North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 70 - CHILDREN'S SERVICES › Subchapter I - MINIMUM LICENSING STANDARDS FOR RESIDENTIAL CHILD-CARE › Section .0600 - SERVICE DELIVERY › Section 70I .0604 - HEALTH SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The residential
				  child-care facility shall ensure that each child shall have a current medical
				  examination. Medical examinations completed by a licensed medical provider
				  (physician, physician's assistant or nurse practitioner, in this Rule,
				  "licensed medical provider") within 12 months prior to the admission of the
				  child to the facility shall be considered current. If a child has not had a
				  medical examination by a licensed medical provider within 12 months prior to
				  admission, the residential child-care facility shall arrange a medical
				  examination for the child within two weeks after admission or sooner if
				  indicated by the child's health condition. The medical examination report shall
				  include a signed statement by a licensed medical provider specifying the
				  child's medical condition and medications prescribed and indicating the
				  presence of any communicable disease which may pose a risk of transmission in
				  the facility. If a child is in the custody of a county department of social
				  services, is already scheduled to have a medical examination completed
				  annually, and is entering a residential child-care facility, the schedule of
				  annual medical examinations is not required to be changed. The facility shall
				  obtain a copy of the most recent medical examination report from the
				  responsible county department of social services.
(b) A child admitted to a residential
				  child-care facility shall be immunized against diphtheria, tetanus, whooping
				  cough, poliomyelitis, red measles (rubeola), rubella, mumps, and any other
				  disease as required by
				  10A NCAC
				  41A .0401, which is hereby incorporated by
				  reference, including subsequent amendments and editions, as age appropriate,
				  prior to admission. The facility shall obtain documentation of
				  immunization.
(c) A residential
				  child-care facility shall make arrangements with one or more licensed medical
				  providers or medical clinics and dentists for the care of the
				  children.
(d) Each child shall have
				  a medical examination at least once a year and more often if indicated by the
				  child's health. A child shall not be allowed to participate in activities that
				  pose risks to his or her health based on any previously diagnosed medical
				  conditions. Any illness, disease, or medical condition of a child shall be
				  identified and treated through proper medical care. Children shall have a
				  psychiatric or psychological examination or both when indicated by the needs of
				  the child, and treatment when recommended by the psychiatrist or
				  psychologist.
(e) Children shall
				  have had a dental examination, by a licensed dentist, within one year prior to
				  admission or arrangements shall be made for an exam within six weeks after
				  admission and annually thereafter. The facility shall document dental services
				  in the child's record.
(f) The
				  facility shall instruct direct child-care staff on medical care that may be
				  given by them without orders from a licensed medical provider. The facility
				  shall instruct direct child-care staff in the facility's procedures for
				  obtaining medical care beyond home health care and handling medical
				  emergencies.
(g) The residential
				  child-care facility shall determine which local hospital will admit children
				  from the facility in the event of serious illness or emergency.
(h) The residential child-care facility shall
				  obtain a mouthpiece, utilize universal precautions, and other precautionary
				  equipment for administering CPR for the children in residence.
(i) The residential child-care facility shall
				  ensure that first aid kits are available for use in each living unit,
				  recreation area, and in vehicles used to transport children.
(j) The residential child-care facility shall
				  not engage in any home health care practices that conflict with the control
				  measures for communicable diseases in
				  10A NCAC
				  41A .0200, which is hereby incorporated by
				  reference, including subsequent amendments and editions.
(k) Direct child-care staff shall be able to
				  recognize common symptoms of common illnesses in children and be alert to any
				  infectious condition and take precautions to prevent the spread of the
				  condition.
(l) Direct child-care
				  staff shall be able to provide home health care. A thermometer shall be kept
				  available for use. When there is risk of transmission, arrangements shall be
				  made for isolation and attendant care of a child with a communicable
				  disease.
(m) Prescription
				  medications shall be administered only when approved by a licensed medical
				  provider.
(n) Non-prescription
				  medications shall be administered to a child taking prescription medications
				  only when authorized by the child's licensed medical provider. The residential
				  child-care facility shall allow non-prescription medications to be administered
				  to a child not taking prescription medication, with the authorization of the
				  parents, guardian, legal custodian, or licensed medical provider.
(o) All prescription and non-prescription
				  medication shall be stored in a locked cabinet, closet, or box not accessible
				  to children.
(p) Each child shall
				  have a medical record that contains written consent from the legal custodian or
				  parent authorizing routine medical and dental treatment and emergency
				  treatment.
(q) A residential
				  child-care facility shall have written policies and procedures regarding the
				  administration of medications to children placed in the residential child-care
				  facility. The executive director of a residential child-care facility, or his
				  or her designee, shall discuss and provide these policies and procedures to the
				  parents, guardian, or legal custodian, and the child (if 12 years of age or
				  older), upon admission. These policies and procedures shall address medication:
(1) administration;
(2) dispensing, packaging, labeling, storage
				  and disposal;
(3) review;
(4) education and training; and
(5) documentation, including medication
				  orders, Medication Administration Record (MAR), orders and copies of lab tests,
				  and medication administration errors and adverse drug reactions.