing that child’s hands as needed when hands are soiled and when each of the following occurs:

(A) First arriving at the facility;

(B) returning from being outdoors;

(D) before and after eating each snack and each meal; and

(E) after feeding or handling any animal.

(e) Clothing, diapers, and bedding. Each applicant, each applicant with a temporary permit, and each licensee shall ensure that the following requirements are met for clothing, diapers, and bedding:

(1) Each child’s clothing, diaper, training pants, or bedding shall be changed without delay whenever wet or soiled. The diaper or training pants of each child shall be checked at least every two hours to determine if a change is needed.

(2) Each child under three years of age shall have at least two complete changes of clothing available.

(f) Hand washing sinks. Sinks for hand washing shall be in or readily accessible to each diaper-changing area and each toileting area.

(g) Diapering. This subsection shall apply if any child in care requires diapering.

(1) Each applicant, each applicant with a temporary permit, each licensee, and each individual caring for children shall follow the diapering procedures provided by the department.

(2) A copy of the procedures shall be posted in each diaper-changing area.

(3) Each area used for diaper changing shall meet the following requirements:

(A) Be located in an area away from the food preparation area;

(B) be located in an area that allows the individual who is changing a diaper to maintain supervision of the other children in care; and

(4) Each child in a family child care home shall be diapered in the child’s own crib or playpen, on a clean, moisture-proof, nonabsorbent pad on the floor, or on a changing table.

(5) Each infant unit and each toddler unit in a child care center shall have a changing table.

(6) No child shall be left unattended on a diaper-changing surface.

(7) If a changing table is used, the table shall meet the following requirements:

(A) Have a moisture-proof, nonabsorbent, smooth surface that is undamaged, does not trap soil, and is easily cleaned;

(B) be sturdy;

(D) if equipped with safety straps, have straps that are easily cleaned and disinfected after each diaper change.

(8) Washable diapers or training pants shall not be rinsed out. They shall be stored in a labeled covered container or plastic bag and returned to the parent or legal guardian.

(9) Disposable diapers and disposable training pants shall be placed in a covered container or plastic bag which shall be emptied daily, or more frequently as necessary for odor control. Each covered container used for disposable diapers and disposable training pants shall be cleaned and disinfected at the end of each day.

(10) Each diaper-changing surface shall be cleaned and disinfected after each use. The surface shall be cleaned by removing any visible soil from the surface with a water saturated disposable paper towel or wipe. After the surface has been cleaned, the surface shall be disinfected.

(h) Toilet training. This subsection shall apply if any child in care is learning to use the toilet.

(1) Toilet training shall begin when the individual caring for children or program director and the parent or legal guardian of a child determine that the child is ready for toilet training.

(2) No child shall be forced to participate in toilet training if the child is not ready.

(3) No child shall be punished or shamed for toileting accidents.

(4) If a toilet training device is used, the following requirements shall be met:

(A) Each toilet training device shall be used and stored in the bathroom.

(B) The wastes shall be disposed of immediately in a flush toilet.

(D) Toilet training devices shall not be counted as toilets.

(i) Medication administration.

(1) Each individual caring for children shall complete medication administration training before administering any medication to any child, as specified in K.A.R. 28-4-114a and K.A.R. 28-4-428a.

(2) If nonprescription medication is to be administered to a child, each individual caring for children shall meet the following requirements:

(A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child;

(B) require that each medication supplied by a parent or legal guardian for the child be in the original container;

(C) ensure that the container is labeled with the first and last name of the child for whom the medication is intended; and

(D) administer each medication according to the instructions on the label.

(3) If prescription medication is administered to a child, each individual caring for children shall meet the following requirements:

(A) Obtain written permission from each child’s parent or legal guardian before administering medication to that child;

(B) keep each medication in the original container labeled by a pharmacist, with the following information:

(i) The child’s first and last name;

(ii) the name of the licensed physician, physician assistant (PA), or advanced practice registered nurse (APRN) who ordered the medication;

(iii) the date the prescription was filled;

(iv) the expiration date of the medication; and

(v) specific, legible instructions for administration and storage of the medication;

(D) administer the medication only to the child designated on the prescription label; and

(E) administer the medication in accordance with the instructions on the label.

(4) Documentation of each medication administered shall be kept on a form provided by the department and maintained in each child’s file.

(5) A copy of the documentation of each medication administered shall be made available to the parent or legal guardian of the child.

(j) Each residential center and group boarding home shall be exempt from subsections (a) through (c). (Authorized by and implementing K.S.A. 65-508; effective Feb. 26, 1990; amended Aug. 2, 2024.)

28-4-133. Reporting critical incidents. This regulation shall apply to each facility.

(a) Reports to parents and legal guardians. Each primary care provider and each program director shall ensure that each of the following critical incidents is immediately reported to the parent or legal guardian of any child affected by the critical incident:

(1) Fire damage or other damage to the facility, or any damage to the property that affects the structure of the facility or the safety of the children in care;

(2) a vehicle collision involving any child in care;

(3) a missing child;

(4) an injury to a child that requires treatment by a health care professional;

(5) an injury to a child by any animal;

(6) the death of any of the following:

(A) A child; or

(B) a staff member in the facility; and

(7) any other occurrence that jeopardizes the safety of any child in care.

(b) Written reports to the department. Each primary care provider and each program director shall ensure that a written report of any critical incident specified in subsection (a) is submitted by the next working day to the department. The report shall be submitted on a form provided by the department. A copy of each critical incident report shall be kept on file at the facility for at least one year from the date of the critical incident. (Authorized by and implementing K.S.A. 65-508; effective Dec. 27, 2019; amended Aug. 2, 2024.)

28-4-420. Definitions. (a) “Administrator” means the staff member of a child care center or preschool who is responsible for the general and fiscal management of the facility.

(b) “Attendance” means the number of children present at any one time.

(c) “Assistant teacher” means the staff member of a child care center or preschool who meets the requirements specified in K.A.R. 28-4-429(g) and is responsible for assisting the lead teacher in the care of children within a unit. Each assistant teacher shall demonstrate the following:

(1) Ability to carry out assigned tasks competently under the guidance of another staff member;

(2) skills and ability to implement age-appropriate activities;

(3) understanding of and the ability to respond appropriately to children’s needs;

(4) the ability to foster positive, healthy relationships with children; and

(5) interpersonal skills necessary to communicate clearly and appropriately.

(d) “Applicant” means a person who has applied for a license but who has not yet been granted a license to operate a facility.

(e) “Applicant with a temporary permit” means a person who has applied for a license and who has been granted a temporary permit to operate a facility.

(f) “Basement” means an area in which all four outside walls are more than two-thirds below ground level.

(g) “Child care center” means a facility:

(1) that provides care and educational activities for children two weeks to 16 years of age at least three hours per day including day time, evening, and overnight care for:

(A) 13 or more children; or

(B) fewer than 13 children if licensed as a center and if the program and building meet child care center regulations; and

(2) that may have hours of operation for more than 24 continuous hours, provided no individual child is present for 24 or more hours of continuous care.

(h) “Disinfect” means full surface application of a disinfectant solution of fragrance-free, environmental protection agency (EPA)-registered chlorine bleach mixed according to the directions on the label or an alternate fragrance-free, EPA-registered disinfectant used according to the directions on the label to any inanimate object.

(i) “Enrollment” means the total number of children for whom services are available.

(j) “Evening care” means care provided after 6:00 p.m. and before 1:00 a.m. the following day for children enrolled at a facility and present during operating hours.

(k) “Fire inspector” means a person approved by the state fire marshal to conduct fire safety inspections.

(l) “Infant” means a child who is between two weeks and 12 months of age, or a child over 12 months who has not learned to walk.

(m) “Lead teacher” means the staff member of a child care center or preschool who meets the requirements specified in K.A.R. 28-4-429(e) and who is responsible for the care and supervision of children within a unit. Each lead teacher shall demonstrate the following:

(1) Knowledge of licensing regulations applicable to their duties;

(2) knowledge of child development, early childhood education, and indicators that a child may not be meeting developmental milestones;

(3) skills and availability to implement age-appropriate activities;

(4) the ability to recognize signs of illnesses, safety and injury hazards, and respond with prevention interventions;

(5) understanding of and ability to respond appropriately to children’s needs;

(6) the ability to foster positive, healthy relationships with children; and

(7) interpersonal skills necessary to communicate clearly and appropriately.

(n) “License capacity” means the maximum number of children that are allowed to attend a facility at any one time.

(o) “Licensed physician” means an individual who is licensed to practice either medicine and surgery or osteopathy in Kansas by the Kansas state board of healing arts or who practices either medicine and surgery or osteopathy in another state and is licensed under the licensing statutes of that state.

(p) “Licensee” means a person who has been granted a license to operate a facility.

(q) “Media” means cable and broadcast television, internet streaming, or other similar digital entertainment.

(r) “Medical record” means the immunization record, health assessment and medical history of each child.

(s) “Overnight care” means care provided after 1:00 a.m. and before 6:00 a.m. the same day for children enrolled at a facility and present during operating hours.

(t) “Preschool” means a facility:

(1) that provides learning experiences for children who have not attained the age of eligibility to enter kindergarten as prescribed in K.S.A. 72-3118(c), and amendments thereto, and who are 30 months of age or older;

(2) that conducts sessions not exceeding three hours per session;

(3) that does not enroll any child more than one session per day; and

(4) that does not serve a meal. The term “preschool” shall include educational preschools, Montessori schools, nursery schools, church-sponsored preschools, and cooperatives. A facility may have fewer than 13 children and be licensed as a preschool if the program and facility meet preschool regulations.

(u) “Preschool age” means a child who is between 30 months of age and the age of eligibility to enter kindergarten as prescribed in K.S.A. 72-3118(c), and amendments thereto.

(v) “Professional development training” means training approved by the secretary that is related to working with children in care.

(w) “Program” means a comprehensive and coordinated plan of activities providing for the education, care, protection, and development of children who attend a preschool or a child care center.

(x) “Program director” means the staff member of a child care center or preschool who meets the requirements specified in K.A.R. 28-4-429(b) or (c) and who is responsible for implementing and supervising the program. Each program director shall demonstrate the following:

(1) Knowledge of child development, early childhood education, and indicators that a child may not be meeting developmental milestones;

(2) knowledge of licensing regulations applicable to child care centers and preschools;

(3) administrative, leadership, and management skills in facility operations;

(4) interpersonal skills necessary to communicate clearly and appropriately;

(5) capability in curriculum design and implementation; and

(6) knowledge of community resources available to families, children and children with special health care needs.

(y) “Sanitize” means full surface application of an EPA regulated food-safe sanitizing solution or heat treatment of any inanimate object used for food preparation or service.

(z) “School-age” means a child who will attain the age of eligibility to enter kindergarten as specified in K.S.A. 72-3118(c), and amendments thereto, but who is not 16 years of age or older.

(aa) “Self-contained unit” means an area separated by walls or partitions not less than five feet high which contains indoor learning materials for the maximum number of children permitted in one group as specified in K.A.R. 28-4-428(a).

(bb) “Sick child” means a child who has a contagious disease or shows other signs or symptoms of an acute illness.

(cc) “Substitute” means an individual who supervises children in the absence of the staff member.

(dd) “Tobacco product” means any product that is made or derived from tobacco, or that contains nicotine, that is intended for human absorption, inhalation, or ingestion, including by consuming or using a cigarette, cigar, pipe, chewing tobacco, snuff, snus, or vape device.

(ee) “Toddler” means a child who has learned to walk and who is between 12 and 30 months of age.

(ff) “Unit” means the number of children that may be present in one group, as specified in K.A.R. 28-4-428(a).

(gg) “Use zone” means the surface under and around a piece of equipment onto which a child falling from or exiting the equipment would be expected to land.

(hh) “Volunteer” means an individual 14 years of age or older who is working in the facility without compensation and meets the requirements specified in K.A.R. 28-4-428a.

(ii) “Weapons” means any of the following:

(1) Firearms;

(2) ammunition;

(3) air-powered guns, including BB guns, pellet guns, and paint ball guns;

(4) hunting and fishing knives;

(5) archery equipment; or

(6) martial arts equipment. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended May 1, 1985; amended May 1, 1987; amended Aug. 2, 2024.)

28-4-421. Terms of temporary permit or license. (a) The license capacity for each child care center and each preschool shall be specified on the temporary permit or license.

(1) License capacity shall be determined by age of children, available space, and number of self-contained units per facility.

(2) Each applicant with a temporary permit and each licensee shall ensure that the license capacity as stated on the temporary permit or license is not exceeded.

(3) No change to the terms of the license, including a change in the license capacity, age of children enrolled, or the number of units, shall be made unless written approval is granted by the secretary.

(b) Validity of the temporary permit or license.

(1) Each temporary permit or license shall be valid only for the person and the address specified on the temporary permit or license.

(2) When an initial or amended license becomes effective, all previous temporary permits or licenses issued to the applicant with a temporary permit or licensee shall become invalid.

(c) Posting the temporary permit or license and the availability of regulations. Each applicant with a temporary permit and each licensee shall post each temporary permit or license in a conspicuous place on the premises that is visible to parents. A copy of the current regulations governing child care centers and preschools shall be readily available to all staff. (Authorized by K.S.A. 65-508; implementing K.S.A. 65-504 and K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended Aug. 2, 2024.)

28-4-422. Applicant requirements; exclusions; application process; amended license; renewal; exceptions; advertising. (a) Applicant requirements. Each person operating a child care center or preschool shall have a temporary permit or license to operate a child care center or preschool before children are in attendance.

(1) Each individual applying for a license shall be 18 years of age or older at the time of application.

(2) Each corporation applying for a license shall be in good standing with the Kansas secretary of state.

(b) Exclusions. The following shall not be considered child care facilities:

(1) A pre-kindergarten program that is operated by an accredited non-public school when all of the following conditions are met:

(A) The program is on the premises of an accredited non-public school;

(B) The program operates only during the academic school year, during academic school hours, and follows the academic school calendar of the accredited non-public school; and

(C) The program services exclusively children who attained the age of four years on or before August 31 of the academic school year.

(2) A program operating less than five consecutive hours or less than two days a week and which does not enroll any child more than one session per day.

(1) Each applicant shall submit for review by the secretary or designee a detailed building and site plan designating the premises to be licensed and showing the following:

(A) Each entrance and exit;

(B) the location and measurements for each room to be used by children;

(D) each bathroom designated for use by children, including the number of toilets and hand sinks;

(E) each hand sink not located in a bathroom that will be used for handwashing;

(F) any other rooms on the premises labeled for intended use;

(G) the location, relative to the building of each outdoor play area, including the measurements of the space to be used, the means of access to the area from the building, and the placement of anchored equipment;

(H) the style, height and location of any fence on the premises; and

(I) additional documentation as determined necessary by the secretary.

(2) Each applicant shall obtain approval of the building and site plan from the secretary before beginning new construction or the renovation of an existing building. If changes to the approved plan are made following the secretary’s approval, the applicant shall submit a description of the proposed changes to the secretary for approval before construction work begins.

(d) Application process. Each person desiring to conduct a child care center or preschool shall submit a complete application on forms supplied by the department and shall include the following:

(1) A statement of services including the following:

(A) The number and ages of children to be served;

(B) the number of units and anticipated license capacity;

(D) the anticipated opening date and projected hours, days, and months of operation;

(2) the nonrefundable fee specified in K.A.R. 28-4-92;

(3) a request for background checks specified in K.A.R. 28-4-125;

(4) a copy of the detailed building and site plan specified in subsection (c);

(5) fire safety approval, including occupancy, from the State fire marshal; and

(6) local city or county code approval, including sanitarian approval when the building is not connected to a public water or sewer system.

(e) Provisions for issuing a license. The granting of a license to any applicant or applicant with a temporary permit may be denied by the secretary if the applicant or applicant with a temporary permit is not in compliance with the following applicable requirements:

(1) K.S.A. 65-504 through 65-506, and amendments thereto;

(2) K.S.A. 65-508, and amendments thereto;

(3) K.S.A. 65-512, and amendments thereto;

(4) K.S.A. 65-531, and amendments thereto;

(5) all regulations governing child care centers and preschools.

(f) Multiple child care facilities.

(1) Each applicant with a temporary permit or licensee who operates more than one child care facility, as defined in K.S.A. 65-503, and amendments thereto, shall maintain each child care facility as a separate entity.

(g) Multiple licenses. No licensee shall be licensed concurrently for or provide more than one type of child care or child and adult care on the same premises.

(h) New temporary permit or license required. Each applicant with a temporary permit and each licensee shall submit a new application, the required forms, and the license fee, and shall obtain a new temporary permit or license from the secretary, as follows:

(1) Before a child care center or preschool that has been closed is reopened;

(2) if there is a change in the location of the program; or

(3) if there is a change of ownership of the program.

(i) Amended license.

(1) Each licensee who intends to change the terms of the license, including the license capacity, age of children enrolled, or number of units shall submit an application for an amended license on a form provided by the department.

(2) If the physical structure of the building changes due to new construction or remodeling or a change in use of space affects the terms of the license, each applicant with a temporary permit or licensee shall submit a building and site plan as specified in subsection (c) of this regulation and fire safety approval from the State fire marshal.

(3) The licensee shall not consider the amendment granted until the amended license is issued by the secretary.

(j) Notification requirements. Each applicant, applicant with a temporary permit and each licensee shall notify the secretary in writing before withdrawing an application, closing the child care center or preschool, or changing the program director;

(k) Annual renewal.

(1) Before the annual renewal date, each licensee desiring to renew the license shall submit the annual nonrefundable renewal license fee and shall complete and submit an application to renew the license, on forms supplied by the department, to the secretary.

(2) Failure to submit the application forms and fee for the renewal of a license shall result in an assessment of a late fee pursuant to K.S.A. 65-505, and amendments thereto, and may result in closure of the facility.

(l) Exceptions.

(1) Each applicant and licensee may submit a written request for an exception to a regulation on a form supplied by the department.

(2) An exception may be granted if the secretary determines that the exception is in the best interest of the child or children and their families and does not violate statutory requirements.

(3) If an exception is granted each applicant and licensee shall receive written notice of the approval of the exception and the exception’s duration. The approval shall be posted next to the license. The exception shall not be considered granted until approval is given by the secretary.

(m) Advertising. If an applicant, applicant with a temporary permit or licensee advertises the availability of services, the advertisement shall not contradict the written description of services submitted with the application. The applicant, applicant with a temporary permit or licensee shall not make a claim of specialized services unless the facility is staffed and equipped to offer those services. No generalized claim of “state approval” shall be made until the secretary issues a temporary permit or license. (Authorized by K.S.A. 65-508; implementing K.S.A. 65-501, 65-504, 65-505 and 65-508; effective May 1, 1983; amended May 1, 1984; amended, T-87-34, Nov. 19, 1986; amended May 1, 1987; amended Aug. 2, 2024.)

28-4-423. Physical plant. (a) Premises.

(1) Each building in which child care is provided shall meet the legal requirements of the community as to fire protection, water supply, and sewage disposal.

(2) A building used as a residence shall be licensed as a child care center only if there is a room or rooms designated exclusively for child care use.

(3) Each area designated for children’s activities shall contain a minimum of 35 square feet of floor space per child, exclusive of kitchen, passageways, storage areas, and bathrooms.

(4) Each building in which child care is provided shall have at least two exits approved by a fire inspector. At least one exit shall lead directly to the outside.

(5) Second floors approved by a fire inspector may be used for children 2.5 years or over. Second-floor windows shall be guarded unless used as a means of egress.

(6) Finished basements approved by a fire inspector may be used for children 2.5 years or older. Basements shall be dry and well-ventilated, heated and cooled as specified in paragraph (a)(19) of this regulation, and lighted as specified in paragraph (a)(17) of this regulation.

(7) When mobile classroom units are used, they shall be securely anchored to the ground and shall meet all requirements for permanent structures.

(8) All stairs that have more than two steps shall be provided with sturdy handrails. When balusters are more than four inches apart, provisions shall be made to prevent a child’s head or body from falling through.

(9) Landings or mounted gates shall be provided beyond each exterior door and each door opening onto a full-length stairway.

(10) Ceiling height in each room used for child care shall not be less than seven feet, six inches.

(11) Windows and doors.

(A) Each window and glass door shall be screened or guarded.

(B) Each window and door opened for ventilation shall be screened.

(12) Floors shall be smooth and not slippery, free from cracks, clean and in good condition. A floor covering, paint, or sealant shall be required over concrete floors.

(13) Carpeting shall be clean and in good repair.

(14) Walls shall be clean and free of cracks.

(15) Electrical outlets shall be covered or inaccessible to prevent access by a child when not in use.

(16) Extension cords or power strips shall be positioned in a manner that prevents a tripping or shock hazard.

(17) Each room occupied by children shall be sufficiently lighted in all parts of the room for any activity in which each child is engaged. When children are napping and during rest periods, each room shall be lighted to allow freedom of movement and to ensure staff members are able to observe the breathing of each child.

(18) The premises shall be maintained in good condition and shall be clean at all times, free from accumulated dirt and trash, and any evidence of vermin or rodent infestation. Each outdoor trash and garbage container shall be covered, and the contents shall be removed at least weekly.

(19) Each room occupied by the children shall be heated, ventilated and cooled. The temperature in each room shall not be less than 65 degrees Fahrenheit nor more than 85 degrees Fahrenheit. Each room occupied by children shall be free of drafts.

(20) Each electric fan, if used, shall be mounted high on the wall or shall be guarded.

(21) When a gas heater is used, it shall be approved by a fire inspector before use. Open-faced heaters shall be prohibited.

(22) All heating elements, including hot water pipes, shall be insulated or installed in such a way that children cannot come in contact with them. Asbestos insulation shall not be used. Fireplaces shall not be used when children are present.

(23) Dangerous instruments, including sharp or pointed objects, shall be in locked storage.

(24) No child in care shall have access to weapons. All weapons shall be stored in a locked room, closet, container, or cabinet. Ammunition shall be kept in locked storage separate from weapons.

(25) The interior and exterior surfaces of the facility shall be free from peeling, chipping, cracking, scaling, and loose paint.

(b) Water supply.

(1) The water supply shall be from a source approved by the local health department, or by the department.

(2) The nitrate content of water for children under one year of age shall not exceed 10 milligrams per liter (10 mg/l) as nitrogen.

(3) Sanitary drinking facilities shall be available to children while indoors or outdoors. One of the following methods shall be used:

(A) Individual disposable cups and a water dispenser;

(B) individually-marked glasses or cups which shall be washed daily; or

(4) Drinking fountains shall not be plumbed to sinks.

(5) Water from drinking fountains shall be under pressure so that the stream is not less than three inches high.

(6) Cold water and hot water shall be supplied to lavatory fixtures accessible to children. Hot water shall maintain a minimum temperature of 90 degrees Fahrenheit and shall not exceed 120 degrees Fahrenheit.

(1) All plumbing fixtures and building sewers shall be connected to public sewers where available.

(2) When a public sewer is not available, a private sewage disposal system meeting requirements of the local health department or the department shall be installed and connected to all plumbing fixtures.

(3) Plumbing shall be installed and maintained according to local and state plumbing codes.

(4) Bathroom facilities shall be readily accessible to the children, and toilets and hand washing sinks shall be placed low or be provided with safety steps.

(5) There shall be one toilet and one hand washing sink for each fifteen children.

(6) Bathroom facilities shall be planned to assure privacy for staff.

(7) Individual towels or disposable products, and toilet paper shall be provided for each child. The use of common towels and washcloths shall be prohibited. When cloth towels and washcloths are used, they shall be labeled with the child’s name, and laundered at least weekly. Hand soap shall be readily accessible in each bathroom.

(d) Laundry facilities.

(1) If laundry is done at the facility, laundry fixtures shall be located in an area separate from food preparation areas and shall be installed and used in such a manner to safeguard the health and safety of the children.

(2) Separate areas shall be provided for soiled and clean items.

(e) Storage, handling, and disposal of hazardous items. The following hazardous items shall be safely stored, handled, and disposed:

(1) All household supplies, cleaning supplies, dangerous chemicals and all bodily care products bearing warning labels to keep out of reach of children shall be in locked storage, except that hand sanitizers, disinfectant solutions used daily to disinfect surfaces, and diapering supplies may be kept unlocked at least five feet above the floor and out of reach of children. Soap used for hand washing may be kept unlocked and placed on the back of the counter by a bathroom or sink.

(2) All medications and products containing alcohol shall be in locked storage.

(3) Tobacco products, ashtrays, lighters, and matches shall be kept in locked storage.

(4) Chemicals and cleaning supplies shall be used and disposed of in accordance with the product safety label. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1985; amended Aug. 2, 2024.)

28-4-426. Administration. (a) Line of authority. There shall be a written delegation of administrative authority designating the person in charge in the facility for all hours of operation.

(b) Admission policy.

(1) Arrangements for the admission of children shall be made prior to the admission date to the center or preschool.

(2) Each admission policy shall be non-discriminatory in regard to race, color, religion, national origin, ancestry, disability, or sex, in accordance with K.S.A. 44-1009. A copy of the admission policy shall be available for review.

(3) Each parent shall be informed of services offered.

(4) Each parent shall be informed when religious training is included in the program.

(1) Accident insurance shall be carried on children.

(2) Liability insurance shall be carried by the center or preschool to provide recourse to parents of children enrolled in the event of negligence.

(3) Before the start of care, documentation of insurance coverage shall be on file, including the name of the insurance company or companies, policy number or numbers and dates of coverage.

(d) Staff records. The following records shall be maintained for each staff person:

(1) A record of education and experience;

(2) date of employment;

(3) a record of scheduled hours;

(4) a record of professional development training;

(5) a health status form; and

(6) work references.

(e) Children’s records.

(1) A daily attendance record shall be maintained and kept on file at the facility.

(2) The following information shall be readily accessible and near the telephone:

(A) Name and date of birth of child;

(B) name, home and business address, and phone numbers of parents or legal guardian;

(D) persons authorized to remove the child from the facility.

(3) A file shall be maintained for each child that includes:

(A) The application for enrollment, beginning date of attendance, and date of termination;

(B) a record of scheduled hours and days of attendance;

(D) each accident report; and

(E) signed parental permission for field trips, transfer of records, and when applicable, walking to and from activities away from the facility.

(4) Children’s records shall be confidential. Staff shall not disclose nor discuss personal information regarding children and their relatives with any unauthorized person.

(5) Each child’s records and reports shall be made available to the child’s parents on request. Each child’s health records shall be returned to the parents when the child is no longer enrolled. (Authorized by K.S.A. 65-508; implementing K.S.A. 65-507 and K.S.A. 65-508; effective May 1, 1983; amended May 1, 1985; amended May 1, 1986; amended Aug. 2, 2024.)

28-4-427. Program. (a) Self-contained units. Programs shall be conducted in self-contained units with staff and children designated for each unit. Applicants that cannot develop self-contained units shall present a plan for use of space to the department for approval.

(b) Equipment, furnishings, and materials.

(1) Low, open shelves shall be provided for play equipment and materials so that they are readily accessible to the children.

(2) Furnishings, including tables and chairs, shall be scaled to the size of the children.

(3) Equipment, materials, and toys used by children shall be of sound construction, free from sharp, rough, loose, or pointed edges, and in good operating condition.

(4) Equipment, furnishings, materials, and toys shall be placed to avoid danger of accident or collision, and to permit freedom of movement.

(5) Equipment, materials, and toys shall be provided in a sufficient quantity so that each child has a choice of at least three activities.

(6) Storage space located conveniently for the staff shall be provided for supplies and equipment not in use.

(7) Each child shall have individual space for the child’s garments, clothing, and possessions during the session attended.

(8) Toys and other items used by children shall be clean and be washed and disinfected before being used by another child if contaminated by saliva or other bodily fluids.

(1) Each applicant with a temporary permit and each licensee shall ensure there is a written lesson plan that provides daily activities that promote healthy growth and development, take into consideration the cultural background and traditions that are familiar to the children, and incorporate both indoor and outdoor activities that are appropriate for the ages and developmental levels of the children in care. The activities, supplies, and equipment shall be designed to promote the following:

(A) Self-esteem and positive self-image;

(B) social interaction, self-expression, and communication skills;

(D) language development and literacy, which may include reading, singing, finger plays, writing, and stories;

(E) large motor, small motor, and visual motor coordination and development, which may include running, climbing, jumping, grasping objects, drawing, buttoning, and tying; and

(F) creative expression, which may include dramatic play, music, and art.

(2) Written lesson plans for each unit shall be made accessible to parents, staff, and the secretary’s designee.

(3) A daily schedule shall be planned to provide a balance of active, quiet, individual, and group activities.

(4) The daily schedule shall be posted in each unit. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended Aug. 2, 2024.)

28-4-428. Staff requirements. Each licensee shall ensure that all of the following requirements are met:

(a) Minimum staff-child ratio.

(1) The ratio between staff members and children shall be determined by the ages of the children and the type of care provided.

(2) The minimum staff-child ratio and the maximum number of children per unit shall be the following, at all times:

Ages of children	Minimum staff-child ratio	Maximum number of children per unit
Infants*	A. 1 to 3 or B. 1 to 4	A. 9 or B. 8
Infants and other children under the age of 6	1 to 6 (including not more than 3 infants)	12 (including not more than 6 infants)
Toddlers	1 to 6	12
Children at least 2 years of age but under the age of 3	1 to 7	14
Children at least 2.5 years of age but under school-age	1 to 12	24
School-age	1 to 16	32
* Only one staff-child ratio may be used at any one time for each infant unit.

(3) No child shall be left unsupervised.

(4) The staff-child ratio shall be considered in compliance when a staff member counted in the staff-child ratio leaves the unit without a substitute for no more than five minutes provided that another staff member remains in the room at all times. If a staff member counted in the staff-child ratio is absent for more than five minutes, but less than 20 minutes, the staff-child ratio shall be considered in compliance when another staff member substitutes for the absent staff member counted in the staff-child ratio.

(5) Each applicant with a temporary permit or each licensee may move any child into the next age-appropriate unit not earlier than 30 calendar days before and not later than 30 calendar days after the child reaches the minimum age of the unit. Upon agreement with the parent or legal guardian that the move is in the best interest of the child, a plan to move any child to the next age-appropriate unit shall be developed and communicated with the parent or legal guardian.

(6) Any school age child not yet attending kindergarten may remain in a preschool unit until the first day of the academic school year in which the child is enrolled in kindergarten.

(7) Any school age child not yet attending first grade may remain enrolled in a unit licensed for children 2.5 years to school age until the first day of the academic school year.

(b) Substitute staff. Each applicant with a temporary permit or licensee shall ensure that substitutes are available to work if there is an emergency or a staff member absence. Each substitute shall meet the requirements for the staff member whom the substitute is replacing.

(c) Volunteers. Each volunteer shall be at least 14 years of age. Any volunteer may be counted in the staff-child ratio if the individual is at least 16 years of age. Each volunteer not counted in the staff-child ratio shall be supervised at all times by a staff member who is not a volunteer when activities involve access to children.

(d) Program director.

(1) Each preschool and each child care center shall have on staff a program director who is employed full time.

(2) Each preschool and each child care center licensed for more than 60 children shall have on staff a program director who has no other assigned tasks or responsibilities that interfere with the essential functions of the job.

(3) Each preschool and each child care center licensed for more than 60 children shall have on staff an administrator, who may also be the program director.

(4) Each preschool and each child care center licensed for more than 100 children shall have on staff a program director who meets the requirements as specified in K.A.R. 28-4-429(c) and who has one year of experience in program administration or management in early childhood care or early childhood education.

(e) Assistant program director.

(1) Facilities licensed for more than 100 children shall have on staff an assistant program director who meets the program director requirements specified in K.A.R. 28-4-429(c) and K.A.R. 28-4-428a.

(2) Facilities licensed for more than 160 children shall have on staff an assistant program director who meets the program director requirements specified in K.A.R. 28-4-429(c) and K.A.R. 28-4-428a and shall not be assigned any tasks or responsibilities that interfere with the essential functions of the job. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended May 1, 1985; amended May 1, 1986; amended May 12, 2017; amended Aug. 2, 2024.)

28-4-428a. Education and training requirements. (a) Orientation.

(1) Each person shall, before applying for a license, complete an orientation program on the requirements for operating a preschool or a child care center. If the person is not an individual, the person shall designate an individual to meet this requirement. The orientation shall be provided by the secretary’s designee that serves the county in which the preschool or child care center will be located.

(2) Each licensee shall provide orientation to each program director not later than seven calendar days after the date of employment and before the program director is given sole responsibility for implementing and supervising the program.

(3) Each licensee shall ensure that orientation is completed by each staff member and by each volunteer. Each staff member and each volunteer shall complete the orientation within seven calendar days after the date of employment or volunteering. Each staff member shall complete the orientation before being given sole responsibility for the care and supervision of children.

(4) Each licensee shall ensure that the orientation for each program director, staff member, and volunteer is related to work duties and responsibilities and includes the following:

(A) Licensing regulations;

(B) the policies and practices of the preschool or child care center, including emergency procedures, behavior management, and discipline;

(D) care and supervision of children in care, including any special needs and known allergies;

(E) health and safety practices; and

(F) confidentiality.

(b) Health and safety training.

(1) Each staff member who is counted in the staff-child ratio, each volunteer who is counted in the staff-child ratio, and each program director shall complete health and safety training either before employment or volunteering or not later than 30 calendar days after the date of employment or volunteering. Each staff member shall complete the training before being given sole responsibility for the care and supervision of children.

(2) The health and safety training shall be approved by the secretary and shall include the following subject areas:

(A) Recognizing the signs of child abuse or neglect, knowledge on the prevention of child maltreatment, shaken baby syndrome, and abusive head trauma, and the reporting of suspected child abuse or neglect;

(B) basic child development, including:

(i) Supervision of children;

(ii) cognitive, social, emotional, physical development; and

(iii) approaches to learning;

(D) recognizing a sick child and prevention and control of infectious diseases, including immunizations;

(E) prevention of and response to emergencies due to food and allergic reactions;

(F) building and premises safety, including identification of and protection from hazards that could cause bodily injury, including electrical hazards, bodies of water, and vehicular traffic;

(G) emergency preparedness and response planning for emergencies resulting from a natural disaster or a human-caused event, including violence at a facility;

(H) handling and storage of hazardous materials and the appropriate disposal of bio-contaminants, including blood and other bodily fluids or waste;

(I) precautions when transporting children, if transportation is provided; and

(J) medication administration training.

(1) Each staff member counted in the staff-child ratio, each volunteer counted in the staff-child ratio, and each program director shall obtain certification in pediatric first aid and in pediatric CPR as specified in this subsection either before the date of employment or volunteering or not later than 30 calendar days after the date of employment or volunteering.

(2) First aid and CPR training and certification shall include a practical application component and be demonstrated in front of an instructor certified by a nationally recognized certification program.

(3) Each individual who is required to obtain the certifications shall maintain current certifications.

(4) Each licensee shall ensure that, for each unit in a preschool or child care center, at least one staff member or volunteer counted in the staff-child ratio who has current certification in pediatric first aid and current certification in pediatric CPR is present at all times.

(d) Infant care training. In addition to the training specified in paragraphs (a) through (c) of this regulation, each lead teacher in an infant unit shall complete four hours of professional development training in an infant-specific subject either before the date of employment or volunteering or not later than 30 calendar days after the date of employment or volunteering.

(e) Annual professional development training requirements.

(1) For purposes of this subsection, “licensure year” shall mean the period beginning on the effective date and ending on the expiration date of a license.

(2) In each licensure year, each program director shall assess the training needs of each staff member counted in the staff-child ratios and each volunteer counted in the staff-child ratios and shall provide or arrange for annual professional development training as needed appropriate to the age of children being supervised.

(3) In each licensure year, each program director shall complete 16 clock-hours of professional development training. Four of the 16 clock-hours shall include the subject areas specified in paragraphs (b)(2)(A), (b)(2)(C) through (J), or subsection (c) and six of the 16 clock-hours shall be in program administration, management, or a related topic.

(4) In each licensure year, each staff member counted in the staff-child ratio and each volunteer counted in the staff-child ratio shall complete 16 clock-hours of professional development training based on the staff member’s or volunteer’s job responsibilities and the training needs identified by the program director. Four of the 16 clock-hours shall include the subject areas specified in paragraphs (b)(2)(A), (b)(2)(C) through (J), or subsection (c).

(5) In each licensure year, each staff member counted in the staff-child ratio and each volunteer counted in the staff-child ratio caring for infants shall complete four of the 16 clock-hours of professional development training in an infant-specific subject.

(6) The training shall be approved by the secretary.

(f) Documentation. Each licensee shall ensure that documentation of all orientation, training, certifications, and education requirements is kept in each individual’s file in the preschool or child care center. (Authorized by and implementing K.S.A. 65-508; effective Feb. 3, 2012; amended May 12, 2017; amended Aug. 2, 2024.)

28-4-429. Staff qualifications. (a) Each staff member shall demonstrate an understanding of children and shall act with sound judgment.

(b) Program director requirements for facilities licensed for less than 24 children. Each applicant, each applicant with a temporary permit, and each licensee shall hire a program director that has the following requirements:

(1) At least 18 years of age;

(2) high school diploma or equivalent; and

(3) one of the following:

(A) Associate degree or a higher degree in early childhood, child development, or a related academic discipline from a regionally accredited college or university;

(B) child development associate credential;

(D) three months of experience in early childhood education providing direct care and supervision to children and three semester hours of academic study or equivalent training in early childhood, child development, or a related academic discipline from a regionally accredited college or university; or

(E) six months of experience in early childhood education providing direct care and supervision to children.

(c) Program director requirements for facilities licensed for 24 or more children. Each applicant, each applicant with a temporary permit, and each licensee shall hire a program director that has the following requirements:

(1) At least 18 years of age;

(2) high school diploma or equivalent; and

(3) one of the following:

(A) Bachelor’s degree or a higher degree in early childhood, child development, or a related academic discipline from a regionally accredited college or university and three months of experience in early childhood education providing direct care and supervision to children;

(B) bachelor’s degree in a non-related academic discipline from a regionally accredited college or university and any of the following options:

(i) Six months of experience in early childhood education providing direct care and supervision to children;

(ii) twelve semester hours of academic study or equivalent training in early childhood, child development, or a related academic discipline;

(iii) child development associate credential; or

(iv) technical certificate or diploma in early childhood;

(C) associate degree in early childhood, child development, or a related academic discipline from a regionally accredited college or university and six months of experience in early childhood education providing direct care and supervision to children;

(D) twelve semester hours of academic study or equivalent training in early childhood, child development, or a related academic discipline from a regionally accredited college or university and any of the following options:

(i) Six months of experience in early childhood education providing direct care and supervision to children;

(ii) child development associate credential; or

(iii) technical certificate or diploma in early childhood;

(E) child development associate credential and one year of experience in early childhood education providing direct care and supervision to children; or

(F) six years of experience in early childhood education providing direct care and supervision to children or four years of experience in a licensed facility providing direct care and supervision to children.

(d) Each individual who has obtained approval of program director qualifications by the secretary or the secretary’s designee before December 31, 2023, shall be exempt from the requirements in paragraph (b)(3) and (c)(3).

(e) Lead teacher. There shall be a lead teacher present with each unit of children in the facility. Each lead teacher shall have the following qualifications:

(1) At least 18 years of age;

(2) high school diploma or equivalent; and

(3) one of the following:

(A) Associate degree or a higher degree in early childhood, child development, or a related academic discipline from a regionally accredited college or university;

(B) technical certificate or diploma in early childhood;

(D) three semester hours of academic study or equivalent training in early childhood, child development, or a related academic discipline from a regionally accredited college or university and three months of experience in early childhood education providing direct care and supervision to children of the same age range they will be serving; or

(E) six months of experience in early childhood education providing direct care and supervision to children of the same age range they will be serving.

(f) Each program director in a facility licensed for less than 24 children may also serve as a lead teacher in the facility.

(g) Assistant teacher. Assistant teachers shall be at least 16 years of age. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended May 1, 1987; amended Aug. 2, 2024.)

28-4-430. Health practices; illness and abuse; general health requirements for staff. (a) Medical record. A completed medical record on the form provided by the department shall be on file at the facility for each child.

(1) Each medical record shall include the results of a health assessment conducted not more than twelve months before and obtained not later than 60 calendar days after the child’s initial enrollment in a child care facility. The assessment shall be conducted by a licensed physician, a physician assistant, or by a nurse approved to perform health assessments.

(2) Each medical record shall include a medical history obtained from the parent or legal guardian. Each applicant with a temporary permit and each licensee shall review with each child’s parent or legal guardian that child’s medical history at least once every 12 months.

(3) Children transferring from one child care facility to another shall not be required to obtain a new health assessment if the previous health assessment record is available.

(4) Tuberculosis testing shall be required only if the child comes in contact with a new active or reactivated case of tuberculosis. The results of the examination shall be maintained in the child’s health record.

(5) Immunizations for each child in care shall be current as medically appropriate and shall be maintained current for protection from the diseases specified in K.A.R. 28-1-20(d). A record of each child’s immunizations shall be obtained not later than 60 calendar days after the child’s initial enrollment in a child care facility and shall be maintained on the child’s medical record form.

(6) Exceptions to the requirements for immunizations shall be permitted as specified in K.S.A. 65-508, and amendments thereto. Documentation of each exception shall be maintained on file at the child care facility.

(7) Each licensee shall provide information to the parents of children in care about the benefits of annual, well-child health assessments for children under six years of age, and biennial health assessments for children six years of age and older. Each licensee shall also provide information about the importance of seeking medical advice when a child exhibits health problems. This information may be either given on a form provided by the department to the parent at the time the child is enrolled or posted in a conspicuous place, with copies of the form available to parents on request.

(b) Health practices.

(1) Each child shall be provided an individual toothbrush for that child’s use. Each child shall brush that child’s teeth or be assisted in brushing that child’s teeth at least once daily. Each toothbrush shall be stored in a sanitary manner and out of reach of children.

(2) Children shall be allowed to go to the bathroom individually as needed.

(1) If a child is absent due to a communicable disease, staff shall inform all parents or legal guardians of the nature of the illness without disclosing the child’s identity.

(2) Each communicable disease shall be reported to the local health department.

(3) Each staff member shall report within 24 hours to the Kansas department for children and families any suspected child abuse or neglect.

(4) Each applicant with a temporary permit or licensee providing care of sick children shall submit written plans regarding the needs of a sick child and the care of a sick child to the department. The plans shall be prepared in consultation with a public health nurse and shall be presented to the parents at the time of enrollment. The requirements for the infectious and contagious diseases specified in K.A.R. 28-1-2 and for the isolation and quarantine of individuals with the infectious and contagious diseases specified in K.A.R. 28-1-6 shall be met.

(5) A quiet area shall be provided for any sick child. Sick children shall be supervised at all times.

(d) Staff.

(1) The use of tobacco products shall be prohibited on the premises.

(2) Alcohol, as defined in K.S.A. 41-102, and amendments thereto, and non-prescribed controlled substances, as defined in K.S.A. 65-4101, and amendments thereto, shall not be consumed on the licensed premises during the hours of operation and shall not be consumed while children are present.

(3) Each child residing in the same location as that of a child care center or preschool shall meet the requirements specified in subsection (a). (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended May 1, 1985; amended May 1, 1986; amended July 11, 2008; amended Aug. 2, 2024.)

28-4-434. Preschools. (a) Inside area. Any building used as a residence shall be licensed as a preschool only if there is a room or rooms designated exclusively for preschool use.

(b) Nutrition.

(1) A nutritious snack shall be provided daily and shall include at least one of the following foods:

(A) Milk, milk product, or food made with milk;

(B) fruit, vegetable, or full-strength fruit or vegetable juice;

(D) peanut butter; or

(E) bread or cereal product.

(2) Fluid dairy products shall be grade A pasteurized. Solid dairy products shall be pasteurized.

(3) Refrigeration shall be provided for perishable foods.

(4) If reusable tableware is used for snacks, appropriate dishwashing methods shall be followed as specified in K.A.R. 28-4-439(q)(2).

(5) Appropriate tableware shall be used for serving snacks. Children’s food shall not be placed on the bare table.

(c) Outdoor play. Outdoor play space shall not be required. If outdoor play is included in the preschool program, the requirements of K.A.R. 28-4-437 shall be met. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended Aug. 2, 2024.)

28-4-435. Programs serving children with special health care needs and disabilities. (a) Records. Each applicant with a temporary permit and each licensee shall maintain on file a copy of the most recent individual family service plan or individual education plan for each child with special health care needs and disabilities enrolled. The plan shall be reviewed by staff in the unit and in consultation with the child’s parent or legal guardian upon enrollment and at least annually.

(b) Physical plant.

(1) Programs which include children who are non-ambulatory shall be conducted on the ground floor. All exits and steps shall have ramps approved by a fire inspector.

(2) Each unit enrolling children with impaired mobility shall have 50 square feet of space for each child with impaired mobility.

(3) When children with impaired mobility are enrolled, toilets and sinks used for hand washing shall be designed to accommodate them.

(c) Each child with special health care needs or disabilities shall be allowed to utilize adaptive equipment as necessary.

(d) Each applicant with a temporary permit and each licensee enrolling children with special health care needs and disabilities shall determine, by an individual assessment of each child’s needs, whether a lower staff-child ratio is required. The staff-child ratio shall allow the needs of all children enrolled to be met. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended Aug. 2, 2024.)

28-4-436. Child care centers: napping and sleeping. (a) Rest period. Each child attending for more than four hours shall be encouraged to nap or rest according to their individual needs. Children who do not sleep shall be permitted to have a quiet time through the use of equipment or activities.

(b) Safe sleep practices for children in care.

(1) Each applicant with a temporary permit and each licensee shall develop a written plan for safe sleep practices and implement safe sleep practices for children in care who are napping or sleeping.

(2) Each applicant with a temporary permit and each licensee shall ensure that the safe sleep practices are shared with the parent or legal guardian of each child before the first day of care.

(3) Each staff member shall follow the safe sleep policies and practices of the child care center.

(4) Each child who is 12 months of age or older shall nap or sleep on a cot or pad. Pads shall be used only over carpet.

(5) Each applicant with a temporary permit and each licensee shall ensure that all of the following requirements are met for each infant in care:

(A) The child shall nap or sleep in a crib or a playpen. Stacking cribs or bassinets shall not be used. Cribs with water-bed mattresses shall not be used.

(B) A crib or playpen shall be provided and used for each child in attendance. The child shall not nap or sleep in the same crib or playpen occupied by another child at the same time.

(D) The child shall be placed on the child’s back to nap or sleep.

(G) The child may nap or sleep in sleep clothing, including sleepers and sleep sacks. Swaddling shall not be permitted.

(c) Napping and sleeping surfaces. Each applicant with a temporary permit and each licensee shall ensure that the following requirements are met for all napping and sleeping surfaces:

(1) Clean, individual bedding shall be provided for each child. There shall be a complete change of bedding after each five uses, immediately when wet or soiled, and always upon a change in the child utilizing the sleeping surface. Blankets shall be laundered monthly.

(2) Each surface used for napping and sleeping shall be kept clean, of safe construction, and maintained in good repair.

(3) Each crib, playpen, cot, and pad shall be used only for children who meet the manufacturer’s recommendations for use, including any age, height, or weight limitations. The manufacturer’s instructions for use, including any recommendations for use, shall be kept on file at the facility.

(4) Cribs, playpens, cots, or pads, when in use for napping or sleeping, shall be separated from each other by at least 24 inches in all directions except when bordering on the wall.

(5) When not in use, cribs, playpens, cots, pads, and bedding shall be stored in a clean and sanitary manner.

(6) Each crib and each playpen shall have a firm, tightfitting mattress and a fitted sheet. The mattress shall be set at its lowest point when any child using the crib or playpen becomes able to either sit up or to pull up to a standing position inside the crib or playpen, whichever occurs first, to ensure that the child cannot climb out of the crib or playpen.

(7) If a crib or playpen is slatted, the slats shall be spaced not more than 2.375 inches apart.

(8) All sides of each crib or playpen shall be up while the crib or playpen is in use.

(9) Each applicant, each applicant with a temporary permit, and each licensee shall ensure that no crib purchased before June 28, 2011 is in use in the facility.

(10) Each pad used for napping and sleeping shall be at least 0.5 inch thick, washable or enclosed in a washable cover, and long enough so that the child’s head and feet rest on the pad. Clean, individual bedding, including a bottom and a top cover, shall be provided for each child.

(11) Each piece of sleeping equipment shall be labeled and designated for use by a single child.

(e) Evening and overnight care. Staff-child ratios shall be met during all hours of care. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended Aug. 2, 2024.)

28-4-437. Child care centers: outside area. (a) Each child care center shall have at least 75 square feet of outdoor play space on the premises for each child using the space at a given time. The total outdoor space shall accommodate not less than one-half of the licensed capacity, or shall include a minimum of 750 square feet, whichever is greater.

(b) The boundaries of outdoor play space shall be enclosed with a fence not less than four feet high.

(d) The outdoor play space shall be well drained and free of hazards.

(e) Outdoor play equipment that is safely constructed and in good repair shall be available and placed in an area free of health, safety, and environmental hazards.

(f) Children shall not be allowed access to a trampoline.

(g) Climbing equipment and swings shall be either anchored in the ground with metal straps or pins or set in cement to prevent movement of the equipment and swings.

(h) All surfaces under and around climbing equipment and swings shall meet the following requirements:

(1) Impact-absorbent surfacing material shall be installed in each use zone under and around anchored equipment over four feet in height, including climbing equipment, slides, and swings.

(2) Impact-absorbent surfacing material shall consist of material intended for playground use, including shredded bark mulch, wood chips, fine sand, fine gravel, shredded rubber, unitary surfacing material, or synthetic impact material.

(3) Hard-surfacing materials including asphalt and concrete shall not be used in any use zone. Hard-packed dirt shall be covered with an impact-absorbent surfacing material as specified in paragraph (h)(2). This requirement shall apply regardless of the height of the climbing equipment, slides, and swings.

(4) Surfaces made of loose material shall be maintained by replacing, leveling, or raking the material.

(i) Swings shall not have wooden or metal seats.

(j) Teeter-totters and merry-go-rounds designed for school-age children shall not be used by children under five years of age.

(k) Sandboxes shall be maintained in a safe and sanitary condition.

(l) The play area shall be arranged so that staff can actively supervise each child at all times.

(m) Staff shall actively engage in the supervision of children utilizing the play area.

(n) Each child shall have access to outdoor equipment and materials in sufficient quantity to allow for at least one self-led activity appropriate to the child’s age level.

(o) There shall be bathroom facilities accessible to the play area. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended Aug. 2, 2024.)

28-4-438. Child care centers: program. Each applicant with a temporary permit and each licensee shall ensure the following:

(a) Regular routines such as eating and napping, and protection from excess fatigue and overstimulation.

(b) Unless extreme weather conditions prevail, a daily period of outdoor play for each child under the supervision of an adult. Children spending more than four consecutive hours at the center shall play outdoors for at least one hour daily.

(d) Routines such as toileting and eating, and intervals between activities so that children do not have to wait in lines or assemble in large groups.

(e) The following requirements if the daily activities include any media viewing:

(1) Each media program shall be age-appropriate and, if rated, shall have a rating appropriate for the ages and developmental levels of the children who view the program.

(2) No child shall be required to participate in media viewing. Each child not engaged in media viewing shall be offered a choice of at least one other activity for that time period.

(f) Activities shall be available for children during the entire time they are in attendance, including early morning and late afternoon. (Authorized by and implementing K.S.A 65-508; effective May 1, 1983; amended Aug. 2, 2024.)

28-4-439. Child care centers: food service. (a) Each applicant with a temporary permit and each licensee shall ensure that any staff member involved with the preparation of meals or snacks meets the following:

(1) Has knowledge of nutritional needs of children;

(2) understands quantity food preparation and service;

(3) practices sanitary methods of food handling and storage; and

(4) is sensitive to individual and cultural food tastes of children.

(b) Centers shall serve meals and snacks as follows:

Length of Time at Center	Food Served
2.5 to 4 hours	1 snack
4 to 8 hours	1 snack & 1 meal
8 to 10 hours	2 snacks & 1 meal or 1 snack & 2 meals
10 hours or more	2 meals & 2 or 3 snacks

(1) Breakfasts shall include:

(A) A fruit, vegetable, or full-strength fruit or vegetable juice;

(B) bread, a bread product or cereal; and

(2) Noon or evening meals shall include one item from each of the following:

(A) Meat, poultry, fish, egg, cheese, peas or beans, or peanut butter;

(B) two vegetables, two fruits, or one vegetable and one fruit;

(D) milk.

(3) Mid-morning and mid-afternoon snacks shall include at least two of the following:

(A) Milk, milk product or food made with milk;

(B) fruit, vegetable, or full-strength fruit or vegetable juice;

(D) bread, bread product or cereal.

(d) All food shall be in good quality and safe for consumption.

(e) Drinking water shall be available to each child at all times when the child is in care.

(f) If a fruit juice or a vegetable juice is served, the juice shall be pasteurized and full-strength.

(g) Fluid dairy products shall be grade A pasteurized. Solid dairy products shall be pasteurized. Dry milk shall be used only for cooking.

(h) A sufficient quantity of food shall be prepared for each meal to allow the children second portions of vegetables or fruit, bread, and milk.

(i) If infants or toddlers are present, the following food service requirements shall be met:

(1) Each infant shall be held when bottle-fed until the child can hold the child’s own bottle.

(2) No child shall be allowed to sleep with a bottle in the child’s mouth.

(3) If prepared formula is used, the following requirements shall be met:

(A) Each bottle that contains prepared formula shall be stored in the refrigerator with the nipple covered.

(B) The bottle shall be labeled with the child’s name, the contents, and the date and time prepared, and shall be used within 24 hours of the time of preparation on the label.

(C) If a child does not finish a bottle, the contents of the bottle shall be discarded within one hour from when the feeding from that bottle started.

(4) If breast milk is used, the following requirements shall be met:

(A) All breast milk shall be labeled with the child’s name and the date and time expressed.

(B) Unfrozen breast milk shall be stored in a refrigerator and shall be used within 96 hours from the time it was expressed.

(C) Frozen breast milk must be stored in a freezer and shall be used within six months from the time it was expressed and within 24 hours from the time it was thawed.

(D) If a child does not finish the bottle of breast milk within two hours from when the feeding from that bottle started, the contents shall be discarded.

(E) Accommodations shall be provided that enables the child’s parent to breastfeed their child.

(5) No formula or breast milk shall be heated in a microwave oven.

(6) Bottles for formula or breast milk shall be prepared and washed in a sink that is not used for handwashing or the sink shall be cleaned and sanitized after being used for handwashing.

(7) Solid foods shall be offered when the program director and the parent or legal guardian of a child determine that the child is ready for solid foods. Opened containers of solid foods shall be labeled with the child’s name, the contents, and the date opened. Containers shall be covered and refrigerated. The food shall be used within three calendar days of the date opened. Food in previously opened containers shall be reheated only once and shall not be served to another child.

(j) Food allergies or special dietary needs of specific children shall be known to all staff members. If any child with a food allergy or a special dietary need is enrolled, the following shall be met:

(1) Utensils, cookware, and food preparation surfaces shall be washed and sanitized between use for foods that risk cross contamination.

(2) Foods that risk cross contamination shall be stored separately from other foods with no potential for leakage onto other foods stored in the vicinity.

(3) Hands shall be washed in between preparing an allergen containing dish and the dish for the child with an allergy. If gloves are used, a fresh pair of gloves will be used before changing from the allergen containing dish to the non-allergen dish.

(4) A list of allergies and special dietary needs will be written and clearly displayed in the food preparation area for each child enrolled at the facility that has a known allergy or a special dietary need.

(k) If any child has a food allergy or special dietary need, staff members and the parent or legal guardian of the child shall make arrangements for the provision of alternative foods or beverages.

(l) Menus shall be shared with parents and legal guardians.

(m) Staff shall sit at the table with the children, and socialization shall be encouraged. Children shall be encouraged to serve themselves.

(n) Children’s food shall not be placed on a bare table.

(o) When meals are prepared on the premises, the kitchen shall be separate from the eating, play, and bathroom areas, and shall not be used as a passageway while food is being prepared. The kitchen shall be inaccessible to children.

(p) Food shall be stored as follows:

(1) Poisonous or toxic materials shall not be stored with food. Medications requiring refrigeration shall be labeled and kept in locked storage in the refrigerator.

(2) All perishables and potentially hazardous foods shall be continuously maintained at 40 degrees Fahrenheit or lower in the refrigerator, or 10 degrees Fahrenheit or lower in the freezer, with 0 degrees Fahrenheit recommended. Each refrigerator and each freezer shall contain a clearly visible, accurate thermometer.

(3) All foods stored in the refrigerator shall be covered. Food which is not in its original, unopened container shall be stored in metal, glass, food-grade sealable plastic bags, or food-grade plastic containers with tightfitting covers and shall be labeled with the date and contents.

(4) Foods not requiring refrigeration shall be stored at least six inches above the floor in clean, dry, well-ventilated storerooms or other areas.

(5) Dry, bulk foods which are not in their original, unopened containers shall be stored in metal, glass, food-grade sealable plastic bags, or food-grade plastic containers with tight-fitting covers, and shall be labeled with the date and contents.

(q) Table service.

(1) Tableware requirements.

(A) Utensils appropriate for the food served shall be provided for each child’s use.

(B) Dishes and glassware shall have smooth, hard-glazed surfaces, and shall be entirely free from cracks or chips.

(2) Tableware shall be maintained in sanitary condition using one of the following methods:

(A) All preparation dishes, service dishes, and non-disposable dishes shall be washed and sanitized after use using one of the following:

(i) A three-compartment sink supplied with hot and cold running water and a drainboard for washing, rinsing, sanitizing, and airdrying;

(ii) a two-compartment sink and a basin for sanitizing the tableware and cooking utensils; or

(iii) a mechanical dishwasher with a sanitizing cycle.

(B) The use of disposable plates and cups, and plastic utensils of food grade, medium weight which are disposed of after each use.

(r) Tables shall be cleaned before and after each meal, and floors shall be swept after each meal.

(s) If meals are delivered from an off-site location:

(1) Food provided from a central kitchen or vendor and delivered to the center shall be obtained from a source licensed or inspected by the Kansas department of agriculture or equivalent food safety licensing agency in another state.

(2) Food shall be transported in covered and temperature-controlled containers. Hot foods shall be maintained at not less than 140 degrees Fahrenheit, and cold foods shall be maintained at 40 degrees Fahrenheit or less.

(3) Food prepared in one licensed center and transferred to another licensed center owned by the same licensee shall be permitted.

(t) Meat shall be from government-inspected sources.

(u) Home-canned food, food from dented, rusted, bulging, or leaking cans, or food from cans without labels shall not be used.

(v) Garbage shall be placed in covered containers inaccessible to children, and shall be removed from the kitchen daily. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended May 1, 1985; amended Aug. 2, 2024.)

28-4-440. Programs serving infants and toddlers. The following requirements shall be met for all infants and toddlers:

(a) Infant and toddler programs shall be conducted on the ground floor only.

(b) Each unit of infants and each unit of toddlers shall be separate from each unit of older children unless otherwise approved by the department.

(d) Cribs and playpens shall be located within the self-contained unit and be separated from the play area. If a barrier is used, it shall not impede supervision.

(e) Safe sleep procedures shall be followed as specified in K.A.R. 28-4-436.

(f) When children are awake, they shall not be left in cribs, playpens, or other confinement for more than 30 minutes.

(g) An adult-size chair shall be provided for each unit of infants.

(h) Children not held for feeding shall have low chairs and tables, infant seats with trays, or high chairs with a wide base and a safety strap.

(i) Either individually labeled towels and washcloths or disposable products shall be provided.

(j) Items that children can place in their mouths shall be washed and sanitized before being used by another child, if contaminated by saliva or other bodily fluids.

(k) Each applicant with a temporary permit and each licensee shall ensure there is one toilet training device or child-sized toilet for every five toddlers.

(l) There shall be daily communication between the parent or legal guardian and the staff about each child’s behavior and development. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended May 1, 1985; amended May 1, 1986; amended, T-87-34, Nov. 19, 1986; amended May 1, 1987; amended Feb. 3, 2012; amended Aug. 2, 2024.)

28-4-441. Programs serving school-age children. (a) Each unit for school-age children shall be separate from units for younger children, except for the following periods:

(1) During the academic school year before and after school, in-service days, school holidays, scheduled or emergency closures, school breaks not to exceed two consecutive weeks, two hours before and after school; and

(2) during the two consecutive weeks before the opening of the academic school year in August or September and following the end of the academic school year in May or June.

(b) Staff-child ratios and unit size shall conform to the provisions of K.A.R. 28-4-428 and shall be based on the age of the youngest child in the group. (Authorized by and implementing K.S.A. 65-508; effective May 1, 1983; amended May 1, 1984; amended May 1, 1985; amended May 1, 1986; amended Aug. 2, 2024.)

28-4-442. (Authorized by and implementing K.S.A. 1988 Supp. 65-510; effective Feb. 26, 1990; revoked Aug. 2, 2024.)

Janet Stanek
Secretary
Department of Health and Environment

Doc. No. 052312

Scott Schwab
Kansas Secretary of State

Kansas Register