Little People's Early Head Start

NAC 280.5

“5. The director of the facility shall maintain a daily sign-in sheet that includes: (a) The first and last names of staff and children; and (b) The times of arrival and departure for staff and children”

NAC 376

“Except as otherwise provided in NAC 432A.585: 1. Each prescribed medication must: (a) Be kept in the original container which must have a child-proof lid; (b) Be plainly labeled; (c) Contain the name of the child or adult for whom it is prescribed; and (d) Be stored in a locked cabinet or be made inaccessible to children. 2. Medications for external use must be kept in a separate section of the locked cabinet. Medications stored in a refrigerator must be made inaccessible to children. Nonprescription medications must be kept in a container with a child-proof lid. 3. Except in an emergency, only one person designated by the licensee of a facility may administer medications to children. A person designated by the licensee of a facility pursuant to this subsection must be trained in the administration of medication by a health care professional or the parent of a child cared for in the facility and authorized to administer the medication pursuant to NRS 453.375 or 454.213 . 4. The licensee of a facility shall maintain a written record containing: (a) The name of each medication administered; (b) The name of the child to whom it was administered; and (c) The date and time on which it was administered on a weekly basis. The record must be kept in the child ' s file. 5. A prescribed medication must, upon discontinuance of use, be promptly destroyed or returned to the child ' s parent.”

NAC 414

“1. A carpeted floor or rug on a floor that is too large to wash in a washing machine must be vacuumed not less than one time each day or more often if necessary and cleaned not less than one time every 3 months or more often if necessary. If the carpeted floor or rug is cleaned by a member of the staff of the facility using a carpet cleaning machine, the Health Division may require the carpeted floor or rug to be professionally cleaned if the carpeted floor or rug does not appear to be clean. 2. Each floor of a facility that is not carpeted must be swept and mopped not less than one time each day or more often if necessary. 3. When cleaning a nonporous surface in a facility, including, without limitation, cleaning toys, cribs, tables, high chairs and surfaces used to change diapers, the staff of the facility shall: (a) Clean the surface first with soap and water to remove any dirt or debris; and (b) Disinfect the surface with a disinfecting agent. 4. The disinfecting agent used pursuant to subsection 3 must consist of: (a) One-fourth of a cup of liquid chlorine bleach added to 1 gallon of water that is prepared fresh daily and kept in a closed container; (b) One tablespoon of liquid chlorine bleach added to 1 quart of water that is prepared fresh daily; or (c) A solution that is approved by the appropriate state or local agency and is at least as effective as the solutions described in paragraphs (a) and (b).”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section.”

NAC.370

“1. Evidence of each child ' s health must be presented to the director of a facility, other than an accommodation facility or a facility that provides care for ill children, within 30 days after the child ' s initial admission. The evidence must include a written statement from a licensed physician or registered nurse attesting to the status of the child ' s health and stating that all known special conditions are under treatment and the child is capable of adjusting to the programs of the facility. 2. A licensee of each such facility shall keep a record of each child which includes any pertinent information on the status of the child ' s health and any special needs of the child.”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section.”

NAC.370

“1. Evidence of each child ' s health must be presented to the director of a facility, other than an accommodation facility or a facility that provides care for ill children, within 30 days after the child ' s initial admission. The evidence must include a written statement from a licensed physician or registered nurse attesting to the status of the child ' s health and stating that all known special conditions are under treatment and the child is capable of adjusting to the programs of the facility. 2. A licensee of each such facility shall keep a record of each child which includes any pertinent information on the status of the child ' s health and any special needs of the child.”

NAC 302

“1. A licensee of a child care facility shall not knowingly appoint a person as director of the facility or appoint or permit the appointment of a person as an employee or volunteer at the facility if the person has been convicted of child abuse or neglect or any other crime involving physical harm to a person or if a criminal action for such a crime is pending against the person. 2. The staff of a child care facility must be able to: (a) Work with children without recourse to physical punishment or psychological abuse; (b) Communicate with children and their parents; (c) Praise and encourage children and provide them with a variety of opportunities for learning and social experiences; and (d) Recognize and eliminate hazards to the safety of children.”

NAC 416

“1. Each member of the staff of a facility that is necessary to meet the applicable requirement for the ratio of caregivers to children set forth in NAC 432A.526 for napping or sleeping children must be on the same floor in the same building where the children are napping or sleeping. Members of the staff of each facility must be readily accessible and available to be summoned to ensure the safety of the children in the facility. 2. Areas provided for napping or sleeping in a facility must be sufficiently lighted to provide for visual supervision of the children at all times. 3. The staff of each facility shall: (a) Ensure that each infant under 12 months of age is placed on his or her back on a firm mattress, mat or pad manufactured for use by an infant when the infant is napping or sleeping; (b) Use a safe, sturdy, well-constructed, single-level, free-standing crib, portable crib or playpen for children to nap or sleep in; (c) Equip any such sleeping device with a waterproof, firm-fitting mattress; (d) Ensure that each crib to be used by a child who is 6 months of age or younger is constructed with vertical slats that are not more than 2 3/8 inches apart; (e) Ensure that a child who is 18 months of age or younger naps or sleeps in a crib which is appropriate for his or her age or in another sleeping device which has been approved by the Health Division; (f) Ensure that a child who is older than 18 months of age naps or sleeps in an appropriate crib or on a cot or mat; (g) Ensure that each sleeping device has appropriate bedding and a waterproof and washable covering; (h) Wipe clean each sleeping device with a disinfectant not less than one time each week or more often if necessary; (i) Ensure that the bedding that each child uses is used only for that particular child; (j) Replace the bedding each time it is wet or soiled by a child or when the sleeping device is to be used by another child; (k) Within 15 minutes after a child in a crib has awakened from a nap or from sleeping, take the child out of the crib and engage him or her in an appropriate activity; (l) Ensure that each child takes a nap as needed; (m) Ensure that each napping or sleeping child is in an area from which the staff can readily hear and see the child; and (n) Ensure that each napping or sleeping child is checked by a caregiver not less than one time every 15 minutes. 4. The staff of a facility shall not change the diaper of a child in a crib or other sleeping device. 5. The staff of a facility shall not use a waterbed, sofa, soft mattress, pillow or any other soft surface as a surface on which to place an infant under 12 months of age to nap or sleep.”

NAC 415.4

“4. A toy or any other piece of equipment that is used for play must be made of a material that is capable of being disinfected and must be cleaned and disinfected promptly after the toy or other piece of equipment has been soiled or put into the mouth of a child, or not less than one time each day.”

NAC 250.4

“4. The play area of each facility must: (a) Be fenced or enclosed in a manner that prevents the unsupervised departure of children from the area; (b) Have an adequate drainage system; (c) Be free of hazards, debris and trash; (d) If it is an outdoor play area, provide, during the months of April through September, a shade area or shade areas that are at least equal in size to the product of 5 square feet multiplied by the total number of children in the outdoor play area; (e) Have appropriate, as determined by the Division, depths and perimeters of resilient surfacing underneath and surrounding any elevated play equipment; (f) Have adequate safety barriers around any elevated platforms; (g) Not have any dangerous or poisonous plants or other vegetative matter located within the boundaries of the play area or in an area that is accessible to children from the play area; (h) Not be in a location where any bodies of water are accessible to children; and (i) If it has playground equipment, have only equipment that is: (1) In good repair; (2) Designed and constructed to minimize injury; (3) Compatible with the age of the children in the care of the facility; (4) Spaced to reduce accidents; and (5) Securely anchored.”

NAC 414

“1. A carpeted floor or rug on a floor that is too large to wash in a washing machine must be vacuumed not less than one time each day or more often if necessary and cleaned not less than one time every 3 months or more often if necessary. If the carpeted floor or rug is cleaned by a member of the staff of the facility using a carpet cleaning machine, the Health Division may require the carpeted floor or rug to be professionally cleaned if the carpeted floor or rug does not appear to be clean. 2. Each floor of a facility that is not carpeted must be swept and mopped not less than one time each day or more often if necessary. 3. When cleaning a nonporous surface in a facility, including, without limitation, cleaning toys, cribs, tables, high chairs and surfaces used to change diapers, the staff of the facility shall: (a) Clean the surface first with soap and water to remove any dirt or debris; and (b) Disinfect the surface with a disinfecting agent. 4. The disinfecting agent used pursuant to subsection 3 must consist of: (a) One-fourth of a cup of liquid chlorine bleach added to 1 gallon of water that is prepared fresh daily and kept in a closed container; (b) One tablespoon of liquid chlorine bleach added to 1 quart of water that is prepared fresh daily; or (c) A solution that is approved by the appropriate state or local agency and is at least as effective as the solutions described in paragraphs (a) and (b).”

NAC 430.3

“3. In addition to the written assessment plan which is developed pursuant to subsection 2, each facility described in subsection 1 shall, within 3 months after a child enrolls in the facility, assess the child by use of, without limitation, portfolios, observations, checklists, rating scales and screening tools. Such an assessment must be repeated biannually thereafter to monitor and support the learning and development of each child enrolled in the facility.”

NAC 376

“Except as otherwise provided in NAC 432A.585: 1. Each prescribed medication must: (a) Be kept in the original container which must have a child-proof lid; (b) Be plainly labeled; (c) Contain the name of the child or adult for whom it is prescribed; and (d) Be stored in a locked cabinet or be made inaccessible to children. 2. Medications for external use must be kept in a separate section of the locked cabinet. Medications stored in a refrigerator must be made inaccessible to children. Nonprescription medications must be kept in a container with a child-proof lid. 3. Except in an emergency, only one person designated by the licensee of a facility may administer medications to children. A person designated by the licensee of a facility pursuant to this subsection must be trained in the administration of medication by a health care professional or the parent of a child cared for in the facility and authorized to administer the medication pursuant to NRS 453.375 or 454.213 . 4. The licensee of a facility shall maintain a written record containing: (a) The name of each medication administered; (b) The name of the child to whom it was administered; and (c) The date and time on which it was administered on a weekly basis. The record must be kept in the child ' s file. 5. A prescribed medication must, upon discontinuance of use, be promptly destroyed or returned to the child ' s parent.”

NAC 414

“1. A carpeted floor or rug on a floor that is too large to wash in a washing machine must be vacuumed not less than one time each day or more often if necessary and cleaned not less than one time every 3 months or more often if necessary. If the carpeted floor or rug is cleaned by a member of the staff of the facility using a carpet cleaning machine, the Health Division may require the carpeted floor or rug to be professionally cleaned if the carpeted floor or rug does not appear to be clean. 2. Each floor of a facility that is not carpeted must be swept and mopped not less than one time each day or more often if necessary. 3. When cleaning a nonporous surface in a facility, including, without limitation, cleaning toys, cribs, tables, high chairs and surfaces used to change diapers, the staff of the facility shall: (a) Clean the surface first with soap and water to remove any dirt or debris; and (b) Disinfect the surface with a disinfecting agent. 4. The disinfecting agent used pursuant to subsection 3 must consist of: (a) One-fourth of a cup of liquid chlorine bleach added to 1 gallon of water that is prepared fresh daily and kept in a closed container; (b) One tablespoon of liquid chlorine bleach added to 1 quart of water that is prepared fresh daily; or (c) A solution that is approved by the appropriate state or local agency and is at least as effective as the solutions described in paragraphs (a) and (b).”

NAC 415.4

“4. A toy or any other piece of equipment that is used for play must be made of a material that is capable of being disinfected and must be cleaned and disinfected promptly after the toy or other piece of equipment has been soiled or put into the mouth of a child, or not less than one time each day.”

NAC 416

“1. Each member of the staff of a facility that is necessary to meet the applicable requirement for the ratio of caregivers to children set forth in NAC 432A.526 for napping or sleeping children must be on the same floor in the same building where the children are napping or sleeping. Members of the staff of each facility must be readily accessible and available to be summoned to ensure the safety of the children in the facility. 2. Areas provided for napping or sleeping in a facility must be sufficiently lighted to provide for visual supervision of the children at all times. 3. The staff of each facility shall: (a) Ensure that each infant under 12 months of age is placed on his or her back on a firm mattress, mat or pad manufactured for use by an infant when the infant is napping or sleeping; (b) Use a safe, sturdy, well-constructed, single-level, free-standing crib, portable crib or playpen for children to nap or sleep in; (c) Equip any such sleeping device with a waterproof, firm-fitting mattress; (d) Ensure that each crib to be used by a child who is 6 months of age or younger is constructed with vertical slats that are not more than 2 3/8 inches apart; (e) Ensure that a child who is 18 months of age or younger naps or sleeps in a crib which is appropriate for his or her age or in another sleeping device which has been approved by the Health Division; (f) Ensure that a child who is older than 18 months of age naps or sleeps in an appropriate crib or on a cot or mat; (g) Ensure that each sleeping device has appropriate bedding and a waterproof and washable covering; (h) Wipe clean each sleeping device with a disinfectant not less than one time each week or more often if necessary; (i) Ensure that the bedding that each child uses is used only for that particular child; (j) Replace the bedding each time it is wet or soiled by a child or when the sleeping device is to be used by another child; (k) Within 15 minutes after a child in a crib has awakened from a nap or from sleeping, take the child out of the crib and engage him or her in an appropriate activity; (l) Ensure that each child takes a nap as needed; (m) Ensure that each napping or sleeping child is in an area from which the staff can readily hear and see the child; and (n) Ensure that each napping or sleeping child is checked by a caregiver not less than one time every 15 minutes. 4. The staff of a facility shall not change the diaper of a child in a crib or other sleeping device. 5. The staff of a facility shall not use a waterbed, sofa, soft mattress, pillow or any other soft surface as a surface on which to place an infant under 12 months of age to nap or sleep.”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section.”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section.”

NAC 415.4

“4. A toy or any other piece of equipment that is used for play must be made of a material that is capable of being disinfected and must be cleaned and disinfected promptly after the toy or other piece of equipment has been soiled or put into the mouth of a child, or not less than one time each day.”

NAC 414

“1. A carpeted floor or rug on a floor that is too large to wash in a washing machine must be vacuumed not less than one time each day or more often if necessary and cleaned not less than one time every 3 months or more often if necessary. If the carpeted floor or rug is cleaned by a member of the staff of the facility using a carpet cleaning machine, the Health Division may require the carpeted floor or rug to be professionally cleaned if the carpeted floor or rug does not appear to be clean. 2. Each floor of a facility that is not carpeted must be swept and mopped not less than one time each day or more often if necessary. 3. When cleaning a nonporous surface in a facility, including, without limitation, cleaning toys, cribs, tables, high chairs and surfaces used to change diapers, the staff of the facility shall: (a) Clean the surface first with soap and water to remove any dirt or debris; and (b) Disinfect the surface with a disinfecting agent. 4. The disinfecting agent used pursuant to subsection 3 must consist of: (a) One-fourth of a cup of liquid chlorine bleach added to 1 gallon of water that is prepared fresh daily and kept in a closed container; (b) One tablespoon of liquid chlorine bleach added to 1 quart of water that is prepared fresh daily; or (c) A solution that is approved by the appropriate state or local agency and is at least as effective as the solutions described in paragraphs (a) and (b).”

NAC 411

“1. Each area in a facility that is used for changing diapers must: (a) Have a smooth, nonabrasive, impervious surface; (b) Be located within close proximity to a sink that is not used for the preparation of food; (c) Not be located in an area in which food is prepared; (d) Have a smooth, nonabsorbent floor covering; (e) Have nearby, for wet or soiled diapers, a washable receptacle that is lined with plastic and covered with a lid; (f) Be kept in good repair and in a safe condition; and (g) Be cleaned and disinfected after each use by removing any visible soil and applying an approved disinfectant. 2. Each soiled cloth diaper and any soiled clothing that may be contaminated with contagious matter must be stored in an individual plastic bag and be returned to the parents daily. The facility is not required to rinse or dump the contents of a diaper or the underwear of a child cared for in the facility. Each diaper used, including, without limitation, a commercial disposable diaper, must be able to contain urine and stool and minimize contamination. If cloth diapers are used on children, an absorbent inner liner and a waterproof outer covering must be provided with the diaper. 3. The staff of a facility: (a) Shall discourage children from coming near an area that is used for changing diapers; and (b) Shall not leave a child unattended in the diaper changing area.”

NAC 412

“1. Each facility must have written procedures concerning the washing of hands. 2. The staff of a facility shall follow the procedures of the facility concerning the washing of hands and shall instruct, monitor and assist the children being cared for at the facility to ensure that the children follow the procedures. 3. The procedures concerning the washing of hands must require, without limitation, that: (a) The staff of the facility wash their hands with soap from a dispenser and warm water: (1) Any time that their hands come into contact with blood, mucus, vomit, feces or urine; (2) Before preparing or handling food; (3) Before engaging in any activity related to serving food, including, without limitation, setting the table; (4) Before and after eating a meal or snack; (5) After using the toilet, helping a child use the toilet or changing a diaper with or without gloves; (6) After attending to an ill child; (7) After handling an animal; (8) Before and after giving medication to a child; and (9) After cleaning a container used to store garbage or handling garbage. (b) The children being cared for in the facility wash their hands with soap from a dispenser and warm water: (1) Any time that their hands come into contact with blood, mucus, vomit, feces or urine; (2) Before handling food; (3) Before and after eating a meal or snack; (4) After handling an animal; (5) After the diaper or underwear of the child is changed; (6) After playing in water; and (7) After playing in a sandbox. (c) The staff of the facility shall ensure that: (1) Each bathroom has running water, soap and single-use or disposable towels; and (2) Any common basin or sink which is filled with standing water is not used for the washing of hands.”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section.”

NAC.370

“1. Evidence of each child ' s health must be presented to the director of a facility, other than an accommodation facility or a facility that provides care for ill children, within 30 days after the child ' s initial admission. The evidence must include a written statement from a licensed physician or registered nurse attesting to the status of the child ' s health and stating that all known special conditions are under treatment and the child is capable of adjusting to the programs of the facility. 2. A licensee of each such facility shall keep a record of each child which includes any pertinent information on the status of the child ' s health and any special needs of the child. Based on record”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization.”

NAC 416

“1. Each member of the staff of a facility that is necessary to meet the applicable requirement for the ratio of caregivers to children set forth in NAC 432A.526 for napping or sleeping children must be on the same floor in the same building where the children are napping or sleeping. Members of the staff of each facility must be readily accessible and available to be summoned to ensure the safety of the children in the facility. 2. Areas provided for napping or sleeping in a facility must be sufficiently lighted to provide for visual supervision of the children at all times. 3. The staff of each facility shall: (a) Ensure that each infant under 12 months of age is placed on his or her back on a firm mattress, mat or pad manufactured for use by an infant when the infant is napping or sleeping; (b) Use a safe, sturdy, well-constructed, single-level, free-standing crib, portable crib or playpen for children to nap or sleep in; (c) Equip any such sleeping device with a waterproof, firm-fitting mattress; (d) Ensure that each crib to be used by a child who is 6 months of age or younger is constructed with vertical slats that are not more than 2 3/8 inches apart; (e) Ensure that a child who is 18 months of age or younger naps or sleeps in a crib which is appropriate for his or her age or in another sleeping device which has been approved by the Health Division; (f) Ensure that a child who is older than 18 months of age naps or sleeps in an appropriate crib or on a cot or mat; (g) Ensure that each sleeping device has appropriate bedding and a waterproof and washable covering; (h) Wipe clean each sleeping device with a disinfectant not less than one time each week or more often if necessary; (i) Ensure that the bedding that each child uses is used only for that particular child; (j) Replace the bedding each time it is wet or soiled by a child or when the sleeping device is to be used by another child; (k) Within 15 minutes after a child in a crib has awakened from a nap or from sleeping, take the child out of the crib and engage him or her in an appropriate activity; (l) Ensure that each child takes a nap as needed; (m) Ensure that each napping or sleeping child is in an area from which the staff can readily hear and see the child; and (n) Ensure that each napping or sleeping child is checked by a caregiver not less than one time every 15 minutes. 4. The staff of a facility shall not change the diaper of a child in a crib or other sleeping device. 5. The staff of a facility shall not use a waterbed, sofa, soft mattress, pillow or any other soft surface as a surface on which to place an infant under 12 months of age to nap or sleep.”

NAC 411

“1. Each area in a facility that is used for changing diapers must: (a) Have a smooth, nonabrasive, impervious surface; (b) Be located within close proximity to a sink that is not used for the preparation of food; (c) Not be located in an area in which food is prepared; (d) Have a smooth, nonabsorbent floor covering; (e) Have nearby, for wet or soiled diapers, a washable receptacle that is lined with plastic and covered with a lid; (f) Be kept in good repair and in a safe condition; and (g) Be cleaned and disinfected after each use by removing any visible soil and applying an approved disinfectant. 2. Each soiled cloth diaper and any soiled clothing that may be contaminated with contagious matter must be stored in an individual plastic bag and be returned to the parents daily. The facility is not required to rinse or dump the contents of a diaper or the underwear of a child cared for in the facility. Each diaper used, including, without limitation, a commercial disposable diaper, must be able to contain urine and stool and minimize contamination. If cloth diapers are used on children, an absorbent inner liner and a waterproof outer covering must be provided with the diaper. 3. The staff of a facility: (a) Shall discourage children from coming near an area that is used for changing diapers; and (b) Shall not leave a child unattended in the diaper changing area.”

NAC 414

“1. A carpeted floor or rug on a floor that is too large to wash in a washing machine must be vacuumed not less than one time each day or more often if necessary and cleaned not less than one time every 3 months or more often if necessary. If the carpeted floor or rug is cleaned by a member of the staff of the facility using a carpet cleaning machine, the Health Division may require the carpeted floor or rug to be professionally cleaned if the carpeted floor or rug does not appear to be clean. 2. Each floor of a facility that is not carpeted must be swept and mopped not less than one time each day or more often if necessary. 3. When cleaning a nonporous surface in a facility, including, without limitation, cleaning toys, cribs, tables, high chairs and surfaces used to change diapers, the staff of the facility shall: (a) Clean the surface first with soap and water to remove any dirt or debris; and (b) Disinfect the surface with a disinfecting agent. 4. The disinfecting agent used pursuant to subsection 3 must consist of: (a) One-fourth of a cup of liquid chlorine bleach added to 1 gallon of water that is prepared fresh daily and kept in a closed container; (b) One tablespoon of liquid chlorine bleach added to 1 quart of water that is prepared fresh daily; or (c) A solution that is approved by the appropriate state or local agency and is at least as effective as the solutions described in paragraphs (a) and (b).”

NAC 415.4

“4. A toy or any other piece of equipment that is used for play must be made of a material that is capable of being disinfected and must be cleaned and disinfected promptly after the toy or other piece of equipment has been soiled or put into the mouth of a child, or not less than one time each day.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization.”

NAC 360

“1. The licensee of a facility shall not disclose to any person who is not a member of the staff of the facility or a member of the licensing staff of the Health Division information pertaining to any child, unless: (a) The parent has given written permission for the disclosure; or (b) There is an emergency as determined by the director or the member of the staff who is in charge at the time of the emergency. 2. The licensee of a facility shall have available forms which allow a parent to release information pertaining to his or her child.”

NAC.370

“1. Evidence of each child ' s health must be presented to the director of a facility, other than an accommodation facility or a facility that provides care for ill children, within 30 days after the child ' s initial admission. The evidence must include a written statement from a licensed physician or registered nurse attesting to the status of the child ' s health and stating that all known special conditions are under treatment and the child is capable of adjusting to the programs of the facility. 2. A licensee of each such facility shall keep a record of each child which includes any pertinent information on the status of the child ' s health and any special needs of the child.”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section.”

NAC 412

“1. Each facility must have written procedures concerning the washing of hands. 2. The staff of a facility shall follow the procedures of the facility concerning the washing of hands and shall instruct, monitor and assist the children being cared for at the facility to ensure that the children follow the procedures. 3. The procedures concerning the washing of hands must require, without limitation, that: (a) The staff of the facility wash their hands with soap from a dispenser and warm water: (1) Any time that their hands come into contact with blood, mucus, vomit, feces or urine; (2) Before preparing or handling food; (3) Before engaging in any activity related to serving food, including, without limitation, setting the table; (4) Before and after eating a meal or snack; (5) After using the toilet, helping a child use the toilet or changing a diaper with or without gloves; (6) After attending to an ill child; (7) After handling an animal; (8) Before and after giving medication to a child; and (9) After cleaning a container used to store garbage or handling garbage. (b) The children being cared for in the facility wash their hands with soap from a dispenser and warm water: (1) Any time that their hands come into contact with blood, mucus, vomit, feces or urine; (2) Before handling food; (3) Before and after eating a meal or snack; (4) After handling an animal; (5) After the diaper or underwear of the child is changed; (6) After playing in water; and (7) After playing in a sandbox. (c) The staff of the facility shall ensure that: (1) Each bathroom has running water, soap and single-use or disposable towels; and (2) Any common basin or sink which is filled with standing water is not used for the washing of hands.”

NAC 416

“1. Each member of the staff of a facility that is necessary to meet the applicable requirement for the ratio of caregivers to children set forth in NAC 432A.526 for napping or sleeping children must be on the same floor in the same building where the children are napping or sleeping. Members of the staff of each facility must be readily accessible and available to be summoned to ensure the safety of the children in the facility. 2. Areas provided for napping or sleeping in a facility must be sufficiently lighted to provide for visual supervision of the children at all times. 3. The staff of each facility shall: (a) Ensure that each infant under 12 months of age is placed on his or her back on a firm mattress, mat or pad manufactured for use by an infant when the infant is napping or sleeping; (b) Use a safe, sturdy, well-constructed, single-level, free-standing crib, portable crib or playpen for children to nap or sleep in; (c) Equip any such sleeping device with a waterproof, firm-fitting mattress; (d) Ensure that each crib to be used by a child who is 6 months of age or younger is constructed with vertical slats that are not more than 2 3/8 inches apart; (e) Ensure that a child who is 18 months of age or younger naps or sleeps in a crib which is appropriate for his or her age or in another sleeping device which has been approved by the Health Division; (f) Ensure that a child who is older than 18 months of age naps or sleeps in an appropriate crib or on a cot or mat; (g) Ensure that each sleeping device has appropriate bedding and a waterproof and washable covering; (h) Wipe clean each sleeping device with a disinfectant not less than one time each week or more often if necessary; (i) Ensure that the bedding that each child uses is used only for that particular child; (j) Replace the bedding each time it is wet or soiled by a child or when the sleeping device is to be used by another child; (k) Within 15 minutes after a child in a crib has awakened from a nap or from sleeping, take the child out of the crib and engage him or her in an appropriate activity; (l) Ensure that each child takes a nap as needed; (m) Ensure that each napping or sleeping child is in an area from which the staff can readily hear and see the child; and (n) Ensure that each napping or sleeping child is checked by a caregiver not less than one time every 15 minutes. 4. The staff of a facility shall not change the diaper of a child in a crib or other sleeping device. 5. The staff of a facility shall not use a waterbed, sofa, soft mattress, pillow or any other soft surface as a surface on which to place an infant under 12 months of age to nap or sleep.”

NAC 320.1

“1. Except as otherwise provided in NRS 432A.177 , within the first 2 weeks after commencing employment, newly employed members of the staff of a facility must be given a written and oral orientation program and be trained in the policies, procedures and programs of the facility by the director or a designee trained by the director. The orientation must address, at a minimum: (a) Any regulatory requirements that govern the facility; (b) The goals and philosophy and the policies and procedures of the facility; (c) Any planned programs or activities of the facility; (d) The policies and practices of the facility for relating to parents; (e) Meal patterns and food-handling policies and practices of the facility; (f) Dealing with occupational health hazards for caregivers, including, without limitation, paying attention to the physical health and emotional demands of the job and being aware of any special considerations required by a caregiver who is pregnant; (g) The emergency health and safety procedures of the facility; and (h) The general health and safety policies and procedures of the facility, including, without limitation, policies and procedures concerning: (1) Hand-washing techniques and requirements; (2) Techniques for diapering and for assisting in the use of a toilet if care is provided to children in diapers or children needing help with using a toilet, including, without limitation, techniques for the disposal of diapers and for changing diapers; (3) Identifying hazards and methods for preventing injuries; (4) Techniques for preparing, serving and storing food for employees who are involved in any of the activities concerning food for children at the facility; (5) Excluding a child from the facility because the child has an illness, and the manner in which illnesses are transmitted between persons; (6) Methods for preparing formula if formula is prepared at the facility; (7) Any precautions and other measures that should be taken to prevent exposure to blood and other bodily fluids, and policies and procedures to follow in the event of exposure to blood or other bodily fluids; and (8) The administration of medication.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization.”

NAC 323

“1. Except as otherwise provided in NAC 432A.521 and NRS 432A.177, within 120 days after commencing his or her employment or position in a child care facility, each person who is employed in a child care facility, other than a person employed in a facility that provides care for ill children, and each director of a child care facility shall complete: (a) Any training required by the facility in which the director serves or in which the person is employed for the purposes of obtaining certification in the administration of cardiopulmonary resuscitation as required pursuant to NAC 432A.322; (b) Three or more hours of training in child development or guidance and discipline specific to the age group served by the facility in which the director serves or in which the person is employed; (c) Two or more hours of training in the administration of first aid; (d) Two or more hours of training in the recognition of signs and symptoms of illness, which must include, without limitation, training in the prevention of exposure to bloodborne pathogens; (e) Two or more hours of training in the recognition and reporting of child abuse and neglect; (f) If the person or director works with infants under 12 months of age, at least: (1) Two hours of training concerning Sudden Infant Death Syndrome; and (2) One hour of training in the prevention of shaken baby syndrome and abusive head trauma; (g) Two or more hours of training in the administration of medication, which must include, without limitation, training in the prevention of and response to food and other allergies; (h) Two or more hours of training in building and physical premises safety, which must include, without limitation, training in the storage of biocontaminants and other hazardous materials; (i) Two or more hours of training in emergency preparedness and response planning for emergencies resulting from a natural or man-made event; (j) If the facility provides transportation, 1 or more hours of training in precautions to be taken when transporting children for each person who will provide such transportation; and (k) Two or more hours of training in lifelong wellness, health and safety of children, which must include, without limitation, training relating to childhood obesity, nutrition and moderate or vigorous physical activity. 2. Except as otherwise provided in NAC 432A.521, within 12 months after commencing employment, each person described in subsection 1 shall, in addition to completing any training required pursuant to subsection 1 and completing any course in the development of children required pursuant to NAC 432A.306, complete at least the number of hours of training described in NAC 432A.326. A person may use training completed pursuant to subsection 1 to satisfy the training requirements set forth in NAC 432A.326. 3. Except as otherwise provided in NAC 432A.521, within 12 months after commencing employment as a member of the staff of a facility, each member of the staff of a facility shall complete a course in the development of children required pursuant to NAC 432A.306. 4. The training concerning the administration of first aid and the recognition of signs and symptoms of illness that is required to be completed pursuant to subsection 1 must be provided by one of the persons, agencies or institutions listed in NAC 432A.308 as qualified to provide such training. 5. The training required pursuant to subsections 1, 2 and 3 must be designed to: (a) Ensure the protection of the health and safety of each child enrolled in the facility; and (b) Promote the physical, moral and mental well-being of each child enrolled in the facility. 6. If the facility is a special needs facility, the training required pursuant to subsections 1, 2 and 3 must also be designed to provide information on the characteristics of handicapping conditions and appropriate programs for children with special needs. The training must be approved by: (a) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such training; or (b) If the training has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency. 7. Evidence that an employee has completed the training required pursuant to subsections 1, 2 and 3 must be included in his or her personnel file and must be kept at the facility. With regard to training concerning the administration of first aid and the recognition of signs and symptoms of illness, the evidence listed in NAC 432A.308 as adequate evidence of compliance is adequate evidence of compliance for the purposes of this section.”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section. Based on interview”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization.”

NAC 320.1

“1. Except as otherwise provided in NRS 432A.177 , within the first 2 weeks after commencing employment, newly employed members of the staff of a facility must be given a written and oral orientation program and be trained in the policies, procedures and programs of the facility by the director or a designee trained by the director. The orientation must address, at a minimum: (a) Any regulatory requirements that govern the facility; (b) The goals and philosophy and the policies and procedures of the facility; (c) Any planned programs or activities of the facility; (d) The policies and practices of the facility for relating to parents; (e) Meal patterns and food-handling policies and practices of the facility; (f) Dealing with occupational health hazards for caregivers, including, without limitation, paying attention to the physical health and emotional demands of the job and being aware of any special considerations required by a caregiver who is pregnant; (g) The emergency health and safety procedures of the facility; and (h) The general health and safety policies and procedures of the facility, including, without limitation, policies and procedures concerning: (1) Hand-washing techniques and requirements; (2) Techniques for diapering and for assisting in the use of a toilet if care is provided to children in diapers or children needing help with using a toilet, including, without limitation, techniques for the disposal of diapers and for changing diapers; (3) Identifying hazards and methods for preventing injuries; (4) Techniques for preparing, serving and storing food for employees who are involved in any of the activities concerning food for children at the facility; (5) Excluding a child from the facility because the child has an illness, and the manner in which illnesses are transmitted between persons; (6) Methods for preparing formula if formula is prepared at the facility; (7) Any precautions and other measures that should be taken to prevent exposure to blood and other bodily fluids, and policies and procedures to follow in the event of exposure to blood or other bodily fluids; and (8) The administration of medication.”

NAC 323

“1. Except as otherwise provided in NAC 432A.521 and NRS 432A.177, within 120 days after commencing his or her employment or position in a child care facility, each person who is employed in a child care facility, other than a person employed in a facility that provides care for ill children, and each director of a child care facility shall complete: (a) Any training required by the facility in which the director serves or in which the person is employed for the purposes of obtaining certification in the administration of cardiopulmonary resuscitation as required pursuant to NAC 432A.322; (b) Three or more hours of training in child development or guidance and discipline specific to the age group served by the facility in which the director serves or in which the person is employed; (c) Two or more hours of training in the administration of first aid; (d) Two or more hours of training in the recognition of signs and symptoms of illness, which must include, without limitation, training in the prevention of exposure to bloodborne pathogens; (e) Two or more hours of training in the recognition and reporting of child abuse and neglect; (f) If the person or director works with infants under 12 months of age, at least: (1) Two hours of training concerning Sudden Infant Death Syndrome; and (2) One hour of training in the prevention of shaken baby syndrome and abusive head trauma; (g) Two or more hours of training in the administration of medication, which must include, without limitation, training in the prevention of and response to food and other allergies; (h) Two or more hours of training in building and physical premises safety, which must include, without limitation, training in the storage of biocontaminants and other hazardous materials; (i) Two or more hours of training in emergency preparedness and response planning for emergencies resulting from a natural or man-made event; (j) If the facility provides transportation, 1 or more hours of training in precautions to be taken when transporting children for each person who will provide such transportation; and (k) Two or more hours of training in lifelong wellness, health and safety of children, which must include, without limitation, training relating to childhood obesity, nutrition and moderate or vigorous physical activity. 2. Except as otherwise provided in NAC 432A.521, within 12 months after commencing employment, each person described in subsection 1 shall, in addition to completing any training required pursuant to subsection 1 and completing any course in the development of children required pursuant to NAC 432A.306, complete at least the number of hours of training described in NAC 432A.326. A person may use training completed pursuant to subsection 1 to satisfy the training requirements set forth in NAC 432A.326. 3. Except as otherwise provided in NAC 432A.521, within 12 months after commencing employment as a member of the staff of a facility, each member of the staff of a facility shall complete a course in the development of children required pursuant to NAC 432A.306. 4. The training concerning the administration of first aid and the recognition of signs and symptoms of illness that is required to be completed pursuant to subsection 1 must be provided by one of the persons, agencies or institutions listed in NAC 432A.308 as qualified to provide such training. 5. The training required pursuant to subsections 1, 2 and 3 must be designed to: (a) Ensure the protection of the health and safety of each child enrolled in the facility; and (b) Promote the physical, moral and mental well-being of each child enrolled in the facility. 6. If the facility is a special needs facility, the training required pursuant to subsections 1, 2 and 3 must also be designed to provide information on the characteristics of handicapping conditions and appropriate programs for children with special needs. The training must be approved by: (a) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such training; or (b) If the training has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency. 7. Evidence that an employee has completed the training required pursuant to subsections 1, 2 and 3 must be included in his or her personnel file and must be kept at the facility. With regard to training concerning the administration of first aid and the recognition of signs and symptoms of illness, the evidence listed in NAC 432A.308 as adequate evidence of compliance is adequate evidence of compliance for the purposes of this section.”

NAC 250.4

“4. The play area of each facility must: (a) Be fenced or enclosed in a manner that prevents the unsupervised departure of children from the area; (b) Have an adequate drainage system; (c) Be free of hazards, debris and trash; (d) If it is an outdoor play area, provide, during the months of April through September, a shade area or shade areas that are at least equal in size to the product of 5 square feet multiplied by the total number of children in the outdoor play area; (e) Have appropriate, as determined by the Division, depths and perimeters of resilient surfacing underneath and surrounding any elevated play equipment; (f) Have adequate safety barriers around any elevated platforms; (g) Not have any dangerous or poisonous plants or other vegetative matter located within the boundaries of the play area or in an area that is accessible to children from the play area; (h) Not be in a location where any bodies of water are accessible to children; and (i) If it has playground equipment, have only equipment that is: (1) In good repair; (2) Designed and constructed to minimize injury; (3) Compatible with the age of the children in the care of the facility; (4) Spaced to reduce accidents; and (5) Securely anchored.”

NAC 411

“1. Each area in a facility that is used for changing diapers must: (a) Have a smooth, nonabrasive, impervious surface; (b) Be located within close proximity to a sink that is not used for the preparation of food; (c) Not be located in an area in which food is prepared; (d) Have a smooth, nonabsorbent floor covering; (e) Have nearby, for wet or soiled diapers, a washable receptacle that is lined with plastic and covered with a lid; (f) Be kept in good repair and in a safe condition; and (g) Be cleaned and disinfected after each use by removing any visible soil and applying an approved disinfectant. 2. Each soiled cloth diaper and any soiled clothing that may be contaminated with contagious matter must be stored in an individual plastic bag and be returned to the parents daily. The facility is not required to rinse or dump the contents of a diaper or the underwear of a child cared for in the facility. Each diaper used, including, without limitation, a commercial disposable diaper, must be able to contain urine and stool and minimize contamination. If cloth diapers are used on children, an absorbent inner liner and a waterproof outer covering must be provided with the diaper. 3. The staff of a facility: (a) Shall discourage children from coming near an area that is used for changing diapers; and (b) Shall not leave a child unattended in the diaper changing area.”

NAC 414

“1. A carpeted floor or rug on a floor that is too large to wash in a washing machine must be vacuumed not less than one time each day or more often if necessary and cleaned not less than one time every 3 months or more often if necessary. If the carpeted floor or rug is cleaned by a member of the staff of the facility using a carpet cleaning machine, the Health Division may require the carpeted floor or rug to be professionally cleaned if the carpeted floor or rug does not appear to be clean. 2. Each floor of a facility that is not carpeted must be swept and mopped not less than one time each day or more often if necessary. 3. When cleaning a nonporous surface in a facility, including, without limitation, cleaning toys, cribs, tables, high chairs and surfaces used to change diapers, the staff of the facility shall: (a) Clean the surface first with soap and water to remove any dirt or debris; and (b) Disinfect the surface with a disinfecting agent. 4. The disinfecting agent used pursuant to subsection 3 must consist of: (a) One-fourth of a cup of liquid chlorine bleach added to 1 gallon of water that is prepared fresh daily and kept in a closed container; (b) One tablespoon of liquid chlorine bleach added to 1 quart of water that is prepared fresh daily; or (c) A solution that is approved by the appropriate state or local agency and is at least as effective as the solutions described in paragraphs (a) and (b).”

NAC 430.4

“4. Each facility described in subsection 1 shall develop a written plan of curriculum for the children enrolled in the facility. The plan must: (a) Be made available for parental review; (b) Be prepared before the early care and education program becomes effective; (c) Be kept on file at the facility for at least 1 year; (d) Include a program of speaking and listening to English; (e) Integrate age appropriate key areas of instruction, including, without limitation, literacy, mathematics, science, social studies, creative expression and the arts, and health and safety; (f) Incorporate instruction, concepts and activities that foster the social, emotional, physical, linguistic and cognitive development of children; and (g) Provide for the involvement of parents of the children enrolled in the facility in learning activities at the facility and at home. Written plan of curriculum for the current week available. Make sure current plans for the current week for all classrooms are accessible.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization. The facility failed to ensure within 90 days after each caregiver commences his employment in the child care facility; they have applied with the Nevada Registry or its successor organization, and/or annually renewed his registration before the date on which it expires. Provide verification the staff members as noted have submitted initial or renewal application.”

NAC 320.1

“1. Except as otherwise provided in NRS 432A.177 , within the first 2 weeks after commencing employment, newly employed members of the staff of a facility must be given a written and oral orientation program and be trained in the policies, procedures and programs of the facility by the director or a designee trained by the director. The orientation must address, at a minimum: (a) Any regulatory requirements that govern the facility; (b) The goals and philosophy and the policies and procedures of the facility; (c) Any planned programs or activities of the facility; (d) The policies and practices of the facility for relating to parents; (e) Meal patterns and food-handling policies and practices of the facility; (f) Dealing with occupational health hazards for caregivers, including, without limitation, paying attention to the physical health and emotional demands of the job and being aware of any special considerations required by a caregiver who is pregnant; (g) The emergency health and safety procedures of the facility; and (h) The general health and safety policies and procedures of the facility, including, without limitation, policies and procedures concerning: (1) Hand-washing techniques and requirements; (2) Techniques for diapering and for assisting in the use of a toilet if care is provided to children in diapers or children needing help with using a toilet, including, without limitation, techniques for the disposal of diapers and for changing diapers; (3) Identifying hazards and methods for preventing injuries; (4) Techniques for preparing, serving and storing food for employees who are involved in any of the activities concerning food for children at the facility; (5) Excluding a child from the facility because the child has an illness, and the manner in which illnesses are transmitted between persons; (6) Methods for preparing formula if formula is prepared at the facility; (7) Any precautions and other measures that should be taken to prevent exposure to blood and other bodily fluids, and policies and procedures to follow in the event of exposure to blood or other bodily fluids; and (8) The administration of medication. New employees were not given a written and oral orientation and training in the policies, procedures, and programs of the facility within the first 2 weeks after commencing employment. Provide orientation and training as required. Please provide a copy of the orientation to Child Care Licensing and keep a copy in the employee's file.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization. The facility failed to ensure within 90 days after each caregiver commences his employment in the child care facility; they have applied with the Nevada Registry or its successor organization, and/or annually renewed his registration before the date on which it expires. Provide verification the staff members as noted have submitted initial or renewal application.”

NAC 320.1

“1. Except as otherwise provided in NRS 432A.177 , within the first 2 weeks after commencing employment, newly employed members of the staff of a facility must be given a written and oral orientation program and be trained in the policies, procedures and programs of the facility by the director or a designee trained by the director. The orientation must address, at a minimum: (a) Any regulatory requirements that govern the facility; (b) The goals and philosophy and the policies and procedures of the facility; (c) Any planned programs or activities of the facility; (d) The policies and practices of the facility for relating to parents; (e) Meal patterns and food-handling policies and practices of the facility; (f) Dealing with occupational health hazards for caregivers, including, without limitation, paying attention to the physical health and emotional demands of the job and being aware of any special considerations required by a caregiver who is pregnant; (g) The emergency health and safety procedures of the facility; and (h) The general health and safety policies and procedures of the facility, including, without limitation, policies and procedures concerning: (1) Hand-washing techniques and requirements; (2) Techniques for diapering and for assisting in the use of a toilet if care is provided to children in diapers or children needing help with using a toilet, including, without limitation, techniques for the disposal of diapers and for changing diapers; (3) Identifying hazards and methods for preventing injuries; (4) Techniques for preparing, serving and storing food for employees who are involved in any of the activities concerning food for children at the facility; (5) Excluding a child from the facility because the child has an illness, and the manner in which illnesses are transmitted between persons; (6) Methods for preparing formula if formula is prepared at the facility; (7) Any precautions and other measures that should be taken to prevent exposure to blood and other bodily fluids, and policies and procedures to follow in the event of exposure to blood or other bodily fluids; and (8) The administration of medication. New employees were not given a written and oral orientation and training in the policies, procedures, and programs of the facility within the first 2 weeks after commencing employment. Provide orientation and training as required. Please provide a copy of the orientation to Child Care Licensing and keep a copy in the employee's file.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization. The facility failed to ensure within 90 days after each caregiver commences his employment in the child care facility; they have applied with the Nevada Registry or its successor organization, and/or annually renewed his registration before the date on which it expires. Provide verification the staff members as noted have submitted initial or renewal application.”

NAC 310.1

“1. Every member of the staff of a facility, including a volunteer, shall present to the director of the facility, to be placed in the employee ' s file, written evidence that the employee is free from communicable tuberculosis. The evidence must be in the form of a report which states that the employee is free from active tuberculosis as required pursuant to subsection 2 or 3. Staff/volunteer as listed on the supplement did not have written evidence of a Mantoux tuberculin skin test or an examination by a provider authorized to diagnose active tuberculosis at least once every 24 months. A report stating the employee/volunteer is free from TB must be secured for any person whose test/examination is more than two years old.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization. The facility failed to ensure within 90 days after each caregiver commences his employment in the child care facility; they have applied with the Nevada Registry or its successor organization, and/or annually renewed his registration before the date on which it expires. Provide verification the staff members as noted have submitted initial or renewal application.”

NAC 310.1

“1. Every member of the staff of a facility, including a volunteer, shall present to the director of the facility, to be placed in the employee ' s file, written evidence that the employee is free from communicable tuberculosis. The evidence must be in the form of a report which states that the employee is free from active tuberculosis as required pursuant to subsection 2 or 3. Staff/volunteer as listed on the supplement did not have written evidence of a Mantoux tuberculin skin test or an examination by a provider authorized to diagnose active tuberculosis at least once every 24 months. A report stating the employee/volunteer is free from TB must be secured for any person whose test/examination is more than two years old.”

NRS 230

“Certificate of immunization prerequisite to admission to child care facility; conditional admission; report to Health Division. Except as otherwise provided in NRS 432A.235 for accommodation facilities: 1. Except as otherwise provided in subsection 3 and unless excused because of religious belief or medical condition, a child may not be admitted to any child care facility within this State, including a facility licensed by a county or city, unless the parents or guardian of the child submit to the operator of the facility a certificate stating that the child has been immunized and has received proper boosters for that immunization or is complying with the schedules established by regulation pursuant to NRS 439.550 <NRS-439.html> for the following diseases: (a) Diphtheria; (b) Tetanus; (c) Pertussis if the child is under 6 years of age; (d) Poliomyelitis; (e) Rubella; (f) Rubeola; and (g) Such other diseases as the local board of health or the State Board of Health may determine. 2. The certificate must show that the required vaccines and boosters were given and must bear the signature of a licensed physician or his or her designee or a registered nurse or his or her designee, attesting that the certificate accurately reflects the child ' s record of immunization. 3. A child whose parent or guardian has not established a permanent residence in the county in which a child care facility is located and whose history of immunization cannot be immediately confirmed by a physician in this State or a local health officer, may enter the child care facility conditionally if the parent or guardian: (a) Agrees to submit within 15 days a certificate from a physician or local health officer that the child has received or is receiving the required immunizations; and (b) Submits proof that the parent or guardian has not established a permanent residence in the county in which the facility is located. 4. If a certificate from the physician or local health officer showing that the child has received or is receiving the required immunizations is not submitted to the operator of the child care facility within 15 days after the child was conditionally admitted, the child must be excluded from the facility. 5. Before December 31 of each year, each child care facility shall report to the Health Division of the Department, on a form furnished by the Division, the exact number of children who have: (a) Been admitted conditionally to the child care facility; and (b) Completed the immunizations required by this section. The below listed children did not have a current immunization record or approved exemption on file at the facility. Obtain and file a current immunization record for the children listed. Director is recommended to sign up for WebIZ training in order to have access to the most up-to-date immunization records on-line. Discard old immunization records upon obtaining most current.”

NAC 310.1

“1. Every member of the staff of a facility, including a volunteer, shall present to the director of the facility, to be placed in the employee ' s file, written evidence that the employee is free from communicable tuberculosis. The evidence must be in the form of a report which states that the employee is free from active tuberculosis as required pursuant to subsection 2 or 3. Staff/volunteer as listed on the supplement did not have written evidence of a Mantoux tuberculin skin test or an examination by a provider authorized to diagnose active tuberculosis at least once every 24 months. A report stating the employee/volunteer is free from TB must be secured for any person whose test/examination is more than two years old.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization. The facility failed to ensure within 90 days after each caregiver commences his employment in the child care facility; they have applied with the Nevada Registry or its successor organization, and/or annually renewed his registration before the date on which it expires. Provide verification the staff members as noted have submitted initial or renewal application.”

NAC 425.3

“3. Except as otherwise provided in paragraph (n) of subsection 3 of NAC 432A.416, each infant and toddler must be under direct visual observation by a qualified caregiver at all times.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization. The facility failed to ensure within 90 days after each caregiver commences his employment in the child care facility; they have applied with the Nevada Registry or its successor organization, and/or annually renewed his registration before the date on which it expires. Provide verification the staff members as noted have submitted initial or renewal application.”

NAC 322

“1. Each person who is employed in a child care facility shall: (a) Except as otherwise provided in subsection 2 and NAC 432A.560 and 432A.570, obtain certification in the administration of cardiopulmonary resuscitation within 90 days after the person commences employment in the facility; and (b) Maintain current certification in the administration of cardiopulmonary resuscitation. 2. A person is not required to obtain the certification required pursuant to subsection 1 if, on the date that he or she commences employment in the facility, the person is certified in the administration of cardiopulmonary resuscitation and that certification satisfies the requirements set forth in this section. 3. The certification required pursuant to subsection 1 must include certification in administering cardiopulmonary resuscitation to children and: (a) To infants, if care is provided to infants at the facility; and (b) To adults, if necessary to ensure that the person is certified to administer cardiopulmonary resuscitation to children of all ages for which care is provided at the facility. 4. Each course completed to obtain and maintain the certification required pursuant to subsection 1 must be taught by a certified instructor who meets the standards of a nationally or internationally recognized provider of training in cardiopulmonary resuscitation, including, without limitation, the American Heart Association, the American National Red Cross, MEDIC FIRST AID International, EMS Safety Services, or the American Safety and Health Institute. 5. Evidence that an employee has obtained and maintained current certification in the administration of cardiopulmonary resuscitation as required pursuant to this section must be included in his or her personnel file and must be kept at the facility. Staff as listed on the supplement did not obtain CPR certification within 90 days of employment or maintain current certification. Ensure required CPR training is completed for staff listed.”

NAC 306

“1. Every caregiver in a child care facility must: (a) Be at least 16 years of age; (b) Be able to summon help in an emergency; (c) Be emotionally and physically qualified to carry out a program which places emphasis on the development of children; and (d) Except as otherwise provided in subsection 5, within 90 days after the caregiver commences employment in the child care facility, apply with The Nevada Registry or its successor organization, and annually renew his or her registration before the date on which it expires. 2. Not more than 50 percent of the caregivers in a child care center, a child care institution or an early care and education program may be under 18 years of age. Any caregiver who is under 18 years of age and is employed in such a facility must: (a) Have completed a course in the development of children which is approved by: (1) The Nevada Registry or its successor organization, or any other agency designated by the Director of the Department to approve such courses; or (2) If the course has not been approved by The Nevada Registry or its successor organization, and the Director of the Department has not designated another agency to approve such courses, the Division or the local licensing agency; or (b) Be currently enrolled in such a course. 3. A child care facility may not be operated unless a person who is 18 years of age or older is on the premises of the facility. 4. A volunteer for a child care facility, regardless of his or her age, and a member of the staff of the facility who is under 18 years of age may not provide direct care to a child at the facility unless the care is provided under the supervision of an employee of the facility who is 18 years of age or older. 5. A caregiver in a child care institution is not required to initially apply with or annually renew his or her registration with The Nevada Registry or its successor organization. The facility failed to ensure within 90 days after each caregiver commences his employment in the child care facility; they have applied with the Nevada Registry or its successor organization, and/or annually renewed his registration before the date on which it expires. Provide verification the staff members as noted have submitted initial or renewal application.”

NAC 322

“1. Each person who is employed in a child care facility shall: (a) Except as otherwise provided in subsection 2 and NAC 432A.560 and 432A.570, obtain certification in the administration of cardiopulmonary resuscitation within 90 days after the person commences employment in the facility; and (b) Maintain current certification in the administration of cardiopulmonary resuscitation. 2. A person is not required to obtain the certification required pursuant to subsection 1 if, on the date that he or she commences employment in the facility, the person is certified in the administration of cardiopulmonary resuscitation and that certification satisfies the requirements set forth in this section. 3. The certification required pursuant to subsection 1 must include certification in administering cardiopulmonary resuscitation to children and: (a) To infants, if care is provided to infants at the facility; and (b) To adults, if necessary to ensure that the person is certified to administer cardiopulmonary resuscitation to children of all ages for which care is provided at the facility. 4. Each course completed to obtain and maintain the certification required pursuant to subsection 1 must be taught by a certified instructor who meets the standards of a nationally or internationally recognized provider of training in cardiopulmonary resuscitation, including, without limitation, the American Heart Association, the American National Red Cross, MEDIC FIRST AID International, EMS Safety Services, or the American Safety and Health Institute. 5. Evidence that an employee has obtained and maintained current certification in the administration of cardiopulmonary resuscitation as required pursuant to this section must be included in his or her personnel file and must be kept at the facility. Staff as listed on the supplement did not obtain CPR certification within 90 days of employment or maintain current certification. Ensure required CPR training is completed for staff listed.”

NAC 385

“1. The staff of each facility shall: (a) Provide appropriate and adequate seating for the children at the facility during snacks and meals; (b) If a high chair is used, ensure that the chair: (1) Is in good condition; (2) Has a wide base; and (3) Has a safety belt for the child; (c) Wash with a detergent and disinfect after each use any chair or table that is used during a snack or meal; (d) Allow, encourage and assist each child to feed himself or herself, including, without limitation, encouraging a child to hold and drink from a cup, use a spoon and use his or her fingers to feed himself or herself; (e) Offer each child drinking water at times other than during his or her regular feedings; (f) Discard any food that is left in a dish after a meal; (g) Ensure that bottles and containers of food are not kept in water longer than 5 minutes, and stir, shake and test a bottle or container of food before using the bottle or container to feed an infant; (h) Not hold an infant while preparing food; (i) On a daily basis, empty, clean and sanitize any pot used to warm a bottle or food; (j) Store each bottle of formula and container of food in accordance with the instructions from the manufacturer of the formula or food; (k) Label each bottle of formula and container of food with the name of the child to whom it belongs and the date the formula or food was prepared by the facility or was prepared or purchased by the parent; (l) Immediately refrigerate and label each container of breast milk provided by a parent; m) Return each bottle to the appropriate parent each day; (n) Return any unused, open container of food to the appropriate parent each day if the child was not fed directly from the container of food; and (o) Develop with the parents of a child a plan for feeding the child, which must include, without limitation: (1) Instructions for feeding; (2) Any special dietary restrictions, including, without limitation, any allergies to food; (3) A schedule of times for feeding; (4) Whether the child will be fed breast milk, formula or solid food; (5) If the child will be fed breast milk or formula, when to begin feeding solid food; and (6) Likes and dislikes of certain foods. 2. A child who is fed with a bottle and does not hold his or her own bottle must be held by a caregiver while being fed with a bottle. The bottle must not be propped for feeding. A child who demonstrates a preference for holding a bottle during feeding may hold his or her own bottle and need not be held by a caregiver if the caregiver is directly observing the child. 3. The staff of a facility may feed a child commercially prepared baby food directly from the jar in which it was packaged or from a separate dish. If the staff feeds the child from the jar, the staff shall discard the jar after it is used. The staff failed to label each bottle of formula and container of food with the name of the child to whom it belonged and the date the formula or food was prepared by the facility or was prepared or purchased by the parent. Ensure formula and food is labeled as required.”