CHAPTER He-C 4000 CHILD CARE LICENSING RULES

Statutory Authority: RSA 170-E:34, I

PART He-C 4001 NH RESIDENTIAL CHILD CARE LICENSING RULES

REVISION NOTE:

Document #13181, effective 3-24-21, readopted with amendments the “New Hampshire State Fire Code Compliance Report” form pursuant to the expedited revisions to agency forms process in RSA 541-A:19-c. Document #13181 contained only the amended form, giving it a new effective date, and updated the revision date on the form from “10/2014” to “3/2021.” The “New Hampshire State Fire Code Compliance Report” form must be submitted pursuant to paragraph (d) of rule He-C 4001.02 titled “Application Form and Attachments”. The requirements on the form are set forth in paragraph (e) of He-C 4001.02. The prior filing affecting He-C 4001.02 was Document #13151, effective 12-30-20. The effective date of the rule remained unchanged by Document #13181. However, the requirements on the form with revision date 3/2021 would be the valid and enforceable rule in case of any conflict between the form and He-C 4001.02(d) and (e) in Document #13151 since the form is defined as a “rule” in RSA 541-A:1, XV and is the later enactment.

He-C 4001.01 Definitions.

(a) “Administer” means an act whereby a single dose of a drug is instilled into the body of, applied to the body of, or otherwise given to a resident for immediate consumption or use.

(b) “Applicant” means a person, corporation, partnership, voluntary association, or other organization, either established for profit or otherwise, who intends to operate one or more residential child care programs, and who indicates that intent to the unit by submitting an application and the application attachments required by He-C 4001.02.

(c) “Authorized staff” means program staff that have completed training in medication safety and administration who are responsible for administration of medications to residents.

(d) “Child” means “child” as defined in RSA 170-E:25, I.

(e) “Child abuse” means the infliction on a child of any of the behaviors set forth in RSA 169-C:3, II (a) - (f).

(f) “Child care agency” means “child care agency” as defined in RSA 170-E:25, II.

(g) “Child endangerment” means the negligent violation of a duty of care or protection owed to a child or negligently inducing a child to engage in conduct that endangers their health or safety.

(h) “Child neglect” means any of the behaviors or circumstances set forth in RSA 169-C:3, XIX (a) or (b).

(i) “Clinical coordinator” means a staff member employed by the residential treatment program responsible for administrative oversight of the clinical services provided at the program. This term includes “treatment coordinator.”

(j) “Clinical staff” means individuals who have a master’s degree in a clinical field such as social work, marriage and family therapy, psychology, guidance counseling, or a degree that would make one eligible for a license from the NH board of mental health practice or NH board of psychologists.

(k) “Commissioner” means the commissioner of the NH department of health and human services, or their designee.

(l) “Corporal punishment” means use of aggressive physical contact or other action designed to cause the resident discomfort, used as a penalty for behavior disapproved of by the punisher.

(m) “Corrective action plan” means “corrective action plan” as defined in RSA 170-E:25, V.

(n) “Department” means “department” as defined in RSA 170-E:25, VI.

(o) “Direct care staff” means program staff who are responsible for providing direct care to residents.

(p) “Directed corrective action plan” means a corrective action plan that is developed and issued by the unit.

(q) “Discharge” means “discharge” as defined in RSA 170-E:42-a, I(a).

(r) “Evaluation” means a multi-disciplinary assessment of the resident’s level of function by professionals licensed or certified in their respective fields of practice or study, which enables facility staff to plan care that allows the resident to reach their highest practicable level of physical, mental, and psychosocial functioning.

(s) “Field trip” means any excursion off the premises of the residential child care program with residential child care staff, other than routine or unplanned local travel such as walks in the neighborhood, travel to the local library, or other routine travel such as travel to and from school, employment, local appointments, or travel to do local errands.

(t) "Full medical withdrawal management" means a protocol for a resident receiving 24-hour nursing supervision overseen by a licensed practitioner, who might be incapable of evacuating a facility on their own or might have medical conditions that require immediate medical intervention, such as seizures, tremors, delirium, cardiac, or are a danger to themselves or others.

(u) “Group home” means “group home” as defined in RSA 170-E:25, II(c).

(v) “Guardian” means “guardian” as defined in RSA 170-E:25, VII.

(w) “Homeless youth” means a person 16 through 20 years of age who is unaccompanied by a parent or guardian and is without shelter where appropriate care and supervision are available, whose parent or legal guardian is unable or unwilling to provide shelter and care, or who lacks a fixed, regular, and adequate residence.

(x) “Homeless youth program” means “homeless youth program” as defined in RSA 170-E:25, II(f).

(y) “Household member" means any person who resides in a child care program other than child care personnel or children admitted to the child care program.

(z) “Incident” means:

(1) Resident behavior that is extreme, including, but not limited to, behavior that is assaultive, destructive, self-injurious, or self-destructive; or

(2) An occurrence involving an accident or injury of a resident, or requiring outside agency involvement.

(aa) “Independent living” means transition to adulthood whereby the resident negotiates living on their own with a set of skills and goals based on the resident’s needs and interests.

(ab) “Independent living home” means “independent living home” as defined in RSA 170-E:25, II(d).

(ac) “License” means “license” as defined in RSA 170-E:25, IX.

(ad) “License capacity” means the maximum number of residents that can be admitted to and present in the residential child care program, as authorized by the license issued.

(ae) “Licensed clinical supervisor” means a registered nurse (RN) licensed under the state of New Hampshire pursuant to RSA 326-B, or an individual licensed by the board of licensing for alcohol and other drug use professionals or board of mental health practice to practice and supervise substance use counseling who meets the initial licensing qualifications set forth in RSA 330-C:18.

(af) “Licensed practitioner” means a:

(1) Medical doctor;

(2) Physician’s assistant;

(3) Advanced practice registered nurse (APRN);

(4) Doctor of osteopathy;

(5) Doctor of naturopathic medicine; or

(6) Any other practitioner with diagnostic and prescriptive powers licensed by the appropriate state licensing board.

(ag) “Mechanical restraint” means “mechanical restraint” as defined in RSA 126-U:1, IV(b).

(ah) “Medical director” means a practitioner licensed in accordance with RSA 329 or RSA 326-B, who is responsible for overseeing the quality of medical care and services in a specialized care program.

(ai) “Medical technology dependent” means a resident with limitations so severe as to require both an assistive medical technology device to compensate for the loss of a vital body function and significant and sustained care to avert death or further disability. Assistive medical technology devices include, but are not limited to tracheostomy tube, feeding tube, c-pap or bi-pap machines, and wheelchairs.

(aj) “Medication” means a drug prescribed for a resident by a licensed practitioner and over-the-counter medications.

(ak) “Medication log” means a written record of medications administered to a resident.

(al) “Medication occurrence” means any error in the administration of a medication as prescribed or in the documentation of such administration, with the exception of a resident’s refusal.

(am) “Medication restraint” means “medication restraint” as defined in RSA 126-U:1, IV(a).

(an) “Mental illness” means a substantial impairment of emotional processes, or of the ability to exercise conscious control of one's actions, or of the ability to perceive reality or to reason, when the impairment is manifested by instances of extremely abnormal behavior or extremely faulty perceptions. It does not include impairment primarily caused by:

(1) Epilepsy;

(2) Intellectual disability;

(3) Continuous or non-continuous periods of intoxication caused by substances such as alcohol or drugs; or

(4) Dependence upon or addiction to any substance such as alcohol or drugs.

(ao) “Monitoring visit” means an announced or unannounced visit made to a residential child care program by department personnel for the purpose of assessing compliance with the standards set by rule adopted by the commissioner pursuant to RSA 541-A.

(ap) “Nursing care” means the provision or oversight of a resident’s physical, mental, or emotional condition by diagnosis as confirmed by a licensed practitioner.

(aq) “Orders” means instructions by a licensed practitioner, produced verbally, electronically, or in writing for medication, treatments, recommendations, and referrals, and signed by the licensed practitioner using terms such as authorized by, authenticated by, approved by, reviewed by, or any other term that denotes approval by the licensed practitioner.

(ar) “Parent” means a father, mother, legal guardian, or other person or agency responsible for the placement of a resident.

(as) “Permanency” means a permanent connection with at least one adult committed to helping the homeless youth meet their needs throughout their life.

(at) “Permit” means “permit” as defined in RSA 170-E:25, X.

(au) “Pre-service training” means training or education required to meet the minimum qualifications for the position of program director, as specified in He-C 4001.19(e), or direct care staff, as specified in He-C 4001.19(f).

(av) “Procedure” means a licensee’s written, standardized method of performing duties and providing services.

(aw) “Program director” means the individual who has responsibility for the daily operation of the residential child care program.

(ax) “Program staff” means all staff, both professional and non-professional, including direct care staff, who are responsible for the supervision, care, or treatment of residents.

(ay) “Pro re nata (PRN)” means medication administered as circumstances might require in accordance with licensed practitioner’s orders.

(az) “Rehabilitative and restorative services” means interventions provided including any medical or remedial services recommended by licensed practitioner within the scope of the residential treatment program’s practice to reduce a physical or mental disability and restore a recipient to their best functional level.

(ba) “Repeat citation” means a citation of a specific licensing rule or law for which the unit has cited the program during the past 3 years, which has not been removed after an informal dispute resolution or overturned after an adjudicatory procedure and that posed a health or safety risk to residents.

(bb) “Reportable incident” means an occurrence of any of the following while the resident is either in the program or in the care of program personnel:

(1) The death of the resident;

(2) Suspected abuse or neglect of the resident;

(3) Emergency medical treatment for the resident;

(4) The impairment of the resident while at the program;

(5) A medication occurrence that required medical intervention for the resident; or

(6) The unexplained absence of a resident from the program.

(bc) “Resident” means a child who has been admitted to a residential child care program.

(bd) “Residential child care program (program)” means “child care agency” as defined in RSA 170-E:25, II.

(be) “Restraint” means “restraint” as defined by RSA 126-U:1, IV.

(bf) “Runaway” means a child who is absent without leave or permission from the program that is responsible for the supervision of that child.

(bg) “Sanitize” means to clean by removing all organic material, then wiping or washing the surface with a disinfecting or germicidal solution or a commercial product designed to kill germs and which, when used in accordance with manufacturer’s directions, does not pose a health or safety risk to residents.

(bh) “Seclusion” means “seclusion” as defined in RSA 126-U:1, V-a.

(bi) “Short term” means a placement which is intended to last for 60 days or less, unless the program has written documentation on file that the 60 day period has been extended by the department’s division for children, youth and families (DCYF), juvenile justice services (JJS), or by the referring agency.

(bj) "Specialized care" means "specialized care” as defined in RSA 170-E:25, II(e). Such care includes substance use disorder and behavioral health. The term also includes “specialized care program (SCP)”.

(bk) “Substance use disorder (SUD)” means a disease that affects a person’s brain and behavior and might lead to an inability to control the use of a legal or illegal substance. Substances can include alcohol and other drugs.

(bl) “SUD program” means a residential program, excluding hospitals as defined in RSA 151:2, I(a), which provides residential SUD treatment relating to the youth’s medical, physical, psychosocial, vocational, and educational needs.

(bm) “Time out” means the restriction of a resident for a period of time to a designated area from which the resident is not physically prevented from leaving, for the purpose of providing the resident the opportunity to regain self-control or as a consequence to a specific behavior.

(bn) “Transfer” means “transfer” as defined in RSA 170-E:42-a, I(b).

(bo) “Treatment plan” means the program’s written, time-limited, goal-oriented therapeutic plan for the child and family, which includes strategies to address the issues that brought the child into placement, and which is developed by the family, program staff, and the agency responsible for the placement of the child. This includes, but is not limited to, a child specific planning document prepared in cooperation with DCYF, JJS, a school district, or other placing or sending organization, or a treatment plan document that complies with He-C 6350.

(bp) “Unit” means the department’s child care licensing unit.

(bq) “Volunteer” means an unpaid person who assists with the provision of food services or activities, and who does not provide direct care or assist with direct care.

(br) “Withdrawal management” means a residential treatment service provided by appropriately trained staff who provide 24-hour supervision, observation, and support for youth who are intoxicated or experiencing withdrawal with prescription medication administered based on the results of an appropriate evaluation tool.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; (see also Revision Note at part heading for He-C 4001); ss by #14214, eff 4-1-25

He-C 4001.02 Application Form and Attachments.

(a) Any person or entity who intends to operate a residential child care program shall create an account in “NH Childcare Information System (NHCIS)” at https://new-hampshire.my.site.com/nhccis/s/login or obtain an application packet from the unit.

(b) All applicants for licensure shall complete and submit an application by either applying online via the NHCIS portal described in (a) above, or by submitting an “Application for Residential Childcare” (February 2025), to the unit, certifying the following:

“I understand that the department may investigate any criminal conviction record, finding of child abuse or neglect, or investigation of or final determination regarding any juvenile delinquency and will make a determination regarding whether the individual poses a current risk to the health, safety or well being of children;

I understand that the department may delay its decision to approve or deny this application pending the outcome of any investigation, when the applicant, owner, or program director, are named as the perpetrator in any current investigation of any crime, or in an allegation of abuse or neglect;

I understand that providing false information on this application or any of the attachments, or failing to disclose any information required on the application, or required to be submitted with this application, shall be considered grounds for license denial or revocation;

I have read the NH residential child care program licensing rules, He-C 4001, and understand that failure to maintain the program in compliance with the applicable rules, may jeopardize my license/permit; and

All information provided as part of this application and in the required attachments is true and complete to the best of my knowledge.”

(c) The applicant shall submit the following with the application:

(1) Written approval from the local health officer, documenting that within the 12 months immediately preceding the date the unit receives the application, the premises has been inspected and approved by a local health officer or duly appointed designee;

(2) A completed “New Hampshire State Fire Code Compliance Report” (February 2025), documenting that, within the 12 months immediately preceding the date the unit receives the application, the premises has been inspected and approved for compliance with the state fire code as defined in RSA 153:1 and as amended by rules adopted pursuant to RSA 153:3, including but not limited to, NFPA 1 and NFPA 101;

(3) Documentation from the applicable town or city that the program has been granted zoning approval and any zoning requirements or restrictions, as applicable, or that no zoning approval is required;

(4) Documentation of education and experience that shows that the program director meets the requirements for their position, as specified in He-C 4001.19(g), which shall include the following:

a. Copies of transcripts, certificates, diplomas, or degrees as applicable; and

b. A resume or other documentation of previous experience;

(5) A copy of documents required by the secretary of state regarding the trade name, limited liability corporation, or corporation, as applicable, documenting approval to conduct business in New Hampshire, and that the entity is in good standing; and

(6) Plans for all residential child care spaces to include:

a. Room description and dimensions;

b. Location of egresses;

c. Fixtures, such as toilets, sinks, bathtubs, and showers;

d. Overall dimension of outdoor play space;

e. Location of fencing and gates, if any;

f. Location of stationary play or recreation equipment; and

g. Location and description of hazards such as pools, bodies of water, or streets.

(d) The applicant, program directors, and all household members aged 10 years and older, shall submit for a background record check as specified in He-C 4001.31.

(e) The unit shall not consider an application complete until it receives all the information specified in (b), (c), and (d) above.

(f) Residential child care programs that have multiple buildings on the same or adjoining property may apply for a single license for those multiple buildings provided that:

(1) In accordance with residential child care space requirements specified in He-C 4001.16, each residence has adequate square footage, common living space, and complete bathroom units for the number of residents who will reside in each building;

(2) An individual who meets at least the minimum qualifications of a direct care staff is designated in charge in each building; and

(3) All program staff and residents are aware of the identity of the direct care staff designated in charge in each building.

(g) Upon receipt of a complete license application, unit staff shall complete an inspection for compliance with He-C 4001.

(h) After the inspection in (g) above, the unit shall issue a 6-month permit or 3-year license, pursuant to He-C 4001.04 and RSA 170-E:31, III and V, that reflects the age range and maximum number of children approved by the local officials, the measured space, and the number of bathroom units.

(i) The permit or license shall:

(1) Not be transferable to a new owner or to a new location; and

(2) No longer be valid when:

a. The licensee has surrendered a license or permit;

b. The license has expired and a complete application form with attachments has not been received by the unit; or

c. The license or permit has been revoked or suspended, and the licensee:

1. Did not request an administrative hearing; or

2. Requested an administrative hearing and a decision was issued upholding the revocation or suspension.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20 (see also Revision Note at part heading for He-C 4001); ss by #14214, eff 4-1-25

He-C 4001.03 Procedures for License Renewal and Revisions.

(a) No less than 3 months prior to the expiration date of the current license, each licensee shall submit an application, to the unit, either online via the NHCIS portal described in He-C 4001.02(a), or by utilizing the “Application for Residential Childcare” form (February 2025).

(b) The following shall be submitted along with the application in (a) above:

(1) The application attachments specified in He-C 4001.02(c)(1), (2), and (5); and

(2) The application attachments specified in He-C 4001.02(c)(6), if there has been changes to the space since the previous application was filed.

(c) In accordance with RSA 541-A:30, I, an existing license shall not expire until the department takes final action upon the renewal application, provided a licensee submits a timely application in accordance with this section.

(d) Prior to adding a license type or prior to relocating, a licensee shall apply for revision of the license by submitting an application in accordance with He-C 4001.02(a) and (c)(1), (2), (3), and (6), as applicable.

(e) A licensee shall notify the unit in writing when adding space not previously approved by the unit, increasing the capacity in one or more buildings, or increasing the overall program capacity.

(f) When a program applies for a revision that will exceed any limits or condition on the written approvals from the local health officer the local fire department, or local zoning officials, the program shall submit new health officer, fire department, and zoning approvals as applicable for each building for which it is seeking a license revision.

(g) The licensee shall not relocate, increase enrollment beyond the current license capacity, or use space not previously approved by the unit, until the unit issues the program a revised license or the program receives other written authorization by the unit.

(h) A licensee shall notify the unit in writing when they wish to change the name of the program, so that the unit can issue a revised license that reflects the name change.

(i) A licensee who discontinues using a space for residential child care shall notify the unit in writing within 5 business days of the change so that the unit can record the change in the file and revise the license accordingly, if necessary.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #14214, eff 4-1-24

He-C 4001.04 Time Frames for Departmental Response to Applications, Petitions, or Requests.

(a) Pursuant to RSA 541-A:29, the department shall approve or deny an application, petition, or request no later than 60 days from receipt of the application, petition, or request and any additional information requested by the department.

(b) The 60 days specified in (a) above shall begin on the date on which all requested information is received by the department.

(c) Any outstanding corrective action plan for violations of rule or statute shall be considered additional information under (a) above.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-24

He-C 4001.05 Board of Directors.

(a) Each program that is incorporated shall have a duly appointed board of directors.

(b) The applicant or licensee shall:

(1) If incorporated, provide a list of the names, addresses, and telephone numbers of current members of the board of directors, and have a copy of current rules of the board of directors on file and made promptly available on the premises of the program for review by the unit upon request during all visits; and

(2) If governed by any other governing body, provide a list of the names, addresses, and telephone numbers of current members of the governing body, and have a copy of any rules by which the governing body operates on file and made promptly available on the premises of the program for review by the unit upon request during all visits.

(c) The board of directors for programs that are incorporated and the owner or governing body for programs that are not incorporated shall maintain a sufficient degree of oversight of the program’s operations to ensure that the program is complying with the provisions of RSA 170-E, this part, and any policies and procedures adopted by the program.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #14214, eff 4-1-24

He-C 4001.06 Statements of Findings and Corrective Action Plans.

(a) The unit shall issue a statement of findings to the applicant or licensee for each licensing and monitoring visit, and each investigatory visit which results in non-compliance with any of the provisions of RSA 170-E or He-C 4001.

(b) At the close of any visit or when an investigation is concluded, or as soon as possible thereafter, the unit shall review with the program director or their designee, a summary of any citations of rules found during the visit.

(c) Within 21 calendar days of the review in (b) above, the unit shall provide the statement of findings via email, by uploading to the program’s NHCIS portal, if applicable, or by U.S. mail if an email address has not been provided.

(d) The program shall not alter the statement of findings, including but not limited to revising evidence or dates as documented by the unit.

(e) The program director or their designee shall submit a corrective action plan for each citation included on the statement of findings, and include:

(1) The action the program has taken or shall take to correct the citations, including any interim measures implemented to protect the health and safety of residents pending correction of the non-compliance;

(2) What measures or systemic changes the program shall implement to ensure that the non-compliance does not recur;

(3) The date by which the program corrected or shall correct each citation; and

(4) The dated signature of the program director or their designee when the corrective action plan is submitted in writing.

(f) The program director or their designee shall complete corrective action plans and return them to the unit in accordance with the following:

(1) The corrective action plan shall be submitted to the unit within 21 calendar days of the date the unit issues the statement of findings; and

(2) The names of individuals shall not be included in the corrective action plans.

(g) The only exceptions to (f)(1) above shall be as follows:

(1) When a program director or their designee requests an informal dispute resolution in accordance with He-C 4001.08, the corrective action plan due date shall be 21 calendar days from:

a. The date the program receives notice of the unit’s decision regarding the informal dispute resolution if the unit is not issuing a revised statement of findings; or

b. The date the unit issues the revised statement of findings as a result of the informal dispute resolution; and

(2) When the program director or their designee requests and receives an extension from the unit, when a corrective action plan cannot be completed and returned by the due date.

(h) When the corrective action plan submitted to the unit by the program in accordance with (e) and (f) above is not acceptable, the unit shall notify the licensee in writing of the reason for rejecting the proposed corrective action plan and request submission of a new corrective action plan.

(i) When a program fails to submit an acceptable corrective action plan, the unit shall create and issue an acceptable corrective action plan, and the program shall return and implement the corrective action plan in accordance with (e) and (f) above.

(j) The unit shall verify implementation of the corrective action plan submitted and approved by the unit by:

(1) Reviewing materials submitted by the licensee;

(2) Conducting a follow-up inspection; or

(3) Reviewing compliance during any subsequent visit conducted in accordance with RSA 170-E:31, IV, RSA 170-E:32, II, or RSA 170-E:40, II.

(k) When the findings of any inspection or investigation indicate that immediate corrective action is required to protect the health and safety of the residents or personnel, the unit shall order the immediate implementation of a directed corrective action plan developed by the unit.

(l) The existence of a corrective action plan shall not prohibit the department from taking other enforcement action available to it under He-C 4001, RSA 170-E, RSA 541-A, or other law.

(m) The department shall initiate enforcement action without requesting that the program submit a corrective action plan when it finds repeat non-compliance with licensing rules or statute, or when it finds non-compliance with a rule or statute resulted in physical injury to a resident or caused a resident to be in danger of physical injury.

(n) Programs shall comply with approved corrective action plans and corrective action plans issued in accordance with (i) and (k) above.

(o) Programs shall maintain on file on the premises and make available upon request to clients and perspective clients, a copy of the statement of findings and corrective action plan approved or issued by the unit for the visit immediately preceding the visit represented on the last statement of findings issued.

(p) All statements of findings issued for non-compliance with any of the provisions of RSA 170-E or He-C 4001, and the corrective action plans submitted in response to those citations shall be considered public information on or after the corrective action plan due date as specified herein.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #14214, eff 4-1-24

He-C 4001.07 Complaints and Investigations.

(a) In accordance with RSA 170-E:40, I and II, the department shall respond to any complaint that meets the following conditions:

(1) The alleged non-compliance occurred within 6 months of the date of the allegation(s);

(2) The complaint includes the complainant’s first-hand knowledge regarding the allegation(s) or on information reported directly to the complainant by a resident who has first-hand knowledge regarding the allegation(s);

(3) There is sufficient specific information for the unit to determine that the allegation(s), if proven to be true, would constitute non-compliance with any of the provisions of He-C 4001 or RSA 170-E; or

(4) The complaint is from any source and alleges non-compliance that occurred at any time if the complaint alleges:

a. Physical injury or abuse;

b. Verbal or emotional abuse; or

c. The danger of physical injury to one or more residents.

(b) After the investigation of a complaint has been completed and the unit determines the complaint is founded, the unit shall issue a statement of findings listing the citation(s) found resulting from the investigation and any other citation(s) found during the investigation.

(c) When the unit determines the complaint unfounded, the unit shall send a notice to the program advising that the complaint was unfounded.

(d) The records compiled during an investigation shall be confidential as required by RSA 170-E:40, III.

(e) Programs shall conduct an internal assessment regarding allegations of staff treatment of residents by obtaining basic information necessary to determine whether the staff presents a current health or safety risk to the residents.

III.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151 eff 12-30-20; ss by #14214, eff 4-1-24

He-C 4001.08 Informal Dispute Resolution.

(a) An opportunity for informal dispute resolution shall be available to the licensee who disagrees with a citation issued by the unit.

(b) When requesting an informal dispute resolution, the applicant, licensee, or program director shall:

(1) Submit a written notice to the unit requesting an informal dispute resolution no later than 14 days from the date of issuance of the statement of findings; and

(2) Include in the notice why the program believes that the unit erroneously issued the citation as noted in the statement of findings.

(c) The unit shall provide a written notice of decision within 30 days from receipt of the request and receipt of any information provided to support the reasons for the dispute.

(d) An informal dispute resolution shall not be an option for any applicant or licensee against whom the unit has initiated a fine, a conditional license, or action to suspend, revoke, deny, or refuse to issue or renew a license, unless the applicant or licensee waives their right to the appeal the action initiated.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #14214, eff 4-1-24

He-C 4001.09 Enforcement Action and Administrative Appeals.

(a) The department shall revoke or suspend a license or deny an application for a new license, license renewal or license revision, in accordance with the provisions of RSA 170-E:27, II, RSA 170-E:29, III and IV, RSA 170-E:29-a, and RSA 170-E:35 if:

(1) After being notified of and given an opportunity to supply missing information, the application does not meet the requirements of He-C 4001.02;

(2) After being notified by the department that an adult or a juvenile who is not a resident admitted to the program may pose a risk to residents, the applicant or licensee refuses to submit a corrective action plan which ensures that the individual is removed from employment or from the household and will not have access to the residents in care;

(3) An applicant or licensee has endangered or continues to endanger one or more residents by a negligent violation of a duty of care or protection owed to the child or negligently inducing such child to engage in conduct that endangers his health or safety;

(4) The applicant or licensee has been found guilty of abuse, neglect, exploitation of any person or has been convicted of child endangerment, fraud or a felony against a person in this or any other state by a court of law, or has been convicted of any crimes as referenced in RSA 170-E:29, III or IV, or RSA 170-E:29-a, or had a complaint investigation for abuse, neglect, or exploitation substantiated by the department or in any other state;

(5) The applicant, licensee or designee of the applicant knowingly provides materially false or misleading information to the department, including information on the application or in the application attachments;

(6) The applicant, licensee or any representative or employee of the applicant fails to cooperate with any inspection, investigation or visit by the department;

(7) The applicant or licensee violates any of the provisions of RSA 170-E:24 –49 or He-C 4001;

(8) The applicant or licensee has demonstrated a history or pattern of multiple or repeat violations of RSA 170-E, or He-C 4001, that pose or have posed a health or safety risk to residents; or

(9) The applicant or licensee fails to submit an acceptable corrective action plan or fully implement and continue to comply with a corrective action plan that has been accepted by the department in accordance with He-C 4001.06.

(b) If a license has been revoked, or has expired without timely application for renewal having been made in accordance with He-C 4001, operation shall be discontinued immediately.

(c) The department shall notify applicants or licensees affected by a decision of the department to deny, revoke or suspend a license of their right to an administrative appeal in accordance with RSA 170-E:36.

(d) If an applicant or licensee fails to request an administrative appeal in writing within 10 days of the receipt of the notice required by RSA 170-E:36, I, the action of the department shall become final.

(e) Administrative appeals under this section shall be conducted in accordance with RSA 170-E:36, II, III, and IV, RSA 170-E:37, RSA 541-A and He-C 200.

(f) Further appeals of department decisions under this section shall be governed by RSA 541-A and RSA 170-E:37.

(g) Any licensee who has been notified of the department’s intent to revoke or suspend a license or deny an application for a license renewal may be allowed to continue to operate during the appeal process except as specified in (h) below.

(h) When the department includes in its notice of revocation or suspension an order of immediate closure, pursuant to RSA 170-E:36, III or RSA 541-A:30, III, the program shall immediately terminate its operation and not operate during the appeal process except under court order, or as provided by RSA 541-A:30, III.

(i) The department shall initiate a suspension of a license rather than revocation when it determines that the action is being initiated against a program that does not have a history of repeat violations of licensing rules or statute and the action is based on a violation or situation which is:

(1) Related to a correctable environmental health or safety issue, including but not limited to, a problem with a program’s water supply, septic system, heating system, or structure; and

(2) Documented by the program as being temporary in nature.

(j) Except for (h) above, any suspension of a license that has not been appealed, or any suspension of a license that has been upheld on appeal shall remain in effect until the department notifies the program whose license was suspended that the suspension has been removed because:

(1) The violation which resulted in the suspension has been corrected; or

(2) The suspension was based on loss of fire or health officer approval and the local fire inspector or inspector from the state fire marshal’s office, or health officer has reinstated the previously rescinded approval.

(k) Upon receipt of notice of the department’s intent to revoke, suspend, deny or refuse to issue or renew a license, the applicant or licensee receiving the notice shall immediately provide the department with a list of the names, addresses and phone numbers of the person or agency responsible for the placement of each current resident.

(l) Based upon information provided under (k) above, the department shall notify the person or agency responsible for the placement of each current resident that the department has initiated action to revoke or suspend the license or deny an application for a license renewal.

(m) The department shall send a copy of the notice required in (l) above to the following entities:

(1) The health officer and fire inspector in the town in which the program is located;

(2) The state office of the United States Department of Agriculture, Child and Adult Food Program, if the residential child care program participates in that program;

(3) The New Hampshire department of education if the program has a school on the premises; and

(4) The director of DCYF.

(n) When a program’s license has been revoked or denied, the department has refused to renew a license, or an application has been denied by the department, if the enforcement action specifically pertained to their role in the program, the applicant, licensee, program director or executive director, shall not be eligible to reapply for a license, or be employed as an executive director or program director for at least 5 years from:

(1) The date of the department’s decision to revoke or deny the license, if no appeal is filed; or

(2) The date an order is issued upholding the action of the department, if that action has been appealed.

(o) Notwithstanding (n) above, the department shall accept an application submitted after the decision to revoke or deny becomes final, provided there has been no violation of RSA 170-E:27, II, RSA 170-E:35, I, or RSA 170-E:35, XIII, only under the following circumstances:

(1) The applicant or licensee, when licensed, did not demonstrate a pattern of repeat violation of licensing rules or statute;

(2) The denial was based on the applicant or licensee’s inability or failure to correct a violation caused by a temporary condition which has been corrected; or

(3) The licensee or applicant who was denied an initial application shows that circumstances have substantially changed such that the department now has good cause to believe that the applicant has the requisite degree of knowledge, skills and resources necessary to maintain compliance with the provisions of RSA 170-E and He-C 4001.

(p) No ongoing enforcement action shall preclude the imposition of any remedy available to the department under RSA 170-E, RSA 541-A, He-C 4001 or other law.

(q) Requests for reconsideration or appeal of any decision by a hearings officer shall be filed within 30 days of the date of the decision.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #14214, eff 4-1-24

He-C 4001.10 Duties and Responsibilities of the Licensee.

(a) The program shall abide by the provisions specified on the permit or license.

(b) Program staff shall:

(1) Display a copy of the current permit or license issued by the department in a prominent location in each building in which residents are housed; and

(2) Not alter the permit or license issued by the department.

(c) A permit or license shall not be transferable to a new owner or new location.

(d) Any licensee, program staff, or other person involved with a program who has reason to suspect that a resident is being abused or neglected shall, immediately or as soon as is reasonably possible, report the suspected abuse or neglect to DCYF at 1-800-894-5533.

(e) When direct care staff who are witness or party to any event that meets the mandated reporting requirement in RSA 169-C:29, the program shall provide opportunity and support to such staff to make the required report. Whenever possible, the staff directly involved or witness to the event shall make reports to the department, with assistance from administrative staff as needed to assure all necessary information is available to make a complete report.

(f) Program staff shall safeguard the confidentiality of all records and personal information regarding any resident.

(g) Applicants, licensees, and all program staff shall keep confidential all records required by the department pertaining to the admission, progress, health, transfer, and discharge of residents under their care and all facts learned about residents and their families with the following exceptions:

(1) Program staff shall, upon request, make available to the department all records that programs are required by RSA 170-E or He-C 4001 to keep, and to such records as necessary for the department to determine staffing patterns and staff attendance; and

(2) Other than as specified in (g)(1) above, program staff shall release information regarding a specific resident only as directed by a parent or guardian of that resident, or upon receipt of written authorization to release such information, signed by that resident’s parent or guardian, unless otherwise restricted by applicable state or federal law.

(h) Information collected by the department during the application process shall be released:

(1) To the applicant, licensee, or their designated representative;

(2) Upon receipt of written authorization by the applicant or licensee to release information; or

(3) To federal, state, and local officials or the entities that provided reports.

(i) Except for law enforcement agencies or in an administrative proceeding against the applicant or licensee, the department shall keep confidential any information collected during an investigation, unless it receives an order from a court of competent jurisdiction ordering the release of specific information.

(j) Applicants, licensees, members of the board of directors or other governing body, program staff, child care interns, child care assistants, and volunteers shall cooperate with the department during all departmental visits authorized under RSA 170-E and He-C 4001.

(k) For the purposes of (j) above, cooperation shall include, but not be limited to not interfering with efforts by representatives of the department to:

(1) Enter the premises and complete an inspection;

(2) Document evidence or findings by taking written statements, and by photographing toys, equipment, and learning materials or conditions inside or outside residential child care space and other areas of the premises accessible to residents;

(3) Make an audio recording of conversations with individuals who have consented to the audio recording;

(4) Interview all individuals whom the department determines might have information relevant to the issues being evaluated; and

(5) Review and reproduce any forms or reports which the applicant or licensee is required to maintain or make available to the department under He-C 4001.

(l) All records and written policies required by He-C 4001 shall be maintained on file and on the premises for review, or provided within 48 hours of a request, for all current staff and residents.

(m) Programs shall retain records in accordance with the following:

(1) For 2 years from the date a resident is transferred or discharged;

(2) For 2 years from the date of termination for records related to staff; and

(3) For all other records 2 years from the date the record was created.

(n) The exception to (l) above shall be when program staff shows good cause as to why the requested reports or records are not immediately available. In such case, the provider shall make the records available within 2 business days, or otherwise obtain an extension from the unit. Good cause shall include circumstances beyond the licensee’s control or other extenuating circumstances.

(o) When the individual who has been identified and approved by the unit as program director leaves the position, the licensee or designee shall:

(1) Notify the unit of the departure of the program director within 10 days;

(2) Within 10 days of the departure of the director, notify the unit of the name of the individual who is temporarily serving as the program director and who meets at least the minimum requirements of a direct care staff; and

(3) Within 120 days of the date of departure of the program director, notify the unit and submit information and documentation required under He-C 4001.02(i) and (j) for the new, qualified program director.

(p) The applicant, licensee, or any child care staff shall not:

(1) Make false or misleading statements to the department, whether verbal or written; or

(2) Falsify any documents, other written information, or reports issued by or required by the department under He-C 4001.

(q) The applicant or licensee shall comply with all applicable federal, state, and local laws, rules, regulations, and ordinances.

(r) The applicant or licensee shall establish, in writing, a chain of command that sets forth the line of authority for the operation of the program.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.11 Health Requirements for Program Staff and Adult Household Members.

(a) A written record of physical examination shall be on file for all program employees and household members who will have regular contact with residents.

(b) The written record of physical examination required in (a) above shall contain or identify:

(1) The name of the examinee;

(2) The date of the examination;

(3) Any contagious or other illness that would affect the examinee’s ability to care for residents or pose a risk to the health or safety of residents;

(4) A record of a negative Mantoux Tuberculin (TB) test for individuals who are determined by a licensed practitioner to be at high risk for exposure to Tuberculosis or the results of a chest x-ray and medical assessment when the individual has a positive TB test due to prior exposure;

(5) Any known limitations or restriction that would affect the examinee’s performance of their residential child care responsibilities or pose a risk to the health or safety of residents;

(6) The signature of the licensed practitioner and date signed; and

(7) The typed or printed name and telephone number of the licensed practitioner.

(c) The initial record of physical examination for newly hired program staff shall have been completed not more than l2 months preceding the date of hire or the date the individual began having regular contact with residents.

(d) When a newly hired program staff has not had a physical exam in accordance with (b) above, an appointment for a future physical exam shall be scheduled within 10 business days of the date the individual begins having regular contact with residents.

(e) When any program staff, intern, child care assistant, volunteer, resident, or household member has symptoms of a reportable communicable disease, not diagnosed by a licensed practitioner, the program director or their designee shall contact the department’s bureau of communicable disease control for instructions regarding exclusion, controlling the spread of the disease, and reporting requirements.

(f) The only exception to (e) above shall be for human immunodeficiency virus (HIV) infection, specifically, the identity of any individual with HIV infection shall be held confidential in accordance with RSA 141-F:8.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #14214, eff 4-1-25

He-C 4001.12 Communicable Disease Issues and Health Requirements for Residents and Other Children.

(a) Parental authorization for medical treatment shall be on the premises for each resident upon his or her first day of residence in the program, except for residents in short term placement, and available in accordance with He-C 4001.10(n).

(b) Physical examinations shall be completed for children admitted to the program as residents and children who reside on the premises of the program.

(c) A child health form or an equivalent record of physical examination documenting that a physical examination was completed within the past 12 months shall be on file for each child, as specified in (b) above, within 30 days of the date any child begins residing on the premises of the program.

(d) When a child has not had a physical examination as required in (c) above, the program shall schedule an appointment for a future physical exam within 10 business days of the date the child begins residing at the program.

(e) The child health form or equivalent record of physical examination required under (c) above shall include at least the following:

(1) The name and date of birth of the child or resident;

(2) The date of the exam;

(3) Diagnoses, if any, and a description of any health condition that might affect the child or resident’s participation in the program;

(4) Documentation of immunizations, including dates immunized;

(5) A history of illness and hospitalizations;

(6) Reports of any screening or assessment;

(7) Notations about the child or resident’s physical, mental, and social development;

(8) A list of current medications, both prescribed and over the counter;

(9) Any known allergies;

(10) Dietary needs, including special diets; and

(11) The signature of a licensed health care practitioner and the date signed.

(f) Physical examinations as required under (b) above shall be completed:

(1) At least every 12 months for each child younger than 6 years of age, with a 60-day grace period to allow the program to obtain the updated physical examination record; and

(2) At least every 24 months for each child 6 years of age or older, with a 60-day grace period to allow the program to obtain the updated physical examination record.

(g) Each resident shall have a dental examination based upon a schedule, which shall:

(1) Take into account the needs of the resident as determined by a licensed dentist; and

(2) Provide for each resident to have a dental examination at intervals of 6 to 12 months.

(h) If the program is unsuccessful in obtaining dental examinations in accordance with (g)(2) above, it shall document good faith efforts to schedule an exam.

(i) A written record documenting the date of the dental exam and treatment needed or provided, shall be maintained on the premises of the program in each resident’s permanent record.

(j) Other medical exams and evaluations shall be completed for each resident as necessary to meet his or her medical needs.

(k) When a resident is believed to have a reportable communicable disease which was not diagnosed by a physician or other health care provider, the program director or designee shall report the known or suspected communicable disease to the department’s bureau of communicable disease control in accordance with RSA 141-C:7 and He-P 301.

(l) The only exception to (k) above shall be for HIV infection, specifically, the identity of any individual with HIV infection shall be held confidential in accordance with RSA 141-F:8.

(m) SCPs shall provide services in a residential setting, including access to nursing or medical care, for all children placed in the program diagnosed as having functional limitations and are dependent upon or require medical technology to maintain or improve independence and health.

(n) SCPs shall provide for the complex health needs of residents whom are medical technology dependent:

(1) In a manner that affords the least intrusive intervention available to ensure his or her safety, the safety of others, and that promotes healthy growth and development;

(2) By providing services and an environment that meets each resident’s needs; and

(3) By training direct care staff in the use and care of the specific medical technology device or devices that residents in their care are dependent upon.

(o) Training shall include:

(1) How to recognize symptoms that may indicate a decline in the resident’s health;

(2) Seizures and seizure disorders;

(3) G/J tube use and care;

(4) Tracheostomy care;

(5) C-pap and Bi-pap care; and

(6) Any intervention or procedure that will heighten direct care staff’s attention to the health and well-being of residents, such as topics on medical changes that require immediate notification for nursing assessment.

(p) All training and education required in (n) and (o) above shall be performed by the appropriate medical professional with the requisite education and licensure to perform such training or utilize outside resources if an appropriate medical professional is not available.

(q) At the time of admission of a resident with special health care needs or who is medical technology dependent, the licensee shall obtain written and signed orders from a licensed practitioner for medications, treatment, and special diet as applicable.

(r) No resident shall be admitted until the appropriate training in (n) and (o) above has been completed.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

He-C 4001.13 Personal Hygiene.

(a) Program staff and residents shall wash their hands as needed.

(b) Individuals who are participating in food preparation or food service shall:

(1) Wash their hands as often as necessary to remove soil and contamination and prevent cross contamination;

(2) Cover any cuts or abrasions with a secure bandage; and

(3) Not participate in food preparation or food service activities when they have:

a. An infection;

b. A cut or wound which is running or weeping; or

c. A communicable disease that could be spread via food preparation or food service.

(c) Program staff shall not wash their hands after diapering or toileting in sinks that are used for food preparation or clean up.

(d) Program staff shall encourage each resident to brush their teeth each morning and before going to bed, and to shower daily.

(e) Each resident shall have an opportunity to have a shower or bath, with adequate hot water, once each day.

(f) Program staff shall assist residents who are medical technology dependent, or whose functional needs require direct assistance with daily personal hygiene. Such assistance shall be care planned and provided based on resident need.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20

He-C 4001.14 Prevention and Management of Injuries, Incidents, Emergencies, and Infection Control.

(a) Program staff shall provide care and supervision at all times to ensure that residents are safe and that their needs are met according to their developmental level, age, emotional or behavioral needs, and in accordance with their treatment plan.

(b) The program shall develop policies for direct care staff, including but not limited to:

(1) Addressing threats of self-harm and suicidal behaviors by residents;

(2) Medical emergencies, including when to immediately call emergency responders;

(3) Addressing threatening behaviors such as physical and sexual assaults on other residents or staff;

(4) Responding to and managing injuries that are not medical emergencies;

(5) The reporting requirements in He-C 4001.23, RSA 126-U, and He-C 901;

(6) Screening any resident who runs away for indications that the resident may be a victim of human trafficking and notifying necessary personnel and authorities;

(7) Supporting residents and managing the behavior of residents, consistent with RSA 126-U, and He-C 901;

(8) Access to respite or temporary care;

(9) How staff will be orientated and trained in accordance with He-C 4001.19(b) to prepare to work with the population served by the program; and

(10) How staff will supervise residents during overnight hours and when taking residents off-site.

(c) All program staff responsible for the care and supervision of residents shall be familiar with the program’s policies required in (b) above.

(d) Each building that residents will spend time in shall be equipped with a telephone that is operable and accessible to residents and staff for incoming and outgoing calls.

(e) The licensee shall maintain an information data sheet in the resident’s record and promptly give a copy to emergency medical personnel in the event of an emergency transfer to a medical facility.

(f) The information data sheet referenced in (e) above shall include:

(1) Full name and the name the resident prefers, if different;

(2) Name, address, and telephone number of the resident’s parent(s), guardian, or agent, if any;

(3) Diagnosis or diagnoses, if more than one;

(4) Medications, both prescription and over the counter, including last dose taken and when the next dose is due;

(5) Allergies;

(6) Functional limitations;

(7) Date of birth;

(8) Insurance information; and

(9) Any other pertinent information not specified in (1)-(8) above.

(g) At least one program staff person who is trained and currently certified in cardiopulmonary resuscitation (CPR) and first aid by the American Red Cross, American Heart Association, Emergency Care and Safety Institute, National Safety Council, or other nationally recognized organization or an individual certified by such organization to train, shall be present:

(1) In each building that is used as a residence, at all times when residents are present; and

(2) When residents are participating in any field trips, outings, or excursions off the premises of the program.

(h) The program director or designee shall obtain and maintain on file, available for review by the unit, copies of current CPR and first aid certifications documenting coverage as required in (g) above.

(i) Each building and program vehicle that is used by residents shall be equipped with first aid supplies adequate to meet the needs of the residents.

(j) The first aid supplies shall be stored in a container that is accessible by program staff but not accessible to residents.

(k) If a resident sustains a serious injury requiring medical transportation, evaluation, or treatment, loses consciousness, or is found or believed to be impaired while at the program, the program director or designee shall notify the unit within one business day and complete and provide the unit with an incident report within 48 hours.

(l) The program director or designee shall conduct fire drills at varying times, including night time hours, once each month in each building that is used as residential child care space.

(m) Programs shall activate the actual fire alarm system for the building for at least 2 of the monthly fire drills required each year.

(n) Programs shall ensure that all residents and program staff evacuate the building during each fire drill.

(o) The staff person conducting the fire drill shall complete a written record of each fire drill that shall:

(1) Be maintained on file at the program for 2 years; and

(2) Be available for review by the fire inspector and the department.

(p) The written record of fire drills required under (o) above shall include at least the following:

(1) The date and time of the drill, and whether the actual fire alarm system was activated;

(2) Exits used;

(3) Number of residents evacuated and total number of people in the building at the time of the drill;

(4) Name of the person conducting drill;

(5) Time taken to evacuate the building;

(6) Any problems encountered; and

(7) A plan for correcting those problems.

(q) The program director or designee shall conduct a fire drill in the presence of a representative of the unit or the local fire department upon request by either of those entities.

(r) If providing withdrawal management, any new SCPs shall comply with the appropriate chapter of NFPA 101 as published by the National Fire Protection Association and as amended by the state board of fire control and ratified by the general court pursuant to RSA 153:5, consistent with the level of needs of residents served.

(s) All programs shall have the following as approved by their local fire inspector:

(1) Smoke detectors consistent with the appropriate level of care being provided by the program;

(2) At least one UL Listed, ABC type portable fire extinguisher, with a minimum rating of 2A-10BC installed on every level of the building with a maximum travel distance to each extinguisher not to exceed 50 feet and maintained as follows:

a. Fire extinguishers shall be inspected either manually or by means of an electronic monitoring device or system at least once per calendar month, at intervals not exceeding 31 days;

b. Records for manual inspection, or electronic monitoring shall be kept to demonstrate that at least 12 monthly inspections have been performed;  

c. Annual maintenance shall be performed on each extinguisher by trained personnel, and a tag or label shall be securely attached that indicates that maintenance was performed; and

d. The components of the electronic monitoring device or system in a. above, if used, shall be tested and maintained annually in accordance with the manufacturers listed maintenance manual; and

(3) A carbon monoxide monitor on every level of the program, in accordance with Saf-C 6015.04.

(t) In addition to the policies required in (b) above, the program shall have an emergency operations plan (EOP), which shall:

(1) Be based on the incident command system and coordinated with the emergency response agencies in the community in which the residential program is located;

(2) Contain guidelines for personnel responsible for critical tasks, including, but not limited to the role of center incident commander, resident care, medical treatment, and notification to parents or guardians; and

(3) Include response actions for natural, human-caused, or technological incidences including, but not limited to:

a. Evacuation, both within building and off-site, relocation;

b Secure campus;

c Drop, cover, and hold;

d. Lockdown;

e. Reverse evacuation;

f. Shelter-in-place; and

g. Bomb threat and scan.

(u) Programs shall develop a continuity of operations plan (COOP) to ensure that essential functions continue to be performed during, or resumed rapidly after, a disruption of normal activities.

(v) All response actions in (t)(3) above shall include accommodations for residents with chronic medical conditions, and residents with disabilities or with access and functional needs.

(w) Programs shall ensure that all staff are trained on the EOP and response actions, and are aware of the location of the plan.

(x) Programs shall conduct evacuation drills at least twice a calendar year and shall record the dates and times of the drills, and maintain the records for review as described in He-C 4001.10(m)(3).

(y) All staff shall review the program's EOP within the first 30 days of employment and any time that the program revises the EOP.

(z) The written policies and procedures and the EOP shall be available in each building of the residential program, in an area easily accessible to program staff.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; amd by #13991, EMERGENCY RULE, eff 5-29-24, EXPIRED:

11-25-24

New. #14123, eff 11-26-24, EXPIRED: 11-26-25; ss by #14214, eff 4-1-25, EXPIRES: 4-1-35

He-C 4001.15 Medication Services.

(a) The licensee shall have and implement written policies and procedures regarding medication administration, including at a minimum:

(1) The documentation requirements;

(2) A system for maintaining counts of controlled drugs;

(3) The process for ordering or re-ordering medication timely to assure a resident’s medication does not run out;

(4) Protocols for medication occurrences;

(5) Protocols for administration of PRN medications; and

(6) The control and safety of medication consistent with the requirements of this section.

(b) Administration of medication to residents shall be performed by authorized staff, registered nurses (RNs), licensed practical nurses (LPNs), or licensed practitioners, accurately and in accordance with the resident’s treatment plan and the licensee’s policies.

(c) Authorized staff shall:

(1) Know and understand the program’s written policies and procedures regarding the administration, documentation, control, and safety of medication;

(2) Administer only those prescription medications for which there is a medication order;

(3) Administer medications only to the residents about whom they have current knowledge relative to their medication regimes; and

(4) Administer PRN medication in accordance with a medication order and a PRN protocol approved by the licensed practitioner, including the specific condition(s) for which the PRN medication is given.

(d) All residents shall be initially assessed to determine the level of support needed specific to medication administration, including the resident’s:

(1) Medication order(s) and medications prescribed;

(2) Health status and health history; and

(3) Ability to manage their medication, consistent with their treatment plan.

(e) Program staff shall obtain, or document their efforts to obtain, oral or written consent from the parent or guardian prior to administering any new or changed prescription medications.

(f) When the responsibility of providing care to a resident is transferred to persons outside the program, such as a home visit, and the resident is taking prescription medication:

(1) The pharmacy container(s) shall be given to the person responsible for the resident;

(2) The program shall document the name, strength, prescribed dose, route of administration, and quantity of each medication provided to the person(s) outside the program, upon the resident’s transfer of care; and

(3) Upon the resident’s return to the program, the program shall document the return of any medications including the name, strength, prescribed dose, route of administration, and quantity of each medication, with an explanation of why the medication was not given per the medication order.

(g) The program shall maintain a copy of each resident’s medication orders in the resident’s record.

(h) Medication orders shall be valid for no more than one year unless otherwise specified by the prescribing licensed practitioner.

(i) Each medication order shall legibly display the following information:

(1) The resident’s name;

(2) The medication name, strength, the prescribed dose, and route of administration;

(3) The frequency of administration; and

(4) The dated signature of the licensed practitioner.

(j) The program shall obtain written orders from a licensed practitioner regarding any prescription medication that is to be administered PRN, which shall include:

(1) The specific conditions for which the medication is given;

(2) The indications and any special precautions or limitations regarding administration of the medication;

(3) The maximum dosage allowed in a 24-hour period; and

(4) The dated signature of the licensed practitioner.

(k) Prior to the administration of medication, authorized staff shall obtain information specific to each medication, including, at a minimum:

(1) The purpose and effect(s) of the medication;

(2) Response time of the medication;

(3) Possible side effects, adverse reactions, and symptoms of overdose;

(4) Possible medication interactions; and

(5) Special storage or administration procedures.

(l) In the event of a medication occurrence, the authorized staff responsible for the administration of the medication shall forward written notification to the program director by the close of the next business day.

(m) When any medication that is administered by program staff results in serious adverse reactions including, but not limited to, impaired speech, mobility, or breathing, semi-consciousness, or unconsciousness, program staff shall:

(1) Immediately call 911 or notify a licensed practitioner for instructions regarding the need for emergency or other medical treatment;

(2) Immediately comply with the instructions provided by the licensed practitioner;

(3) Remain with the resident until they are fully alert and oriented and have recovered all physical capabilities that had been impaired by the medication, or until responsibility for the resident’s care is transferred to a licensed practitioner in a medical facility; and

(4) Notify the parents or guardian within 24 hours with documentation of the notice, or documentation of the efforts to notify them.

(n) Prior to administering medication to any resident, program staff shall complete and document training on medication safety and administration, as specified in (o) below.

(o) Training in medication safety and administration, as required in (n) above, shall:

(1) Be delivered by a physician, APRN, RN, or LPN practicing under the direction of an APRN, RN, or physician, or by another qualified individual;

(2) Be provided in person, via distance learning, a video presentation, or web-based; and

(3) Address the following:

a. The safe administration of medication, including but not limited to:

1. Administration of the correct medication;

2. Administration of the correct dosage of the medication;

3. Administration of the medication to the correct resident;

4. Administration of the medication to the resident at the correct times and frequency;

5. Administration of the medication to the resident by the correct method of administration;

6. Infection control and aseptic procedures related to administration of medication; and

7. Resident’s rights regarding refusing medications;

b. Possible side effects and adverse reactions to the medications to be administered and required reporting regarding those issues;

c. Proper storage, disposal, security, error control, and documentation as related to the medications to be administered;

d. Any other unusual occurrence related to the safe storage or administration of medication and reporting requirements regarding those issues;

e. Conditions or situations requiring emergency medical intervention; and

f. Methods of administration including, but not limited to oral, injection, topical application, or inhalation.

(p) In addition to (o) above, authorized staff shall complete 2 hours of training annually on medication safety and administration.

(q) Documentation of training in medication safety and administration shall be maintained on file at the program available for review by the unit, and shall include the staffs’ name, certification of successful completion of the training, the name and qualifications of the trainer, and the date completed.

(r) For each resident, program staff shall maintain medication information on file and available for review by the unit, which includes, at a minimum:

(1) A written medication order, as specified in (i) above;

(2) Written authorization from the parent or guardian to administer medication, if applicable;

(3) The name and contact information of the parent or guardian, if applicable; and

(4) Allergies, if applicable.

(s) Program staff shall maintain a daily medication log for each dose of medication administered to each resident.

(t) The medication log required in (s) above shall:

(1) Be maintained on file in the program, available for review by the unit;

(2) Be completed by the authorized staff who administered the medication immediately after the medication is administered; and

(3) For each medication prescribed, include at a minimum:

a. The name of the resident;

b. The date and time the medication was taken;

c. A notation of any medication occurrence or the reason why any medication was not administered or taken as ordered or approved;

d. The dated signature of the authorized staff who administered the medication to the resident; and

e. For administration of a PRN, documentation including the reason for administration and the name and title of the person who authorized the PRN.

(u) The licensee shall require that all telephone orders from a licensed e practitioner or their agent, for medications, treatments, and diets are documented in writing, including facsimiles, by the licensed practitioner within 24 hours.

(v) Authorized staff shall record any changes regarding prescription medications in the resident’s medication log, including the name or initials of the authorized staff recording the change, and the date and time.

(w) No person other than a licensed practitioner shall make changes to the written order of a licensed practitioner regarding prescribed medication.

(x) All medication maintained by the program shall be stored in accordance with the following:

(1) Medication shall be kept in a storage area that is:

a. Locked and accessible only to authorized personnel;

b. Organized to allow correct identification of each resident’s medication(s);

c. Illuminated in a manner sufficient to allow reading of all medication labels; and

d. Equipped to maintain medication at the proper temperature;

(2) Schedule II controlled substances, as defined by RSA 318-B:1-b, shall be kept in a separately locked compartment within the locked medication storage area and accessible only to authorized personnel;

(3) Topical liquids, ointments, patches, creams, and powder forms of products shall be stored in a manner such that cross-contamination with oral, optic, ophthalmic, and parenteral products shall not occur; and

(4) All medication shall be kept in the original containers or pharmacy packaging and properly closed after each use unless otherwise allowed by law.

(y) All medication shall be accompanied by:

(1) The physician’s written order, which may be the prescription label; and

(2) The manufacturer’s written instructions for dosage for non-prescription medication.

(z) Medications such as insulin, inhalers, and epi pens shall be permitted to be in the possession of a resident in accordance with their ability, as specified in their treatment plan.

(aa) All medications belonging to staff shall be stored in a locked area, separate from residents’ medications or otherwise inaccessible to residents.

(ab) The program director or designee may elect to have a supply of non-prescription medication available, including but not limited to acetaminophen, ibuprofen, aspirin, cold medicines, or antacids that may be administered to residents for minor illnesses, provided those medications are stored and administered in accordance with the requirements in this section.

(ac) Any contaminated, expired, or discontinued medication, whether prescription or over the counter, shall be destroyed within 7 days of identification as contaminated, expired, or discontinued.

(ad) All medication shall be destroyed in accordance with the United States Environmental Protection Agency’s, “How to Dispose of Medicines Properly” guidance, (April 2011), available as noted in Appendix A.

(ae) Destruction of prescription drugs under (ad) above shall:

(1) Be accomplished by an authorized staff and witnessed by one staff; and

(2) Be documented in the resident’s medication record, including the legible, dated signature of the staff person who disposed of the drugs and the staff person who witnessed the disposal.

(af) Programs providing SUD services shall have a clearly identified policy for storage and administration of naloxone that includes the following:

(1) The process for regularly reviewing and updating the standing order for the naloxone kits on the premises;

(2) The process for ensuring regular review of naloxone kits for expiration;

(3) A statement that staff shall call 911 immediately if naloxone is administered; and

(4) A statement that staff shall call 911 immediately if naloxone is not administered but an overdose is suspected.

(ag) Medication administered by individuals authorized by law to administer medications shall be:

(1) Prepared immediately prior to administration; and

(2) Prepared, identified, and administered by the same person in compliance with RSA 318-B and RSA 326-B.

(ah) Authorized staff may plan for medication administration off-site, such as for an outing or field trip, or at school when the school is on the same campus as the residential program, by preparing a dose or doses of medication for administration when the resident is off-site. Authorized staff shall not repackage medication for administration to residents when they are present in the program.

(ai) If a nurse delegates the task of medication administration to an individual not licensed to administer medications, the nurse shall follow the requirements of RSA 326-B.

(aj) Programs shall have a written policy establishing procedures for the prevention, detection, and resolution of controlled substance misuse, and diversion, which shall apply to all personnel, and which shall be the responsibility of a designated employee or interdisciplinary team.

(ak) The policy in (aj) above shall include:

(1) Education;

(2) Procedures for monitoring the distribution and storage of controlled substances;

(3) Voluntary self-referral by employees who are misusing substances;

(4) Co-worker reporting procedures;

(5) Drug testing procedures to include, at a minimum, testing where reasonable suspicion exists;

(6) Employee assistance procedures;

(7) Confidentiality;

(8) Investigation, reporting, and resolution of controlled drug misuse or diversion; and

(9) The consequences for violation of the controlled substance misuse, and diversion prevention policy.

(al) Programs that opt to obtain epinephrine auto-injectors for use in emergencies, in accordance with RSA 329:1-h, shall have and abide by a policy for the storage, maintenance, control, and general oversight of epinephrine auto-injectors acquired by the program, in accordance with RSA 329:1-h, III.

(am) Pursuant to RSA 329:1-h, V, programs that opt to obtain epinephrine auto-injectors under (al) above shall designate staff to administer them and assure those staff are trained in accordance with the following:

(1) Complete an anaphylaxis training program at least every 2 years, following completion of the initial anaphylaxis training program;

(2) Such training shall be conducted by a nationally recognized organization experienced in training unlicensed persons in emergency health care treatment or an entity or individual approved by the board of medicine; and

(3) Training may be conducted online or in person and, at a minimum, shall cover:

a. How to recognize signs and symptoms of severe allergic reactions, including anaphylaxis;

b. Standards and procedures for the storage and administration of an epinephrine auto-injector; and

c. Emergency follow-up procedures.

(an) Programs shall keep on file the certificate of successful completion of the training under (am) above.

(ao) Programs shall have on file written authorization from the parent or guardian of a resident for use of an epinephrine auto-injector in an emergency.

(ap) Programs shall educate residents regarding all medication prescribed, including the name of the medication and why they take it, based upon the residents’ age and intellectual abilities.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.16 Residential Child Care Space.

(a) In all programs, space that is designated, inspected, and approved as residential child care space shall not be used for any purposes or activities that could jeopardize the health or safety of residents or otherwise negatively impact the program.

(b) Programs shall provide:

(1) A living room or community space with comfortable furnishings, available, and accessible to residents for regular and informal use for general relaxation and entertainment;

(2) Bedrooms that are separated by gender and that have:

a. A minimum of 50 square feet of floor space per occupant;

b. Ceilings that are at least 7 feet high at the highest peak;

c. An outside window; and

d. An operable door;

(3) An area that is suitable and available for private discussions and counseling sessions;

(4) Sturdy, comfortable furniture and furnishings, that are clean and in good repair;

(5) Bathroom facilities that provide residents with age appropriate privacy while changing clothes, showering, attending to personal hygiene, and using the toilet;

(6) When available on site, outdoor space that is maintained in a neat, safe, clean condition and is available to residents for active recreation; and

(7) Screens for all operable windows in the facility.

(c) If seclusion is used, then rooms used for seclusion shall be in compliance with the provisions of RSA 126-U.

(d) Programs shall have a communication system in place so that residents and program staff can effectively contact personnel when they need assistance with the care of residents or in an emergency.

(e) Programs shall assure that damage to the residence or equipment identified in (f) and (g) below is repaired within 7 days, or as soon as possible after the damage has occurred.

(f) Programs shall maintain all residential spaces in good repair and workable condition, including but not limited to, cabinets, ceilings, appliances, windows, doors, screens, sinks, and toilets.

(g) All living space and recreation areas used by residents shall be equipped with operable lighting sufficient to allow individuals to enter, exit, and move about the premises of the program safely.

(h) Programs shall provide sufficient sturdy tables and chairs to ensure each resident’s comfort for meals, snacks, and for work or play at tables.

(i) Programs shall provide each resident with a bed equipped with:

(1) A pillow and a firm mattress that is:

a. Clean;

b. In good repair;

c. Free from rips or holes in the fabric covering that would allow residents access to the interior components of the mattress;

d. Cleaned and sprayed with a disinfecting spray before being used for a new resident; and

e. Replaced or sanitized promptly if soiled by urine, feces, blood, or vomit; and

(2) Adequate bedding to ensure the resident’s comfort that is cleaned and maintained as follows:

a. Sheets and pillow cases shall be cleaned at least once each week and more frequently if soiled; and

b. Blankets, comforters, bedspreads, and mattress covers shall be cleaned at least once each month and more frequently if soiled.

(j) Programs shall provide separate sleeping and bathroom facilities for staff and family members of staff who reside in the program.

(k) Programs shall ensure that in each building in which residents reside, for every 4 residents there shall be one bathroom unit that is accessible to residents and equipped with:

(1) An operable door; and

(2) A properly functioning sink, toilet, and shower or tub.

He-C 4001.17 Health and Safety in the Residential Child Care Environment.

(a) Program staff shall maintain the residential child care environment free of conditions hazardous to residents, including but not limited to, the following:

(1) Electrical hazards;

(2) Guns, or live or spent ammunition;

(3) Holes in flooring, loose floor tiles, or loose throw rugs, which present a slipping or tripping hazard;

(4) Loose and flaking paint which is accessible to residents;

(5) Unclean conditions, which demonstrate a lack of regular cleaning;

(6) Inadequate protections against insects and rodents; and

(7) Garbage and rubbish stored in an unsanitary manner.

(b) Programs shall assure that any hazardous condition in the licensed premises, including but not limited to those identified in (a) above, is immediately addressed, and that residents do not have access to any hazardous conditions or materials pending repair or replacement.

(c) When interior or exterior surfaces of a building built prior to 1978 are in deteriorating condition, including flaking, chipping, and peeling paint, or are subject to renovations or construction, a U.S. Environmental Protection Agency certified renovator shall be utilized to make the deteriorated surfaces intact, in accordance with 40 CFR 745.90(a) and (b) and He-P 1600.

(d) When there is information or evidence indicating that the building might contain asbestos hazards, the applicant, licensee, or designee shall submit evidence that the building has been inspected by a licensed asbestos inspector and is free of asbestos hazards or otherwise treated or contained in a manner approved by a licensed asbestos inspector.

(e) Program staff shall clearly label and store all toxic materials, including, but not limited to, cleaners, household chemicals, and paint, separate from food items, in cabinets which are locked or otherwise inaccessible to residents.

(f) Notwithstanding (e) above, at the discretion of the program director, residents may be allowed to use household cleaning products and laundry supplies to complete a specific task, provided the resident completing the task shall be under the supervision of program staff while the cleaning products are accessible, and the cleaning products shall not be accessible to other residents not involved in the cleaning task.

(g) Program staff shall maintain on file at the residence documentation of current vaccinations as required by law for all pets and animals that are present on the premises of the program.

(h) Pets and animals that have been determined by the department to pose a health or safety risk to children shall not be permitted on the premises of the program, including, but not limited to, the following:

(1) Bats;

(2) Turtles;

(3) Tortoises;

(4) Snakes;

(5) Iguanas;

(6) Other lizards or reptiles;

(7) Hedgehogs;

(8) Parakeets; and

(9) Parrots and parrot-like birds.

(i) All enclosed living areas used by residents shall:

(1) Be ventilated by means of a mechanical ventilation system or one or more screened windows that can be opened, and will not pose a hazard to residents; and

(2) From September 1 through May 31, have a safe, functioning heating system, which is cleaned, serviced, and maintained at least once annually and which ensures that whenever residents are present, or expected to arrive within one hour, the temperature is maintained at:

a. Not less than 65 degrees Fahrenheit during waking hours, except for areas being used for active physical exercise or recreation; and

b. Not less than 55 degrees Fahrenheit during sleeping hours.

(j) Program staff, child care interns, and volunteers shall not smoke or use tobacco products while they are responsible for the care of residents or within sight of residents, nor allow residents to smoke or use tobacco, have access to tobacco products, or be exposed to second hand smoke.

(k) All toys, equipment, and learning materials shall be:

(1) In good repair;

(2) Safe;

(3) Free of lead paint or other poisonous material; and

(4) Cleaned as often as needed to keep them free of a buildup of dirt.

(l) Program staff shall maintain the outside play or recreation areas free of hazards and debris, including but not limited to trash, litter, machinery, and tools.

(m) During activities conducted in the water, including wading, swimming, and boating, the following shall apply:

(1) All activities shall be supervised in accordance with the following:

a. Program staff shall provide close supervision to residents at all times, to include a ratio of one staff to no more than 4 residents when no lifeguard is present;

b. At least one staff person who is currently certified in CPR and first aid shall be present with the residents at all times;

c. At least one staff person who has completed training in water safety shall be present with the residents at all times;

d. A rescue buoy, ring buoy, or water rescue throw bag shall be brought to or present at all swimming and boating activities where there is no lifeguard present; and

e. Notwithstanding a. through d. above, a program may allow a resident to be at a water activity independently, if the program director provides a written and dated authorization, after assessing the following:

1. A resident’s swimming ability, such as whether they have completed a Red Cross or other recognized swimming program;

2. A resident’s ability to be independent;

3. Under what circumstances the resident may be at a water activity independently; and

4. Whether or not a lifeguard must be on duty or other adult must be present at the water activity; and

(2) All pools used as part of the residential child care operation shall be maintained in accordance with the printed instructions of the manufacturer or installer regarding cleaning, filtration, and chemical treatment, and the following:

a. Swimming pools shall be secured in a manner that is childproof and lockable; and

b. Pool gates, fences, or other barriers as required in a. above shall be locked at all times, except when the residents are involved in an allowable water activity in the pool.

(n) Toys or other items which are routinely mouthed by residents shall be cleaned and sanitized after each use by a resident, and at the end of each day.

(o) Residents who have developmental delays and are likely to put objects in their mouths, shall be closely supervised when they have access to the items in (n) above and (p)(11) below.

(p) Program staff shall comply with the following age related environmental health and safety requirements:

(1) Residents younger than 6 years of age shall not have access to the following:

a. Cords or strings long enough to encircle a resident’s neck, including but not limited to pull toys, telephone cords, and window blind cords;

b. Balusters which are spaced more than 3 1/2 inches apart on handrails and guardrails on play structures, lofts, stairs, steps, decks, porches, balconies, or other barriers;

c. Sharp knives and sharp objects or objects with sharp edges, except that, at the discretion of program staff and under close supervision, program staff may allow use of scissors or knives for specific cooking projects, craft projects, or meal times;

d. Unstable or easily tipped heavy furnishings or other heavy items which, if not secured to the wall or floor or both, could easily fall on residents and would be likely to cause injury; and

e. Toy boxes and any other chest type storage facilities that have a lid that does not have a safety lid support;

(2) Play areas accessible to residents younger than 6 years of age shall be enclosed by a fence when the unit determines that the play area is unsafe because it is located on a roof, or adjacent to any of the following:

a. A street or road; or

b. Any dangerous areas, any swimming pool, or any body of water;

(3) All fencing required under (2) above shall:

a. Be designed to restrain residents from climbing out of, over, under, or through the fence;

b. Have a child proof self-latching device on any gates; and

c. Be maintained in good repair, free of damage or wear that could expose residents to hazards;

(4) When accessible to residents younger than 6 years of age, ground area under and extending at least 39 inches beyond the external limits of outdoor play equipment which would allow a resident to fall from a height of more than 29 inches shall be constructed and maintained at all times with an energy absorptive surface, including but not limited to sand, bark mulch, pea stone, soft wood chips, or rubber mats manufactured for use as gym mats;

(5) The energy absorptive material required in (4) above shall be:

a. Maintained at a depth of at least 8 inches; and

b. Checked and raked regularly to remove any foreign matter, correct compaction, and increase absorption;

(6) Adult toilets and hand washing sinks used by residents younger than 6 years of age shall be equipped with footstools or platforms;

(7) Foot stools or platforms required in (6) above shall:

a. Have a non-porous finish that is easily cleanable; and

b. Be designed to prevent tipping;

(8) The fall zone under and around all indoor swings, slides, and climbing equipment from which a resident could fall from a height of more than 29 inches shall be covered with mats designed for gymnastics, if they are accessible to or will be used by residents younger than 6 years of age;

(9) Residents younger than 3 years of age shall not have access to stairs or steps that are not equipped with safety gates;

(10) Baby walkers with wheels shall be prohibited in all programs;

(11) Residents younger than 4 years of age shall not have access to toys, toy parts, and other materials which pose a choking risk or are small enough to be swallowed, such as coins and balloons;

(12) There shall be an individual crib or playpen for each resident 12 months of age and younger; and

(13) Cribs and playpens required under (12) above shall:

a. Be manufactured on or after June 28, 2011, or if manufactured prior to that date, has a Children’s Product Certificate (CPC), or test report from a consumer product safety commission (CPSC) accepted third- party lab, provided by the manufacturer documenting the crib’s compliance with 16 CFR 1219 as required by 16 CFR 1219 and 1220;

b. Not be stacked;

c. Be free of cracked or peeling paint, splinters, and rough edges;

d. Have no missing, loose, broken, or improperly installed parts, screws, brackets, baseboards, or other loose hardware or damaged parts on the crib or mattress supports;

e. Not have holes or tears in the mesh walls or in the material that connects the walls to the bottom of the crib or play pen;

f. Have fitted sheets designed for the size mattress, including elastic corners so that there is no excess fabric with visible folds or bunching, and that do not compress the mattress;

g. Not have bumper pads, blankets, flat sheets, pillows, quilts, comforters, sleep positioners, or any soft items or toys with infants up to 12 months of age; and

h. Have mattresses which:

1. Are in good repair, free of rips or tears; and

2. Fit the crib or playpen so that space between the mattress and the crib or playpen is not more than 2 adult fingers wide and does not create a suffocation hazard.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.17 Health and Safety in the Residential Child Care Environment.

(a) Program staff shall maintain the residential child care environment free of conditions hazardous to residents, including but not limited to, the following:

(1) Electrical hazards;

(2) Guns, or live or spent ammunition;

(3) Holes in flooring, loose floor tiles, or loose throw rugs, which present a slipping or tripping hazard;

(4) Loose and flaking paint which is accessible to residents;

(5) Unclean conditions, which demonstrate a lack of regular cleaning;

(6) Inadequate protections against insects and rodents; and

(7) Garbage and rubbish stored in an unsanitary manner.

(b) Programs shall assure that any hazardous condition in the licensed premises, including but not limited to those identified in (a) above, is immediately addressed, and that residents do not have access to any hazardous conditions or materials pending repair or replacement.

(c) When interior or exterior surfaces of a building built prior to 1978 are in deteriorating condition, including flaking, chipping, and peeling paint, or are subject to renovations or construction, a U.S. Environmental Protection Agency certified renovator shall be utilized to make the deteriorated surfaces intact, in accordance with 40 CFR 745.90(a) and (b) and He-P 1600.

(d) When there is information or evidence indicating that the building might contain asbestos hazards, the applicant, licensee, or designee shall submit evidence that the building has been inspected by a licensed asbestos inspector and is free of asbestos hazards or otherwise treated or contained in a manner approved by a licensed asbestos inspector.

(e) Program staff shall clearly label and store all toxic materials, including, but not limited to, cleaners, household chemicals, and paint, separate from food items, in cabinets which are locked or otherwise inaccessible to residents.

(f) Notwithstanding (e) above, at the discretion of the program director, residents may be allowed to use household cleaning products and laundry supplies to complete a specific task, provided the resident completing the task shall be under the supervision of program staff while the cleaning products are accessible, and the cleaning products shall not be accessible to other residents not involved in the cleaning task.

(g) Program staff shall maintain on file at the residence documentation of current vaccinations as required by law for all pets and animals that are present on the premises of the program.

(h) Pets and animals that have been determined by the department to pose a health or safety risk to children shall not be permitted on the premises of the program, including, but not limited to, the following:

(1) Bats;

(2) Turtles;

(3) Tortoises;

(4) Snakes;

(5) Iguanas;

(6) Other lizards or reptiles;

(7) Hedgehogs;

(8) Parakeets; and

(9) Parrots and parrot-like birds.

(i) All enclosed living areas used by residents shall:

(1) Be ventilated by means of a mechanical ventilation system or one or more screened windows that can be opened, and will not pose a hazard to residents; and

(2) From September 1 through May 31, have a safe, functioning heating system, which is cleaned, serviced, and maintained at least once annually and which ensures that whenever residents are present, or expected to arrive within one hour, the temperature is maintained at:

a. Not less than 65 degrees Fahrenheit during waking hours, except for areas being used for active physical exercise or recreation; and

b. Not less than 55 degrees Fahrenheit during sleeping hours.

(j) Program staff, child care interns, and volunteers shall not smoke or use tobacco products while they are responsible for the care of residents or within sight of residents, nor allow residents to smoke or use tobacco, have access to tobacco products, or be exposed to second hand smoke.

(k) All toys, equipment, and learning materials shall be:

(1) In good repair;

(2) Safe;

(3) Free of lead paint or other poisonous material; and

(4) Cleaned as often as needed to keep them free of a buildup of dirt.

(l) Program staff shall maintain the outside play or recreation areas free of hazards and debris, including but not limited to trash, litter, machinery, and tools.

(m) During activities conducted in the water, including wading, swimming, and boating, the following shall apply:

(1) All activities shall be supervised in accordance with the following:

a. Program staff shall provide close supervision to residents at all times, to include a ratio of one staff to no more than 4 residents when no lifeguard is present;

b. At least one staff person who is currently certified in CPR and first aid shall be present with the residents at all times;

c. At least one staff person who has completed training in water safety shall be present with the residents at all times;

d. A rescue buoy, ring buoy, or water rescue throw bag shall be brought to or present at all swimming and boating activities where there is no lifeguard present; and

e. Notwithstanding a. through d. above, a program may allow a resident to be at a water activity independently, if the program director provides a written and dated authorization, after assessing the following:

1. A resident’s swimming ability, such as whether they have completed a Red Cross or other recognized swimming program;

2. A resident’s ability to be independent;

3. Under what circumstances the resident may be at a water activity independently; and

4. Whether or not a lifeguard must be on duty or other adult must be present at the water activity; and

(2) All pools used as part of the residential child care operation shall be maintained in accordance with the printed instructions of the manufacturer or installer regarding cleaning, filtration, and chemical treatment, and the following:

a. Swimming pools shall be secured in a manner that is childproof and lockable; and

b. Pool gates, fences, or other barriers as required in a. above shall be locked at all times, except when the residents are involved in an allowable water activity in the pool.

(n) Toys or other items which are routinely mouthed by residents shall be cleaned and sanitized after each use by a resident, and at the end of each day.

(o) Residents who have developmental delays and are likely to put objects in their mouths, shall be closely supervised when they have access to the items in (n) above and (p)(11) below.

(p) Program staff shall comply with the following age related environmental health and safety requirements:

(1) Residents younger than 6 years of age shall not have access to the following:

a. Cords or strings long enough to encircle a resident’s neck, including but not limited to pull toys, telephone cords, and window blind cords;

b. Balusters which are spaced more than 3 1/2 inches apart on handrails and guardrails on play structures, lofts, stairs, steps, decks, porches, balconies, or other barriers;

c. Sharp knives and sharp objects or objects with sharp edges, except that, at the discretion of program staff and under close supervision, program staff may allow use of scissors or knives for specific cooking projects, craft projects, or meal times;

d. Unstable or easily tipped heavy furnishings or other heavy items which, if not secured to the wall or floor or both, could easily fall on residents and would be likely to cause injury; and

e. Toy boxes and any other chest type storage facilities that have a lid that does not have a safety lid support;

(2) Play areas accessible to residents younger than 6 years of age shall be enclosed by a fence when the unit determines that the play area is unsafe because it is located on a roof, or adjacent to any of the following:

a. A street or road; or

b. Any dangerous areas, any swimming pool, or any body of water;

(3) All fencing required under (2) above shall:

a. Be designed to restrain residents from climbing out of, over, under, or through the fence;

b. Have a child proof self-latching device on any gates; and

c. Be maintained in good repair, free of damage or wear that could expose residents to hazards;

(4) When accessible to residents younger than 6 years of age, ground area under and extending at least 39 inches beyond the external limits of outdoor play equipment which would allow a resident to fall from a height of more than 29 inches shall be constructed and maintained at all times with an energy absorptive surface, including but not limited to sand, bark mulch, pea stone, soft wood chips, or rubber mats manufactured for use as gym mats;

(5) The energy absorptive material required in (4) above shall be:

a. Maintained at a depth of at least 8 inches; and

b. Checked and raked regularly to remove any foreign matter, correct compaction, and increase absorption;

(6) Adult toilets and hand washing sinks used by residents younger than 6 years of age shall be equipped with footstools or platforms;

(7) Foot stools or platforms required in (6) above shall:

a. Have a non-porous finish that is easily cleanable; and

b. Be designed to prevent tipping;

(8) The fall zone under and around all indoor swings, slides, and climbing equipment from which a resident could fall from a height of more than 29 inches shall be covered with mats designed for gymnastics, if they are accessible to or will be used by residents younger than 6 years of age;

(9) Residents younger than 3 years of age shall not have access to stairs or steps that are not equipped with safety gates;

(10) Baby walkers with wheels shall be prohibited in all programs;

(11) Residents younger than 4 years of age shall not have access to toys, toy parts, and other materials which pose a choking risk or are small enough to be swallowed, such as coins and balloons;

(12) There shall be an individual crib or playpen for each resident 12 months of age and younger; and

(13) Cribs and playpens required under (12) above shall:

a. Be manufactured on or after June 28, 2011, or if manufactured prior to that date, has a Children’s Product Certificate (CPC), or test report from a consumer product safety commission (CPSC) accepted third- party lab, provided by the manufacturer documenting the crib’s compliance with 16 CFR 1219 as required by 16 CFR 1219 and 1220;

b. Not be stacked;

c. Be free of cracked or peeling paint, splinters, and rough edges;

d. Have no missing, loose, broken, or improperly installed parts, screws, brackets, baseboards, or other loose hardware or damaged parts on the crib or mattress supports;

e. Not have holes or tears in the mesh walls or in the material that connects the walls to the bottom of the crib or play pen;

f. Have fitted sheets designed for the size mattress, including elastic corners so that there is no excess fabric with visible folds or bunching, and that do not compress the mattress;

g. Not have bumper pads, blankets, flat sheets, pillows, quilts, comforters, sleep positioners, or any soft items or toys with infants up to 12 months of age; and

h. Have mattresses which:

1. Are in good repair, free of rips or tears; and

2. Fit the crib or playpen so that space between the mattress and the crib or playpen is not more than 2 adult fingers wide and does not create a suffocation hazard.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.18 Water Supply, Septic Systems, Bathroom Facilities.

(a) The licensee shall assure that there is a safe supply of water under pressure, which is available for drinking, cooking, and household use.

(b) Hot water under pressure, which measures at least 100 degrees Fahrenheit, shall be available at all sinks, showers, and bathtubs located in living space that is used by residents during operating hours.

(c) Hot water at taps that are accessible to residents shall be regulated to maintain a temperature at the tap of not higher than 120 degrees Fahrenheit.

(d) Programs that have their own independent water supply and are not considered to be public water systems as defined in RSA 485:1-a, XV and confirmed by the New Hampshire department of environmental services (NHDES), shall test their water supply utilizing a laboratory accredited under the environmental laboratory accreditation program in accordance with Env-C 300.

(e) For new applicants of programs as described in (d) above , not more than 90 days prior to the date the application is submitted to the unit, water testing shall be conducted for arsenic, bacteria, nitrate, nitrite, lead, both stagnant and flushed, copper, both stagnant and flushed, fluoride, uranium, radon, manganese, and PFAS, and provide the results to the unit with the application.

(f) Ongoing water testing shall be conducted as follows and results maintained on file at the program, available for review by the health officer and the department:

(1) Once every 3 months for bacteria;

(2) Annually for arsenic, nitrate, and nitrite; and

(3) At least once every 3 years for stagnant lead, stagnant copper, fluoride, and manganese.

(g) Any program whose water test results has exceeded maximum contaminant levels established in Env-Dw 700 or action levels established in Env-Dw 714 shall immediately contact the unit to report that finding and provide the unit with a plan for how it will ensure that residents will not be at risk from exposure to the unsafe water.

(h) Within 30 days of the date the program learns that they have failed a water test the program shall submit to the unit an acceptable corrective action plan which details what action will be taken to correct the unsafe condition of the water and a date by which that action will be complete, unless the program requests, either verbally or in writing, and the unit agrees to extend that deadline.

(i) The unit shall extend the deadline in (h) above if it determines that the program can demonstrate that it has made a good faith effort to develop and submit the corrective action plan within the 30-day period but has been unable to do so and that the health, safety, or well-being of the residents will not be jeopardized by granting the extension.

(j) When a program fails to submit a written proposed corrective action plan within 30 days of receiving the unacceptable test result under (h) above, the unit shall initiate action to suspend the license or permit in accordance with He-C 4001.09(i), until such time as laboratory results meeting those requirements are received by the unit.

(k) Programs shall ensure that there are functional sewage disposal facilities.

(l) There shall be flush toilets in working order connected to a sewage disposal system.

(m) Any program whose septic system is showing signs of failure, shall immediately contact the unit and the local health officer to inform them of the problem, and provide an interim corrective action plan to include a timeline for repairs and how it will ensure that residents will not be exposed to any risks from the failed septic system.

(n) If a program determines that it cannot comply with the timeline for repairs as required in (m) above, it shall request an extension from the unit.

(o) The unit shall grant the extension in (n) above if the program provides a written plan for completion of the repairs, and the safety and well-being of the residents is maintained.

(p) At least once each day and whenever visibly soiled, sinks, toilets, commodes, foot stools, potty chairs, and adapters shall be cleaned to remove visible dirt and sanitized.

(q) Toilet paper, individual cloth or paper towels, and individual bar or liquid soap shall be available and accessible to residents and staff.

(r) Bathroom floors and other surfaces shall be cleaned at least weekly, and more often when obviously soiled.

(s) Programs serving diapered residents and residents who are not toilet trained shall have a designated diaper changing area that:

(1) Is not located in kitchens, food preparation or food service areas, or on surfaces where food is prepared or served;

(2) Is located adjacent to or in close proximity to a hand washing sink to allow access for hand washing without having to open doors or have physical contact with other residents;

(3) Has a non-porous, washable surface, which shall be sanitized after each diaper change and used exclusively for diaper changing;

(4) Contains a foot-activated receptacle for disposal of soiled disposable diapers and cleansing articles; and

(5) Is equipped with a sink used for adult and resident hand washing before or after diaper changing or toileting.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.19 Staff Interactions with Residents and Staff Qualifications.

(a) Program staff shall:

(1) Relate with residents in a professional, respectful manner;

(2) Have the ability to identify the needs of the residents and possess skill in planning and implementing services of the program, in accordance with the residents’ service and treatment plans; and

(3) Maintain professional boundaries with all residents at all times.

(b) Prior to having contact with residents, personnel shall receive a tour of and complete an orientation to the program that includes the following:

(1) The program’s complaint procedures;

(2) The duties and responsibilities of the position;

(3) The medical emergency procedures;

(4) The emergency and evacuation procedures;

(5) The infection control procedures;

(6) The program confidentiality requirements;

(7) Grievance procedures for both staff and residents;

(8) The policies required in He-C 4001.14(a); and

(9) The mandatory reporting requirements including RSA 161-F:46 and RSA 169-C:29.

(c) No new direct care staff shall be solely responsible for residents in care until they have completed the orientation required above and reviewed the service plan for each resident for whom they will care.

(d) The program director or designee shall, for each staff person who is responsible for the care, supervision, or treatment of residents, have on file available for review by the unit documentation of job qualifications such as:

(1) All required education, such as a diploma, transcripts, certificates, or degrees; and

(2) All required training and experience, as set forth on an application form or resume.

(e) For the purposes of this section, the field of human services shall include residential care, education, social work, mental health, law enforcement, psychology, sociology, pastoral counseling, theology, juvenile justice, medical services, corrections, substance abuse, social services, recreation, or a related field.

(f) The unit shall accept the following education and training for program staff:

(1) Credit courses in human services, offered by a regionally accredited college or university, toward meeting pre-service and in-service training requirements;

(2) Non-credit courses in human services, which are offered by a regionally accredited college or university, toward meeting pre-service and in-service training requirements at a ratio of 12 contact hours equal one credit; and

(3) Conference sessions, workshops, non-credit correspondence courses, or other non-credit distance learning courses related to human services, that are open to individuals working in the residential child care field or to the public or both, and are presented by an instructor who has at least a bachelor’s degree in human services or the subject area in which they are teaching, at a ratio of 12 contact hours equals one credit.

(g) The program director shall meet at least one of the following pre-service training and education options:

(1) A master’s degree in the field of human services, business administration, or public administration, awarded by a regionally accredited college or university, plus 2 years of experiences as a professional in human services, which included administrative responsibilities; or

(2) A bachelor’s degree with a minimum of 12 credits in the field of human services, business administration, or public administration, awarded by a regionally accredited college or university, plus 3 years of experience as a professional in human services, which included administrative responsibilities.

(h) Direct care staff shall be at least 21 years of age, have a high school diploma, high school equivalency certificate, or general equivalency diploma, and meet one of the following pre-service training and education requirements:

(1) An associate’s or higher degree with a minimum of 12 credits in the field of human services, or other field related to residential care, awarded by a regionally accredited college or university;

(2) The equivalent of 2 years of full-time experience working with children, either as a paid employee or volunteer, including as a para-professional in a public school;

(3) Any combination of college credits in human services and experience with children that total 2 years, as follows:

a. Two years of full-time college shall equal 60 credits;

b. Two years of full-time employment shall equal 3000 hours; and

c. One credit shall equal 50 hours of experience;

(4) Documentation of 7 years of parenting experience; or

(5) The equivalent of 2 years of full-time experience working with adults in a licensed residential setting.

(i) When an applicant for a direct care staff member does not meet one of the provisions in (h) above:

(1) An agreement shall be on file, signed, and dated by the individual and the program director or designee, which includes a written plan for:

a. Attaining 12 credits in human services within 2 years from the date that the individual begins working as a direct care staff, with documentation on file of the completion of 3 credits every 6 months, beginning on the date of hire;

b. How the program will supervise the individual while they are working on acquiring the required 12 credits; and

c. Maintaining current documentation of earned credits on file in the individual’s personnel file; and

(2) No more than 30% of staff shall be hired under the provisions of (i)(1)a. above.

(j) A child care assistant, intern, or volunteer shall:

(1) Be at least 18 years of age;

(2) Work at all times under the supervision of an on-duty staff person who meets at least the minimum qualifications for the position of direct care staff;

(3) Not be responsible for the care or supervision of residents including treatment, discipline, restraints, counseling, or administration of medication; and

(4) Not be included in the staff to resident ratio.

(k) Supervision as referenced in (j)(2) above shall require that a staff person who meets at least the minimum qualifications of direct care staff shall at all times have:

(1) Knowledge of and accountability for the activity and whereabouts of the child care interns, child care assistants, or volunteers and the residents with whom they are working; or

(2) The ability to either see or hear the child care intern, child care assistant, or volunteer and the residents with whom they are working.

(l) The exception to (k) above shall be that the program director or designee may at their discretion, authorize a specific child care assistant, intern, or volunteer to be responsible for one or more residents during time limited, specific activities, either indoors or outdoors, including off premises.

(m) The licensee shall provide all personnel with an annual continuing education or in-service education training, which at a minimum contains the following:

(1) The licensee’s infection control program;

(2) The licensee’s written emergency plan;

(3) The licensee’s policies and procedures; and

(4) The mandatory reporting requirements including RSA 161-F:46 and RSA 169-C:29.

(n) The licensee shall:

(1) Educate personnel about the needs and services required by the residents under their care and document such education to include demonstrated competencies; and

(2) Ensure that all personnel have received the training necessary to be qualified personnel to include demonstrated competency in the training given with documentation maintained in the employee personnel file.

(o) Personnel and staff shall not:

(1) Be impaired while on the job by any substances including, but not limited to, legally prescribed medication, therapeutic cannabis, alcohol, or illegal drugs; or

(2) Expose residents to tobacco, alcohol, or illegal drugs or controlled substances.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.20 Staffing Requirements and Ratios.

(a) In all programs there shall be a program director that assumes responsibility for the daily operation of the program.

(b) Programs shall, at a minimum, maintain the following staff to resident ratios and retain documentation of it for a 6-month period:

(1) Independent living homes shall maintain a minimum staff to resident ratio of one staff person to 8 residents during awake hours and one staff person to 12 residents during sleeping hours;

(2) All other programs shall maintain a minimum staff to resident ratio of one staff person to 6 residents during awake hours and one staff person to 12 residents during sleeping hours; and

(3) SCPs shall comply with the staff-to-resident ratios in He-C 4001.30(r).

(c) Notwithstanding the required minimum staff to resident ratios specified in (b) above, when a staff person takes one or more residents off the premises for a routine trip, such as a medical or dental appointment, recreation, or social activity, the program may have one fewer staff person with the residents who will remain on the premises of the program, provided that:

(1) The program director or designee has authorized the reduced staff to resident ratio, based upon their determination that the staff remaining on the premises of the program can meet the individual needs of each resident; and

(2) In no case shall the staff to resident ratio go below one to 12.

(d) Notwithstanding the staff to resident ratios set forth in (b) and (c) above, when a resident’s treatment plan requires that a resident needs a staff to resident ratio that is more stringent than the required staff to resident ratios, the program shall comply with the resident’s treatment plan.

(e) The licensee shall assign at least one staff to help orient a newly admitted resident to the program and to the services available to the resident.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.21 Programming, Treatment Planning, and Transfer or Discharge Requirements.

(a) Program staff shall, with input from the person or program placing the resident, have referral information on each resident, including:

(1) The reason for the placement;

(2) The anticipated length of stay;

(3) The contact information for the parent or guardian; and

(4) The contact information for the person or program placing the resident.

(b) Except for residents in short term placement, a written treatment plan shall be in place for each resident no later than 30 days from the date of admission, which shall identify:

(1) The resident’s physical, social, behavioral, medical, and educational needs; and

(2) How the program will meet those needs.

(c) Program staff shall review and modify the written treatment plan required in (b) above as the resident’s needs change.

(d) Once the written treatment plan required in (b) above is developed, program staff shall familiarize themselves with the identified needs of each resident and implement the plan.

(e) The program director or designee shall:

(1) Not rely upon residents to maintain the facility; and

(2) Only allow residents to perform work inside or outside the program, which is:

a. Compliant with child labor laws and regulations; and

b. Consistent with the resident’s age and abilities.

(f) Program staff shall:

(1) Plan daily activities that promote healthy development and provide for social relationships, creative activities, hobbies, and participation in neighborhood, school, and other community groups appropriate to the age, developmental level, and needs of each resident;

(2) Provide that work assignments for the resident do not interfere with the regular school programs, study periods, recreation, or sleep;

(3) Provide each resident with clothing that is individually fitted and appropriate to the season;

(4) Instruct each resident regarding good health practices, including proper habits in eating, bathing, and personal hygiene;

(5) Provide each resident with a clean towel and washcloth weekly, or more often if towels or washcloths become soiled or odorous; and

(6) Provide each resident with necessary individual toilet articles and supplies for personal grooming and hygiene suitable to their age and needs.

(g) Each resident shall have education and training, including:

(1) Regular school attendance as required by law; and

(2) The opportunity to complete high school or the opportunity for vocational guidance.

(h) Academic programs within the facility shall meet the requirements of the New Hampshire department of education.

(i) Each resident shall have the opportunity to practice their religious beliefs.

(j) Licensees shall transfer or discharge residents in accordance with the requirements of RSA 170-E:42-a.

(k) The licensee shall:

(1) Establish procedures to prepare the staff and residents for the arrival of a new resident;

(2) Provide staff with appropriate information to receive the new resident and assist in their adjustment, which shall include at a minimum:

a. Reason for placement, medical condition(s), and behavior problems, as applicable; and

b. Specific instructions related to the individual needs of the resident, including the need for an individualized restraint method consistent with RSA 126-U, if appropriate, de-escalation techniques, and the resident’s preferred activities as described in the resident’s service plan;

(3) Meet the needs of the residents;

(4) Verify the qualifications of all personnel; and

(5) Provide sufficient numbers of personnel who are present in the program and are qualified to meet the needs of residents during all hours of operation.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.22 Interactions Between and Among Residents.

(a) Program staff shall:

(1) Establish and make residents aware of rules or limits for acceptable behavior which are consistently applied, realistic, designed to promote cooperation and respect, and are appropriate and understandable to the development level of the resident;

(2) Apply rules in accordance with the resident’s individual service plan and treatment plan as they apply to their behaviors and staff responses thereto; and

(3) Make residents aware of the consequences of not complying with the established limits or rules for acceptable behavior, as identified in their individual service plan and treatment plan.

(b) Program staff shall not:

(1) Abuse or neglect residents;

(2) Use corporal punishment;

(3) Attempt to control any resident’s behavior by actions which are humiliating, threatening, shaming, frightening, or otherwise damaging to residents;

(4) Withhold food from residents or take food away as a means of discipline;

(5) Shame, humiliate, or discipline any resident for toileting accidents;

(6) Prevent a resident from using bathroom facilities, except as necessary to protect a resident’s safety, as documented in the resident’s case plan or treatment plan;

(7) As a means of discipline or punishment:

a. Require or deny residents sleep or rest;

b. Require residents younger than 6 years of age to go to their crib, bed, or playpen;

c. Withhold a resident’s shoes or clothing, except as necessary to protect the resident’s health or safety or to prevent the resident from running away;

d. Require a resident to perform physical exercise or perform tasks, which are humiliating, unusual, or physically exhausting; or

e. Use group punishment for misbehaviors of individuals except when documented as part of the treatment plan;

(8) Use sensory deprivation;

(9) Use mechanical restraints, and specifically any equipment, material, or device that is applied to a resident for the purpose of restricting their movement or activity;

(10) Allow residents to discipline other residents; or

(11) Use rough handling on residents, including but not limited to, grabbing, pushing, pulling, and dragging.

(c) Each use of time out shall:

(1) Not be in a locked room;

(2) Be appropriate to the resident’s developmental level and circumstances; and

(3) Be limited to the minimum amount of time necessary to:

a. Allow the resident to regain self-control;

b. Be effective as a consequence; or

c. Protect the safety of the resident in time out or other residents.

(d) The applicant, licensee, program director, and program staff shall take prompt action to protect residents from abuse, neglect, corporal punishment, or other mistreatment by any individual.

(e) Program staff shall use seclusion and restraint in accordance with RSA 126-U and He-C 901.

(f)  Before any program staff participates in a restraint or the use of seclusion, they shall have completed a curriculum in restraint techniques that is designed to protect the resident from risk of harm to self, others, property, or the public.

(g)  Restraint techniques used shall be consistent with the curriculum required in (f) above and be reviewed at least annually with program staff to maintain competency.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; amd by #13991, EMERGENCY RULE, eff 5-29-24, EXPIRED: 11-25-24

New. #14123, eff 11-26-24, EXPIRED: 11-26-25; ss by #14214, eff 4-1-25, EXPIRES: 4-1-35

He-C 4001.23 Incident Reports and Reporting Requirements.

(a) Licensees shall ensure that program staff complete all reports and comply with reporting requirements for uses of restraint and seclusion, in accordance with RSA 126-U and He-C 901.

(b) For other incidents defined in He-C 4001.01(z) the licensee shall complete a legible, written incident report.

(c) For incidents described in (b) above, the report required shall include:

(1) The program name;

(2) A description of the incident, including what led to the incident, where it occurred, and identification of injuries, if applicable;

(3) The name of the licensee(s) or personnel involved in, witnessing, or responding to the reportable incident;

(4) The name of resident(s) involved in or witnessing the reportable incident;

(5) The date and the beginning and ending time of the reportable incident;

(6) The action taken in direct response to the reportable incident, including any follow-up;

(7) If medical intervention was required, by whom, and the date and time;

(8) When the resident’s guardian, agent, surrogate decision-maker, or personal representative, if any, was notified;

(9) The signature of the person reporting the reportable incident; and

(10) The date and time the resident’s licensed practitioner was notified, if applicable.

(d) If the incident is a reportable incident as defined in He-C 4001.01(bb), the program shall notify the unit within 48 hours of the incident.

(e) Incident reports shall be maintained as part of the involved resident’s records and be made available on the premises of the program for review by the department.

(f) Program staff shall provide the resident’s parent(s) or guardian(s) with information regarding incident reports on the next business day, which shall include all of the information included on the incident report.

(g) If the parent(s) or guardian(s) do not have a telephone or cannot be reached, program staff shall document their efforts to notify them and send a written copy of the incident report to the parent(s) or guardian(s).

(h) For uses of seclusion, restraint, or other intentional physical contact with a child which is response to a child’s aggression, misconduct, or disruptive behavior, program staff shall notify the resident’s parents or guardians in accordance with RSA 126-U and He-C 901.

(i) Immediately following any fire or emergency incident, licensees shall notify the unit by phone, followed by written notification within 72 hours, with the exception of a false alarm or emergency medical services (EMS) transport for a non-emergent reason.

(j) The written notification required by (i) above shall include:

(1) The date and time of the incident;

(2) A description of the location and extent of the incident, including any injuries or property damage;

(3) A description of events preceding and following the incident;

(4) The name of any personnel or residents who were evacuated as a result of the incident, if applicable;

(5) The name of any personnel or residents who required medical treatment as a result of the incident, if applicable; and

(6) The name of the individual the licensee wishes the unit to contact if additional information is required.

(k) As soon as is practicable but no longer than 24 hours after the use of a medication restraint, the resident’s licensed practitioner shall be notified of the use of such restraint.

(l) Program staff shall immediately notify the local police department, the unit, and the resident’s parent or guardian when a resident is unaccounted for after searching the buildings and grounds, and determining that the resident is a danger to their self or others, or the resident is in danger because of the current weather conditions or season.

(m) The program director or designee shall notify the unit, the parent or guardian, and the person or agency responsible for the resident’s placement within 24 hours of the serious injury or death of any resident.

(n) In the event of the death of a resident, the program director or designee shall provide a written report to the unit and the person or agency responsible for the resident’s placement, within 72 hours of the death, detailing the circumstances of the death.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; amd by #13991, EMERGENCY RULE, eff 5-29-24, EXPIRED: 11-25-24

New. #14123, eff 11-26-24, EXPIRED: 11-26-25; ss by #14214, eff 4-1-25, EXPIRES: 4-1-35

He-C 4001.24 Nutrition.

(a) Programs shall offer residents 3 meals and 2 snacks each day that meet US Department of Agriculture dietary allowances.

(b) Residents shall not be denied meals or snacks for any reason except according to a licensed practitioner’s order.

(c) No resident shall be secluded at mealtime unless they pose a risk of harm to themselves or others.

(d) Residents shall not be coerced to eat against their will, except by written order of the resident’s licensed practitioner.

(e) Programs shall meet the nutritional needs of each resident on a therapeutic or medically prescribed special diet.

(f) Child care program personnel shall assure that all food and drink served to residents are:

(1) Safe for human consumption and free of spoilage or other contamination;

(2) Stored, prepared, and served in a manner consistent with safe food handling practices for the prevention of food borne illnesses, including those set forth in He-P 2300; and

(3) Stored in a way to protect it from dust, insects, rodents, overhead leakage, unnecessary handling, and all other sources of contamination.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20’ ss by #14214, eff 4-1-25

He-C 4001.25 Transportation and Trips.

(a) Program staff shall bring on all field trips, outings, and excursions off campus, a copy of the authorization for medical treatment required under He-C 4001.12(a), for each resident participating in the field trip.

(b) Residents who are transported by the program and during any program sponsored activity shall be transported in vehicles that are:

(1) Driven by individuals who are at least 21 years of age and hold a valid driver’s license;

(2) Inspected in accordance with Saf-C 3200;

(3) Maintained in a safe operating condition;

(4) Registered in accordance with Saf-C 500;

(5) Insured for personal liability, and medical payments; and

(6) Free of obstructions on the floors and seats.

(c) Program staff shall be prohibited from using cell phones while operating a vehicle to transport residents.

(d) Program staff shall not permit any resident to remain in any vehicle unattended by program staff unless the resident is at a level of supervision that allows the resident to be unaccompanied by program staff for specific activities, and if driving, the resident has a valid driver’s license.

(e) Keys to vehicles, including vehicles belonging to program staff, shall not be accessible to residents, except for a resident who is driving a vehicle pursuant to (d) above.

(f) The number of individuals who are transported by the program or transported in any vehicle during any program-sponsored activity, shall be limited to the number of persons the vehicle is designed to carry.

(g) Residents younger than 5 years of age who are transported by the program or transported in any vehicle during any program sponsored activity shall not be transported in any vehicle exempted from seat belt requirements under RSA 265:107-a, II.

(h) Program staff shall secure residents via individual, age-appropriate child restraints or seat belts in accordance with RSA 265:107-a.

(i) Programs shall comply with RSA 126-U:12 regarding restrictions in the use of mechanical restraints during the transport of residents.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.26 Independent Living Homes.

(a) Independent living homes shall comply with He-C 4001.01 through He-C 4001.25, He-C 4001.31, and this section, except as provided in (b) below.

(b) Independent living homes shall be exempt from:

(1) He-C 4001.21(e)(1), regarding responsibility for the operation and maintenance of the facility;

(2) He-C 4001.17(e), specifically regarding resident’s access to cleaning products;

(3) He-C 4001.21(f)(3), regarding clothing requirements; and

(4) He-C 4001.14(g), regarding program staff certified in cardiopulmonary resuscitation (CPR) and first aid being present in each building when residents are present, provided that certified staff are on the premises.

(c) Program staff shall be on the premises when one or more residents are on the premises.

(d) Independent living homes shall not be required to have staff in the residence when residents are not on the premises of the program.

(e) Program staff shall provide an effective communication system between the residents of an independent living home and staff to ensure that program staff are available to always address the needs of the residents.

(f) Kitchen facilities shall be available and accessible for use by all residents and program staff.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #14214, eff 4-1-25

He-C 4001.27 Short Term Placements.

(a) The requirements in this section shall apply only to residents who are in short term placement.

(b) Programs that admit residents for short term placements shall comply with He-C 4001.01 through 4001.25, He-C 4001.31, and this section.

(c) Within 5 calendar days of the date the resident is admitted to the program, the program shall obtain or document efforts to obtain the following for each resident:

(1) Written authorization for emergency medical treatment, signed by the resident’s parents or guardian, as required under He-C 4001.12(a);

(2) Any history of childhood diseases;

(3) Any current medications prescribed for the resident;

(4) The date of the resident’s last visit to a licensed practitioner;

(5) The date and reason for any previous hospitalizations and surgeries;

(6) Current medical problems;

(7) Any allergies to food or medications;

(8) Any special dietary needs or restrictions; and

(9) Any functional limitations.

(d) Within 30 days of the date the resident is admitted to the program, the program shall obtain or document efforts to obtain a record of physical examination completed in accordance with He-C 4001.12(b) and (c) s which shall be available for review by the unit.

Source. #2664, eff 3-30-84, EXPIRED: 3-30-90

New. #8581, eff 4-20-06, EXPIRED: 4-20-14

New. #10576, INTERIM, eff 4-26-14, EXPIRES: 10-23-14; ss by #10705, eff 10-23-14; ss by #14214, eff 4-1-25

He-C 4001.28 Homeless Youth Programs.

(a) The requirements in this section shall apply only to programs which serve residents who are in homeless youth placement.

(b) Programs receiving homeless youth in accordance with RSA 170-E:25, II(f), shall do so for the purpose of providing shelter, basic needs, and services, which shall include an individual assessment, referral, housing, and case management to facilitate safety, permanency, wellbeing, and independent living.

(c) The program shall have and implement a written policy consistent with the mandated reporting statute RSA 169-C:29 through RSA 169-C:39, with a particular focus on neglect and abandonment.

(d) The homeless youth program shall provide training to all staff on the mandated reporting statute RSA 169-C:29 through RSA 169-C:39 and on the policy in (c) above.

(e) Homeless youth programs shall comply with RSA 170-E:27-a, except that the notification in RSA 170-E:27-a, I(c), shall be to the department’s DCYF.

(f) Homeless youth programs shall document attempts to contact a parent or legal guardian of a resident 16 or 17 years of age in accordance with RSA 170-E:27-a.

(g) Agencies licensed as homeless youth programs which have a license for one or more additional types of residential child care programs shall have and implement a policy consistent with RSA 169-C:16, II, and RSA 169-D:9-c, I, to address supervision, commingling, and safety for multiple populations.

(h) Homeless youth programs shall develop written protocols with local police department(s) regarding notification to the local police department for residents who are 16 or 17 years of age. In cases where local police departments refuse to participate in the development of such protocols, the homeless youth program shall document the efforts taken to engage them.

(i) Homeless youth programs shall comply with He-C 4001.01 through He-C 4001.25, He-C 4001.31, and this section, except for:

(1) He-C 4001.12(a)–(g); and

(2) He-C 4001.21(b)–(g).

(j) Homeless youth programs shall maintain written documentation for each resident including the following information:

(1) Name, sex, and age of the resident;

(2) Name, address, and telephone number of an adult next of kin or guardian, if available;

(3) Date of admission;

(4) Referral source, if any;

(5) Medical or health information, if available;

(6) Any diseases or injuries diagnosed while in care; and

(7) Educational status.

(k) Homeless youth programs shall obtain urgent medical or dental care for each resident, as needed.

(l) If parental authorization for medical treatment, in accordance with He-C 4001.12(a), is not obtainable for residents who are 16 or 17 years of age, the homeless youth program shall document efforts to obtain such authorization.

(m) If urgent medical or dental treatment is not available due to lack of authorization from a parent or guardian, the program shall contact DCYF for assistance.

(n) Homeless youth programs shall provide residents with information about educational rights in accordance with the McKinney Vinto Act, 42 USC 11431 et. seq.

(o) Homeless youth programs shall make appropriate referrals for the resident based on the health, education, housing, and permanency needs of each resident including available community-based services and resources.

(p) Homeless youth programs shall develop a transition and discharge plan for each resident that addresses the resident’s needs at the time of discharge.

Source. #10319, eff 7-1-13; ss by #13750, eff 9-23-23; ss by #14214, eff 4-1-25

He-C 4001.29 Specialized Care Programs (SCPs).

(a) Residents who have medical or behavioral health needs, or both, requiring specialized care necessitates programming that incorporates an increased awareness of the unique needs, as well as attention, adaptation, and accommodative measures beyond what are considered routine. For the purposes of this section, such medical or behavioral health needs are those defined in He-C 4001.01(bj), and which may be congenital, developmental, or acquired through disease, trauma, or environmental causes, and which impose limitations in performing daily self-maintenance activities or substantial limitations in a major life activity.

(b) SCPs shall comply with:

(1) He-C 4001.01 through He-C 4001.25, He-C 4001.31, and this section; and

(2) Any other federal, state, and professional standards related to the treatment of any medical diagnosis of any resident.

(c) In addition to the policies required in He-C 4001.14 and He-C 4001.15, SCPs shall have written policies and procedures governing the operation of the program relative to the provision of services, available for review by the unit, that include the following:

(1) Intake and admissions procedures that clearly state the criteria for the SCP population to be served;

(2) A description of the services provided within the program to meet the special medical needs of the residents;

(3) A description of the professional services provided on site and in the local community that will be contracted or accessed to ensure the special medical needs of the residents are met;

(4) The organizational chart, job descriptions of staff, and contracts with medical staff, clinical staff, and consultants used to meet the special medical needs of the population being served; and

(5) How direct care staff will be orientated and trained to prepare to work with the population being served.

(d) The program director, together with relevant members of the administration, clinical, and direct-care staff, shall annually review all policies and procedures and revise them as needed to ensure consistency with current practice and professional standards.

(e) All clinical services provided by the licensee shall:

(1) Focus on the residents strengths;

(2) Be sensitive and relevant to the diversity of the residents;

(3) Be child and family-centered; and

(4) Be designed to acknowledge the impact of violence and trauma on resident’s lives, which shall be addressed in the services provided.

(f) The licensee shall assess and monitor the quality of care and services it provides to residents on an ongoing basis.

(g) SPCs providing behavioral health services shall employ or contract with:

(1) A clinical coordinator who shall:

a. Be a full-time employee;

b. Meet the definition of clinical staff in He-C 4001.01(j); and

c. Have 2 years post-graduate experience in human services; and

(2) Clinical staff to meet the needs of the residents who shall:

a. Be a full-time employee or a part-time employee with a minimum of 22 hours a week; and

b. Meet the criteria specified in He-C 4001.01(j).

(h) SCPs shall:

(1) Provide administrative services that include the appointment of a full-time, on-site program director who is responsible for the day-to-day operations of the SPC, who meets the requirements specified in He-C 4001.19(g);

(2) Contract with or employ professional staff to meet the needs of residents, including but not limited to clinical, medical, and social needs;

(3) Employ direct care staff to implement service plans on a daily basis;

(4) Assign all direct care staff and clinical staff to a staff person who has supervisory or administrative responsibility and experience suitable to the goals of the program and the responsibilities of the staff supervised;

(5) Require direct care and clinical staff to have scheduled supervision with the assigned supervisor regarding resident’s needs and methods of meeting those needs, which shall occur a minimum of weekly or more frequently as needed;

(6) In addition to He-C 4001.19(b), provide orientation for all new employees to acquaint them with the program's philosophy, organization, policies, and services. No new direct care staff shall be solely responsible for residents until they have completed the orientation;

(7) Ensure that all staff who perform direct care to residents or who are providing treatment, education, and recovery support services shall be under the direct supervision of a licensed clinical supervisor pursuant to the supervision requirements in Alc 400; and

(8) Require that all personnel follow the orders of the licensed practitioner for each resident and encourage the residents to follow the licensed practitioner’s orders.

(i) An SCP that is not able to meet the needs of any resident whom requires specialized care, as described in this section, shall notify the unit and expeditiously seek an alternative placement, which can provide for the resident’s needs on a long-term basis and ensure that all needs are met until such time transfer or discharge can safely occur.

(j) SCPs shall assess each resident within 24 hours of admission to determine each resident’s needs and abilities on the following:

(1) Walking and ambulation;

(2) Transfers;

(3) Ability to self-evacuate;

(4) Fall risk;

(5) Mood and behavior;

(6) Communication;

(7) Nutrition and oral health;

(8) Medications and treatments including nebulizers and oxygen;

(9) Personal hygiene and assistance with activities of daily living;

(10) Whether or not safety devices, such as helmet, mittens, or safety belt, are needed; and

(11) Nursing care and services.

(k) The assessment conducted in accordance with (j) above shall be:

(1) Incorporated into the resident’s service plan and treatment plan; and

(2) Documented in the resident’s file and available for review by unit staff.

(l) In addition to the treatment plan required in He-C 4001.30, SCPs shall develop a service plan, meaning a written guide, in consultation with the resident and parent, guardian, agent, or personal representative, as applicable, as a result of the assessment conducted in accordance with (j) above for the provision of care and services which shall:

(1) Be completed within 24 hours of the completion of the assessment and within 24 hours of the completion of subsequent assessments;

(2) Identify the resident's needs;

(3) Identify the services that the SCP will provide and the staff person responsible for providing or arranging for the services while the resident is in care;

(4) Include the following areas:

a. Educational;

b. Vocational;

c. Health, including medical, dental, and ancillary services;

d. Behavior management, including specific individual modifications of the restraint plan, if necessary;

e. Life skills; and

f. Social services, including family work, psychological and psychiatric services, and counseling;

(5) Be made available to all personnel for residents whom they assist;

(6) Be completed in consultation with the resident and parent, guardian, agent, or personal representative, as applicable, and if any of these individuals are unable or unwilling to participate, it shall be documented in the resident record; and

(7) Be available on site for review by the unit.

(m) The service plan identified in (l) above shall include on an ongoing basis:

(1) The date a problem or need was identified as a result of the assessment conducted in (k) above;

(2) A description of the problem or need;

(3) The goal or objective of the plan;

(4) The action or approach to be taken;

(5) The responsible person(s) or position; and

(6) The date of reevaluation, review, or resolution.

(n) The licensee shall explain all service plans to all child care personnel responsible for implementing the service plan, to the resident’s parent, guardian, agent, or personal representative, as appropriate, and to the resident in a manner consistent with their maturity and capacity to understand.

(o) All service plans shall be reviewed and updated as often as necessary, but no less frequently than every 6 months to re-assess the resident’s needs and determine if:

(1) The service plan will be continued for another 6 months;

(2) The service plan will be revised to meet the needs of the resident;

(3) The service plan will be discontinued because the plan is no longer needed; and

(4) Shall be available for review by the unit.

(p) Progress notes shall be written at least every 90 days and include, at a minimum:

(1) Service plan outcomes;

(2) The resident’s physical, functional, and mental abilities; and

(3) Changes in behavior, such as eating habits, sleeping pattern, and relationships.

(q) If a resident refuses care or services that could result in a threat to their health, safety, or well-being, or that of others, the licensee or their designee shall:

(1) Inform the resident of the potential results of their refusal;

(2) Notify the licensed practitioner and parent, guardian, agent, or personal representative, if any, of the resident’s refusal of care; and

(3) Document in the resident’s record the refusal of care and the resident’s reason for the refusal.

(r) If a resident is non-verbal or incapable of understanding the need for care or services as identified in (q) above but exhibits behaviors that represent refusal of any care or services:

(1) Such behaviors shall be documented in the resident’s record; and

(2) Staff shall consult with appropriate personnel of the SCP to determine if the care plan requires modifications or if the needs of the resident exceed the services that the SCP is able to provide.

(s) The licensee shall insure that medically necessary glasses, hearing aids, prosthetic devices, corrective physical or dental devices, or any equipment necessary or treatments prescribed by the examining physician are provided to the resident if the resident’s parent, guardian, agent, or personal representative, as applicable, does not provide them.

(t) The licensee shall not require any resident to receive medical treatment or screening when the parents or guardians of such resident object based on religious beliefs.

(u) Programs providing SUD services shall:

(1) Provide administrative services that include the appointment of a full-time, on-site program director who is responsible for the day-to-day operations, who shall be at least 21 years of age and have a minimum of one of the following combinations of education and experience:

a. A bachelor’s degree from an accredited institution and one year of relevant experience working in a health related field;

b. A New Hampshire license as an RN, with at least one-year relevant experience working in a health related field;

c. An associate’s degree from an accredited institution plus 3 years relevant experience in a health related field;

d. A MLADC or LADC license issued by the state of New Hampshire; or

e. Licensed by the New Hampshire board of mental health practice with at least one year of relevant experience working in SUD treatment;

(2) Employ or contract with a medical director who:

a. Is a licensed practitioner who is licensed in the state of New Hampshire; and

b. Has experience providing medical services to residents with behavioral health or substance use disorder needs;

(3) Employ or contract with a nurse who is currently licensed in the state of New Hampshire pursuant to RSA 326-B, or licensed pursuant to the multi-state compact, and who is an RN or LPN with at least 2 year's relevant experience in substance use disorder treatment or behavioral health services;

(4) Employ or contract with a clinical services director who is a LADC or MLADC licensed by the New Hampshire board of licensing for alcohol and other drug use professionals or an individual licensed by the board of mental health practice and who has at least 2 years relevant experience in treatment of SUD or behavior services;

(5) Employ or contract with additional professional staff to meet the needs of residents, including but not limited to clinical, medical, and social needs; and

(6) Employ direct care staff to implement service plans on a daily basis.

(v) In programs providing SUD services, all direct care personnel shall be at least 21 years of age unless they are:

(1) A licensed nursing assistant working under the supervision of a nurse in accordance with Nur 700; or

(2) Involved in an established educational program working under the supervision of licensed staff.

(w) In addition to (u) and (v) above, all programs providing SUD services shall:

(1) Ensure that all staff who perform direct care to residents or who are providing treatment, education, and recovery support services shall be under the direct supervision of a licensed clinical supervisor pursuant to the supervision requirements in Alc 400;

(2) Require all personnel to follow the orders of the licensed practitioner for each resident, and encourage the residents to follow the licensed practitioner’s orders; and

(3) Require staff to obtain continuing education requirements, in accordance with Alc 400, and maintain documentation of the training in the employee’s individual personnel file for review by the unit.

(x) In programs providing SUD services, the services shall be evidence-based by meeting one of the following:

(1) The services shall be included as an evidence-based mental health and substance abuse intervention on the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Evidence-Based Practices Resource Center” available at https://www.samhsa.gov/libraries/evidence-based-practices-resource-center?f%5B0%5D=resource_topic%3A20277 , (as accessed and printed on January 27, 2025), available as noted in Appendix A;

(2) The services are published in a peer reviewed journal and found to have positive effects; or

(3) The treatment and support service provider shall be able to document the services effectiveness based on a theoretical model with validated research or a documented body of research generated from similar services that indicates effectiveness.

(y) In addition to (x) above, programs providing SUD services, shall deliver those services in accordance with:

(1) The American Society of Addiction Medicine’s (ASAM), “The ASAM Criteria”, (Fourth edition), available as noted in Appendix A; or

(2) The U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Knowledge Application Program (KAP) Resource Documents and Manuals” (July 2020 edition), available at https://www.samhsa.gov/kap/resources, or as noted in Appendix A.

(z) Programs operating a SCP shall appoint an individual who will oversee the development and implementation of an infection control program that educates and provides procedures for program staff for the prevention, control, and investigation of infectious and communicable diseases.

(aa) The infection control program shall include written procedures for:

(1) Proper hand washing techniques;

(2) The utilization of universal precautions;

(3) The management of residents with infectious or contagious diseases or illnesses;

(4) The handling, storage, transportation, and disposal of those items identified as infectious waste in Env-Sw 904; and

(5) The reporting of infectious and communicable diseases as required by He-P 301.

(ab) The infection control education program shall address at a minimum the:

(1) Causes of infection;

(2) Effects of infections;

(3) Transmission of infections; and

(4) Prevention and containment of infections.

Source. #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.30 Treatment Planning Process for Specialized Care Programs.

(a) SCPs shall conduct a psycho-social assessment of each resident with recommendations for treatment.

(b) Based on the assessment and recommendations in (a) above, the SCP shall conduct a treatment team meeting and develop a treatment plan within 30 calendar days of placement of the resident.

(c) The treatment plan shall include:

(1) The summary of the psycho-social assessment;

(2) A transitional section for the resident and family that includes:

a. An estimate of the resident’s length of stay, based upon referral information and the SCP’s assessment; and

b. A permanency plan identifying the following alternatives for the resident, including the identified resource, if known at the time of the treatment plan:

1. Reunification with the family;

2. Adoption;

3. Guardianship by a relative or other person;

4. Permanent placement with a fit and willing relative; or

5. Another planned permanent living arrangement (APPLA) in accordance with RSA 169-C:24-b, II(a)(3);

(3) Community reintegration and transition tasks that identify the following:

a. Specific needed supports or services that would provide for the resident to successfully transition out of the SCP and into the community;

b. The treatment team member who is responsible for completing each task necessary; and

c. The projected time frame for completion of each task; and

(4) The date and signatures of the following team members, indicating their participation:

a. The resident;

b. The resident’s parents or guardian(s);

c. The licensed practitioner; and

d. The clinical coordinator or the SCP’s program director. If the licensed practitioner is also the clinical coordinator, they shall indicate dual functions.

(d) The treatment team shall consist of the individuals identified in (c) above in addition to the following invited participants:

(1) Clinical staff of the SCP;

(2) Attorney or guardian ad litem (GAL) for the resident;

(3) A representative of the local educational agency when clinically appropriate; and

(4) Other persons significant in the resident’s life if clinically appropriate, including but not limited to:

a. Teachers;

b. Staff members from the SCP;

c. Counselors;

d. Friends;

e. Relatives; and

f. Educational surrogate.

(e) When any of the individuals in (d) above do not participate, the SCP shall document its efforts to involve them.

(f) Changes and updates to the treatment plan shall be made based on progress identified by the treatment team, areas of continued treatment needs, achievement of goals or objectives, and effectiveness of interventions identified in the treatment plan.

(g) Revisions to the treatment plan outside the scheduled treatment plan reviews shall include the signatures of the licensed practitioner, clinical coordinators, and other team members identified, as available, and shall be explained in writing to any individuals of the team who are unable to participate.

(h) SCPs shall acquire signatures on the treatment plans of individuals identified in (c)(4) and (d) above within 7 calendar days of the treatment team meeting, or if signatures cannot be obtained, the following occurs:

(1) Reasonable efforts to obtain the signature of the parent(s) or guardian(s) and DCYF shall be documented as meeting the requirements of (c)(4) above; and

(2) Any team members participating through electronic means, other than the licensed practitioner or clinical coordinator, may provide verbal assent in lieu of signature on the treatment plan but this shall not preclude efforts identified in (1) above.

(i) During each treatment team meeting, the treatment team shall review and update the treatment plan as necessary, in accordance with the following:

(1) Three months from the initial treatment plan; and

(2) Every 3 months thereafter until transfer or discharge, at no point exceeding 3 months.

(j) Once the treatment plan is complete, all clinical and direct care staff shall receive supervision and instruction to ensure that they consistently implement each resident’s treatment plan.

(k) The treatment plan shall be filed in the resident’s record and copies provided to the individuals identified in (c)(4) and (d) above.

(l) The treatment team and the staff of the SCP shall implement the treatment plan, which shall be reflected in the resident’s daily routine, logs, progress notes, and transfer or discharge summary.

(m) The treatment plan shall at a minimum, contain the following domains relating to rehabilitative and restorative services provided by the SCP:

(1) Safety and behavior of the resident;

(2) Family;

(3) Medical;

(4) Education, if clinically necessary; and

(5) Adult living preparation if determined clinically necessary.

(n) Each domain identified in (m) above shall address:

(1) The goals and measurable objectives to be achieved by the resident and family;

(2) The time frames for completion of objectives; and

(3) The individualized interventions that will be used to address the objectives, including:

a. Identification of the staff or individual providing or implementing the stated intervention;

b. The frequency of the intervention; and

c. How that intervention is documented.

(o) All programs shall provide and coordinate services and treatment interventions to meet the goals identified in the treatment plan, as follows:

(1) Treatment interventions shall meet the individual needs of the residents and families in therapeutic and group-living experiences;

(2) Treatment programs shall include individual or group problem solving and decision-making;

(3) The clinical coordinator shall ensure therapeutic interventions and other services are implemented and integrated into the treatment programming for the individual resident and family;

and

(5) Direct care staff that provides group counseling shall receive supervision from clinical staff.

(p) Depending on the needs of the resident and family, services required by the treatment plan, including individual, group, and family counseling shall be available within the SCP or shall be provided through local community agencies, as follows:

(1) Treatment plans shall provide and allow for increased community-based integration and involvement, based on progress and individualized needs; and

(2) The clinical coordinator or another staff member who meets the requirements of clinical staff may provide individual or family counseling.

(q) The program shall maintain a multi-disciplinary, self-contained means of service delivery to meet the needs identified within the treatment plan, in accordance with the following:

(1) There shall be a clinical staff to resident ratio of one clinical staff to 10 residents;

(2) There shall be clinical services provided through the residential treatment program’s on-site program unless a special circumstance is identified through the treatment plan to support utilizing a community provider;

(3) Clinical staff shall provide treatment interventions to meet the individual needs of the residents and families served and shall provide a therapeutic group-living experience;

(4) Unless otherwise specified in the resident’s treatment plan, any combination of individual, group, or family counseling services shall be provided to each resident or the family a minimum of 3 times a week;

(5) There shall be a family-centered services component designed to promote and provide opportunities for families to be involved in all aspects of their child’s care, including, but not limited to:

a. Activities designed to promote permanency and support continued family involvement throughout placement;

b. Services that promote family involvement and partnership in a therapeutic process from intake to transfer or discharge, which supports the identified permanency plan;

c. Implementation of the reasonable and prudent parent standard by staff including a description of how the program will identify and support normal age and developmental experiences including social, extracurricular, enrichment, and cultural activities in the community;

d. Whenever possible, activities in the family’s home at the family’s convenience, and other services to support the identified permanency plan;

e. Parental or guardian education, as needed to support the resident and family’s permanency, safety, and well-being;

f. Communication that includes the family in the program’s initial orientation process and ongoing activities; and

g. The program’s grievance procedures, which shall ensure that residents may constructively address their concerns without fear of retaliation; and

(6) The program shall organize its clinical staff and family workers in a flexible manner so long as families are seen face-to-face no less than one time per week, unless otherwise specified in the resident’s treatment plan, in accordance with the following:

a. Technology may be used to supplement clinical services as a part of the resident’s treatment; and

b. The utilization of a video-conferencing technology shall not replace face-to-face contact unless documented in the resident’s treatment plan with the agreement of the treatment team.

(r) The program shall be staff-secure and be able to serve those residents whose needs require a high level of treatment and supervision, in accordance with the following:

(1) There shall be a minimum staff to resident ratio of one staff to 4 residents during hours when residents are awake; and

(2) There shall be an awake staff member in each building housing residents.

Source. #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.31 Background Checks and Determination of Eligibility for Employment.

(a) Background record checks shall be completed in accordance with this section.

(b) Prior to the start date and every 5 years thereafter, an employee, volunteer, household member, or other individual who will be working in the residential program and is 18 years of age or older shall submit for a background record check using the NHCIS portal.

(c) The background record check shall be completed in accordance with RSA 170-E:29-a, unless exempted from this requirement as permitted under RSA 170-E:29-a, IV-a.

(d) For individuals exempted from completing a background record check in accordance with (c) above, the program shall ensure the individual completes a request to transfer their employment eligibility to the program using the NHCIS portal.

(e) For every individual age 12 years through 17 years, other than residents admitted to the program, the program shall, prior to the individual’s start date, submit to the unit:

(1) A completed and notarized “Staff and Household Member Form” (February 2025), certifying the following:

“a) All information provided above is accurate.

b) I have not been convicted of a felony consisting of murder, child abuse or neglect, crimes against children (including pornography and trafficking), spousal abuse, rape or sexual assault, kidnapping, arson, physical assault or battery, or a drug related offense (in the last 5 years) or convicted of a violent misdemeanor as an adult against a child including child abuse, child endangerment, sexual assault or child pornography, or a crime which shows that I might be reasonably expected to pose a threat to a child, such as violent crime or sexually related crime against an adult.” ; and

(2) All forms and any required fees to complete registry checks when the individual has lived in any state other than NH, or a United States territory, within the previous 5 years.

(f) Individuals age 12 years through 17 years who completed the registry checks through the unit during the previous 5 year period and who have been employed, are a volunteer, or a household member in any New Hampshire licensed child care program within the prior 6 months of their start date, shall submit a completed and notarized “Staff and Household Member Form” (February 2025), and shall be exempt from submitting the item in (e)(2) above.

(g) Upon receipt of the information requested in (b) and (e) above, the unit shall assess the individual’s eligibility for employment in accordance with RSA170-E:29-a, V or VI, and if eligible, notify the program of the individual’s eligibility and the date the eligibility expires, which shall be 5 years for submissions in (b) and the 18th birthday of the individuals submitted in (e).

(h) All individuals shall complete the background record check prior to their expiration of eligibility.

(i) If the unit determines that an individual is ineligible, in accordance with RSA170-E:29-a, V or VI, it shall provide notice to the individual that:

(1) The individual has been determined by the unit to be ineligible;

(2) The basis for the determination that the individual is ineligible; and

(3) The individual’s right to challenge their criminal record pursuant to Saf-C 5703.

(j) If the unit determines that an individual is ineligible to work in child care, in accordance with RSA 170-E:29-a, V or VI, it shall provide notice to the residential child care program that:

(1) The individual has been determined by the unit to be ineligible;

(2) The program shall take immediate action to prohibit the individual from being on the premises of the residential child care program and from having access to the residents admitted to the program; and

(3) The residential child care program shall inform the unit in writing of the specific action it has taken as required under (2) above.

(k) When the program learns of any charges or convictions of individuals after the determination of eligibility, the program shall report them to the unit immediately.

(l) The unit may require the individual to complete additional background checks when the unit needs additional information to determine if the individual’s eligibility must be rescinded per RSA 170-E:29-a, VII, with notification provided per (i) and (j) above.

Source. #13151, eff 12-30-20; ss by #14214, eff 4-1-25

He-C 4001.32 Waivers of Rules.

(a) Applicants or licensees shall request a waiver through the NHCIS portal or by providing the following information in writing to the unit:

(1) The program name, address, phone number, email address, and license number;

(2) The rule numbers for which the program is requesting a waiver;

(3) A brief explanation of the reason for the waiver, the length of time for which the waiver is requested, how the program will meet the intent of the rule, and any affect the granting of the waiver will have on the health and safety of the residents in the program; and

(4) The number and range of ages of the residents affected by the waiver.

(b) The unit shall grant a waiver if it determines the alternative proposed by the applicant or licensee:

(1) Meets the objective or intent of the rule;

(2) Does not negatively affect the health, safety, or well-being of the residents; and

(3) Does not negatively affect the quality of resident services.

(c) A program’s compliance with an approved waiver shall be considered equivalent to complying with the rule from which waiver was sought.

(d) The unit shall not approve any request for a waiver of any of the provisions of RSA 170-E or of any rules of other state agencies which are referred to in this chapter.

Source. #14214, eff 4-1-25

He-C 4001.33 Administrative Fines.

(a)  The department shall assess administrative fines in accordance with RSA 170-E:34, I(j) and RSA 170-E:45-a.

(b)  The department shall send a written notice of intent to impose a fine which shall include:

(1)  The amount of the fine and the citation(s) for which the fine is being assessed;

(2)  The automatic reduction of the fine by 25% by submitting to the department, no later than 10 days from receipt of the notice, payment of the reduced fine, and a corrective action plan which has been accepted and approved by the department; and

(3)  The right to request an administrative hearing no later than 14 days of receipt of the notice, including the contact information for the hearings unit.

(c)  If a written request for an administrative hearing is not made as specified in (b)(3) above, the action of the department becomes final and the fine shall be paid to the department no later than 30 days from the receipt of the notice.

(d)  When an administrative hearing is conducted and the department’s decision to impose a fine is upheld, the fine shall be due and payable within 10 days of the date of the hearing officer's decision.

(f)  The imposition of fines shall not prohibit the department from enforcing any conditions or any other enforcement action available to it under He-C 4001 or RSA 170-E.

(g)  The department shall impose fines in accordance with the following:

(1)  For failure to comply with the provisions of a license or permit, in violation of He-C 4001.10(a), the fine shall be $500.00;

(2)  For a repeat citation for failure to comply with the provisions of a license or permit, in violation of He-C 4001.10(a), the fine shall be $500.00, plus $100.00 for each day that the program fails to comply with the provisions of a license or permit;

(3)   For a failure to cease operating an unlicensed residential child care program after being notified by the department of the need for a license, in violation of RSA 170-E:27, I, the fine shall be $2,000.00 for an applicant or unlicensed provider;

(4) For a failure to submit a renewal application for a license in accordance with RSA 170-E:32, I and He-C 4001.03(a), the fine shall be $500.00;

(5) For a failure to cease operations after suspension, revocation, or denial of a permit or license, in violation of RSA 170-E:27, I, or continuing to operate after a failure to renew the license by the expiration date, in violation of RSA 170-E:32, I and He-C 4001.03(a), the fine for an applicant, unlicensed provider, or a licensee shall be $2,000.00;

(6) For advertising services or otherwise representing that the program has a license to provide residential child care services it is not licensed to provide, in violation of RSA 170-E:27, I, the fine for an applicant, licensee or unlicensed provider shall be $500.00;

(7)  For failure to submit any requested reports or failing to make available any records required by the unit for investigation, monitoring, or licensing purposes in violation of He-C 4001.10(l), the fine shall be $500.00, per offense, plus $100.00 per day, per offense, for each day for which the unit does not receive the requested documents;

(8)  For falsifying any documents, other written information, or reports issued by or required by the unit, in violation of He-C 4001.10(o)(2), the fine shall be $1000.00 per offense;

(9)  For failure to cooperate during any visit authorized under RSA 170-E or He-C 4001, in violation of He-C 4001.10(j) and (k), the fine shall be $1,000.00;

(10)  For failure to submit a corrective action plan, in violation of He-C 4001.06(e) or (f), the fine shall be $500.00, unless an extension has been granted by the unit;

(11)  For failure to implement or maintain the corrective action plan that has been approved or issued by the unit, in violation of He-C 4001.06(e), (f), or (i) the fine shall be $500.00;

(12)  For failure to supervise each resident in care, in violation of He-C 4001.14(a), the fine shall be $750.00;

(13)  For abusing or neglecting a resident or residents, or failing to protect a resident or residents from abuse or neglect when the licensee or program director either knew or should have known about the abuse or neglect, in violation of He-C 4001.10(d) or (e), the fine shall be $2,000.00;

(14)  For using corporal punishment, or failing to protect a resident or residents from corporal punishment in the residential child care program when the licensee or program director either knew or should have known about the corporal punishment, in violation of He-C 4001.22(b)(2), the fine shall be $1,000.00;

(15)  For using inappropriate discipline or rough handling a resident or residents, or failing to protect a resident or residents from inappropriate discipline or rough handling when the licensee or program manager either knew or should have known about the inappropriate discipline or mistreatment, in violation of He-C 4001.22(b)(11), the fine shall be $500.00;

(16)  For using prohibited restraints or acts of seclusion on a resident, in violation of RSA 126-U and He-C 4001.22(e), the fine shall be $1,000.00;

(17) For non-compliance with RSA 170-E:29-a and He-C 4001.32 regarding completion of criminal background record checks, the fine shall be $500.00;

(18) For non-compliance with RSA 170-E:29-a and He-C 4001.32 when an employee, household member, or other individual continues to work in the program after notification of ineligibility by the unit, the fine shall be $100.00 per day;

(19)  For non-compliance with any statute or any rule which results in endangering one or more residents, in violation of RSA 170-E:27, II, the fine shall be $1,000.00;

(20)  For non-compliance with any statute or rule which results in physical injury to one or more resident, or exposes one or more residents to imminent death, loss, or injury, the department shall assess a fine of $2,000.00 for each non-compliance, plus $500.00 per day that the non-compliance exists; and

(21)  When an inspection determines that non-compliance with RSA 170-E or He-C 4001 is a repeat citation of any of the rules specified in (g)(1) through (19) above, the fine shall be double the initial fine, but not to exceed $2,000.00.

(h) Each day an applicant or licensee continues to be in violation of the provisions of RSA 170-E or He-C 4001 shall constitute a separate violation and shall be fined in accordance with this section. If the applicant or licensee is making good faith efforts to comply with He-C 4001, as verified by documentation or other means, the department shall not issue a daily fine.

Source. #14214, eff 4-1-25

PART He-C 4002 NH CHILD CARE PROGRAM LICENSING RULES

REVISION NOTE:

Document #14356, effective 9-22-25, readopted with amendment Part He-C 4002 titled “NH Child Care Licensing Rules”. Amendments included extensive revision to the rules in Part He-C 4002 and the deletion of rule He-C 4002.15 titled “Notice and Reporting Requirements to the Department and Parents”, which necessitated the renumbering of subsequent rules in Part He-C 4002 as indicated in the source notes. Document #14356 replaces all prior filings affecting the former rules in Part He-C 4002.

The prior filings affecting the deleted He-C 4002.15 included the following documents:

#2664, eff 3-30-84, EXPIRED 3-30-90

#4871, eff 7-24-90

#5203, eff 8-16-91

#6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

#6719, eff 3-25-98

#7294, eff 5-26-00

#9160, INTERIM, eff 5-26-08

#9310, eff 11-23-08 (from He-C 4002.17)

#12046, INTERIM, eff 11-19-16

#12174, EMERGENCY RULE, eff 5-17-17

#12415, eff 11-6-17

#13373, eff 4-22-22

He-C 4002.01 Definitions.

(a) “Accredited college or university” means a college or university acknowledged as meeting acceptable levels of quality through accreditation by any of the accrediting organizations recognized by the US Department of Education or the Council for Higher Education Accreditation.

(b) “Agency administrator” means a person who meets the qualifications of a center director and is employed by the licensee to oversee multiple child care agencies by a single or the same applicant or licensee.

(c) “Applicant” means “applicant” as defined in RSA 170-E:2, I.

(d) “Assistant group leader” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.34.

(e) “Assistant teacher” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.34.

(f) “Associate teacher” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.34.

(g) “Authorized staff” means child care staff that have completed training in medication safety and administration who are responsible for administration of medications to children.

(h) “Center based program” means any program owned and operated by one applicant and is licensed to provide any of the following types of child care:

(1) Group child care center;

(2) Infant and toddler program;

(3) Night care program;

(4) Preschool program;

(5) School-age program; or

(6) Any combination thereof.

(i) “Child” means “child” as defined in RSA 170-E:2, II.

(j) “Child care assistant” means a person who is employed in or is seeking employment in a New Hampshire licensed family child care program or a small child care center, who meets the age, education, and experience requirements specified in He-C 4002.33(g).

(k) “Child care manager” means a person who is responsible for the daily operation of a small child care center, and who provides the child care for at least ⅔ of the operating hours.

(l) “Child care staff” means:

(1) All child care staff categories as specified in He-C 4002.33 and 4002.34; and

(2) Agency administrator and site coordinator, as defined in He-C 4002.01(b) and 4002.01(bm), respectively.

(m) “Child care worker” means a person who is employed in or is seeking employment in a New Hampshire licensed family child care home, family group child care home, or small child care center, who meets the age, education, and experience requirements specified in He-C 4002.33(f).

(n) “Child day care” means “child day care” as defined in RSA 170-E:2, III. This term includes “child care”.

(o) “Child day care agency” means “child day care agency” as defined in RSA 170-E:2, IV. The term includes “agency” and “child care program”.

(p) “Citation” means non-compliance with a rule adopted in accordance with RSA 541-A.

(q) “Clean” means to remove dirt, debris, and bodily fluids by scrubbing and washing with a detergent solution and rinsing with water, or in accordance with the manufacturer’s instructions for cleaning.

(r) “Commissioner” means “commissioner” as defined in RSA 170-E:2, V.

(s) “Corporal punishment” means the intentional infliction of physical pain by any means for the purpose of punishment, correction, discipline, instruction, or any other reason.

(t) “Corrective action plan (CAP)” means “corrective action plan” as defined in RSA 170-E:2, VI.

(u) “Days” means calendar days unless otherwise specified herein.

(v) “Department” means “department” as defined in RSA 170-E:2, VII.

(w) “Developmentally appropriate” means actions, environment, equipment, supplies, communications, interactions, and activities that are based on the family culture, and the individual physical, emotional, social, and cognitive needs of each child in care.

(x) “Directed corrective action plan” means a corrective action plan that is developed and issued by the department.

(y) “Document” means any record, either in paper or electronic format, required in He-C 4002. This term includes “documentation”.

(z) “Family child care provider” means the individual in whose home family or family group child care services are provided, who is responsible for the operation of the program, and who provides the child care for at least ⅔ of the operating hours.

(aa) “Family day care home” means “family day care home” as defined in RSA 170-E:2, IV(a). This term includes “family child care home”.

(ab) “Family group day care home” means “family group day care home” as defined in RSA 170-E:2, IV(b). This term includes “family group child care home”.

(ac) “Full day school program” means a program administered by a public or private school that is approved by the department of education.

(ad) “Group child care center” means “group child care center” as defined in RSA 170-E:2, IV(c).

(ae) “Group leader” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.34(q).

(af) “Guardian” means “guardian” as defined in RSA 170-E:2, VIII.

(ag) “Household member” means any person residing in the home of an applicant for licensure as a program, if the program will be located in that home.

(ah) “Infant” means a child from the time of birth up to 12 months old.

(ai) “Infant and toddler program” means “infant and toddler program” as defined in RSA 170-E:2, IV(d).

(aj) “In-service professional development” means professional development activities including training or education acquired after an individual meets the qualifications for their position and which is acceptable toward meeting the annual professional development requirements for child care staff, as specified in He-C 4002.32.

(ak) “Junior helper” means a person who is engaged in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.33(k) or He-C 4002.34(o).

(al) “Lead teacher” means a person who is employed in or is seeking employment in a New Hampshire licensed childcare program, who meets the age, education, and experience requirements specified in He-C 4002.34(k).

(am) “License” means “license” as defined in RSA 170-E:2, IX.

(an) “License capacity” means the number and ages of children specified on the license or permit allowed to be in care at any one time.

(ao) “Licensee” means the person or entity to whom the department has issued a permit in accordance with RSA 170-E:2, XI or license in accordance with RSA 170-E:2, IX.

(ap) “Licensed practitioner” means a physician, physician's assistant, advanced registered nurse practitioner, dentist, or other licensed professional with prescriptive authority.

(aq) “Licensing coordinator” means a person employed by the department who consults with and inspects programs for compliance with RSA 170-E and He-C 4002.

(ar) “Medication” means a drug prescribed for a child by a licensed practitioner.

(as) “Medication error” means any error in the administration of a prescribed or over-the-counter medication, or an error in the documented administration of any medication or over-the-counter medication.

(at) “Medication order” means a document, produced electronically or in writing, for an identified child by a licensed practitioner for medications, treatments, and referrals, and signed by the licensed practitioner using terms such as authorized by, authenticated by, approved by, reviewed by, or any other term that denoted approval by the licensed practitioner.

(au) “Monitoring visit” means “monitoring visit” as defined in RSA 170-E:2, X.

(av) “Night care agency” means “night care agency” as defined in RSA 170-E:2, IV(e). This term includes “night care program”.

(aw) “Over-the-counter medications” means non-prescription medications.

(ax) “Permit” means “permit” as defined in RSA 170-E:2, XI.

(ay) “Policy” means a formal written document outlining the procedures for implementation of requirements specified in this chapter.

(az) “Preschool program” means “preschool program” as defined in RSA 170-E:2, IV(f).

(ba) “Program” means any or all of the following types of child day care agencies providing care on or off the approved licensed premises:

(1) Infant and toddler program;

(2) Family child care program;

(3) Family group child care program;

(4) Group child care center;

(5) Night care program;

(6) Preschool program;

(7) School age program; and

(8) Small child care center.

(bb) “Program manager” means a family child care provider, child care manager, center director, agency administrator, site coordinator, or site director who has the authority to submit applications, waiver requests, corrective action plans, and any other executive actions required or identified in this chapter.

(bc) “Project leader” means a person who is engaged in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.34(s).

(bd) “Qualified substitute director” means a person who assumes the responsibilities of a center director or site director and who meets the age, education, and experience requirements of the position for which they are substituting in order to meet the requirements under He-C 4002.34(a) and (b).

(be) “Regularly” means “regularly” as defined in RSA 170-E:2, XII.

(bf) “Related coursework” unless otherwise specified, means courses completed at an accredited college or university in child growth and development, lifespan development, human growth and development, infant and toddler development, developmental psychology, family studies, early childhood, elementary, and special education, and any other coursework focused on children.

(bg) “Repeat citation” means a citation of a specific licensing rule or law for which the program has been previously cited during the past 3 years, and which has not been removed as a result of an informal dispute resolution or overturned as a result of an adjudicatory procedure. A repeat citation does not need to include the same set of circumstances, or involve the same child care staff or the same child or children as in the original citation.

(bh) “Rough handling” means an aggressive physical act against a child, except when necessary to protect a child from harming themselves or others.

(bi) “Sanitize” means to clean to remove all organic material then wipe down or wash with a solution of chlorine bleach and room temperature or cool water which is mixed fresh daily per manufacturer’s directions for sanitation and left on the surface for 2 minutes or with an environmental protection agency (EPA) approved germicide designed to kill germs and which, when used in accordance with manufacturer’s directions, does not pose a health or safety risk to children.

(bj) “School-age program” means “school-age program” as defined in RSA 170-E:2, IV(g).

(bk) “Serious injury” means an injury to a child that requires medical treatment or hospitalization.

(bl) “Serious safety risk” means behavior of such intensity, frequency, or duration that the safety of the child or others is placed in jeopardy.

(bm) “Site coordinator” means a person who is qualified as a site director and is employed to oversee multiple school age program licenses by a single applicant or licensee.

(bn) “Site director” means a person who is employed in or is seeking employment in a New Hampshire licensed child care program, who meets the age, education, and experience requirements specified in He-C 4002.34(p).

(bo) “Small group child day care center” means “small group child day care center” as defined in RSA 170:E:2, IV(i). This term includes “small child care center”.

(bp) “Statement of findings” means a written report issued by the department which details the findings of a visit or an investigation conducted by the department.

(bq) “Substitute” means a person who assumes the responsibility of assistant teacher, associate teachers, lead teachers, or group leaders, on a temporary basis, who meets the age requirements of the position for which they are substituting.

(br) “Toddler” means a child over 12 months to 35 months old, except as referenced in He-C 4002.36.

(bs) “Topical substances” include, but are not limited to, non-prescription medications such as sunscreen, insect repellent, teething aids, and diaper ointments.

(bt) “Unit” means the child care licensing unit within the department.

(bu) “Water activity” means any activity during which children have access to or use of splashing pools, wading pools, and swimming pools with or without slides, and other similar bodies of water including ponds, rivers, lakes, and the ocean, and excluding water tables and sprinklers.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.02 Licensure and Approval: Initial Applications, License Renewal, and Revisions.

(a) Any person or entity who intends to operate a program shall create an account in “New Hampshire Connections Information System (NHCIS)” at https://new-hampshire.my.site.com/nhccis/s/login/?ec=302&startURL=%2Fnhccis%2Fs%2F or obtain an application packet from the unit.

(b) All new applicants for licensure shall complete and submit an application by either applying online via the portal described in (a) above or by submitting to the department:

(1) An “Application for Family Child Care Program” (August 2025) certifying that:

“I understand that the department may investigate any criminal conviction record, finding of child abuse or neglect, or investigation of or final determination regarding any juvenile delinquency and will make a determination regarding whether the individual is eligible to be in a child care program;

I understand that the department may delay its decision to approve or deny this application pending the outcome of any investigation, when the applicant, owner, or family child care provider, are named as the perpetrator in any current investigation of any crime, or in an allegation of abuse or neglect;

I understand that providing false information on this application or any of the attachments, or failing to disclose any information required on the application, or required to be submitted with this application, shall be considered grounds for license denial or revocation;

I have read the NH child care program licensing rules, and understand that failure to maintain my program in compliance with the rules, may jeopardize my license/permit and/or result in fines being assessed by the department;

I authorize any police department, court system or human service agency in this or any other state to release copies of any criminal records or child abuse or neglect records to the department; and

All information provided as part of this application and in the required attachments is true and complete to the best of my knowledge.”; or

(2) An "Application for Child Care Center" (August 2025) certifying that:

“I understand that the department may investigate any criminal conviction record, finding of child abuse or neglect, or investigation of or final determination regarding any juvenile delinquency and will make a determination regarding whether the individual is eligible to be in the child care program;

I understand that the department may delay its decision to approve or deny this application pending the outcome of any investigation, when the applicant, owner, center director, site coordinator, or site director, are named as the perpetrator in any current investigation of any crime, or in an allegation of abuse or neglect;

I understand that providing false information on this application or any of the attachments, or failing to disclose any information required on the application, or required to be submitted with this application, shall be considered grounds for license denial or revocation;

I have read the NH Child Care Program licensing rules, and understand that failure to maintain my program in compliance with the applicable rules, may jeopardize my license/permit and/or result in fines being assessed by the department;

I authorize any police department, court system or human service agency in this or any other state to release copies of any criminal records or child abuse or neglect records to the department; and

All information provided as part of this application and in the required attachments is true and complete to the best of my knowledge.”

(c) The applications in (b) above shall not be considered complete until the department receives all of the information as specified in (e) below.

(d) Center based programs with multiple buildings on the same or contiguous properties may apply for a single license via one application for those buildings provided that:

(1) The buildings are on a single, site-specific address;

(2) There is a system or procedure in place so staff in each building can quickly and easily communicate with staff in the other buildings, thereby allowing the multiple buildings to function efficiently as a single program;

(3) Staffing requirements for center-based agencies with multiple buildings are met as specified in He-C 4002.34; and

(4) In each building, there are adequate square footage and bathroom facilities for the number of children who will be cared for, in accordance with He-C 4002.21.

(e) Except as specified in (f) below, the applicant for a new license shall submit to the department the following with the application:

(1) A “Child Care Personnel Health Form” (August 2025) or an equivalent record of a health screening for the program manager, completed by a licensed practitioner no more than one year prior to the date the department receives the application, certifying that the program manager has no apparent health problems that would prohibit their employment caring for children, and an authorization by the program manager for the licensed practitioner to release the medical information on the form to the child care program and the child care licensing unit;

(2) Written approval from the local health officer documenting that, within the 12 months immediately preceding the date the department receives the application, the premises have been inspected and approved by a local health officer, for operation as a program;

(3) Written approval from the local fire inspector that, within the 12 months preceding the date the application for licensure is received by the department, the premises have been inspected for compliance with Saf-FMO 300 and RSA 153:1 VI-a, by the local fire department or the state fire marshal’s office, and approved to operate as a program;

(4) Documentation from the applicable town or city that the program has been granted zoning approval or that no zoning approval is required;

(5) Background check forms as specified in He-C 4002.40 for:

a. The owner or applicant;

b. All household members aged 12 years and older; and

c. The program manager;

(6) Verification from the New Hampshire secretary of state that the applicant is in good standing;

(7) A diagram of the indoor and outdoor space for each building, which includes:

a. For indoor space:

1. Room dimensions;

2. Location of exits;

3. How each room will be used;

4. The location of bathrooms and bathroom fixtures, such as toilets and sinks;

5. The location of other handwashing sinks; and

b. For outdoor play space:

1. The overall dimensions of outdoor play space;

2. The location of exits, gates, and stationary play equipment;

3. The location of the outdoor play space in relation to the indoor space; and

4. The presence of and location of any pools, ponds, streams, rivers, streets, roads, or other hazards that are in close proximity; and

(8) In accordance with RSA 130-A:5-d, II, certification of lead safety for new applicants in buildings erected prior to January 1, 1978.

(f) In accordance with RSA 170-E:6, school-age programs operating in buildings in which public or private schools are located shall not be required to submit the documentation required in (e)(2) through (4) or (8) above.

(g) For all programs, the applicant shall submit documentation that the program manager meets the age, education, and experience requirements for the applicable program type(s) as specified in He-C 4002.33 and He-C 4002.34, such as copies of transcripts, certificates, diplomas, a non-expired NH child care credential, or degrees as applicable, and a résumé or verification of previous experience if such experience is required to meet the qualifications for the position.

(h) No less than 3 months prior to the expiration date of the current license, applicants for license renewal shall submit to the department the following through the “NHCIS” portal at https://new-hampshire.my.site.com/nhccis/s/login/?ec=302&startURL=%2Fnhccis%2Fs%2F or by using the forms below:

(1) A signed and completed application “Application for Family Child Care Program” (August 2025) or "Application for Child Care Center" (August 2025) for license renewal, in accordance with He-C 4002.02;

(2) Written approval from the local health officer documenting that, within the 12 months immediately preceding the date the department receives the application, the premises have been inspected and approved by a local health officer, for operation as a program;

(3) Written approval from the local fire inspector that, within the 12 months preceding the date the application for licensure is received by the department, the premises have been inspected for compliance with Saf-FMO 300 and RSA 153:1 VI-a, by the local fire department or the state fire marshal’s office, and approved to operate as a program;

(4) Verification from the New Hampshire secretary of state that the applicant is in good standing;

(5) A completed “Staff and Household List” (August 2025) or updated staff roster in NHCIS; and

(6) A diagram of the indoor and outdoor space if changed since the previous application.

(i) Upon receipt of a complete license application and inspection by department staff, the department shall:

(1) Issue a 6-month permit to the applicant for a new applicant; or

(2) Issue a 3-year license to the applicant for a license renewal.

(j) The license issued in accordance with (i) above shall reflect the maximum number of children approved by the local fire inspector, health officer, and zoning officials, and in accordance with the available floor space as measured by the department in accordance with He-C 4002.21(c) and (d) and the number of available toilets and sinks in accordance with He-C 4002.21(b).

(k) In accordance with RSA 541-A:30, I, if a timely and sufficient application has been made in accordance with agency rules for renewal of a license for any activity of a continuing nature that does not automatically expire by law, the existing license shall not expire until the agency has taken final action upon the application for renewal.

(l) The license or permit shall:

(1) Not be transferable to a new owner or to a new location; and

(2) No longer be valid when:

a. The licensee has surrendered a license or permit;

b. The license has expired and a complete application form with attachments has not been received by the department; or

c. The license or permit has been revoked or suspended and:

1. The licensee did not request an administrative hearing; or

2. The licensee requested an administrative hearing and, following that hearing, a decision was issued upholding the revocation or suspension.

(m) The licensee shall apply for revision of the license:

(1) When they wish to add additional program types or change the type(s) of program for which they are licensed or permitted; or

(2) Prior to moving to a new location.

(n) A licensee who wishes to increase their license capacity shall:

(1) Submit a written request to the department;

(2) Obtain approvals from the local fire inspector, health inspector, and zoning officials, when the increase exceeds the limits established in the current approvals;

(3) Submit diagrams of indoor and outdoor space, in accordance with He-C 4002.02(d)(7), if there have been changes in the child care space; and

(4) Not increase enrollment beyond the current license capacity until the department issues the program a revised license or permit or other written authorization by the department for the increased license capacity.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.03 Time Frames for Departmental Response to Applications.

(a) Pursuant to RSA 541-A:29, the department shall approve or deny an application, petition, or request within 60 days from receipt of the application, petition, or request and any additional information requested by the department.

(b) The 60 days for departmental response specified in (a) above shall begin on the date on which all requested information is received by the department.

(c) For license renewal applications, any outstanding corrective action plan for citations of rule or statute shall be considered additional information under (a) above.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.04); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.12); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.04 Waivers of Rules.

(a) Applicants or licensees who wish to request a waiver of rules shall contact the unit to initiate the waiver request process.

(b) Applicants or licensees with a “NHCIS” portal account shall request a waiver through their account or by providing a completed “Waiver Request Form” (August 2025).

(c) A waiver shall be granted to the applicant or licensee if the department determines that the alternative proposed by the applicant or licensee:

(1) Meets the objective or intent of the rule; and

(2) Does not negatively impact the health, safety, or well-being of the children.

(d) When a waiver is approved, the applicant or licensee’s subsequent compliance with the alternatives approved in the waiver shall be considered equivalent to complying with the rule from which waiver was sought.

(e) The department shall not approve any request for a waiver of any of the provisions of RSA 170-E or of any rules of other state agencies.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.05); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.03); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.05 Program Administration, Requirements for Reporting to the Unit, and License and Permit Requirements.

(a) The program shall:

(1) Abide by the provisions specified on the license or permit; and

(2) Not alter the license or permit issued by the department.

(b) As mandated reporters, the program manager or designee shall report to the division for children, youth, and families (DCYF) at 1-800-894-5533, if the licensee, child care staff, or other person involved with a program suspects that a child is being abused or neglected, in accordance with RSA 169-C:29.

(c) Program managers shall notify the unit using NHCIS or in writing regarding the following program changes:

(1) Prior to changing the name of the program or advertising under a new name, and provide documentation from the secretary of state, if applicable, and the date for which they want the new program name to be effective, so that the unit can issue a revised license which reflects the name change; and

(2) Within 5 business days when there is a change in mailing address, email address, or phone number.

(d) Program managers shall notify the unit in writing:

(1) Within 24 hours of any occurrence of a missing child or a child who was either inside or outside without staff supervision unless otherwise permitted in accordance with He-C 4002.19;

(2) Within 24 hours to initially report the death of a child, with a follow up report no later than 72 hours after the death, detailing the circumstances;

(3) Within 24 hours of a change of indoor or outdoor space if, due to an emergency, approved child care space cannot be used due to reasons including, but not limited to, damages which make an area unsafe for children;

(4) No later than the next business day:

a. When there is an allegation of abuse or neglect involving a child while in the care and custody of the licensee;

b. When a staff member of the program used corporal punishment on, or rough handling of, a child in care;

c. In addition to (d)(1) above, after calling law enforcement or emergency responders to the program for incidents or events involving enrolled children; and

d. When there is a motor vehicle accident involving program staff and children, or when children are involved in a motor vehicle accident during a program-sponsored trip involving a driver not employed by the licensee; and

(5) Within 30 business days if the applicant permanently discontinues using a space for child care if it affects the license capacity as reflected on the license, so that the unit can record the change in the file and revise the license accordingly if necessary.

(e) The department shall authorize a licensee to exceed its license capacity for up to a maximum of 20 workdays in a calendar year, if the department finds that the approval will not result in:

(1) More than 4 children younger than 3 years of age being cared for at the same time in a family or family group child care home or small child care center;

(2) More than 2 children younger than 24 months of age in a family child care home or small child care center, without an additional child care worker or child care assistant present and assisting in the care of the children;

(3) More than 2 children over license capacity in a family or family group child care home or small child care center;

(4) More than 4 children over license capacity in all other programs; or

(5) Health or safety risks to children.

(f) With the exception of a family child care provider, when the program manager on record with and approved by the department leaves the position, the licensee or their designee shall submit to the department:

(1) Written notice within 10 business days of the date of the vacancy; and

(2) The name and qualifications of the individual who will substitute in the role, together with documentation that the individual accepted the position.

(g) Any individual assuming the role of center director or site director on a temporary basis who is not qualified for the position in accordance with He-C 4002.34 shall serve in that role for not more than 120 consecutive days.

(h) Not more than 120 consecutive days after the date the qualified center director or site director previously on record with and approved by the department leaves the position, the program shall:

(1) Replace that individual with a fully qualified center director or site director; and

(2) Submit to the department information and documents for the new qualified center director or site director, including:

a. Name;

b. The effective hiring date;

c. Documentation of education and experience as specified in He-C 4002.34; and

d. A “Child Care Personnel Health Form” (August 2025) or an equivalent record of a health screening, as specified in He-C 4002.02(d).

(i) When an agency administrator or site coordinator leaves their position, the program shall: 

(1) Replace them with a new agency administrator or site coordinator within 120 days and submit information as specified in (h)(2) above; or

(2) Submit information in (h)(2) above for each center director or site director at each location if the agency administrator or site coordinator position will not be filled.

(j) In accordance with RSA 170-E:6-b, each licensee shall either maintain liability insurance or provide disclosure to parents or guardians at enrollment of their child that the program is uninsured.

(k) All documentation required by the department, whether maintained by the program in electronic or paper format, shall be complete, legible, and available for review by the department upon request.

(l) The licensee shall maintain a child’s records on file at the program or keep them readily available for 2 years after the child’s last day of enrollment in the program.

(m) The licensee shall maintain the following documentation on file at the program or keep the documentation readily available for at least one year:

(1) Staff records;

(2) Staff and child attendance records;

(3) Field trip permission slips;

(4) Emergency operations plan (EOP) practice drills; and

(5) Monthly fire drills.

(n) The program manager or designee shall submit any reports or make available to the department any records or information required by the department for investigation, monitoring, or licensing purposes upon written request from the department.

(o) The applicant, licensee, or any child care staff shall not:

(1) Prevent, interfere with, or fail to cooperate with any inspection or investigation conducted by the department; or

(2) Falsify any documents, other written information, or reports issued by or required by the department under He-C 4002.

(p) Programs shall comply with all applicable local, state, and federal ordinances, rules, and laws.

(q) A licensee who has an unplanned temporary closure shall notify the department of such closure as soon as practicable.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.06); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.06 Statements of Finding and Corrective Action Plan.

(a) The department shall issue a statement of findings to the program for each licensing and monitoring visit, and each investigatory visit which results in one or more citations.

(b) The department shall not require a corrective action plan as specified in (f) below when:

(1) The department determines that all the following conditions are met:

a. The citation is under He-C 4002.22, He-C 4002.23, or He-C 4002.24;

b. The citation is not a repeat citation;

c. The citation is corrected prior to or immediately during the visit;

d. The citation is not a New Hampshire state fire code violation; and

e. The citation does not immediately jeopardize the health, safety, or well-being of a child or children in care; or

(2) The program manager self-reports the non-compliance, which includes the corrective action already taken to correct the non-compliance, and the department determines that the corrective action taken is acceptable for correcting the non-compliance.

(c) At the close of any visit or when an investigation is concluded, or as soon as possible thereafter, the department shall review with the program manager or their designee, a summary of any citations of rules found during the visit.

(d) Within 21 calendar days of the visit review in (c) above, and in accordance with RSA 170-E: 10, III, the department shall provide the statement of findings via email, if a valid email address has been provided by the program, by uploading to the program’s NHCIS portal, if applicable, or by U.S. mail if an email address has not been provided.

(e) The program shall not alter the statement of findings issued by the department.

(f) The program manager shall complete a corrective action plan for each citation included on the statement of findings, which shall include:

(1) The action the program has taken or will take to correct the citation(s);

(2) The steps the program will take to ensure compliance with these rules and the applicable statutes in the future;

(3) The date by which each of the citations was corrected or will be corrected;

(4) The interim measures the program has implemented to protect the health and safety of children, when the citation cannot be corrected immediately; and

(5) The signature of the program manager if not submitted via NHCIS.

(g) The program manager shall complete and submit corrective action plans, excluding the names of individuals, within 21 days of the date of issuance.

(h) In addition to the corrective action plan, the program may submit a separate response to the department's findings. The response shall be posted with the corrective action plan on the website, in accordance with RSA 170-E:10, II and III.

(i) When the department determines that there is an imminent threat to the health, safety, or well-being of children, it shall issue a directed corrective action plan to the program, without first offering the program an opportunity to complete a corrective action plan.

(j) When the corrective action plan submitted to the department by the program is not acceptable for correcting the citation, the department shall:

(1) If submitted via NHCIS, respond with an explanation as to why the plan is not acceptable or incomplete, after which the program manager shall modify their corrective action plan accordingly and resubmit it to the department via NHCIS; or

(2) If submitted via email, respond via email with an explanation as to why the plan is not acceptable or incomplete, after which the program manager shall modify their corrective action plan accordingly and resubmit it to the department via email.

(k) Programs shall comply with approved corrective action plans and directed corrective action plans.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.07); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.07 Informal Dispute Resolution and Independent Informal Dispute Resolution.

(a) An informal dispute resolution (IDR) shall not be an option for any applicant or licensee against whom the department has initiated a fine, a conditional license, or action to suspend, revoke, deny, or refuse to issue or renew a license or permit.

(b) An opportunity for IDR shall be available to the licensee who disagrees with a citation issued by the department, per RSA 170-E:10-a.

(c) When requesting an IDR, the licensee shall:

(1) Submit a written notice to the department requesting an IDR no later than 14 days from the date of issuance of the statement of findings; and

(2) Include in the notice the reason why the licensee believes that the citation was issued erroneously as noted in the statement of findings.

(d) In accordance with RSA 170-E:10-a, written notice of the department’s decision to uphold, remove, or revise the citation shall be provided to the licensee within 30 days from receipt of the request and receipt of all information from the applicant or licensee.

(e) Licensees may request an independent informal dispute resolution (IIDR) after requesting an IDR and the outcome does not result in removal or revision of the disputed citation.

(f) When requesting an IIDR, the licensee shall submit a written request to the department no later than 10 days of receipt of the outcome of the IDR.

(g) The IIDR panel members shall include at least one member of the Child Care Advisory Council and no less than 3 licensed child care providers.

(h) The IIDR panel shall communicate its recommendations in writing to the department within 5 days of the IIDR review, which shall include each citation disputed and a detailed explanation for each recommendation.

(i) The unit shall review the recommendations and remove the citations if the following conditions are met:

(1) The evidence presented at the IIDR existed prior to the citation being issued;

(2) There is a preponderance of evidence that the non-compliance cited did not occur; and

(3) The evidence presented creates a change in material fact(s) that results in a rescission or

revision of a citation.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.08); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 402.11); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.08 Staff and Child Attendance Records.

(a) The program shall have a record of each child’s attendance in each room that:

(1) Documents each child’s daily arrival at and departure from the program, in real time; and

(2) Is recorded all in one place, in a manner that reflects the number of children present in each room throughout the day.

(b) In addition to the requirements in (a) above, the program shall include or have the date of birth immediately available for each child listed on the child attendance record.

(c) The program shall have a record of daily staff attendance, including the staff’s full name, scheduled work hours, their position as identified under He-C 4002.34, and their arrival and departure times at the program and in each room or group throughout the day, as applicable, recorded in real time by the staff.

(d) The staff attendance record shall be recorded all in one place, in a manner that reflects the staff present in each room throughout the day.

(e) The only exception to (c) above is staff shall not be required to sign in and out for breaks lasting fewer than 15 minutes when the staff remains in the building, or to conduct necessary tasks on the premises.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.09); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.09 Staff Record Requirements.

(a) The program shall maintain on file for each staff member, whether paper or electronic:

(1) Documentation of the staff’s qualifications, including required work experience and education, which demonstrates that they meet the qualifications for their position;

(2) Documentation of a completed background check in accordance with He-C 4002.40;

(3) A record of initial health screening upon hire, in accordance with (b) below;

(4) Documentation of orientation, certifications, training, and professional development, as applicable; and

(5) Documentation of supervision regarding disciplinary actions or investigations specific to the staff member.

(b) A written record of a health screening for all child care staff, household members, and other individuals who work with children in the classroom and who have 5 or more hours per week of contact with children shall:

(1) Be on file at the program and available for review by the department within 60 days of the date of hire or the date the household member or individual begins working with children in the classroom for 5 or more hours per week; and

(2) Include, at a minimum, the information on the “Child Care Personnel Health Form” (August 2025) provided by the department, or its equivalent.

(c) The only exception to (b) above shall be for child care staff working in school age programs who are currently employed in a public or private school.

(d) The initial record of the health screening for newly hired child care staff shall:

(1) Have been completed not more than 12 months preceding the date of hire or the date the individual began working with children in the classroom for 5 or more hours per week; and

(2) Include a statement by the health care provider that indicates the individual has no apparent health conditions that would prohibit or inhibit their ability to care for children.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.10); ss by #9605, eff 11-26-09; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.10 Child Record Requirements.

(a) Program managers shall ensure that for each child there is a “Child Care Registration and Emergency Information” (August 2025) form, completed by the parent or guardian, or an equivalent form on file on the child’s first day in attendance, in accordance with (b) below.

(b) The equivalent form allowed pursuant to (a) above shall include:

(1) Full legal name of the child;

(2) Child’s date of birth;

(3) Child’s physical address and mailing address;

(4) Child’s home telephone number;

(5) Date of enrollment in the program;

(6) The name, physical address, and mailing address of the parent(s) or guardians responsible for the child, if different from the child’s address;

(7) Telephone numbers for the child’s parents or guardians and instructions as to how the parents or guardians can be contacted during the hours that the child is at the program;

(8) Email addresses for the parents or guardians, if available;

(9) Name and telephone number of at least one person who will assume responsibility for the child if, for any reason, the parents or guardians cannot be reached immediately in an emergency;

(10) Any chronic conditions, allergies, or medications in case of sudden illness or injury;

(11) Written parental or guardian permission for first aid treatment;

(12) Written parental or guardian permission for emergency medical transportation and treatment; and

(13) Names and telephone numbers of any person(s) other than parents or guardians who are authorized to remove the child from the program.

(c) The program shall ensure each child’s registration and emergency information form or an equivalent form contains the following statements:

(1) “The licensing authority for this program is the child care licensing unit (CCLU) within the bureau of licensing and certification in the department of health and human services.  Child care programs are required to post a copy of the most recent statement of findings (SOF) and the corresponding corrective action plan (CAP) in a location which is accessible to parents, and programs must maintain copies of the most recent SOF with CAP and make them available for parents to review upon request. SOFs and CAPs are also available on-line at: https://new-hampshire.my.site.com/nhccis/NH_ChildCareSearch or by contacting the unit at cclunit@dhhs.nh.gov or 603-271-9025.

WHAT WE DO: The CCLU regulates and oversees child day care programs for compliance with licensing rules. A licensing coordinator conducts a yearly, unannounced monitoring visit at every program, as well as an unannounced visit prior to the expiration of a license every three years. CCLU also investigates allegations of non-compliance with licensing rules. Information about CCLU can be found on our website: https://www.dhhs.nh.gov/programs-services/childcare-parenting-childbirth/child-care-licensing.

CONVERSATIONS WITH CHILDREN – MONITORING VISITS: During routine monitoring visits, the Licensing Coordinator (LC) informally speaks with children to ask general questions about their day-to-day experiences in the child care program, using developmentally appropriate speech and language. The conversations and interactions take place while children are engaged in their daily routine with their class or group. At no time will a child be forced to speak with a LC.

CONVERSATIONS WITH CHILDREN – COMPLAINT INVESTIGATIONS: During visits to investigate a complaint, if the LC believes your child may have relevant information, and that it would be best to interview your child separately, away from their class or group, the LC will ask the classroom staff which children they may interview, based upon your choice below. If you wish to be notified prior to an LC speaking with your child, the LC will contact you for permission to speak with your child either at the program but away from the group, or arrange a date, time, and location with you to speak with the child. If you approve the on-site conversation with your child, the LC will ask staff to recommend a place in the program. The LC will introduce themselves, ask your child their name, and explain that their job is to make sure child care programs are safe. The LC will ask your child if they want to talk to the LC about their child care. The LC will ask open-ended, non-leading questions, and at no time will your child be forced to speak with the LC.

The LC will ask children questions such as: routines for snacks/lunch, handwashing, outdoor play, the rules, what happens when a child breaks a rule, rest/nap, fire drills, and what they like/dislike about child care.

Based upon the information above, please indicate your preference:

a. I give permission for child care licensing staff to speak with my child while with their class or group;

b. I give permission for child care licensing staff to interview my child at the child care program separate from their class or group;

c. I wish to be notified prior to child care licensing staff speaking with my child at the child care program separate from their class or group; and

d. I do not give my permission for child care licensing staff to speak with my child while with their class or group.”; and

(2) “I hereby give permission for the staff of _______________________ to provide simple first aid treatment to my child, _________________________ when necessary. In the event of a more serious illness or injury, I give permission for my child to be transported to a hospital or other emergency medical facility to receive emergency medical treatment. I also authorize ambulance/rescue squad attendants to administer such treatment as is medically necessary, and I authorize licensed health care practitioners working in the hospital or emergency medical facility to examine and provide emergency medical treatment to my child if warranted. I understand that I will be contacted by child care program personnel as soon as possible regarding any emergency involving my child.”

(d) The program shall request and maintain on file for each child documentation of immunizations in accordance with RSA 141-C:20-a, RSA 141-C:20-b, and He-P 301.14.

(e) The documentation described in (d) above shall be on file on the first day the child is in attendance at the program or, pursuant to 45 CFR § 98, 41(a)(1)(i)(C), for children experiencing homelessness or for children in foster care within 60 days of the first date of attendance, to allow families or persons responsible for their care to obtain and provide documentation of immunizations.

(f) Exemptions from the immunizations required under (d) above shall be in accordance with RSA 141-C:20-c.

(g) The program shall obtain and maintain on file a child health screening form “New Hampshire Early Childhood Health Assessment Record” (August 2025), the first part completed and signed by the child’s parent or guardian, and the second part completed and signed by the child’s licensed practitioner,, or an equivalent record of physical examination, providing the following permission to exchange information:

“I_______________________, authorize and request my child’s primary car provider to exchange information about my child’s health and development as pertains to this form with the program/school listed below. The information may be provided by phone, fax, mail, or in person. I understand that the disclosed information will be considered confidential and will be used only for the health and educational benefit of my child and family. Except as needed to comply with federal and state regulations, it will not be re-disclosed to any other person, school, or agency without my consent. I understand that this form will expire in one year unless I choose to cancel my permission in writing before that time.”

(h) The child health screening form shall be available for review by the department for each child no more than 60 calendar days after the date of admission.

(i) Programs shall not be required to obtain physical examination records for children whose parents or guardians object in writing, on the grounds that such physical examination is contrary to their religious beliefs.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.11); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.11 Children Who Are Ill.

(a) Child care staff shall observe each child, each day upon arrival and throughout the day for injuries and symptoms of illness which:

(1) Impair or prohibit the child’s participation in the regular child care activities; or

(2) Require more care than child care staff are able to provide without compromising the health and safety of the ill or injured child, or the other children in their care. 

(b) Child care staff shall provide any child who is ill an opportunity to rest or an opportunity to do a quiet activity in a comfortable, supervised area, including areas not regularly considered child care space, such as offices, provided the space is safe for children to occupy, until parents or guardians arrive to remove the child from the program.

(c) The program manager or designee shall notify a child’s parent or guardian immediately upon determining the need to remove their child from the program due to illness.

(d) The program manager or designee shall contact the bureau of disease control and prevention for instructions in accordance with the following:

(1) When child care staff or children in the program have symptoms of or are known to have a communicable disease to determine whether the ill individual is required to be excluded from the program; and

(2) To determine reporting requirements in accordance with RSA 141-C:7, He-P 301.03(c) and (d), and He-P 301.03(h).

(e) When any child care staff or children in the program have symptoms of or are known to have a communicable disease any spills of bodily fluids shall be immediately cleaned and sanitized as specified in He-C 4002.22(ag) and (ah).

Source. #2664, eff 3-30-84; amd by #4157, eff 11-3-86; amd by #4228, eff 2-23-87; ss by #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.12); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.12 Serious Injuries, Medical Emergencies, and Reporting Requirements.

(a) If any child while in the care of the program sustains a serious injury, as defined in He-C 4002.01(bk), or otherwise requires emergency services as prescribed in first aid and CPR training, the program manager or designee shall:

(1) Immediately notify emergency personnel and the child’s parents or guardians; and

(2) Notify the department within 48 hours via NHCIS.

(b) The program manager or designee shall provide a written report by the next business day to the parents or guardians of the child or children that sustained a serious injury to fully inform them of the details of the incident reported in (a) above, including, if known:

(1) The name of individuals involved in, and who witnessed, the incident, while keeping the identities of other children confidential;

(2) What occurred prior to and following the incident;

(3) When and where the incident occurred; and

(4) Any action taken, or that will be taken by the program in response to the incident.

(c) The program manager or designee shall immediately notify a child’s parent or guardian if their child sustains a bump or injury to their head or face that is more than a minor injury such as a scrape or scratch, resulting in any one of the following:

(1) Excessive bruising or swelling;

(2) An increase in fussiness or sleepiness;

(3) Dizziness, clumsiness, or trouble with coordination;

(4) Nausea or vomiting;

(5) Loss of consciousness;

(6) Headache;

(7) Speech, vision, or hearing impairment; or

(8) Discharge or blood from the bump.

(d) Except as required in (b) above, when a child sustains an injury pursuant to (c) above, the program manager or designee shall provide written notification to the child’s parent or guardian as soon as possible on the date of the injury, detailing how the injury occurred, the date, time, and location of the injury, a description of the first aid treatment given to the child, and the name of the staff who administered first aid.

(e) First aid beyond cleaning a minor scrape or applying a cold cloth or an adhesive bandage, shall only be administered by staff currently certified in first aid.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.14); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.13 Children With Disabilities.

(a) The licensee shall accept and make reasonable accommodations to welcome and serve, or continue to serve, any child with a disability.

(b) In determining whether accommodations are reasonable and necessary, the program shall:

(1) Refer to the Americans with Disabilities Act; and

(2) If applicable, request parental or guardian release of information from professionals providing services to the child specific to the disability.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.15); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.14 Required Postings.

(a) The program shall post in a prominent location:

(1) The current license or permit, visible to parents or guardians, staff, and visitors;

(2) The most recent statement of findings and corrective action plan approved by the department, where it is visible to parents or guardians, staff, and visitors; and

(3) A written procedure for emergencies and managing injuries, which shall include:

a. The location of first aid supplies;

b. The location of child care registration and emergency information forms;

c. The name, address, and telephone number of the hospital to which children will be taken in case of acute emergency when parents or guardians cannot be contacted, or delay of treatment appears dangerous;

d. Instructions to dial 911 to access emergency responders;

e. The Northern New England Poison Center at 1-800-222-1222; and

f. The names and telephone numbers of emergency substitute staff; and

(4) Emergency and evacuation procedures, posted next to each exit.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.16); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35

He-C 4002.15 Requirements for Written Policies and Procedures.

(a) Licensees shall have and implement written policies regarding:

(1) A retention policy to prevent the suspension and expulsion of children, which includes:

a. The steps the program will take to assist the child in maintaining enrollment;

b. Ongoing communication with the parent or guardian and parent or guardian notification when the child’s enrollment cannot be maintained;

c. The responsibilities of the program in response to the child’s behaviors; and

d. Clear conditions, expectations, or steps under which the program will no longer maintain a child’s enrollment due to the child’s behaviors that pose a serious safety risk;

(2) Children’s access to and use of television, video, and electronic devices;

(3) The administration of medication to children;

(4) Excluding children when they are ill, including symptoms, and when they might return;

(5) The provision of meals and snacks, including when parents or guardians fail to send meals or snacks from home if the program does not provide meals or snacks; and

(6) The responsibility of staff and volunteers for supervision of children during field trips and water activities, which includes knowing who is in charge, the identity and number of the children they are responsible for, and the frequency of conducting and documenting head counts of children.

(b) The policy regarding a retention plan required in (a)(1) above shall only apply when addressing a child's behavior and not a parent’s or guardian's misconduct or the parent’s or guardian's failure to comply with other child care rules or laws.

(c) Programs operating exclusively outdoors shall have written policies to include:

(1) The conditions when the program will not operate due to inclement weather, including excessive heat, extreme cold, or when there is a severe weather alert;

(2) The expectation of parents or guardians to provide appropriate clothing according to the season and current weather conditions; and

(3) How child care staff will monitor children regarding their comfort including their warmth or signs of overheating and the action child care staff will take in response to children’s comfort related to the weather conditions.

(d) The program shall provide all written policies to parents or guardians at enrollment. 

(e) In addition to the requirements for policies and procedures above, the program manager shall provide all child care staff with all policies and procedures upon hire, and ensure that they are familiar with them and comply with them, as applicable.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.18); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.16)

He-C 4002.16 Emergency Preparedness, Practice Drills, and Fire Drills.

(a) Except for nature-based programs that operate solely outside, programs shall conduct fire drills in accordance with the following:

(1) Programs that operate continuously throughout the year shall conduct at least one drill each month of operation;

(2) Programs that operate only during the school year shall conduct a drill within 14 days of opening each year and monthly thereafter;

(3) Programs that operate only during the summer months shall conduct one fire drill in each month of operation;

(4) Child care staff shall conduct fire drills at varying times during operating hours, including night time hours, if applicable, to ensure that each child attending the program experiences fire drills;

(5) Child care staff shall activate the actual fire alarm system for the building for at least 2 of the required monthly fire drills required each year and use a fire alarm or smoke detector to signal all other fire drills;

(6) All children and child care staff shall evacuate the building during each fire drill; and

(7) Child care staff shall check daily attendance records to ensure that all children and staff are accounted for, after the building is evacuated.

(b) The only exception to (a)(5) above shall be for school age programs operating in a public or private school, use of the actual fire alarm system for the building shall not be required for the monthly fire drills.

(c) Programs shall complete a written record of fire drills, which shall be available for review during visits by the fire inspector and the department.

(d) The written record of fire drills required under (c) above shall include:

(1) The date and time the drill was conducted and if the actual fire alarm system was used;

(2) The exits used;

(3) The number of children evacuated and total number of people in the building at the time of the drill;

(4) The amount of time taken to evacuate the building; and

(5) The name of the person conducting the drill.

(e) The program manager or designee shall conduct a fire drill in the presence of a representative of the department or the local fire department upon request by either of those entities.

(f) Programs shall have an emergency operations plan (EOP) prior to issuance of a permit or renewal of a license.

(g) All EOPs shall include accommodations for infants and toddlers, children with chronic medical conditions, and children with disabilities or with access and functional needs and:

(1) Be created in coordination with local emergency response agencies in the community in which the program is located;

(2) Contain procedures for communication and reunification with families; and

(3) Include response actions for natural, human-caused, or technological incidences including, but not limited to:

a. Evacuation, both within the building and off-site;

b. Secure campus;

c. Drop, cover, and hold;

d. Lockdown;

e. Reverse evacuation;

f. Shelter-in-place; and

g. Bomb threat or scan.

(h) Programs that plan to resume operations after an emergency shall have a continuity of operations plan (COOP) to ensure that essential functions continue during, or resume rapidly after, a disruption of normal activities.

(i) Programs shall ensure that all staff and volunteers are trained on the EOP and response actions and are aware of the location of the plan.

(j) Upon enrollment, programs shall provide families with information from the EOP that addresses communication and reunification procedures.

(k) Programs shall conduct evacuation drills at least twice a year and dates shall be recorded and available for review pursuant to (m) below. A simulated drill is acceptable.

(l) The program manager or their designee shall practice at least 2 different components of their EOP drills, other than evacuation drills, with all staff and children each calendar year.

(m) The program manager or their designee shall record and maintain on file for review, a log of the practice drills and staff reviews required in (k) and (l) above, that include:

(1) The date and time of the drill or simulated drill;

(2) The type of drill practiced, simulated, or reviewed;

(3) The method of review or practice, such as in-person, or review of on-line training;

(4) The name of all staff and children that participated, as applicable; and

(5) The signature and date of the person conducting the drill, simulation, or review.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08, EXPIRES: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.19); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.17)

He-C 4002.17 Interactions Between and Among Adults and Children.

(a) Child care staff shall regularly interact with children at their level, maintain eye contact, and, whenever appropriate, sit on the floor with them.

(b) When a child is engaging in unacceptable behavior, child care staff shall:

(1) Redirect a child’s attention to a desirable activity by providing positive guidance, positively worded directions, and developmentally appropriate explanations for limits and rules;

(2) Establish developmentally appropriate rules or limits for acceptable behavior, which are equitable, consistently applied, and developmentally appropriate;

(3) Demonstrate desired behavior and problem-solving skills and then redirect children to acceptable behavior;

(4) Arrange equipment, materials, activities, and schedules in a way that promotes desirable behavior; and

(5) Implement safe, logical, and natural consequences related to the misbehavior and enforce those consequences as soon as possible after the misbehavior has occurred.

(c) Child care staff shall use separation from the group only as a method to enable a child to regain control of themselves, and not as a punitive disciplinary technique. Child care staff shall check in with children to determine when they are ready to rejoin the group.

(d) When a child is separated from the group, they shall be able to see and hear the other children and be within hearing and vision of child care staff, except when child care staff remove a child from the classroom to a quieter area which is visible by other child care staff, to provide one-on-one attention.

(e) Child care staff and household members shall not:

(1) Abuse or neglect children;

(2) Use rough handling on children;

(3) Shake children;

(4) Use corporal punishment on children;

(5) Require children to stand or sit facing walls or corners;

(6) Shame, humiliate, threaten, or frighten children;

(7) Confine infants or toddlers in highchairs or other seating devices or equipment, which restricts their movement, as a disciplinary technique;

(8) Place or confine children in equipment that is not appropriate for their age, including but not limited to cribs, playpens, or highchairs;

(9) Withhold food from children, forcibly feed children, or discipline children for not eating;

(10) Discipline any child for toileting accidents, lapses in toileting habits, or prohibiting children from using the toilet as a form of discipline;

(11) Isolate a child as a form of discipline;

(12) Require children to rest, sleep, or go to their mat, crib, or rest area as a means of discipline, or discipline children for not sleeping or resting during naptime;

(13) Yell in anger or frustration at or in the presence of children;

(14) Use profanity or obscene language with children or among themselves where children can hear them; or

(15) Endanger a child as per RSA 170-E:4, II.

(f) The applicant, licensee, and all child care staff shall take prompt action to protect children from abuse, neglect, rough handling, and corporal punishment, including but not limited to actions in (e) above.

(g) The program manager or their designee shall immediately notify the child’s parent or guardian:

(1) After calling emergency services to report that their child died while under the care of the program;

(2) After calling the police when the program determines that their child is missing;

(3) To report any allegation of abuse or neglect involving their child while in the care and custody of the licensee;

(4) To report that their child was the victim of corporal punishment, rough handling, or other harsh treatment by child care staff;

(5) To report that their child was physically injured because they were not supervised; or

(6) To report that their child’s health, safety, or well-being was otherwise jeopardized due to a program’s non-compliance with licensing rules.

(h) The department shall notify the child’s parent or guardian if it determines that the program manager or their designee did not notify a child’s parent or guardian in accordance with the requirements in (g) above.

(i) If a child’s actions pose an imminent serious safety risk to the child or others that could result in serious bodily harm, child care staff may move the child to another area, holding the child as gently as possible and as briefly as necessary to protect the child and others.

(j) If a child has multiple incidents as described in (i) above and does not respond to techniques described in (b) above, the program manager shall, in consultation with parents or guardians, create and implement a behavior management plan which supports the retention policy pursuant to He-C 4002.15(a)(1).

(k) The program shall ensure that parents or guardians have access to the program and to their children, at any time children are in attendance and without prior notification. This requirement shall not prohibit the program from locking the doors for security purposes or checking parent’s or guardian’s identification.

(l) The only exceptions to (k) above shall be if there is a court order or other legal documentation limiting parental or guardian access.

(m) Child care staff shall not:

(1) Be impaired while on the job by any substances including, but not limited to, legally prescribed medication, alcohol, or illegal substances; and

(2) Use alcohol or illegal substances while caring for children.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.20); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.18)

He-C 4002.18 Programming.

(a) Programs shall provide and implement a written schedule of typical daily activities offered to the children, which shall include opportunities for individual and group activities for each child, time for meals, snacks, sleep, or rest, and indoor and outdoor activities, and which shall be available for review by the department and parents or guardians.

(b) Program staff shall:

(1) Provide prompt attention to the individual physical needs of each child, such as diapering, toileting, feeding, sleeping, washing, and first aid; and

(2) Provide a variety of hands-on, developmentally appropriate activities, opportunities, and experiences for each child that foster and support cognitive, physical, social, and emotional development, and approaches to learning.

(c) Child care staff shall not allow children to provide care to other children, such as feeding infants, picking up infants or toddlers, changing diapers, assisting with toileting, or supervising children.

(d) Programs shall provide opportunity for at least 60 minutes daily of gross motor activity, whether inside or outside, for children, except preschools operating 5 or fewer hours per day shall provide at least 20 minutes of inside or outside gross motor activity daily.

(e) When taking children outside, staff shall assure that children are appropriately dressed for the weather conditions and shall monitor the children regularly for comfort in both hot and cold weather.

(f) Child care staff shall not allow a child to go outside when the child has a health concern as documented on their allergy care plan or as documented by the child's licensed practitioner limiting time outdoors.

(g) Child care staff shall adhere to instructions from the child's parent or guardian related to protection from sun exposure and apply sunscreen per manufacturer's instructions.

(h) Center-based programs shall not combine children younger than 24 months in a mixed age group which includes children older than 47 months, except:

(1) For time limited, specific activities, including but not limited to meals, snacks, naps, or rest time, and special occasions such as birthday or holiday celebrations or visitor presentations;

(2) When there are 17 or fewer children present in the program, including 5 children enrolled in a full day school program, and a maximum of 12 preschool children, of which no more than 4 children shall be younger than 36 months of age; or

(3) With a department approved plan for multi-age classrooms.

(i) Child care staff shall:

(1) Not confine awake infants and toddlers in restrictive equipment such as infant seats, seated infant carriers, car seats, swings, highchairs, stationary activity centers, strollers, cribs, or playpens for more than 15 minutes in any 2-hour period, unless necessary to provide for the physical safety of the infant or toddler when staff are otherwise engaged in the care of another child, such as changing a diaper or providing first aid;

(2) Allow infants and toddlers to remain in a highchair for more than 15 minutes when they are actively engaged in eating during snack or meals, in strollers for walks, or for non-ambulatory infants only, in cribs or playpens when outside;

(3) Provide stimulating activities such as age-appropriate toys or books to infants or toddlers while they are in equipment specified in (1) above; and

(4) Not leave infants or toddlers unattended in seating, carrying, or other devices placed on countertops, tables, or other elevated surfaces.

(j) Programs that are authorized by license or permit to care for children as young as 6 weeks of age may care for a child younger than 6 weeks of age for a maximum of 12 hours per week per child with prior approval from their local fire officer and notification to the department.

(k) In a family or family group child care home licensed to care for children 6 weeks of age, the restriction specified in (j) above shall not apply to the family child care provider’s own biological, adopted, or foster care infant younger than 6 weeks of age or an infant younger than 6 weeks of age who resides in the provider’s home, provided that, in doing so, it will not result in exceeding the limits specified in He-C 4002.33(m) through (o).

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.21); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.19)

He-C 4002.19 Prevention and Management of Injuries.

(a) Child care staff shall supervise every child in care at all times.

(b) In center-based programs, staff shall:

(1) Know the number and identity of children in their care; and

(2) Position themselves to:

a. Be able to hear all children younger than school age at all times, continuously scan the entire environment to know where children are and what they are doing, and be able to physically respond immediately;

b. Always know the whereabouts and activities of all school age children in their care when children are briefly out of sight, such as when transitioning from one area to another or using the bathroom, and shall be able to physically respond immediately; and

c. Allow for visual supervision of all children while children are eating and shall be able to physically respond immediately to any child.

(c) The only exception to (b)(2)a. above shall be children 4 years and older may leave the classroom to use a bathroom located on the same level as the classroom, provided that child care staff are aware of each child leaving the classroom to use the bathroom and the level of the building that the bathroom is located on is used exclusively by the child care program.

(d) Video monitors shall not replace the supervision of children, except as provided for in He-C 4002.25(j) and (k).

(e) In family child care homes and small child care centers, child care staff who are working alone shall supervise children in accordance with the following:

(1) The child care staff may step away from the children to meet basic care needs throughout the day, provided that:

a. The time away is time limited; and

b. The child care staff shall always be able to hear all children preschool age and younger and be able to physically respond immediately, if necessary;

(2) The child care staff shall always know the whereabouts and activities of all school age children and shall be able to physically respond immediately;

(3) The child care staff may allow school-age children 6 years of age and older to play outside when the child care staff is inside, with written parental or guardian permission; and

(4) When children are eating, the child care staff shall be positioned to allow for visual supervision of all children and shall be able to physically respond immediately to any child.

(f) Child care staff shall not carry a child while stepping over a low wall, gate, or other similar barrier.

(g) Child care staff shall protect younger or less mobile children from accident or injury which could be caused by older or more physically active children.

(h) The program shall obtain the following documents from the parents or guardians of each child with a food allergy or other allergy, which results in a serious reaction:

(1) A written care plan that includes instructions regarding food(s) or other allergens to which the child is allergic and steps for child care staff to take to avoid the allergens; and

(2) A written treatment plan, detailing the treatment to be implemented in the event of an allergic reaction, which shall include:

a. The names, doses, and methods of prompt administration of any medications, where the medication needs to be stored in relation to the child, taking into consideration the storage requirements in He-C 4002.20(j)(2), and instructions on how to administer the prescribed medication; and

b. Specific symptoms that would indicate the need to administer one or more medications.

(i) At all times, at least one child care staff supervising a child with an allergy care plan shall have completed the training specified in He-C 4002.32(b)(5).

(j) The program manager or their designee shall notify a child’s parent or guardian when the program deviates from the planned menu as indicated on children’s allergy care plans, as applicable.

(k) With permission of the parent or guardian, the program shall post each child’s allergy care plan and treatment plan in the kitchen or food preparation area, the child's classroom, and wherever the child might have contact with the allergen(s).

(l) In the event a parent or guardian does not authorize posting of their child’s allergy care plan or treatment plan as required in (k) above, the program shall not post the plans, but ensure the plans are available in the locations in (k) above, and all staff working in those locations know where the plans are and review the plans upon entering those locations.

(m) All child care staff responsible for food preparation and food service, and all child care staff responsible for supervising children with an allergy, including staff covering breaks, shall read and familiarize themselves with the allergy care plans and treatment plans, to ensure that no child is accidentally exposed to an allergen.

(n) The program manager or their designee shall immediately notify a child’s parent or guardian in the event of a suspected allergic reaction or ingestion of or contact with a known allergen, even if a reaction did not occur.

(o) Program staff shall notify emergency services immediately whenever staff administer epinephrine (Epi-pen) to a child.

(p) Programs shall be equipped with a telephone that is operable and accessible to all child care staff during all operating hours for incoming and outgoing calls. The phone may be a cellular phone or a landline.

(q) Child care staff shall report any occurrence of a missing child to emergency services, as soon as child care staff have determined that the child cannot be promptly located on the premises of the child care program.

(r) There shall be at least one staff person present with all children during all operating hours, both on and off premises, who is trained and currently certified in pediatric cardiopulmonary resuscitation (CPR) and first aid, which shall be obtained by the American Red Cross, American Heart Association, Emergency Care and Safety Institute, National Safety Council, American Trauma Event Management, or other nationally recognized organization.

(s) CPR and first aid training as specified in (r) above may be received via correspondence or on-line, provided a skill test is required to be performed prior to becoming certified.

(t) Programs shall maintain on file, available for review by the department, copies of current CPR and first aid certificates and licenses.

(u) Programs shall have on the premises and on all field trips, a selection of non-expired first aid supplies adequate to meet the needs of the children.

(v) Programs shall store the first aid supplies required under (u) above in a portable container, in a location that is accessible by staff.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (He-C 4002.22); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.19); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.20)

He-C 4002.20 Administration and Storage of Medication.

(a) For the purposes of this section, “administer” means an act whereby a single dose of a medication is instilled into the body of, applied to the body of, or otherwise given to a child for immediate consumption or use.

(b) For programs that administer medication:

(1) Only authorized staff, a registered nurse (RN), licensed practical nurse (LPN), or licensed practitioner shall administer prescription and over-the-counter medications to children, in accordance with the child’s medication order;

(2) Authorized staff shall administer only those medications for which there is a medication order provided by a licensed practitioner, and written permission from the parent or guardian; and

(3) Programs shall not accept any prescription medications that do not include a prescription label or medication order from a licensed practitioner.

(c) Each medication order shall legibly display:

(1) The child’s name;

(2) The medication name, strength, the prescribed dose and method of administration;

(3) The frequency of administration;

(4) The indications for usage of all medications to be used pro re nata (PRN), meaning when necessary; and

(5) The dated signature of the licensed practitioner for orders other than the prescription label.

(d) Medication orders for PRN medication shall include:

(1) The indications and any special precautions or limitations regarding administration of the medication;

(2) The maximum dosage allowed in a 24-hour period;

(3) The dated signature of the parent or guardian for topical substances or over-the-counter medication; and

(4) For other than the prescription label, the dated signature of the licensed practitioner for prescription medication.

(e) In the event of a medication error in the administration of medication, the family child care provider, center director, site director, or designee shall notify the child’s parents or guardians immediately.

(f) Prior to administering prescription and over-the-counter medication to any child, child care staff shall complete and document training on medication administration, as required by He-C 4002.32(b)(4), delivered by the department, a physician, RN, or LPN practicing under the direction of an APRN, RN, or physician, or online training approved by the department.

(g) Authorized staff shall complete training in medication safety and administration every year.

(h) For each child receiving medication, child care staff shall maintain medication information on file and available for review by the department, including medication orders, parental or guardian authorization to administer medication, and information regarding a child’s allergies, if applicable.

(i) Child care staff shall maintain a written record for each dose of medication administered to each child, which shall:

(1) Be completed by the authorized staff who administered the medication immediately after the medication is administered; and

(2) For each administered medication, include at a minimum:

a. The name of the child;

b. The date and time the medication was taken;

c. A notation of any medication error or the reason why any medication was not taken as ordered or approved;

d. The dated signature of the authorized staff who administered the medication to the child; and

e. For administration of a PRN, documentation shall also include the reason for administration.

(j) All medication shall be:

(1) Inaccessible to children;

(2) Stored at the temperature and conditions recommended by the manufacturer or as directed on the prescription label;

(3) Stored in a secondary container separate from food if in a refrigerator; and

(4) Labeled with the child’s name to ensure correct identification of each child's medication.

(k) Medications such as insulin, inhalers, and epi-pens shall be readily accessible to child care staff caring for children requiring such medications, to assure timely administration when needed and in accordance with parental or guardian instructions in He-C 4002.19(h)(2)a.

(l) Programs may permit school-age children to possess medications described in (k) above provided there is written authorization from the prescribing licensed practitioner and written permission from the child’s parent or guardian on file at the program.

(m) The only exception to (l) above shall be when a school-age child is with children younger than 6 years of age, insulin, inhalers, and epi-pens shall not be in the school-age child’s possession but shall be readily accessible to child care staff.

(n) All medications belonging to child care staff shall be stored separate from children’s medications in a locked area, or otherwise inaccessible to children.

(o) All prescription or over-the-counter medication shall be kept in the original containers or pharmacy packaging and properly closed after each use.

(p) Topical substances shall be labeled with ingredients and indicated use.

(q) Any contaminated, expired, or discontinued medication, whether prescription or over-the-counter, and topical substances shall be returned to the child’s parents or guardians whenever possible or, if belonging to the program, disposed of properly by authorized staff.

(r) Child care staff shall administer over-the-counter medications in accordance with the manufacturer’s instructions or written instructions from the child’s licensed practitioner.

(s) Programs that opt to obtain epinephrine devices for use in emergencies, in accordance with RSA 329:1-h, II, shall have and abide by a policy for the storage, maintenance, control, and general oversight of epinephrine devices acquired by the program, for compliance with RSA 329:1-h, III.

(t) Pursuant to RSA 329:1-h, V, programs that opt to obtain a prescription for epinephrine devices under (s) above shall designate and train authorized staff to administer epinephrine in accordance with the following:

(1) Authorized staff shall complete an anaphylaxis training program at least every 2 years, following completion of the initial anaphylaxis training program;

(2) Such training shall be conducted by a nationally recognized organization experienced in training unlicensed persons in emergency health care treatment or an entity or individual approved by the board of medicine;

(3) Training may be conducted online or in person and, at a minimum, shall cover:

a. How to recognize signs and symptoms of severe allergic reactions, including anaphylaxis;

b. Standards and procedures for the storage and administration of an epinephrine device; and

c. Emergency follow-up procedures; and

(4) The certificate of completion for the training shall be on file for review by the unit.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.23); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.18); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.21)

He-C 4002.21 Approval of Child Care Space and License Capacity: Indoors and Outdoors.

(a) Prior to use for child care, all indoor and outdoor child care space shall be:

(1) Inspected and approved by the local fire inspector, in accordance with RSA 170-E:6 and He-C 4002.02(e)(3);

(2) Inspected and approved by the local health officer, in accordance with RSA 170-E:6 and He-C 4002.02(e)(2); and

(3) Inspected by the department in accordance with RSA 170-E:8, III, and RSA 170-E:9, II, and these rules.

(b) The licensee shall provide and maintain at least one toilet and one handwashing sink for every 20 children of their licensed capacity.

(c) There shall be a minimum of 35 feet of net floor area per child, inside the rooms used by children, calculated by excluding non-occupiable spaces including corridors, stairs, bathrooms, electrical or mechanical rooms, closets, and fixed equipment, which shall be subtracted from the total area to determine the net floor area.

(d) The department shall determine the license capacity by adding the number of children each room can accommodate based on (c) above, and in accordance with local fire, health, and zoning approvals.

(e) The department shall not consider common space, hallways, lockers, bathrooms, cooking areas of the kitchen, closets, or offices as child care space when determining license capacity.

(f) The program shall have space of its own, apart from other groups that might be using the facility, during the time that it operates.

(g) Programs which are in the same building with other licensed entities or programs for children that are license exempt, pursuant to RSA 170-E:3, shall:

(1) Not be responsible for or supervise any children not enrolled in the licensed program;

(2) Not allow children from the license exempt program to mix with children enrolled in the licensed program; and

(3) Not allow children from the license exempt program to share space that is being used by children enrolled in the licensed program.

(h) Programs shall not overcrowd child care space with adult-sized furniture or other items.

(i) For programs licensed before November 23, 2008, whose capacities included the use of common space as described in rules previous to that date, shall be allowed to have no more than up to 2 children over the classroom capacity, regularly assigned to each classroom, provided the common space was approved by and is on file with the department.

(j) For programs licensed before May 30, 1998, whose capacities included the use of common space as described in rules previous to that date, shall be allowed to have no more than up to 4 children over the classroom capacity, regularly assigned to each classroom, provided the common space was approved by and is on file with the department.

(k) Programs shall be equipped with an outside play area, which directly adjoins the indoor space of the facility and contains a minimum of 50 square feet of outdoor play area for each child based upon the program’s license capacity.

(l) The only exceptions to (k) above are as follows:

(1) Programs may utilize department approved outdoor play space which is located within 1/8 of a mile from the program, provided the program submits a written plan to the department showing that children can safely travel to and from the play area and the program;

(2) Programs may operate with 50 square feet of outdoor play area per child for 1/3 of the program’s license capacity, provided that no more than 1/3 of the license capacity is in the play area at one time; and

(3) Programs that operate 5 or fewer hours per day provided the curriculum includes at least 20 minutes of gross motor activities.

(m) For programs operating exclusively outdoors, the department shall determine the license capacity based on the area of outdoor space and the proposed staffing patterns as specified in these rules.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.24); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.22)

He-C 4002.22 Health and Safety Requirements for Indoor Space.

(a) Child care staff shall ensure that the indoor space is:

(1) Safe, clean, free of clutter, and in good repair;

(2) Free from electrical hazards, such as overloaded outlets or extension cords, frayed, cracked, or crimped cords, or unprotected outlets;

(3) Well-ventilated by means of unobstructed mechanical ventilation system or open, screened window(s);

(4) Well-lit and arranged to provide clear pathways for staff and children to move about safely and to allow for the visual supervision of children by staff;

(5) Free of damp conditions which result in visible mold, mildew, or a musty odor;

(6) Free of heavy furnishings or items not secured to the wall or floor that could easily tip or are unstable;

(7) Free of fumes from toxic or harmful chemicals or materials;

(8) Free of tripping hazards, exclusive of toys and equipment when in use by children; and

(9) Free of poisonous plants.

(b) Child care staff shall ensure that potentially harmful items, including but not limited to matches, lighters, chemicals, materials labeled “harmful if swallowed,” flammable materials, sharp objects, and staffs’ personal belongings are locked or inaccessible to children.

(c) All substances labeled “harmful if swallowed” or “flammable” and all containers storing cleaning materials shall be labeled as to the contents and stored separately from food and medications.

(d) Non-toxic materials labeled “keep out of reach of children” shall only be used during a teacher-directed activity.

(e) Cords or strings long enough to encircle a child’s neck, such as cords on window blinds, curtains, or shades, shall be kept out of children’s reach.

(f) Child care staff shall ensure that the presence of pets in the program does not present a hazard to the children, including but not limited to:

(1) Reptiles, amphibians, and birds, including baby chicks and ducklings, shall not be permitted in roms or outdoor spaces regularly occupied by children;

(2) When bringing animals into a child care, staff shall supervise children when the animals are available, designated areas shall be cleaned and sanitized after animal contact, and food or drink shall not be consumed in these areas;

(3) Cages or other habitats shall be cleaned of all fecal material and sanitized on an as needed basis but no less than once per week;

(4) Staff shall wear gloves while cleaning animal cages or habitats;

(5) All staff and children shall wash hands with soap and warm running water after contact with animals or their cages or habitats; and

(6) Dogs, cats, and ferrets shall be kept clean and free of parasites, fleas, ticks, mites, and lice, and vaccinated against rabies, with proof of current vaccination on site at the program and available for review by department staff.

(g) Programs shall maintain bathroom facilities in accordance with the following:

(1) Sinks, toilets, footstools, potty chairs, and adapters shall be cleaned and sanitized at least once a day and when visibly soiled;

(2) Bathroom floors and other surfaces adjacent to toilets, including but not limited to walls, shall be cleaned and sanitized at least weekly, and when visibly soiled; and

(3) Toilet paper, individual cloth or paper towels, and liquid soap from a dispenser shall be available and accessible to children and staff.

(h) The program shall take prompt action to eliminate insects or rodents, and clean and sanitize all surfaces where there is visible evidence of their presence.

(i) Pesticides shall not be used in areas used by children while children are present, and shall be used per manufacturers’ instructions.

(j) Programs shall maintain the child care space in compliance with Saf-FMO 300 and Saf-C 6000 by not blocking exits, or evacuation routes, including doorways, hallways, and stairs that are a means of egress, and by maintaining smoke detectors in working order.

(k) The licensee shall prohibit smoking and vaping in the building anytime for center-based programs or during operating hours for family child care homes.

(l) Child care staff who smoke or vape during their breaks shall not do so in view of children or while responsible for the care of children.

(m) Child care staff who smoke or vape shall wash their hands and change into fresh clothing or remove smoke contaminated outerwear prior to working with children.

(n) There shall be adequate space for each child’s possessions, such as individual cubbies, lockers, baskets, or bins.

(o) Children’s toothbrushes shall be stored separately to air dry and be labeled with each child’s name.

(p) All windows used for ventilation shall include screens in good repair, to prevent insects from entering the building.

(q) Garbage shall be disposed of in a lined and covered container and staff shall empty trash containers daily or sooner if contents create an odor or a health risk.

(r) Stairways with more than 3 steps shall be equipped with handrails.

(s) In programs serving children younger than 3 years old, the licensee shall ensure that there are barriers placed at the top and bottom of stairwells opening into areas used by children younger than 3 years, unless prohibited by building or fire department regulations. Pressure gates at the top of stairs shall not be used.

(t) Open stairways used by children younger than school age shall have railings or banisters installed along the open or unprotected side(s).

(u) Programs shall:

(1) Have a safe, functioning heating system;

(2) Maintain a temperature of not less than 65 degrees Fahrenheit whenever children are present; and

(3) Protect children from contact with exposed heat sources, including steam and hot water pipes, and radiators, via the use of permanent screens, guards, insulation, or another suitable device that prevents children from coming in contact with them.

(v) Prior to using portable space heaters or portable radiators in child care space, programs shall obtain written approval from the local fire inspector with documentation of the approval available for review by department staff during on-site visits.

(w) All portable space heaters or radiators shall:

(1) Be inaccessible to children;

(2) Bear the safety certification of a recognized laboratory such as Underwriters Laboratory (UL) or Electro Technical Laboratory (ETL);

(3) Be placed at least 3 feet from curtains, papers, furniture, or any other flammable object; and

(4) Be installed and operated in accordance with the manufacturer’s specifications.

(x) All fuel burning stoves, including but not limited to wood, coal, pellet, or gas, when used during child care, shall:

(1) Meet applicable local and state codes with documentation of such approval available for review by department staff during on-site visits; and

(2) Be maintained in a manner that ensures the safety of all children, by use of partitions, screens, guards, or other similar barricades, as approved by the local fire official.

(y) Child care staff shall be in the room with children whenever a fireplace is in use.

(z) All working fireplaces in space used by children shall:

(1) Have a secure child-proof barrier in place at all times; and

(2) Be equipped with padding or otherwise protected if the hearth presents a hazard to children.

(aa) Guns, weapons, or live or spent ammunition shall be locked, and the key or code used to lock these items shall be stored separately and out of the reach of children.

(ab) Pursuant to 40 CFR 745, when interior surfaces of a building built prior to 1978 are in a deteriorating condition, including but not limited to flaking, chipping, and peeling paint, or are subject to renovations or construction, the licensee shall utilize a U.S. Environmental Protection Agency certified Renovation, Repair, and Painting (RRP) contractor, in accordance with 40 CFR 745.90(a) and (b) and He-P 1600.

(ac) In addition to (ab) above, until the deteriorated surfaces can be made intact, the program shall provide the department with a plan, in writing, that ensures children will not have access to those surfaces and includes the expected date of completion of the work.

(ad) Construction, remodeling, or alteration of structures during child care operations shall be done in a manner as to prevent exposure of children to hazardous or unsafe conditions including, but not limited to, fumes, dust, construction materials, and tools which pose a safety hazard.

(ae) When there is information or evidence indicating that the building might contain asbestos hazards, programs shall submit evidence that the building has been inspected by a licensed asbestos inspector and is free of asbestos hazards or submit a plan of action to reduce or eliminate any existing contamination to be approved by the department.

(af) When there is information indicating that the building or water supply might contain radon hazards, programs shall submit evidence that the building has been inspected by a licensed radon inspector and is free of radon hazards or submit a plan of action to reduce or eliminate any existing contamination to be approved by the department.

(ag) Child care staff shall immediately clean and sanitize spills of bodily fluids using soap and water and then disinfectant.

(ah) Child care staff shall:

(1) Wear non-porous gloves when cleaning bodily fluid spills;

(2) Place soiled clothing in a plastic bag, tied securely and return the items to the child’s parent or guardian at pick up;

(3) Dispose materials contaminated by bodily fluids in a plastic bag with a secure tie or in covered, plastic bag-lined, hands-free receptacle;

(4) Clean, rinse, disinfect, wring, and hang to dry mops used to clean bodily fluids; and

(5) Immediately wash their hands with soap and running water after discarding the gloves.

(ai) Programs shall place American Society for Testing and Materials (ASTM) gymnastic standard mats under and extending at least 39 inches beyond the fall zone of all indoor swings and climbing equipment, including slides or lofts, which would allow a fall from a height of more than 29 inches.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.25); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.14); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.23)

He-C 4002.23 Health and Safety Requirements for Outdoor Space.

(a) The play area shall:

(1) Be accessible to children with disabilities;

(2) Be appropriate for each age group served, including use of toys and equipment that is age and developmentally appropriate to the needs of the children enrolled;

(3) Provide for both direct sunlight and shade; and

(4) Be free from trash, feces, and hazardous or dangerous areas, items, or materials.

(b) Fencing shall enclose all play areas if the department determines the play area is unsafe or poses a risk of injury to children because it is located adjacent to:

(1) A street or road;

(2) A swimming pool or other body of water, including a river, pond, or stream;

(3) An active railroad track or crossing;

(4) Sharp inclines or embankments; or

(5) Any dangerous area.

(c) All fencing required by the department or otherwise intended to limit children’s access to a defined area shall:

(1) Have no gaps greater than 4 inches and be designed to restrain preschool children from climbing out of, over, under, or through the fence; and

(2) Either:

a. Be equipped with a child proof self-latching device on any gates leading to an entrance or egress; or

b. Be equipped with a child proof lock if the area is determined to be hazardous to children.

(d) The licensee shall protect outdoor play space located on a roof with a barrier at least 7 feet high, which children cannot climb.

(e) The licensee shall install suitable barriers, including but not limited to bulkhead doors, to prevent falls into outdoor stair or window wells.

(f) The department shall approve porches and decks before use as play areas.

(g) Porches and decks shall comply with the following:

(1) If they are more than 3 feet from ground level, there shall be protective railings in accordance with applicable building codes;

(2) Railings shall be sturdy and constructed in a way that will prevent a young child from going underneath, over, or through them;

(3) There shall be a child safety gate or other barricade on stairs whenever the porch or deck is in use by children younger than 3 years old; and

(4) The family child care provider, center director, or site director shall monitor the condition of porches and decks to ensure that there are no splinters, cracks, or protruding nails or screws, and discontinue use of the area until repairs are complete.

(h) For outdoor play equipment that would allow a child to fall from a height of more than 29 inches, programs shall:

(1) Equip and maintain the ground area under and extending at least 39 inches beyond the external limits of such equipment with an energy absorptive surface; and

(2) Utilize an energy absorptive surface, required by (1) above, that:

a. Does not present a choking hazard if used by children younger than 3 years;

b. Is checked and raked regularly to remove any foreign matter, correct compaction, and increase absorption; and

c. Is a unitary surface documented by the manufacturer in accordance with the standards of ASTM International’s “ASTM F1292 Standard Specification for Impact Attenuation of Surfacing Materials Within the Use Zone of Playground Equipment” (2022 edition), available as noted in Appendix B, and installed per manufacturer’s instructions or conforms with Table 4.2.1 below:

Table 4.2.1 Energy Absorptive Surface

Fall Height of Equipment	Wood Chips	Bark Mulch	Engineered Wood Fibers	Sand	Pea Gravel	Shredded Rubber
30 inches to 5 feet	6 inches	6 inches	6 inches	9 inches	9 inches	6 inches
6 feet	6 inches	6 inches	6 inches	N/A	12 inches	6 inches
7 feet	6 inches	9 inches	9 inches	N/A	N/A	6 inches
8 feet	9 inches	9 inches	12 inches	N/A	N/A	6 inches
9 feet	9 inches	9 inches	12 inches	N/A	N/A	6 inches
10 feet	9 inches	9 inches	12 inches	N/A	N/A	6 inches

(i) To prevent injury, programs shall not:

(1) Allow children to play on equipment or structures that require energy absorptive material pursuant to (h) above when the energy absorptive material is compacted and unable to be loosened, such as when frozen; and

(2) Place infant and toddler play equipment or structures that do not require energy absorptive materials on tar, pavement, cement, or other similar materials.

(j) All fencing, balusters, handrails, and guardrails, or slats on lofts, stairways, decks, porches, or balconies that are accessible to children shall be constructed and maintained to prevent entrapment hazards.

(k) All swimming pools on the premises of the child care program and used as part of the child care operations shall be clean and maintained in accordance with the manufacturer’s or installer’s printed instructions regarding cleaning, filtration, and chemical treatment.

(l) All swimming pools on the premises of the child care program shall be inaccessible to children in accordance with the following:

(1) In-ground pools shall be enclosed by a fence with a gate equipped with a child proof, self-latching device and a lock;

(2) Above ground pools shall be enclosed by a fence with a gate which has a child proof, self-latching device and a lock, or equipped with a lockable gate, lockable swing up stairway, or other lockable barrier to prevent access to the stairs or ladders, or otherwise make the pool inaccessible to children;

(3) A pool that is directly accessible from inside the building shall have a secure, lockable barrier that meets the requirements in (1) and (2) above to make the pool inaccessible to children;

(4) Pool gates, fences, or other barriers as required in (1), (2), and (3) above shall be locked during all operating hours, except when the children are involved in a supervised water activity in the pool; and

(5) The keys, combinations, or other means to open the locks required in (1) through (4) above shall not be accessible to children.

(m) Each swimming pool shall be equipped with a ring buoy and attached rope of sufficient length to reach the center of the pool from the edge of the pool and shall be kept out of children’s reach.

(n) Wading pools shall:

(1) Be emptied and cleaned after each use;

(2) Be stored so that water does not collect in them; and

(3) Not contain water that is more than 10 inches deep.

(o) Pursuant to 40 CFR 745 when exterior surfaces of a building built prior to 1978 are in a deteriorating condition, including but not limited to flaking, chipping, and peeling paint, or are subject to renovations or construction, a U.S. Environmental Protection Agency certified Renovation, Repair, and Painting (RRP) contractor shall be utilized, in accordance with 40 CFR 745.90(a) and (b) and He-P 1600.

(p) In addition to (o) above, until such time as the deteriorated surfaces can be made intact, the program shall provide the department with a plan, in writing, that ensures children will not have access to those surfaces and includes the expected date of completion of the work.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.26); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.14); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.24)

He-C 4002.24 Learning Materials, Toys, and Equipment.

(a) Programs shall provide toys, equipment, furniture, and learning materials that are:

(1) Age and developmentally appropriate;

(2) Of sufficient quantity and variety to meet the needs of the children cared for in the program;

(3) Available and accessible to children;

(4) Cleaned on a regular basis;

(5) Cleaned and sanitized after each use for toys or items mouthed by a child;

(6) Sturdy and safely constructed and installed;

(7) Maintained in a safe, secure, and workable condition, free from lead paint, protruding nails, splinters, rust, and other hazards that might be dangerous to children; and

(8) Used in a safe manner, in accordance with manufacturer’s instructions.

(b) Infants and toddlers in elevated seating equipment shall be secured in the equipment as instructed by the manufacturer.

(c) Child care staff shall not use any equipment, materials, furnishings, toys, or games identified by the U.S. Consumer Product Safety Commission as being hazardous.

(d) All play equipment and structures shall be free of entrapment hazards, including gaps that are between 3 ½ inches and 9 inches apart on balusters, handrails, guardrails, or slats on play structures, lofts, stairways, decks, porches, or balconies, that are accessible to children.

(e) Child care staff shall not allow children younger than 3 years of age to have access to toys, toy parts, and other materials that pose a suffocation or choking risk or are small enough to be swallowed, including, but not limited to, coins, balloons, exposed foam padding, or empty plastic bags.

(f) The only exception to (e) above for children age 24 months to 3 years shall be during teacher directed activities under direct supervision by child care staff, provided there is written parental or guardian consent on file acknowledging their understanding that the program uses small items during teacher directed and supervised activities.

(g) Infants shall not be placed in any equipment, including but not limited to stationary activity centers that require them to support their heads on their own if they have not yet acquired that ability.

(h) Baby walkers with wheels are prohibited in programs.

(i) Toy boxes accessible to children used to store any child care materials and equipment shall have a safety lid support or not have a lid.

(j) Infants shall only have access to toys with strings or cords up to 6 inches in length.

(k) Toddlers shall only have access to toys with strings or cords up to 12 inches in length, or any length for a teacher-directed activity.

(l) Except for therapeutic equipment or small trampolines intended for individual use with direct adult supervision, the use of trampolines by enrolled child care children, whether indoors or outdoors, is prohibited.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.27); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.22); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.25)

He-C 4002.25 Rest and Sleep.

(a) Child care staff shall arrange cribs, cots, beds, mats, or playpens in a manner that ensures that:

(1) They do not block passageways and exit routes, to allow for emergency evacuation and access to each child by staff;

(2) They are spaced at least 2 feet apart while in use or separated by a solid divider on one side only, allowing for adequate supervision by staff and air circulation; and

(3) Children are placed head to toe.

(b) Programs shall ensure that each child requiring rest or sleep is provided with a sleeping bag, crib, cot, bed, or mat.

(c) Each infant 12 months of age and younger shall be placed on their back to sleep in an individual crib or play pen, unless they have demonstrated the ability to climb out.

(d) Child care staff shall discontinue using cribs or play pens with children who have demonstrated the ability to climb out of them.

(e) No crib shall be used unless manufactured on or after June 28, 2011, or if manufactured prior to that date, has a Children’s Product Certificate (CPC), or test report from the U.S. Consumer Product Safety Commission (CPSC) accepted third-party lab, provided by the manufacturer documenting the crib’s compliance with 16 CFR 1219 and 1220.

(f) Cribs and play pens required under (c) above shall:

(1) Not be stacked;

(2) Be in good repair;

(3) Not have holes or tears in the mesh walls or in the material that connects the walls to the bottom of the crib or play pen;

(4) Have tight fitted sheets designed for the size mattress that do not compress the mattress;

(5) Not have bumper pads, blankets, flat sheets, pillows, quilts, comforters, sleep positioners, or any items or toys with infants up to 12 months of age; and

(6) Have mattresses which are in good repair, free of rips or tears, and fit the crib or playpen so that the space between the mattress and crib or playpen is not more than 1 inch wide and does not create a suffocation hazard. 

(g) If an infant up to 12 months falls asleep outside of their crib or play pen, including entering the program asleep in a car safety seat, staff shall immediately move the infant and place them on their back in a crib or play pen.

(h) When child care staff place infants in their crib or play pen for sleep, they shall check the infants to ensure that they are comfortably clothed and not overheated or sweaty, and that bibs and garments with ties or hoods are removed.

(i) Children older than 3 months shall not be swaddled or placed in restrictive or weighted sleep suits or devices unless there are written medical orders from the child’s primary licensed practitioner.

(j) In family and family group child care homes and small child care centers, use of an electronic monitor shall only be used to monitor sleeping children on the same level in lieu of direct supervision, in accordance with the following:

(1) There is written authorization on file from the parents or guardians of the child, indicating that they are aware of and agree to the use of the monitor;

(2) The child care staff responsible for their supervision can easily hear sounds from the monitor and respond; and

(3) Every 15 minutes, the child care staff responsible for their supervision conduct in-person checks of infants and toddlers sleeping in a crib or playpen, to ensure that each child is safe and comfortable, including a check of their faces, viewing the color of their skin and to check on their breathing.

(k) In center-based programs, use of an electronic monitor, whether only audio or both audio and visual, shall be permissible in lieu of having staff in the same room with only infants or toddlers sleeping in cribs or playpens, in accordance with the following:

(1) There is written authorization on file from the parents or guardians of the child, indicating that they are aware of and agree to the use of the monitor;

(2) The child care staff required to maintain ratio are located in an adjoining room where they can easily hear sounds from the monitor and respond; and

(3) Every 15 minutes, the child care staff conduct in-person checks of infants and toddlers sleeping in a crib or playpen, to ensure that each child is safe and comfortable, including a check of their faces, viewing the color of their skin and to check on their breathing.

(l) Blankets, sleeping bags, bedding, cots, and mats shall be stored in a manner that ensures that sleeping surfaces are not touching, or the items shall be washed and sanitized before re-use if stored in a way that sleeping surfaces are touching.

(m) All bedding shall be cleaned at least once a week and more frequently if soiled, and between uses by different children.

(n) Programs shall provide children who attend for more than 5 hours with an opportunity for at least one hour of quiet activities, rest, or sleep, in any combination to equal one hour, depending on the needs of each child.

(o) Programs shall allow children time to fall asleep and awaken at their own pace within a block of time set aside as nap or rest time.

(p) Programs shall provide children who do not fall asleep after 30 minutes with an opportunity to do a quiet activity.

(q) Child care staff shall not:

(1) Require that children who are awake stay on mats, sleeping bags, cots, or beds for more than 60 minutes; or

(2) Require children to sleep.

(r) For children 24 months through 5 years, during naptime, a center-based program may have one less staff person in a classroom than required to meet ratios in accordance with He-C 4002.35 through He-C 4002.36 provided that:

(1) The total number of child care staff required to maintain all ratios are on the premises of the program;

(2) The ratio of awake children to staff in the classroom shall be no more than half the number of children as stated in He-C 4002.35 through He-C 4002.36;

(3) Rooms in which staff is reduced shall be equipped with a two-way communication system to allow for immediate contact with other staff for assistance and response;

(4) There is a safety plan on file for review by the department, child care staff, and parents or guardians which includes plans or procedures for:

a. Evacuation;

b. Supervision;

c. Environment;

d. Schedule;

e. Naptime policy; and

f. Staff training and support;

(5) The program provides parents or guardians with written notice of the reduction of staff; and

(6) Documentation of the written notice in (5) above shall be available for review by department staff during visits.

(s) During rest and sleep, programs shall always maintain ratios for children under 24 months, in accordance with He-C 4002.35 and 4002.36, except as specified in (t) below.

(t) Ratios for children under 24 months in mixed age groups with children 24 months and older shall be based on the average age of the children in each group during naptime, in accordance with (s) above.

(u) Programs shall base the staff to child ratio on the average age of the children in each group in accordance with (t) above when there are mixed age groups in the same room.

(v) No child shall wear a necklace during nap time or during sleep, unless the necklace is fused or has a fixed knot such that it cannot be removed.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.28); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.22); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.26)

He-C 4002.26 Water Testing and Sewage Disposal.

(a) Programs shall have a safe supply of water under pressure available for drinking and household use.

(b) Hot water shall be at least 85 degrees Fahrenheit and available at all indoor sinks during operating hours.

(c) Hot water at taps which are accessible to children shall have an automatic control to maintain a temperature at the tap of not higher than 120 degrees Fahrenheit.

(d) Programs that have their own independent water supply and are not considered to be public water systems as defined in RSA 485:1-a, XV and confirmed by the New Hampshire department of environmental services (NHDES), shall test their water supply utilizing a laboratory accredited under the environmental laboratory accreditation program in accordance with Env-C 300.

(e) New applicants that have their own independent water supply shall submit with their application documentation of water test results completed not more than 90 days prior to the date of submission of the application for arsenic, bacteria, nitrate, nitrite, lead, both stagnant and flushed, copper, both stagnant and flushed, fluoride, uranium, radon, manganese, and PFAS.

(f) In addition to (d) and (e) above, programs that have their own independent water supply shall conduct ongoing water testing and maintain the results on file at the program, available for review by the health officer and the department, in accordance with the following:

(1) Once every 3 months for bacteria;

(2) Annually for arsenic, nitrate, and nitrite; and

(3) At least once every 3 years for stagnant lead, stagnant copper, fluoride, and manganese.

(g) The results of water tests required by (e) and (f) above, and results of any other water tests, shall comply with the maximum contaminant levels established in Env-Dw 700 for bacteria, nitrates, nitrites, arsenic, and fluoride, and shall not exceed the action levels established in Env-Dw 714 for stagnant copper and RSA 485:17-a for stagnant lead, and when the manganese level exceeds 0.3 mg/L, as established in Env-Or 602.03, Table 600-1, alternate water sources shall be used for infants.

(h) Any program whose water test result has exceeded maximum contaminant levels or action levels in (g) above shall immediately contact the department to report that finding and provide the department with a plan for how it will ensure that children will not be at risk from exposure to the unsafe water.

(i) Within 30 days of the date a program learns that they have failed a water test, including programs on a public water system and programs with their own independent water supply, the program shall submit to the department an acceptable corrective action plan which details what action will be taken to correct the unsafe condition of the water and a date by which that action will be complete, unless the program requests, either verbally or in writing, and the department agrees, to extend that deadline.

(j) The department shall extend the deadline in (i) above if it determines that the program can demonstrate that it has made a good faith effort to develop and submit the corrective action plan within the 30-day period but has been unable to do so, and that the health, safety, or well-being of children will not be jeopardized by granting the extension.

(k) When a program fails to submit a written proposed corrective action plan within 30 days of receiving the unacceptable test result under (g) above, the department shall initiate action to suspend the license or permit in accordance with He-C 4002.43(r) and (s), until such time as laboratory results meeting those requirements are received by the department.

(l) During all hours of operation there shall be functional sewage disposal facilities.

(m) There shall be flush toilets in working order connected to a sewage disposal system.

(n) Any program whose septic system is showing signs of failure shall immediately contact the department and the local health officer to inform them of the problem and provide an interim corrective action plan to include a timeline for repairs and how it will ensure that children will not be exposed to any risks from the failed septic system.

(o) Privies shall be permissible in lieu of, or in addition to flush toilets connected to a sewage disposal system, provided the privy complies with this section.

(p) The licensee shall obtain approval by the town health officer for use of a privy.

(q) The privy shall be constructed in accordance with Env-Wq 1022.01.

(r) There shall be running water for handwashing available and accessible inside the privy area or immediately upon exiting the privy.

(s) The contents of the pit shall be covered daily with lime or other suitable agent to eliminate insects and odors.

(t) The materials for liming and disinfection shall be kept in proximity to the privy where they are readily available for use and stored in a manner where children cannot access the contents.

(u) The privy and the pit shall be made fly-tight and provided with self-closing lids.

(v) Child care staff shall maintain the privy in clean and sanitary conditions at all times.

(w)  The licensee shall maintain chemical toilets in accordance with Env-Wq 1600, which shall be pumped by a septage hauler licensed by the department of environmental services.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.29); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.27)

He-C 4002.27 Bathroom Requirements.

(a) Prior to use, the local health officer or designee and the department shall approve portable sinks intended for use to meet any of the requirements of He-C 4002.

(b) Toilet facilities shall afford privacy appropriate to the child’s development and ability.

(c) Staff shall be able to hear children and respond when children need assistance and to prevent unsafe behavior.

(d) Programs licensed to care for children younger than 3 years of age shall provide potty chairs or adult toilets with adapters.

(e) Program staff shall place potty chairs within easy access to a toilet and sink to allow child care staff to proceed to the toilet to empty the potty chair and proceed to the hand washing sink without having to open doors or gates or have physical contact with other children.

(f) Programs staff shall not place potty chairs in food preparation areas or food service areas. 

(g) Program staff shall empty and sanitize each potty receptacle after each use.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.30); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.28)

He-C 4002.28 Diapering and Toilet Learning.

(a) Programs serving diapered children and children who are not toilet trained shall have a diaper changing area, which shall be located adjacent to or in close proximity to a designated hand washing sink to allow access for hand washing without having to open doors or gates or have physical contact with other children.

(b) Children in diapers shall be changed on a non-porous, washable surface, used exclusively for diaper changing and sanitized after each diaper change.

(c) A covered, hand-free receptacle, lined with a plastic bag, shall be located within reach of the diaper changing area for disposal of soiled disposable diapers and cleansing articles.

(d) The diaper changing area shall not be in kitchens or in food preparation or food service areas, or on surfaces where food is prepared or served.

(e) In addition to the requirements in (a) through (d) above, in center-based programs the diaper changing area shall be:

(1) Located in the room where the children in diapers are cared for; and

(2) Equipped with a sink adjacent to or near the diaper changing area designated exclusively for adult and child hand washing after diaper changing or toileting.

(f) Programs shall not use a sink for hand washing after diapering or toileting if food preparation or washing dishes or eating utensils occurs in the sink.

(g) At least every 2 hours, child care staff shall check diapers or clothing to determine if they are soiled or wet, and change them if they are.

(h) During each diaper change, soiled areas of children shall be washed with single use cleansing articles such as baby wipes or soft paper towels that have been moistened with water.

(i) If an elevated diaper changing surface is used, child care staff shall remain at the elevated diaper changing surface and keep one hand on the child at all times while a child is on it.

(j) For each child there shall be a supply of clean diapers, clothing, and bedding for use as needed.

(k) Programs shall obtain written instructions from the parent or guardian for the use of non-disposable diapers, which shall include instructions for the sanitary handling, storage, and return of soiled diapers to the parent or guardian.

(l) Soiled disposable diapers and cleansing articles shall immediately be placed in a plastic bag lined, hands-free receptacle.

(m) The plastic bag containing the soiled diapers and cleansing articles shall be removed daily, securely closed, and placed outside in covered garbage cans for collection or removal at regular intervals.

(n) Covered hands-free receptacles used to dispose of diapers and cleansing articles shall be cleaned and sanitized at least once each day.

(o) Programs using a commercial diaper service shall handle soiled diapers in accordance with written instructions from the service, with a copy of the instructions available on site for review by the department upon request.

(p) Toilet learning shall be individualized, developmentally appropriate, conducted in accordance with a plan developed by each child’s parents or guardians and child care staff, and never forced.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.31); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.28); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.29)

He-C 4002.29 Handwashing.

(a) Child care staff shall wash their hands with liquid soap and running water as needed and:

(1) After each diaper change or toileting;

(2) After handling any bodily fluid;

(3) After cleaning up or handling the garbage;

(4) After playing outdoors;

(5) Before and after eating;

(6) Before and after administering medication; and

(7) Before and during any food preparation or service as often as necessary to remove soil and contamination and prevent cross contamination when changing tasks or from raw to ready to eat foods.

(b) Child care staff shall:

(1) Teach children the importance of hand washing with liquid soap and running water; and

(2) Instruct, encourage, remind, or assist infants and children as needed throughout each day to wash their hands as necessary to comply with (a)(1) through (5) above. 

(c) Sinks that are used for food preparation or clean up, including sinks used for getting water for baby bottles, rinsing bottles, or dishes, and washing toys, shall not be used for brushing teeth, hand washing after toileting, or diaper changing.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-97; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.26); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.30)

He-C 4002.30 Nutrition, Food Service, and Food Safety.

(a) Child care staff shall assure that all food and drink served to children is:

(1) Safe for human consumption and free of spoilage or other contamination;

(2) Stored, prepared, and served in a manner consistent with safe food handling practices for the prevention of food borne illnesses, including those set forth in He-P 2300; and

(3) Stored in a way to protect it from dust, insects, rodents, overhead leakage, unnecessary handling, and all other sources of contamination.

(b) Meals and snacks provided by programs shall meet US Department of Agriculture dietary allowances.

(c) Child care staff shall assure that no more than 3 hours elapse between meals and snacks offered to the children.

(d) Child care staff shall:

(1) Follow individual feeding schedules provided by the parent or guardian of each child who has not reached a developmental level which enables them to eat on schedule; and

(2) Comply with dietary restrictions as requested in writing by the parents or guardians of each child, due to food allergies, religious, or philosophical beliefs.

(e) Child care staff familiar with children’s allergy action plans and known allergens shall take steps to ensure that children are not served or exposed to the known allergens.

(f) Child care staff shall not serve foods that can cause a choking hazard to children younger than 3 years of age or to children who have been identified as having chewing and swallowing difficulties.

(g) In programs serving infants and toddlers, child care staff shall:

(1) Follow individual feeding schedules provided by the parent or guardian of each child who has not reached a developmental level, which enables them to eat on schedule;

(2) Not introduce new or solid foods to any child without the consent of their parent(s) or guardian(s), and as appropriate based upon their chewing and swallowing capability;

(3) Hold infants younger than 6 months of age or who are unable to sit in feeding chairs while being fed;

(4) Not hold more than one infant at a time to bottle-feed them;

(5) Not prop bottles; and

(6) Not feed infants or children while in a crib, or while on rest mats, beds, cots, or sleeping bags.

(h) Child care staff shall dispose of, or return to the parent or guardian, milk, formula, or food unfinished by a child, as directed by the parent or guardian.

(i) Breast milk and prepared formula shall be stored in covered containers, labeled with the child’s name and dated.

(j) Breast milk shall be:

(1) Used immediately or stored in the refrigerator no longer than 4 days;

(2) Labeled as used and returned to the refrigerator after each feeding if there is any left-over in the bottle, if being returned to the parent or guardian; and

(3) Not fed to the child if left unrefrigerated for more than 2 hours.

(k) Prepared formula shall be:

(1) Used immediately or stored in the refrigerator no longer than 24 hours;

(2) Discarded if not fed to an infant and left unrefrigerated for more than one hour; and

(3) Discarded after each feeding, if there is any leftover in the bottle.

(l) Frozen breast milk shall be labeled and dated and stored in a freezer at 0 degrees Fahrenheit for no longer than 6 months.

(m) Thawed breast milk shall be used within 24 hours.

(n) Child care staff shall gently swirl the bottle of formula or breast milk to recombine the contents after warming by:

(1) Holding under warm running water;

(2) Placing in a container of lukewarm water; or

(3) A waterless warmer.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.22); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.31)

He-C 4002.31 Field Trips, Water Activities, and Transportation.

(a) Programs that opt to allow child care staff to take children on routine or unplanned local trips, such as walks in the neighborhood, trips to the local library, or other routine errands, shall obtain a signed and dated general permission slip from each child’s parent or guardian, which specifies all approved destinations and activities.

(b) Child care staff who take the children off the premises for trips under (a) above shall call parents or guardians or post a notice at the program, informing parents or guardians of the destination and route of any unplanned trips, and the estimated time of return to the program.

(c) The program manager shall obtain a signed and dated permission slip from each child’s parents or guardians prior to allowing a child to participate in any water activities on or off the premises of the program, or any field trip off the premises of the program.

(d) The permission slip required in (c) above shall be retained by the program and available for review by the department for a minimum of 2 years after the date of the last water activity or field trip covered by the permission slip, and include:

(1) For water activities, the date(s) and destination(s) covered by the permission slip, whether the child can swim, and the child’s comfort level in or near water; and

(2) For all other field trips, the date(s), destination(s), and activities covered by the permission slip.

(e) Whenever the program provides transportation, it shall ensure that:

(1) Any vehicle used for transportation of children is legally registered and inspected in accordance with the laws of the state where the owner of the vehicle resides;

(2) The vehicle is maintained in a safe operating condition, and is clean and free of obstructions on the floors and seats;

(3) The operator of any vehicle transporting children is at least 18 years old and holds a valid driver’s license;

(4) The driver and any other attendants in the vehicle have received training in the safe transportation of children;

(5) The driver of the vehicle is alert and not distracted; and

(6) The driver of the vehicle takes attendance before and after each trip and conducts a complete vehicle inspection after every trip to ensure that no child is left alone in a vehicle at any time.

(f) Child care staff shall not permit any child to remain in any vehicle unattended by staff of the child care program.

(g) Any vehicle used to transport children, whether owned by the program, a child care staff member, or by a parent or guardian who is transporting children other than their own, shall have proof of current liability insurance.

(h) Child care staff shall ensure:

(1) The number of children riding in any vehicle does not exceed the number of persons the vehicle is designed to carry;

(2) Individual, age-appropriate child restraints or seat belts are provided for and used by each child in accordance with RSA 265:107-a, and the driver and any other adults shall use their seatbelts when transporting children; and

(3) All children remain seated when the vehicle is in operation.

(i) Child care staff shall carry on all field trips:

(1) A copy of each child’s registration and emergency information forms;

(2) A first aid kit in the vehicle whenever children are present;

(3) A copy of the parental or guardian permission slip for the field trip;

(4) A record documenting that staff accounted for each child every time they entered or exited the vehicle;

(5) All emergency and currently prescribed child medications, as applicable; and

(6) In each vehicle, a form that includes the program name, address, and phone number.

(j) There shall be a working cell phone or other mechanism for making emergency telephone calls available in each vehicle during transport.

(k) All swimming pools and wading pools on the premises of the child care program and used as part of the child care operations shall be supervised in accordance with the following:

(1) Child care staff shall supervise children at all times when they have access to wading pools that have water in them;

(2) Child care staff shall not allow children inside the wading pool, swimming pool area, or in the swimming pool without adult supervision; and

(3) There shall be at least one staff person who is currently certified in CPR and who has completed a water safety training within the previous 3 years always present with the children during any water activity, and whenever children have access to swimming pools or other bodies of water.

(l) When children are engaged in water activities, an adult who reports that they know how to swim shall always be present with children.

(m) Child care staff who are responsible for children engaged in water activities shall be able and willing to immediately respond to any child in the water who needs assistance.

(n) Lifeguards, swimming instructors, and similar individuals not employed by the program shall not be considered as staff to meet required staff to child ratios and supervision unless they are responsible only for the children participating in the field trip.

(o) The program manager shall maintain staff to child ratios and minimum staffing requirements during routine daily transportation and other routine trips such as walks in the neighborhood and trips to the local library.

(p) Center-based programs shall staff water activities in accordance with the following:

(1) For children ages 24 to 35 months the maximum group size shall be 8 children, with a ratio of one staff to 2 children;

(2) For children ages 36 to 47 months the maximum group size shall be 12 children, with a ratio of one staff to 4 children;

(3) For children ages 48 to 59 months the maximum group size shall be 18 children, with a ratio of one staff to 6 children; and

(4) For children ages 56 months and older, if licensed as a school age program, the maximum group size shall be 24 children, with a ratio of one staff to 8 children.

(q) Center-based programs shall staff field trips in accordance with the following:

(1) For children 18 months and younger the maximum group size shall be 6 children, and the ratio shall be one staff to 3 children;

(2) For children ages 19 to 35 months the maximum group size shall be 12 children, with a ratio of one staff to 4 children;

(3) For children ages 36 to 47 months the maximum group size shall be 18 children, with a ratio of one staff to 6 children;

(4) For children ages 48 to 59 months the maximum group size shall be 20 children, with a ratio of one staff to 8 children; and

(5) For children ages 56 months and older, if licensed as a school age program, the maximum group size shall be 24 children, with a ratio of one staff to 10 children.

(r) At least one child care staff or volunteer with each group of children in (p) and (q) above shall be 21 years of age or meet the qualification requirements to be alone with children.

(s) In a center-based program, the staff to child ratio and maximum group size for a mixed age group of children participating in any field trip or water activity shall be based on the age of the youngest child in the group.

(t) Center-based programs may exceed the maximum group size specified in (p) above for water activities, and (q) above for all other field trips only:

(1) During transportation to the field trip or water activity;

(2) At snack or mealtimes during the field trip or water activity; and

(3) During water activities where certified lifeguards or water safety instructors are present and exclusively supervising the water activities of the children in care of the program.

(u) In a family or family group child care home and small child care centers, for all water activities on or off the premises of the program, child care staff shall comply with the staffing requirements specified in He-C 4002.33, and the minimum staff to child ratios and staffing levels as follows:

(1) There shall be one staff member for every 2 children, 35 months and younger, and the staff assigned to this age group shall be responsible only for the children in this age group; and

(2) For children ages 3 years and older, the ratio shall be determined by the age of the youngest child in the group as follows:

a. If the youngest child is 3 years old, there shall be one staff member for every 4 children;

b. If the youngest child is 4 years old , there shall be one staff member for every 6 children; and

c. If the youngest child is 5 years of age or older, there shall be one staff member for every 8 children.

(v) Child care staff who meet the requirements of at least a group leader in a school-age program, associate teacher in all other center-based programs as specified in He-C 4002.34, or child care worker in family based programs or small child care centers as specified in He-C 4002.33 shall be designated as in charge and present during any water activity or field trip.

(w) All child care staff participating in any water activity or field trip shall be aware of the identity of the person designated in charge.

(x) At least one staff person who has successfully completed a basic water safety course within 1 year prior to the water activity shall be present during any water activity for every 12 children.

(y) Except during swimming activities conducted by a qualified swim instructor, a person certified in water safety and rescue, or a lifeguard, child care staff shall prohibit each child who cannot swim from going into water that reaches higher than their knees.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.29); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.32)

He-C 4002.32 Professional Development.

(a) In addition to program managers, all child care staff who are responsible for the supervision of children, or who are necessary for the staff to child ratios, shall have on file documentation of completion of training in accordance with (b) below, which shall:

(1) Be completed within 90 days of the first date of employment;

(2) Be completed within 2 weeks for programs operating 3 months of the year or less; or

(3) If completed prior to employment, provide documentation of previous completion.

(b) The training required in (a) above shall include:

(1) Child care licensing orientation;

(2) Prevention and control of infectious diseases, including immunization requirements, exemptions, and grace periods as referenced in He-C 4002.10;

(3) Prevention of SIDS and use of safe sleep practices, if the program is licensed for infants 12 months and younger;

(4) Medication administration;

(5) Prevention of and response to emergencies due to food and other allergic reactions;

(6) Building and safety of physical premises, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic;

(7) Prevention of shaken baby syndrome and abusive head trauma;

(8) Emergency preparedness and response planning, including training on all required components in the emergency operations plan as specified in He-C 4002.16;

(9) Handling and storage of hazardous materials and the appropriate disposal of bio-contaminants;

(10) Appropriate precautions in transporting children for child care staff who will provide transportation or accompany children during transportation;

(11) Pediatric first aid and pediatric CPR;

(12) Prevention, recognition, and reporting of child abuse and neglect; and

(13) Child development, including cognitive, physical, social, and emotional development, and approaches to learning.

(c) In addition to the training required in (b) above, child care staff shall:

(1) Complete training on prevention of SIDS and use of safe sleep practices and prevention of shaken baby syndrome and abusive head trauma prior to working with infants 12 months and younger;

(2) Complete training on appropriate precautions in transporting children prior to transporting or accompanying children during transportation; and

(3) Complete training on medication administration prior to administering medication to children.

(d) Child care staff who have not yet completed the training in (1) through (3) below shall work under the direct supervision and observation of a staff member who has completed the following trainings:

(1) Prevention, recognition, and reporting of child abuse and neglect;

(2) Prevention of shaken baby syndrome and abusive head trauma; and

(3) Pediatric first aid and pediatric CPR.

(e) The program manager and all child care staff shall complete 12 hours of professional development within their first 12 months of hire, and annually thereafter, in accordance with the following:

(1) A minimum of 3 hours shall be in health and safety topics listed in (b)(2)-(13) above; and

(2) The remaining 9 hours shall be in any other areas listed in (o) below.

(f) Beginning on the employee’s start date, the employee shall complete the equivalent of one hour of professional development per month for the remainder of the calendar year, which may include the training in health and safety topics listed in (b)(2)-(13) above.

(g) Assistant teachers, associate teachers, group leaders, assistant group leaders, child care workers, and child care assistants shall be exempt from (e) above, if they work fewer than 25 hours per week year-round or more than 25 hours per week during school vacations, or both, for the same licensee.

(h) The child care staff exempt in (g) above shall instead obtain 8 hours of professional development annually, of which a minimum of 3 hours shall be in any of the health and safety areas listed in (b)(2)-(13) above, and the remaining hours shall be in any areas in (o) below.

(i) Child care staff attending high school or college full time shall obtain 3 hours of professional development in health and safety areas listed in (b)(2)-(13) above annually. 

(j) Full time college attendance shall mean enrolled in a minimum of 12 credit hours per semester.

(k) All substitutes and any volunteer who works alone with children or is counted in staff-to-child ratios shall complete the health and safety trainings as required by (b) above and 3 hours of annual professional development in health and safety areas listed in (b)(2)-(13).

(l) Professional development shall include trainings, workshops, technical assistance, self-study, or college courses.

(m) Self-study projects shall:

(1) Not exceed 4 of the required 12 hours of professional development; and

(2) Not be utilized to obtain the professional development in health and safety requirements in (b)(2)-(13) above.

(n) Self-study projects referenced in (m) above shall:

(1) Be based on current research in child development or early childhood;

(2) Demonstrate developmentally appropriate practice;

(3) Support the knowledge and skills needed to care for young children; and

(4) Be documented and include an evaluation component.

(o) In addition to (b) above, professional development shall be in any of the following areas:

(1) Health and safety;

(2) Caring for children with exceptionalities;

(3) Nutrition;

(4) Any child care related courses sponsored or funded by the department;

(5) Indoor and outdoor learning environments;

(6) Behavior guidance;

(7) Leadership, child care administration, or mentoring;

(8) Financial management;

(9) Working with families; or

(10) Legal issues in child care.

(p) The department shall accept the following toward meeting in-service professional development requirements:

(1) Credit courses offered by a regionally accredited college or university with one credit equal to 12 hours;

(2) Non-credit courses offered for continuing education units by an accredited college or university;

(3) Conference sessions, workshops, or technical assistance presented by an individual who meets one of the following criteria:

a. Is credentialed by the department’s bureau of child development and head start collaboration, NH early childhood professional development system in accordance with RSA 170-E:50;

b. Has at least a bachelor’s degree in the subject area which they are providing professional development;

c. Meets the minimum qualifications for the position of center director;

d. Holds a professional license or certification through a professional organization relevant to the subject area which they are providing professional development; or

e. Is employed or was previously employed in a position such as a trainer, instructor, or consultant by an organization specializing in one of the areas referenced in (o) above in which they are providing professional development;

(4) Provision of training or technical assistance developed and presented live, in real time, or via live remote learning by an employee of the program or an individual hired by the program shall be in accordance with the following:

a. The training is conducted when the trainees are not responsible for children;

b. Except for classroom observations, technical assistance is provided when the subject(s) of the technical assistance are not responsible for children; and

c. Information regarding credentials of the individual, their methods, content and objective, dates and times of trainings or technical assistance, and a list of participants is on file at the program and available for review by the department to assist the department in determining that:

1. The individual meets the requirements specified in (3)a. through e. above; and

2. The training or technical assistance is designed to increase the knowledge or skills of an individual to prepare them to work with children more effectively in a program; and

(5) Online training and correspondence courses, provided documentation of completion includes:

a. The title of the training;

b. The completion date;

c. The hours awarded; and

d. A description which indicates the training is designed to increase the knowledge or skills of an individual to prepare them to work with children more effectively in a program.

(q) Unless otherwise specified on the training certificate or course description for more or fewer hours, training hours for certification in first aid shall count as 2 hours and training for certification in CPR shall count as 3 hours towards annual professional development requirements.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.33); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.30); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.33)

He-C 4002.33 Family Child Care Programs, Family Group Child Care Programs, and Small Child Care Centers.

(a) Family and family group child care homes and small child care centers shall comply with He-C 4002.01 through He-C 4002.32 and this section.

(b) Family child care shall:

(1) Only be provided in a dwelling that provides complete independent living facilities for one or more persons, including permanent provisions for living, sleeping, eating, cooking, and sanitation and occupied for living purposes on a full-time basis by the family child care provider; or

(2) Be located:

a. Physically on the same property as the family child care provider’s permanent residence and such residence is a single family home;

b. In a duplex structure containing 2 independent side-by-side dwelling units and the family child care provider permanently resides in the other dwelling unit located in the duplex; or

c. In a structure with a maximum of 3 stories, with no more than one dwelling unit located on each floor level, and the family child care provider permanently resides in one of the other dwelling units located in the 3 story structure.

(c) A small group child care center shall operate in a location that is not the residence of the licensee, and shall not provide care for more than 12 children.

(d) A family child care provider shall not hold more than one family child care license.

(e) To qualify as a family child care provider or a child care manager of a small child care center, an individual shall be:

(1) At least 21 years of age; or 

(2) At least 18 years of age and submit with their application documentation that they have a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC), and at least one of the following:

a. Successful completion of a 2-year child care curriculum approved by the department of education; or

b. College courses, totaling 6 credits, in child development or human growth and development, early childhood, or elementary education, or other field of study focused on children, including at least one 3-credit course in child growth and development, awarded by an accredited college or university.

(f) A child care worker shall be 18 years of age or older.

(g) A child care assistant, whether paid or volunteer, shall:

(1) Be 16 years of age or older; and

(2) Work under the direct observation and supervision of the family child care provider, a child care manager, or a child care worker at all times.

(h) Family child care providers or small child care centers may employ substitute staff who meet the age requirements of the staff position for whom they are substituting and assume the responsibilities of any child care staff on an emergency or temporary basis for not more than 90 consecutive days and not more than a maximum of 120 days in a 12-month period.

(i) Family child care providers, child care workers, and child care managers shall complete professional development requirements in accordance with He-C 4002.32.

(j) Documentation of professional development requirements shall be maintained at the program and available for review by the department.

(k) A junior helper in any family child care program or a small child care center, whether paid or volunteer, shall:

(1) Be at least 14 years of age;

(2) Work with children only under the direct supervision and observation of a staff person who meets at least the minimum qualification of a child care worker;

(3) Not be calculated in staff to child ratios as specified in (m) through (p) below; and

(4) Not be required to complete professional development hours as specified in He-C 4002.32.

(l) The license capacity for family or family group child care homes shall include the provider’s own, foster, and resident children up to 6 years of age, when they are present.

(m) A family child provider, family group child care provider, child care manager, or a child care worker who is working alone shall not care for more than 6 children plus 3 school-age children during hours when school is not in session, provided that:

(1) Of the 6 children, no more than 4 children are younger than 36 months of age; and

(2) Of the 6 children, no more than 2 children are younger than 24 months of age.

(n) A family child care provider plus a child care worker or child care assistant shall not care for more than 6 children plus 3 school-age children when school is not in session. Of the 6 children, no more than 4 shall be younger than 36 months of age.

(o) A family group child care provider plus a child care worker or child care assistant shall not care for more than 12 children plus 5 school-age children when school is not in session. Of the 12 children, no more than 4 children shall be younger than 36 months of age.

Source. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16,; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.31); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.34)

He-C 4002.34 Requirements for Child Care Staff in Center-Based Programs.

(a) All center-based programs, other than those operating solely as a school-age program, shall have a center director who meets the following conditions:

(1) The center director or qualified substitute director shall be on the premises or readily available for at least 60% of each day’s daytime operating hours; and

(2) Programs operating as a night care program, the center director, qualified substitute director, or lead teacher shall be on the premises or readily available for at least 60% of the program’s evening and nighttime operating hours.

(b) School-age programs shall have a site director who meets the following conditions:

(1) For school-age programs operating 5 or fewer hours per day, a site director or qualified substitute director shall be on the premises during all operating hours;

(2) For school-age programs operating more than 5 hours per day a site director or qualified substitute director shall be on the premises or readily available for at least 60% of each day’s daytime operating hours; or

(3) For school-age programs with a site coordinator assigned, a group leader who is at least 20 years of age shall be on the premises during all operating hours.

(c) Center directors, agency administrators, site coordinators, and site directors shall:

(1) Be responsible for the daily operation of the program and ensure the program’s compliance with He-C 4002; and

(2) Designate a staff person who meets at least the minimum qualifications of group leader in school-age programs who is at least 18 years old and associate teacher in all other center-based programs, in accordance with this section, who will be in charge and assume the responsibilities of the center director or site director in their absence.

(d) With the exception of programs operating only as a school age program, there shall be at least one lead teacher on the premises during all operating hours, and one out of every 6 child care staff who are required to be on the premises in order to meet minimum staff to child ratios shall meet the minimum qualifications of a lead teacher.

(e) The only exception to (d) above shall be for the first and last hour of a center-based program operating more than 5 hours per day, provided an associate teacher as described in (l) below is on the premises.

(f) Center-based programs that wish to apply for or have a single license for multiple buildings at the same address in accordance with He-C 4002.02(d), and which choose not to have a center director in each building shall designate a staff person who qualifies as a lead teacher to be in charge in each building without a center director, who reports to the center director.

(g) School age programs that wish to apply for or have a single license for multiple buildings at the same address in accordance with He-C 4002.02(d), and which choose not to have a site director in each building shall designate a staff person who qualifies as a group leader to be in charge in each building without a site director, who reports to the site director.

(h) The center director, agency administrator, site coordinator, site director, or their designee shall have available for review at the program for all child care staff, documentation to verify that the person qualifies for their position in accordance with this section.

(i) Center-based programs may employ substitute staff for up to 120 consecutive days for the same position only if the individuals meet the age requirements of the staff position for whom they are substituting.

(j) A center director in a center-based program shall:

(1) Be at least 21 years of age;

(2) Have a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC);

(3) Have 3 credits in management or supervision, awarded by an accredited college or university, a minimum of 2 years’ experience in a supervisory or management position in lieu of the 3 credits in management and supervision, or a written plan for completion of 3 credits in management or supervision from an accredited college or university;

(4) Have a minimum of 1500 hours experience working with children in a licensed child care program or public or private elementary school; and

(5) Have one of the following:

a. A minimum of an associate’s degree awarded by an accredited college or university in related coursework;

b. An additional 3000 hours of experience working with children in a licensed child care program or in a public or private elementary school and documentation of a non-expired child development associates (CDA) in center-based programs awarded by the council for professional recognition;

c. Current certification in early childhood, elementary, or special education by the department of education;

d. Certification in a teacher preparation program accredited by the Montessori Accreditation Council for Teacher Education (MACTE) in infant and toddler, early childhood or elementary I;

e. Documentation of 60 credits, awarded by an accredited college or university, of which at least 24 shall be in related coursework, including at least 3 credits in each of the following core knowledge areas:

1. Children with special needs;

2. Child growth and development or human growth and development; and

3. Curriculum for early childhood education; or

f. Documentation from or on file with the department that the individual working as the center director qualified for and was employed in the position of center director on or before November 6, 2017, with no break in employment as the center director since receipt of the approval.

(k) A lead teacher in a center-based program shall have a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC), be at least 18 years old, and have one of the following:

(1) A minimum of 18 credits in related coursework, awarded by an accredited college or university, including at least 3 credits in child or human growth and development, plus a minimum of 1000 hours experience working with children in a licensed child care program or public or private elementary school;

(2) A minimum of 12 credits in related coursework, awarded by an accredited college or university, plus 3000 hours experience working with children in licensed child care program or public or private elementary school;

(3) Documentation of a non-expired child development associates (CDA) in center-based programs awarded by the council for professional recognition;

(4) A credential from a teacher preparation program accredited by MACTE;

(5) Five years as a licensed family child care provider with no enforcement actions imposed by the department;

(6) Successful completion of the New Hampshire Early Childhood Apprenticeship Program;

(7) A minimum of 1000 hours of supervised child care experience in a licensed child care program, documentation of successful completion of a 2-year vocational course in career and technical education with an additional 9 credits in related coursework;

(8) Documentation from or on file with the department that the individual working as a lead teacher qualified for and was employed in the position of lead teacher on or before November 6, 2017, with no break in employment as a lead teacher; or

(9) At least 3 credits in child or human growth and development, plus a minimum of 4,500 hours of documented experience as an associate teacher for the same licensee, and with a letter from the center director stating that the individual has demonstrated the skills necessary to be a lead teacher.

(l) An associate teacher in a center-based program shall be at least 18 years old, have a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC), and have one of the following options:

(1) Written documentation from or on file with the department that the individual working as an associate teacher qualified for and was employed in the position of an associate teacher on or before November 6, 2017, with no break in service as an associate teacher since receipt of the approval;

(2) A minimum of 9 credits in related coursework, awarded by an accredited college or university, including at least one 3 credit course in child or human growth and development;

(3) Certification as para II educator by the department of education and 1000 hours of experience in a public or private school, including experience with children up to age 8;

(4) A minimum of 1000 hours of supervised child care experience in a licensed child care program, and knowledge of child growth and development obtained through one of the following:

a. Completion of a high school level 2-year career and technical education course in teacher education;

b. A 3-credit course in child or human growth and development, awarded by an accredited college or university; or

c. Thirty hours of training in child growth and development, granted by an accredited college or university, an authorized provider of the International Association for Continuing Education and Training or obtained through documented life experience, including experience with the same age children the associate teacher supervises, such as a family child care provider, service as a foster parent, work as a school teacher, work as a camp counselor and experience as a group leader for children in sports or other activities, such as scouts or little league, or closely related experience; or

(5) At least one 3 credit course in child or human growth and development plus 3 years as a licensed family child care provider or as the child care manager of a small child care center.

(m) Assistant teachers in a center-based program, whether paid or volunteer, shall:

(1) Be at least 15 years of age; and

(2) Work with children only under the direct supervision and observation of a staff person who meets at least the minimum qualifications of an associate teacher.

(n) Notwithstanding (m)(2) above, assistant teachers shall only be alone with a child or group of children if the following conditions are met:

(1) The center director has approved the specific assistant teacher to do this, with approval documented in the employee’s file;

(2) The employee has been deemed eligible to work pursuant to RSA 170-E:7, III;

(3) The employee has at least 3 months of experience at the program;

(4) The employee has completed the required trainings pursuant to He-C 4002.32(a); and

(5) The specific activities that the assistant teacher may be alone with children include:

a. Walking children:

1. To or from a bathroom;

2. To or from receiving first aid treatment;

3. To or from a bus stop; and

4. From one classroom or area to another within the licensed premises;

b. Supervising an ill child while waiting for pick-up by a parent or guardian;

c. Supervising a group of children for up to 5 minutes when other child care staff leave the classroom to do a task that cannot be completed by the assistant teacher;

d. Supervising any children that might otherwise be without direct staff supervision pursuant to He-C 4002.19; or

e. Covering staff breaks or curriculum planning time for no more than one hour per classroom or group, provided the assistant teacher is at least 18 years old and has a high school diploma or equivalent.

(o) A junior helper in any center-based program, whether paid or volunteer, shall:

(1) Be at least 12 years of age;

(2) Work with children only under the direct supervision and observation of a staff person who meets at least the minimum qualification of an associate teacher;

(3) Not be calculated in staff to child ratios as specified in He-C 4002.35 through He-C 4002.37 and He-C 4002.39; and

(4) Not be required to complete professional development hours as specified in He-C 4002.32.

(p) A site director or a site coordinator in a school-age program shall be at least 20 years of age, have a high school diploma or equivalent, including but not limited to General Equivalency Diploma (GED), a High School Equivalency Test (HiSet), or a Test Assessing Secondary Completion (TASC), and have at least one of the following:

(1) Written documentation from or on file with the department that they were qualified and employed as a site director in a school-age program on or before the effective date of these rules in 2022;

(2) A minimum of an associate’s degree awarded by an accredited college or university in related coursework;

(3) Certification of successful completion of training as a recreation director plus 1000 hours experience working with children in a licensed child care program, recreation program or a public or private elementary school;

(4) A total of 12 credits in child development, education, recreation, or related coursework, awarded by an accredited college or university, plus 1000 hours of experience working with children;

(5) Certification as an educator by the department of education; or

(6) Experience working with children totaling 2000 hours and:

a. Certification as a para II educator by the department of education; or

b. Both of the following:

1. Documentation of enrollment in a course for at least 3 credits in child development, education, recreation, or related coursework, through an accredited college or university and a written plan on file for completion of at least 3 additional credits as specified; and

2. Within 12 months of the date the individual begins working as a site director, documentation of successful completion of at least 6 credits as specified in b.1. shall be on file for review by the department.

(q) A group leader in a school-age program shall be at least 17 years of age, and have one of the following:

(1) Experience working with school-age children, totaling 600 hours;

(2) Documentation of at least 3 credits in child development, education, recreation, or related coursework, awarded by an accredited college or university;

(3) Documentation that they are a certified coach;

(4) Documentation of 5 years of parenting experience; or

(5) Documentation from or on file with the department that they were qualified and employed as a group leader in a school-age program on or before the adoption of these rules in 2022.

(r) An assistant group leader in a school-age program, whether paid or volunteer, shall:

(1) Be at least 15 years of age; and

(2) Work with children only when under the direct supervision and observation of a site director or group leader as described in this section.

(s) A project leader in a school-age program shall:

(1) Be at least 15 years of age;

(2) Be recommended by a school or established youth-related organization or agency;

(3) Have a written plan for their project; and

(4) Not be required to complete in-service professional development hours as specified in He-C 4002.32.

(t) Site directors in programs with a project leader shall:

(1) Inform the project leader of program policies and child care licensing rules;

(2) Require child care staff to observe or check on the project leader every 20 minutes;

(3) Supervise, or require that the group leader supervise, the project leader; and

(4) Have a consent form on file for review by the department that is signed by the parent or guardian of each child participating in an activity with a project leader.

(u) Project leaders shall not be calculated in staff to child ratios as specified in He-C 4002.38.

Source. #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.32); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.35)

He-C 4002.35 Group Child Care Centers.

(a) Group child care centers shall comply with He-C 4002.01 through He-C 4002.32, He-C 4002.34, and this section, unless otherwise specified.

(b) Programs shall staff group child care centers with at least one associate or lead teacher per group.

(c) For children ages 36 months up to 47 months, the maximum group size shall be 24 with one teacher for every 8 children.

(d) For children ages 48 months up to 59 months, the maximum group size shall be 24 with one teacher for every 12 children.

(e) For children ages 60 months and over, the maximum group size shall be 30 with one teacher for every 15 children.

(f) A second staff person shall be in the building when 11 or more children are present.

(g) Group child care centers shall base the staff to child ratio and group size on the average age of the children in the group when there are mixed ages in the same group.

(h) When the average age of children is younger than 36 months, group child care centers shall comply with staff to child ratios and requirements specified in He-C 4002.36.

Source. #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.33); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.36)

He-C 4002.36 Infant and Toddler Program.

(a) Infant and toddler programs shall comply with He-C 4002.01 through He-C 4002.32, He-C 4002.34, He-C 4002.40 through He-C 4002.44, and this section, unless otherwise specified.

(b) Programs shall staff infant and toddler programs with at least one associate or lead teacher per group.

(c) For children ages 6 weeks up to 12 months, the maximum group size shall be 12 with one teacher for every 4 children.

(d) For children ages 12 months up to 24 months, the maximum group size shall be 15 with one teacher for every 5 children.

(e) For children ages 24 months up to 36 months, the maximum group size shall be 18 with one teacher for every 6 children.

(f) Notwithstanding (c) through (e) above, a second staff person shall be in the building when 5 or more children are present.

(g) In addition to the staffing requirements under (b) through (e) above, programs licensed as infant and toddler programs shall base the staff to child ratio and group size on the average age of the children in each group when there are mixed age groups in the same room.

Source. #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08; ss by #9310, eff 11-23-08 (formerly He-C 4002.38); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.34); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.37)

He-C 4002.37 Preschool Programs.

(a) Preschool programs shall comply with He-C 4002.01 through He-C 4002.32, He-C 4002.34, He-C 4002.40 through He-C 4002.44, and this section.

(b) Preschool programs shall meet the staff to child ratio requirements specified in He-C 4002.35(b) through (g), as applicable.

(c) Preschool programs shall, in accordance with RSA 170-E:2, IV(f), operate 5 or fewer hours per day.

Source. #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.35); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.38)

He-C 4002.38 School-Age Programs.

(a) School-age programs shall comply with He-C 4002.01 through He-C 4002.32, He-C 4002.34, He-C 4002.40 through He-C 4002.44, and this section, unless otherwise specified.

(b) All school age programs shall be exempt from He-C 4002.08(b) only regarding recording birth dates on attendance records.

(c) School-age programs that operate in a building which currently house a public or private school shall:

(1) Identify and protect children from hazards such as vehicular traffic with direct supervision if the environment does not provide adequate protection; and

(2) Be exempt from modifying the environment to comply with He-C 4002.

(d) Programs that serve only children attending part day public kindergarten or full-day public school, or which have rooms used exclusively by kindergarten or school age children, shall be exempt from:

(1) He-C 4002.22(a)(2) regarding unprotected outlets only;

(2) He-C 4002.22(b) regarding access to sharp objects and hand sanitizer, provided the hand sanitizer is used by children under staff supervision;

(3) He-C 4002.22(d) regarding non-toxic materials labeled “keep out of reach of children”; and

(4) He-C 4002.22(e) regarding long cords and strings.

(e) In lieu of He-C 4002.25(n), school-age programs operating for more than 5 hours per day shall provide children with an opportunity for at least 30 minutes of quiet activities, rest, or relaxation.

(f) Programs shall staff school age programs with at least one group leader per group.

(g) The maximum group size shall be 45 with one staff for every 15 children.

(h) In addition to the staffing requirements in (f) above, programs licensed as school-age programs shall have a second staff person in the building when 13 or more children are present.

(i) School-age programs that hold combination licenses with multiple program types shall provide separate space for the school-age children during the hours of operation of the school-age program when 9 or more school age children are present.

(j) When 8 or fewer school-age children are present, programs shall have the option to combine school-age children with children 4 years of age and older.

(k) Programs shall have and maintain on file for review by parents or guardians and the department a written schedule of daily activities that ensures that the curriculum includes:

(1) Opportunities for children to help in planning their own activities;

(2) Time for structured and unstructured play, both indoors and outdoors;

(3) Opportunities for active and quiet activities; and

(4) Opportunities for individual and group experiences, both child-initiated and staff directed.

Source. #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08; ss by #9310, eff 11-23-08; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.36); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.39)

He-C 4002.39 Night Care Program.

(a) Any program which intends to provide child care services during the evening or night time hours, between 7:00 PM and 5:00 AM shall be licensed to operate as a night care program.

(b) Center-based night care programs shall comply with He-C 4002.01 through He-C 4002.32, He-C 4002.34, He-C 4002.40 through He-C 4002.44, and the requirements applicable to the specific program type(s) for which they are licensed as well as the requirements in this section.

(c) Night care programs operating in private homes shall comply with all of the requirements for family and family group child care homes but shall not be required to comply with the requirements specified in He-C 4002.34.

(d) Child care staff shall not allow children attending a night care program to remain in the program for more than a total of 13 hours in any 24-hour period, except in an emergency, or situations when the parents or guardians are working over 13 hours during a 24-hour period, or parents or guardians are deployed during the weekend by the military.

(e) Child care staff shall schedule activities in night care programs that address the basic and individual needs of children, including but not limited to relaxation, meals, play, and sleep.

(f) Child care staff shall provide for privacy appropriate to the developmental needs and ages of children while allowing for age-appropriate supervision of each child for bathing and toileting, and for sleeping if staff are not in the same room or are using an electronic monitor to check on the sleeping children.

(g) Child care staff shall provide each child in a night care program with clean bedding and a bed or crib with a mattress, a cot, or sleeping bag on a rest mat.

(h) Child care staff shall make sleeping arrangements that ensure that children who stay all night are not disturbed by the departure or arrival of those who stay only a portion of the night.

(i) Child care staff shall be awake during operating hours.

Source. #7294, eff 5-26-00; ss by #9160, INTERIM, eff
5-26-08; ss by #9310, eff 11-23-08 (formerly He-C 4002.38); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.37); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.40)

He-C 4002.40 Background Checks and Determination of Eligibility.

(a) Background record checks shall be completed in accordance with this section.

(b) The following individuals shall complete and submit for a background record check using the NHCIS portal, “New Background Record Check” (August 2025) prior to employment or residency, as applicable, and every 5 years thereafter:

(1) Child care staff;

(2) Substitutes;

(3) Other employees;

(4) Volunteers who might be alone with children or are included in staff to child ratios; and

(5) Household members 18 years of age and older, or when turning 18 years of age.

(c) By submitting for a background check in NHICS as required in (b) above, each individual certifies at submission:

“a) All information provided above is accurate.

b) I have not been charged pending disposition or convicted of a felony consisting of murder, child abuse or neglect, crimes against children (including pornography and trafficking), spousal abuse, rape or sexual assault, kidnapping, arson, physical assault or battery, or a drug related offense (in the last 5 years) or any other violent or sexually related charge or misdemeanor against a child, including child abuse, child endangerment, sexual assault, or a misdemeanor involving child sexual abuse images, or a crime which shows that I might be reasonably expected to pose a threat to a child, such as violent crime or sexually related crime against an adult.”

(d) The background record check shall be completed in accordance with RSA 170-E:7, unless exempted from this requirement as permitted under RSA 170-E:7, II-a.

(e) Pursuant to RSA 170-E:7, IV-b, individuals exempt in accordance with (d) above shall have on file at the program, a statement from the individual stating since the day the individual’s background check was completed, that they have not been convicted of any crimes as specified in RSA 170-E:7, III and IV, and have not had a finding by the department or any administrative agency in this or any other state for abuse, neglect, or exploitation.

(f) For all household members between 13 through 17 years of age, the program shall submit to the unit a completed and notarized “Staff and Household Member Form” (August 2025), certifying the following:

“a) All information provided above is accurate.

b) I have not been charged pending disposition or convicted of a felony consisting of murder, child abuse or neglect, crimes against children (including pornography and trafficking), spousal abuse, rape or sexual assault, kidnapping, arson, physical assault or battery, or a drug related offense (in the last 5 years) or any other violent or sexually related charge or misdemeanor against a child including child abuse, child endangerment, sexual assault, or a misdemeanor involving child sexual abuse images, or a crime which shows that I might be reasonably expected to pose a threat to a child, such as violent crime or sexually related crime against an adult.”

(g) The form required in (f) above shall be submitted:

(1) With the initial licensing application in accordance with He-C 4002.02(e)(5);

(2) When a household member reaches 13 years of age; and

(3) When an individual between 13 through 17 years of age becomes a household member.

(h) The unit shall determine the individual’s eligibility in accordance with RSA 170-E:7, III and IV and notify the program and individual within 45 days of submission of all required information as required in this section and RSA170-E:7.

(i) Individuals required to complete background record checks as specified in (b) above may be on the premises for orientation or training activities but shall not interact with children until the program receives notice of eligibility from the unit.

(j) When the unit receives the results of the fingerprint-based criminal background check for an individual that does not include any disqualifying information as described in RSA 170-E:7, III and IV, it shall notify the program that the individual may be present in the program, provided the individual is never alone with children and always under the direct supervision and observation of a staff member whom the unit has deemed eligible. This direct supervision and observation shall continue until the unit receives all results from the background check required in RSA 170-E:7 and notifies the program and individual as described in (h) above.

(k) When the department determines that an individual is ineligible to work in child care, in accordance with RSA 170-E:7, III or IV, it shall provide notice to the individual that includes:

(1) The department’s determination of ineligibility;

(2) The basis for the determination; and

(3) The individual’s right to challenge their criminal record pursuant to Saf-C 5703.12.

(l) When the department determines that an individual is ineligible to work in child care, in accordance with RSA 170-E:7, III or IV, it shall provide notice to the child care program that:

(1) The department determined the individual to be ineligible to work in child care; and

(2) The program shall take immediate action to prohibit the individual from being on the premises of the child care program and from having access to the children enrolled in the program.

(m) The child care program shall inform the department in writing within 2 business days of receipt of the notice in (k) above of the specific action it has taken as required under (l)(2) above.

(n) The program manager shall update the staff roster in the NHCIS portal within 5 business days when the individuals as described in (b) above are no longer working in the program or part of the household, with the date they left the program.

(o) The program manager shall notify the department immediately when they learn of any charges or convictions of an individual after the individual’s determination of eligibility.

(p) The department shall require the individual to complete additional background checks when the department needs additional information to determine if the individual’s eligibility must be rescinded per RSA 170-E:7, IV-a, with notification provided per (k) and (l) above.

Source. #13373, eff 4-22-22; ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.41)

He-C 4002.41 Complaints and Investigations.

(a) In accordance with RSA 170-E:17, II, the department shall respond to any complaint that meets at least one of the following conditions:

(1) The alleged non-compliance(s) occurred within 6 months of the date of the allegation(s);

(2) The complaint includes the complainant’s first-hand knowledge regarding the allegation(s) or on information reported directly to the complainant by a child who has first-hand knowledge regarding the allegation(s);

(3) There is sufficient specific information for the department to determine that the allegation(s), if proven to be true, would constitute non-compliance of any of the provisions of RSA 170-E or He-C 4002; or

(4) The complaint is from any source and alleges non-compliance that occurred at any time if the complaint alleges:

a. Physical injury or abuse;

b. Verbal or emotional abuse; or

c. The danger of physical injury to one or more children.

(b) When the complaint is determined to be substantiated, a statement of findings shall be issued to the program listing the citations found resulting from the investigation and any additional citations found.

(c) When the complaint is determined to be unfounded, the department shall send a notice to the program advising that the complaint was unfounded.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.08); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (from He-C 4002.07); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.42)

He-C 4002.42 Confidentiality.

(a) Any information collected by the department pursuant to RSA 170-E:7 regarding criminal conviction records or founded cases of child abuse or neglect, which results in a department determination that the individual being investigated is ineligible to work with children, shall be kept confidential by the department, with the following exceptions:

(1) The program in which the individual is employed shall be notified that the individual has been determined to be ineligible to work with children, in accordance with the provisions of RSA 170-E:7, III, or RSA 170-E:7, IV, so that the program can take corrective action; and

(2) If a statement of findings is issued regarding the employment or presence in the program of an individual covered under (1) above, it shall not include the name of that individual on the statement of findings and shall only specify that the individual was determined by the department to be ineligible to work with children.

(b) The department shall keep confidential information collected during the application process and any records in its possession regarding the admission, progress, health, and discharge of children, with the following exceptions:

(1) Upon receipt of:

a. A written request from the applicant, licensee, or their designated legal representative, the department shall release to the requester, information obtained during the application process; and

b. Upon receipt of a written authorization to release information, signed by the applicant or licensee, or in the case of personal information, signed by the individual who is the subject of the information, the department, shall release any information collected during the application process; or

(2) During an administrative proceeding against the applicant or licensee.

(c) The department shall release information to law enforcement agencies or in an administrative proceeding against the applicant or licensee. Otherwise, the department shall keep confidential any information collected during an investigation, unless it receives an order to release, destroy, or take any action relating to the information from a court of competent jurisdiction.

(d) Applicants, licensees, and all child care staff shall keep confidential all records required by the department pertaining to the admission, progress, health, and discharge of children under their care and all information learned about children and their families.

(e) Child care staff shall:

(1) Allow the department access to all records that programs are required by department rule or state statute to keep, and to such records as necessary for the department to determine staffing patterns and staff attendance; and

(2) Release information regarding a specific child only as directed by a parent or guardian of that child, or upon receipt of written authorization to release such information, signed by that child’s parent or guardian.

(f) In addition to the confidentiality requirements in (d) above, child care staff shall discuss or share information regarding the admission, progress, behavior, health, or discharge of a child with the child’s parent(s) or guardian(s) in a manner that protects and maintains confidentiality for both the child and the child’s parent(s) or guardian(s).

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08: 11-22-08; ss by #9310, eff 11-23-08 (from He-C 4002.08); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.08); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.43)

He-C 4002.43 Enforcement Action and Right to Appeal.

(a) Pursuant to RSA 170-E:11, IV through VI, the department shall consider the following enforcement actions in response to non-compliance with licensing rules and laws:

(1) Assessment of administrative fines;

(2) Placement of conditions on a permit or license;

(3) Suspension of a permit or license;

(4) Denial of an application for a new or renewed license; or

(5) Revocation of a permit or license.

(b) The department shall place conditions on a license or permit when it determines that the applicant or licensee is in violation of any of the provisions of RSA 170-E or any rule, and it determines that placement of those conditions shall:

(1) Protect the health, safety, or well-being of children;

(2) Assist the applicant or licensee to achieve and maintain compliance with licensing rules or statute; or

(3) Assist the applicant or licensee to avoid suspension, revocation, or denial of their license or permit.

(c) When the department intends to place conditions on a license or permit, it shall send to the applicant or licensee a notice setting forth:

(1) The reason(s) for the intended action;

(2) The specific condition(s) the department intends to place on the license or permit;

(3) The effective date(s) of the proposed conditions;

(4) Notice that, once the department places conditions on the license or permit, failure to comply with those conditions shall constitute failure to comply with the provisions of license; and

(5) Information about the right to request an administrative hearing by submitting a written request for an administrative hearing to the commissioner no later than 10 calendar days from the date of receipt of the notice.

(d) The conditions placed in accordance with (b) above:

(1) Shall be determined by the department, based on the single or combination of options specified that will best address the specific issue or problem; and

(2) Shall include, but not be limited to:

a. Prohibiting a licensee from enrolling any additional children in a program;

b. Reducing the license capacity or the number of children for whom a licensee is authorized to care in a specific component of a program;

c. Requiring an individual to obtain additional education other than that required for their position, or to complete additional in-service professional development activities, in excess of the annual requirement as specified under He-C 4002.32 in order to prepare them to more effectively work with children or assist them in achieving and maintaining compliance with He-C 4002;

d. Requiring an applicant or licensee to hire additional staff on a temporary or permanent basis;

e. Prohibiting a licensee from applying for an increase in the license capacity, or any addition of new program types to an existing license or permit, until they achieve and maintain compliance with He-C 4002;

f. Prohibiting an applicant or licensee from applying for additional child care program licenses; or

g. Requiring the licensee to replace the center director, site director, or site coordinator.

(e) The department’s decision to place conditions on a license or permit shall become final when:

(1) The applicant or licensee does not request an administrative hearing as specified in (c)(5) above; or

(2) The department’s decision to place conditions on the license or permit is upheld after an administrative hearing.

(f) The placement of conditions on a license or permit shall not prohibit the department from enforcing any conditions or any other enforcement action available to it under He-C 4002 or RSA 170-E.

(g) When the department places conditions on a license or permit, the department shall issue a revised license or permit reflecting the conditions imposed.

(h) Upon receipt of notice of the department’s intent to place conditions on a license, the applicant or licensee receiving the notice shall immediately provide the department with evidence that the program notified all the parents or guardians of enrolled children of the conditions imposed on the license by the department.

(i) When a program has met the conditions placed on the license and has maintained compliance with all licensing rules and statutes related to the conditions for a period of one year or the period reflected on the license or permit, whichever is greater, the department shall:

(1) Provide written notice to the licensee of the department's intention to rescind the conditions; and

(2) Issue a revised license or permit.

(j) The department shall revoke a permit or license or deny an application for a new license, license renewal, or license revision in accordance with RSA 170-E:12 if:

(1) The applicant or licensee fails to provide or does not meet the requirements of He-C 4002.02;

(2) The applicant or licensee refuses to submit or adhere to an agreement or corrective action plan which ensures that an individual determined ineligible for employment or as a household member is removed from employment or from the household and will not have access to the children in care during the operating hours of the program;

(3) The applicant or licensee has endangered, or continues to endanger one or more children, or otherwise caused one or more children to be physically or mentally injured;

(4) The applicant or licensee has a:

a. Finding of abuse, neglect, or exploitation of any person;

b. Conviction of child endangerment, fraud, or a felony against a person in this or any other state by a court of law;

c. Conviction of any crime as referenced in RSA 170-E:7, III or IV; or

d. Complaint investigation for abuse, neglect, or exploitation substantiated by the department or in any other state;

(5) The applicant, licensee, or any representative or employee thereof knowingly provides false or misleading information to the department, including but not limited to information on the application or in the application attachments;

(6) The applicant, licensee, or any representative or employee thereof fails to cooperate with any inspection by the department or fails to submit any records or reports required by the department;

(7) The applicant or licensee has demonstrated a history or pattern of multiple or repeat citations of RSA 170-E or He-C 4002, that pose or have posed a threat to the safety of a child or children;

(8) The applicant or licensee fails to submit an acceptable corrective action plan or fully implement and continue to comply with a corrective action plan approved by the department in accordance with He-C 4002.06(f) through (i);

(9) The applicant or licensee fails to pay a fine assessed by the department as specified in He-C 4002.44; or

(10) The applicant or licensee fails to implement and comply with conditions placed on a license by the department as specified in He-C 4002.44(g).

(k) If the department revokes a license or permit, or if a license or permit has expired due to the program’s failure to submit a timely application for renewal in accordance with He-C 4002, the program shall discontinue operations immediately.

(l) The department shall notify applicants or licensees of a decision of the department to deny, revoke, or suspend a license of their right to an administrative hearing in accordance with RSA 170-E:13.

(m) If an applicant or licensee fails to request an administrative hearing in writing within 10 days of the receipt of the notice required by RSA 170-E:13, I, the action of the department shall become final.

(n) Administrative hearings under this section shall be conducted in accordance with RSA 170-E:13 and 14, RSA 541-A, and He-C 200.

(o) Further appeals of department decisions under this section shall be governed by RSA 170-E:14.

(p) Any licensee who has been notified of the department’s intent to revoke or suspend a license or deny an application for license renewal may continue to operate during the appeal process except as specified in (q) below.

(q) When the department includes in its notice of revocation or suspension an order of immediate closure, pursuant to RSA 170-E:13, III, or RSA 541-A:30, III, the program shall immediately terminate its operation and not operate while an administrative hearing is pending except under court order or as provided by RSA 541-A:30, III.

(r) The department shall initiate suspension of a license or permit rather than revocation when it determines that:

(1) The program does not have a history of repeat citations of licensing rules or statute and the action is based on non-compliance or a situation that is:

a. Related to a correctable environmental health or safety issue, including but not limited to a problem with a program’s water supply, septic system, heating system, or structure; and

b. Documented by the program as being temporary in nature; or

(2) The action is for one of the following for an applicant or licensee, and is under appeal:

a. A criminal conviction; or

b. A finding by the division for children, youth, and families, of child abuse, neglect, or endangerment.

(s) Any suspension of a license or permit for which an administrative hearing has not been requested or any suspension of a license that has been upheld by an administrative hearing shall remain in effect until the department notifies the program whose license or permit was suspended that the suspension has been removed because:

(1) The non-compliance which resulted in the suspension is corrected; or

(2) The suspension was the result of loss of fire or health officer approval, and the local fire or health officer has reinstated their approval.

(t) Upon receipt of notice of the department’s intent to revoke, suspend, deny, or refuse to issue or renew a license or permit, the applicant or licensee shall immediately provide the department with a list of the names, addresses, including email addresses, and phone numbers of the parents or guardians of enrolled children and staff employed by the program.

(u) Based upon information provided under (t) above, the department shall notify the parents or guardians of children currently enrolled in the program, and staff employed by the program that the department has initiated action to revoke or suspend the license or deny an application for a license renewal.

(v) When a program is allowed to continue operating pending appeal as provided in (p) above, the program shall provide the suspension or revocation notice to any new families prior to enrollment of their child or children or prospective staff prior to offer of employment.

(w) The department shall send a notice equivalent to the notice specified in (u) above to the following entities:

(1) The health officer and fire inspector serving the town in which the program is located;

(2) The organization or entity who provides resource and referral services, pursuant to RSA 171-E:5-a; and

(3) The state office of the United States Department of Agriculture, food and nutrition service, child and adult care food program.

(x) A program manager shall be ineligible to reapply for a license, employment as a center director, site director, site coordinator, or be a family child care provider, or hold any corporate office or controlling interest in any licensed program after revocation of a license or denial of an application.

(y) The period of ineligibility in (x) above shall be at least 5 years from:

(1) The date the decision to revoke or deny becomes final; or

(2) The date an order is issued upholding the action of the department if an administrative hearing was requested.

(z) When an individual enters into an administrative agreement with the department to surrender a license or withdraw an application that exceeds the 5 years in (y) above, this administrative agreement shall supersede the rule.

(aa) The department shall accept an application from an individual or consider an individual to be eligible to be employed as an agency administrator after the 5 year period specified in (y) above only when it determines that the individual has, through education, training, or experience, acquired the knowledge and skills, and has the resources necessary to operate or direct a child care program in compliance with licensing rules and statute.

(ab) Prior to the passage of 5 years, the department shall consider a request by the individual to be employed as an agency administrator for another applicant or licensee, or to become an applicant for a license, only under the following circumstances:

(1) The revocation or denial was based on the agency administrator’s inability to correct the non-compliance due to the applicant or licensee’s refusal or inability to correct; and

(2) The agency administrator employed by the applicant or licensee whose license was revoked or application was denied shows that circumstances have substantially changed such that the department now has a good cause to believe that they have the requisite degree of knowledge, skills, and resources necessary to maintain compliance with the provisions of RSA 170-E and He-C 4002.

(ac) Notwithstanding (aa) above, the department shall consider an application submitted after the decision to revoke or deny becomes final, but before the expiration of the 5 years referenced in (y) above, provided revocation or denial was the result of non-compliance with RSA 170-E:4, II, RSA 170-E:12, I, RSA 170-E:12, V, RSA 170-E:12, VI, RSA 170-E:12, VII, RSA 170-E:12, VIII, and RSA 170-E:12, XI, and only under the following circumstances:

(1) The denial or revocation was based on the applicant or licensee’s inability or failure to correct non-compliance caused by a temporary condition which has been corrected; or

(2) The licensee or applicant who was denied an initial application shows that circumstances have substantially changed such that the department now has a good cause to believe that the applicant has the requisite degree of knowledge, skills, and resources necessary to maintain compliance with the provisions of RSA 170-E and He-C 4002.

(ad) No ongoing enforcement action shall preclude the imposition of any remedy available to the department under RSA 170-E, RSA 541-A, He-C 4002, or other law.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.10); ss by #9605, eff 11-26-09; ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.09); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.44)

He-C 4002.44 Administrative Fines.

(a) The department shall assess administrative fines in accordance with RSA 170-E:11, VI and VII, and RSA 170-E:21-a.

(b) The department shall send a notice of intent to assess a fine by certified mail and email, or by hand delivery to any person, applicant, or licensee.

(c) The written notice required under (b) above shall include:

(1) The amount of the fine, the citation(s), and dates, if applicable, for which the fine is being assessed;

(2) Information regarding the right to request an administrative hearing, including the name, address, phone number, and email of the hearings unit, and deadline by which to request a hearing;

(3) Information about the option of reducing any assessed fine by 25% by submitting to the department, no later than 10 days from receipt of the notice, payment of the reduced fine, and a written statement waiving the right to request an administrative hearing regarding the fine, signed by the applicant or licensee; and

(4) The name of a contact person within the office of legal and regulatory services, bureau of facility licensing and certification.

(d) If the applicant or licensee does not request an administrative hearing as specified in (c)(2) above, the department’s decision to assess a fine shall become final after the 10-day period specified in (c)(3) above and the fine shall be paid to the department no later than 10 days from that date.

(e) When an administrative hearing is conducted and the department’s decision to assess a fine is upheld, the fine shall be due and payable within 10 days of the date of the hearing officer's decision.

(f) The assessment of fines shall not prohibit the department from enforcing any conditions or any other enforcement action available to it under He-C 4002 or RSA 170-E.

(g) The department shall assess fines in accordance with the following:

(1) For failure to comply with the provisions of a license or permit, in violation of He-C 4002.05(a)(1), the fine shall be $200.00, plus $100.00 per day for each day for which the department has evidence that the program continues to fail to comply with the provisions of a license or permit, in violation of He-C 4002.05(a), after receipt of written notice of non-compliance from the department;

(2) For a repeat citation for failure to comply with the provisions of a license or permit, in violation of He-C 4002.05(a)(1), the fine shall be $500.00, plus $100.00 for each day for which the department has evidence that the program continues to fail to comply with the provisions of a license or permit, in violation of He-C 4002.05(a), after receipt of written notice of non-compliance from the department;

(3) For operating a child care program without a license or permit, in violation of RSA 170-E:4, I, the fine shall be $500.00, plus $100.00 per day for each day for which the department has evidence that the program continues to operate, in violation of RSA 170-E:4, I;

(4) For continuing to operate a child care program after voluntarily closing, or for continuing to operate under an expired license after failing to submit a timely renewal application, in violation of RSA 170-E:4, I, the fine shall be $1,000.00, plus $100.00 per day for each day for which the department has evidence that the program continues to operate, in violation of RSA 170-E:4, I;

(5) For continuing to operate a child care program after suspension, revocation, or denial of a license or permit, in violation of RSA 170-E, I, the fine shall be $2,000.00, plus $500.00 per day for each day for which the department has evidence that the former licensee continues to operate a child care program in violation of RSA 170-E:4, I;

(6) For failure to submit any requested reports or failing to make available any records required by the department for investigation, monitoring, or licensing purposes in violation of He-C 4002.05(k), (l), (m)(4), or (n), the fine shall be $500.00, per offense, plus $100.00 per day, per offense, for each day for which the department does not receive the requested documents;

(7) For making false or misleading statements, either verbal or written, to the department, or for directing, requiring, or knowingly allowing any child care staff to make false or misleading statements to the department, or falsifying any documents, other written information, or reports issued by or required by the department, in violation of He-C 4002.05(o), the fine shall be $1000.00 per offense;

(8) For failure by the applicant, licensee, or by any child care staff at the direction of or on behalf of the applicant, licensee, center director, or site director, to cooperate during any visit authorized under RSA 170-E or He-C 4002, in violation of He-C 4002.05(o) the fine shall be $1000.00;

(9) For failure to submit a corrective action plan, in violation of He-C 4002.06(g), the fine shall be $200.00;

(10) For failure to implement or maintain the corrective action set forth in any corrective action plan that has been accepted or issued by the department, in violation of He-C 4002.06(k), the fine shall be as follows:

a. If the same non-compliance is cited within 2 years of the original citation, the fine shall be $250.00; and

b. If the same non-compliance is cited a third time within 2 years of being fined in a. above for the original citation, the fine shall be $500.00;

(11) For failure to supervise each child in care, in violation of He-C 4002.19(a), the fine shall be $750.00;

(12) For abusing or neglecting a child or children, or failing to protect a child or children from abuse or neglect by any individual when the licensee, or program manager, either knew or should have known about the abuse or neglect, in violation of He-C 4002.17(e)(1) and (f), the fine shall be $1000.00;

(13) For using corporal punishment, or failing to protect children from corporal punishment in the child care program by any child care staff, household member, or other individual, when the licensee, or program manager either knew or should have known about the corporal punishment, in violation of He-C 4002.17(e)(4) and (f), the fine shall be $1000.00;

(14) For using prohibited discipline practices, or failing to protect children from prohibited discipline practices when the licensee, or program manager either knew or should have known about the prohibited discipline practices or mistreatment, in violation of He-C 4002.17(e)(2) and (f), the fine shall be $500.00;

(15) For employing an agency administrator, center director, child care manager, site coordinator, or site director, who does not meet the qualifications for the position, in violation of He-C 4002.34(j) and (p) respectively, under circumstances where the department has not granted a waiver in accordance with He-C 4002.04, the fine shall be $500.00;

(16) For failure to complete the criminal background check process, in violation of RSA 170-E:7 and He-C 4002.40, the fine shall be $500.00, plus $100.00 per day when the non-compliance is not corrected and the employee, household member, or other individual continues to work in the program without having completed the criminal background check process;

(17) For non-compliance of any statute or any rule which results in endangering one or more children, in violation of RSA 170-E:4, II, the fine shall be $1000.00 for each citation, plus $200.00 per day for each day for which the department has evidence that the non-compliance continues after receipt of written notice of non-compliance from the department;

(18) For a repeat citation of any rule not specified in (g)(3) through (17) above, the fine shall be $200.00;

(19) When an inspection results in a determination that non-compliance of RSA 170-E or He-C 4002 is a repeat citation of any of the rules specified in (g)(3) through (18) above, the fine shall be twice the amount as the original fine assessed, not including any applicable daily rates;

(20) For the purposes of (g)(18) and (19) above, each incident of non-compliance shall constitute a separate citation subject to a separate fine;

(21) For non-compliance of any statute, or rule which results in physical injury to one or more children, or places one or more children in jeopardy of physical harm, the department shall assess a fine of $2,000.00 for each non-compliance, plus $500.00 per day that the non-compliance exists; and

(22) Each day that the individual or licensee continues to be in violation of the provisions of RSA 170-E or He-C 4002 shall constitute a separate violation and shall be subject to fines in accordance with He-C 4002.44 provided that if the applicant or licensee is making good faith efforts to comply with the provisions of RSA 170-E or He-C 4002, as verified by documentation or other means, the department shall not issue a daily fine.

Source. #2664, eff 3-30-84, EXPIRED 3-30-90

New. #4871, eff 7-24-90; ss by #5203, eff 8-16-91; ss by #6558, INTERIM, eff 8-16-97, EXPIRED: 12-14-97

New. #6719, eff 3-25-98; ss by #7294, eff 5-26-00; ss by #9160, INTERIM, eff 5-26-08; ss by #9310, eff 11-23-08 (from He-C 4002.11); ss by #12046, INTERIM, eff 11-19-16; ss by #12174, EMERGENCY RULE, eff 5-17-17; ss by #12415, eff 11-6-17; ss by #13373, eff 4-22-22 (formerly He-C 4002.10); ss by #14356, eff 9-22-25, EXPIRES: 9-22-35 (formerly He-C 4002.45)

PART He-C 4003 YOUTH RECREATION CAMPS

He-C 4003.01 Purpose. The purpose of this part is to set forth minimum standards for housing, health, safety, and sanitary conditions for children attending youth recreation camps (YRC) in New Hampshire (NH).

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.02 Applicability.

(a) All persons, corporations, trusts, authorities, government agencies, political subdivisions, or any other entities shall comply with the requirements of He-C 4003 to operate a YRC in NH.

(b) The definitions in He-C 4003.03 shall apply throughout this part.

(c) The rules in He-C 4003 shall apply to:

-

(1) All YRCs as defined herein; and

(2) Any organization or program exempt from licensing under RSA 170-E:3, I, that chooses to apply for and obtain a license under these rules.

(d) Except as provided in (c)(2), the rules in He-C 4003.03 through He-C 4003.43 shall not apply to:

(1) Any child day care agency as defined in RSA 170-E:2, IV; or

(2) Places, entities, and programs exempt from licensing under RSA 170-E:3, I.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.03 Definitions.

(a) “Activity leader” means an individual volunteering for or contracted with the YRC to oversee a specific activity, the purpose of which is to teach a skill, such as horseback riding, archery, or a craft.

(b) “Applicant” means an individual, agency, partnership, corporation, government entity, association, or other legal entity seeking a license to operate a YRC pursuant to RSA 170-E.

(c) “Authorized staff” means a licensed practitioner or YRC staff with the authority to administer medication to campers as specified in He-C 4003.40.

(d) “Camp administrator” means the individual responsible for the operation and management of a YRC.

(e) “Camp director” means the individual in charge of the day-to-day operations of a YRC while in session, and who may be the same individual as the camp administrator.

(f) “Camp facilities” means all the structures at a YRC, whether temporary or permanent, used by YRC staff or campers for sleeping, eating, personal hygiene, recreation, instruction, health care, or camp management, or any combination thereof.

(g) “Camper” means any youth enrolled in a YRC.

(h) “Camper with a disability” means a camper who, for any physical, psychological, or developmental reason, has one or more counselors assigned to work specifically with them.

(i) “Certified as an emergency medical responder” means certified as an emergency medical responder:

(1) By the United States Department of Transportation (USDOT); or

(2) Through a different nationally recognized course whose standards are no less stringent than the certification standards of the USDOT.

(j) “Certified in first aid and CPR” means certified in adult and pediatric first aid, and cardiopulmonary resuscitation (CPR):

(1) By the American Red Cross; or

(2) Through a different nationally recognized course whose standards are no less stringent than the certification standards of the American Red Cross.

(k) “Certified in wilderness and remote first aid” means certified in wilderness and remote first aid:

(1) By the American Red Cross; or

(2) Through a different nationally recognized course whose standards are no less stringent than the certification standards of the American Red Cross.

(l) “Communicable disease” means “communicable disease” as defined in RSA 141-C:2, VI.

(m) “Counselor” means an individual who is responsible for the direct supervision of campers and the supervision and training of counselors-in-training or junior counselors, or both.

(n) “Counselor-in-training (CIT)” means an individual who works directly with campers only under the supervision of a counselor.

(o) “Corrective action plan” means a written proposal setting forth the procedures by which a YRC will come into compliance with the requirements set by rules adopted by the commissioner under RSA 541-A, and subject to the approval of the unit. Corrective action plans include the time needed to assure compliance and the steps proposed by the YRC to reach compliance.

(p) “Day” means calendar day unless otherwise specified.

(q) “Day camp” means a YRC that operates for less than 24 hours per day.

(r) “Department” means the department of health and human services.

(s) “Emergency medical services” means “emergency medical services” as defined in RSA 153-A:2, VI.

(t) “Infirmary” means the area designated at a YRC for on-site medical care of campers and YRC staff.

(u) “In operation” means campers are in attendance at a YRC.

(v) “Junior counselor (JC)” means an individual who works directly with campers only under the supervision of a counselor.

(w) “Licensed practitioner” means any of the following individuals who is licensed in the state of NH:

(1) Medical doctor;

(2) Physician’s assistant;

(3) Advanced practice registered nurse (APRN);

(4) Doctor of osteopathy;

(5) Doctor of naturopathic medicine;

(6) Registered nurse (RN); or

(7) Licensed practical nurse (LPN).

(x) “Off-site overnight camping” means any venture that:

(1) Involves a recreation activity, including but not limited to hiking, climbing, biking, canoeing, horseback riding, water activities, camping, and tenting;

(2) Occurs for the duration of one night or longer; and

(3) Occurs outside of the normal sleeping quarters of the YRC.

(y) “Person” means any municipality, governmental subdivision, public or private corporation, individual, partnership, or other entity.

(zy) “Public water system (PWS)” means “public water system” as defined in RSA 485:1-a, XV.

(aa) “Recreation camp” means “recreation camp” as defined in RSA 170-E: 55, I namely, “any place set apart for recreational purposes for children. It shall not apply to group child day care cents and preschool programs as defined in RSA 170-E:2, private camps owned or leased for individual or family use, or to any camp operated for a period of less than 10 days in a year”. This term includes “youth recreation camp (YRC)”.

(ab) “Reportable disease” means a communicable disease, as defined in RSA 141-C:2, VI, required to be reported to the commissioner of the department pursuant to RSA 141-C:7 and He-P 301.02.

(ac) “Residence camp” means a YRC that operates for 4 or more consecutive 24-hour days.

(ad) “Season” means the period(s) of time in the licensing year during which a seasonal YRC plans to operate and does operate.

(ae) “Seasonal camp” means a YRC that is not a year-round camp.

(af) “Serious injury” means an injury that requires outside emergency medical treatment or hospitalization.

(ag) “State fire code” means “state fire code” as defined in RSA 153:1, VI-a.

(ah) “Statement of findings” means a written report issued by the unit which details the findings of a visit or an investigation conducted by the unit.

(ai) “Unit” means the child care licensing unit within the department of health and human services.

(aj) “Year-round camp” means a YRC that operates during each calendar quarter of the year.

(ak) “Youth” means individuals who are under 18 years of age. This term includes “child”, “children”, and “minor”.

(al) “YRC owner” means the person or entity that owns and is responsible for the operation and management of a YRC.

(am) “YRC staff” means the individuals employed by, contracted with, or volunteering for a YRC, to:

(1) Manage the camp, including office personnel, managers, and kitchen and maintenance staff; and

(2) Work directly with campers, including counselors, counselors in training, junior counselors, activity leaders, instructors, and licensed practitioners.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.04 License Required.

(a) As specified in RSA 170-E:56, I:

(1) No person shall for profit or for charitable purposes operate any YRC without a license issued by the department; and

(2) The license to operate a year-round camp required by RSA 170-E:56 shall be good only for the calendar year in which it is issued.

(b) Any person or entity that is licensed as a child care program in accordance with He-C 4002, or exempt from licensure pursuant to RSA 170-E:3, I shall be exempt from licensure under He-C 4003.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.05 YRC License Application Requirements.

(a) Each applicant for a YRC license shall either apply online via the “NH Childcare Information System (NHCIS)” portal at https://new-hampshire.my.site.com/nhccis/s/login/, or submit the following information to the unit:

(1) The name of the YRC;

(2) The location where the YRC operates in NH, by street address and municipality;

(3) The name, primary mailing address, daytime telephone number, emergency telephone number, and e-mail address of the camp administrator ;

(4) Whether the YRC has operated previously in NH, and if so the following information:

a. A list showing the year(s) the YRC operated;

b. For each year, the name under which the YRC operated, if different from the name in which the current application is being made; and

c. Whether the YRC’s license has ever been suspended or revoked;

(5) The capacity of the YRC, as follows:

a. Maximum number of campers per camp session; and

b. Number of YRC staff;

(6) Whether the YRC is a seasonal camp or a year-round camp;

(7) Whether the YRC is a day camp or a residential camp;

(8) For a seasonal camp, the opening date and closing date for campers;

(9) For a seasonal camp, the camp administrator’s seasonal mailing address(es) and daytime telephone number(s) if different than their primary mailing address, or phone number as requested in (a)(3) above;

(10) Whether the camp prepares or serves food to the campers or staff;

(11) The name of each lake or river, if any, on which the YRC is located; and

(12) The address of each YRC website and social media network site, if any.

(b) In addition to the application in (a) above, the applicant shall submit to the unit the following attachments:

(1) A notarized Form 2501 “DCYF Central Registry Name Search Authorization Release of Information to Third Party” (June 2020), as described in He-C 4003.17(b)(3), for the camp administrator and camp director;

(2) The criminal history record check results of the camp administrator and camp director from each state where the camp administrator and camp director have lived, which may be done through a national database if the database includes all such states;

(3) Results of the check of the national sex offender registry for the camp administrator and the camp director;

(4) Documentation that the camp director meets the requirements specified in He-C 4003.15;

(5) The fee required by RSA 170-E:56, I, made payable to “Treasurer, State of New Hampshire”;

(6) If applicable, proof of authorization from the NH secretary of state to do business in the state of NH in the form of one of the following:

a. “Certificate of Authority,” if a corporation;

b. “Certificate of Formation,” if a limited liability corporation; or

c. “Certificate of Trade Name,” where applicable; and

(7) A YRC checklist, consisting of a list of the operating standards that apply to the YRC that shall indicate the status of the YRC’s compliance with each requirement specified in He-C 4003.13 through He-C 4003.41, as follows:

a. A status of “YES” means the YRC complies with the requirement;

b. A status of “PENDING” means the YRC does not comply with the requirement as of the application date but will be brought into compliance prior to the arrival of campers; and

c. A status of “NO” means the YRC does not currently comply with the requirement and does not have a plan to come into compliance prior to the arrival of campers.

(c) For any standard marked as “PENDING” or “NO” on the YRC checklist, the applicant shall provide a narrative explanation of the reason(s) for the non-compliance and:

(1) A brief description of the plan(s) to bring the YRC into compliance; or

(2) A request for a waiver of the requirement as specified in He-C 4003.42.

(d) The submission of the application in accordance with (a) above shall constitute that the YRC owner or designee certifies that:

(1) The information provided in and with the application is true, complete, and not misleading to their knowledge and belief; and

(2) They understand that any license granted based on false, incomplete, or misleading information shall be subject to suspension or revocation.

(e) The applicant shall file the complete application with attachments at least 60 days prior to the opening of the YRC.

(f) If the applicant for a YRC license chooses to provide the unit with a written complete application, they shall submit it to the unit at the following address:

Department of Health and Human Services

Child Care Licensing Unit

129 Pleasant Street

Concord, NH 03301-3857

(g) A license shall not be transferable to a new owner or new location.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.06 Application Processing.

(a) An application shall not be considered complete until all of the information requested in He-C 4003.05 is received by the unit.

(b) Upon receipt of an application, the unit shall review the application to determine whether the application is complete.

(c) In accordance with RSA 541-A:29, I, if the application is not complete the unit shall notify the applicant in writing no later than 30 days of receipt of the application of what is required to complete the application.

(d) Any outstanding corrective action plan, as required in He-C 4003.09(d), for identified area(s) of non-compliance with rule or statute shall be considered additional information under (c) above, and shall be required for the application to be complete.

(e) Upon notifying an applicant that the application is not complete, the unit shall suspend further processing of the application pending receipt of the information missing from the application.

(f) Pursuant to RSA 541-A:29, the unit shall approve or deny an application, petition, or request within 60 days from receipt of a complete application, petition, or request, inclusive of any additional request by the unit.

(g) The unit shall approve or deny waiver requests within 60 days of receipt of a waiver request.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.07 Approval Criteria.

(a) The unit shall approve a YRC license application for a previously licensed YRC if:

(1) The applicant submitted a complete application;

(2) The camp administrator and camp director is not on the DCYF central registry for abuse and neglect or the national sex offender registry, and the criminal record history for the camp administrator and camp director does not include any criminal conviction for any offense involving:

a. Causing or threatening direct physical injury to any individual;

b. Causing or threatening harm of any nature to any youth; or

c. Unlawfully taking property of another, whether through force or threat of force or through deception;

(3) The information supplied by the applicant shows that the YRC:

a. Is in compliance with applicable requirements specified in He-C 4003.13 through He-C 4003.41, or will be in compliance prior to campers arriving at the YRC; or

b. Is being granted a waiver of the requirement pursuant to He-C 4003.42;

(4) The YRC’s license has not been suspended or, if the license has been suspended, the condition(s) which resulted in the reason(s) for the suspension have been corrected or will be addressed as specified in (3), above; and

(5) The YRC has no outstanding non-compliances identified during an inspection conducted in accordance with this part.

(b) The unit shall approve a YRC license application for a YRC that has not previously been licensed under these rules if:

(1) The criteria specified in (a)(1)-(3) above, are met; and

(2) The pre-season inspection demonstrates compliance with He-C 4003.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-245 EXPIRES: 5-23-35

He-C 4003.08 Issuance of YRC License.

(a) If the application is approved, the department shall issue a YRC license to the applicant that contains the following information:

(1) The YRC license number as assigned by the unit;

(2) The name of the YRC owner;

(3) Citations to department statutes and rules that apply to the YRC’s operation;

(4) The name of the YRC;

(5) The location of the YRC by street and municipality;

(6) The effective date of the license; and

(7) The signature of the department’s chief legal officer, or designee.

(b) The camp administrator or camp director shall post the YRC license in a prominent place where it is visible to interested parties, such as state and local officials and parents or legal guardians of campers, the central YRC office, or where official camp notices are posted.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.09 Inspection of YRC Facilities, Statement of Findings, and Corrective Action Plans.

(a) As specified in He-C 4003.07(b)(2), unit staff shall inspect a YRC that has not previously been licensed in NH prior to the issuance of a YRC license.

(b) Unit staff shall inspect each licensed YRC, while the YRC is in operation, to determine compliance with He-C 4003.

(c) The unit shall issue a statement of findings, which identifies areas of non-compliance with He-C 4003.

(d) If the statement of findings issued pursuant to (c) above identifies one or more areas of non-compliance with He-C 4003, the camp administrator or camp director shall submit a corrective action plan within 21 days, that includes the following:

(1) The action the YRC has taken or will take to correct the area(s) of non-compliance;

(2) The steps the YRC will take to ensure compliance with these rules and the applicable statutes in the future;

(3) The date by which the YRC corrected or will correct each of the non-compliances; and

(4) The interim measures the YRC has implemented to protect the health and safety of campers, when the non-compliance cannot be corrected immediately.

(e) The corrective action plan shall not include the names of individuals.

(f) When the corrective action plan submitted to the unit by the YRC in accordance with (d) and (e) above is not acceptable for correcting the non-compliance, the unit shall issue a directed corrective action plan to the YRC.

(g) When the unit determines that there is an imminent threat to the health or safety of campers, it shall issue a directed corrective action plan to the YRC without first offering the YRC an opportunity to take corrective action or submit a corrective action plan.

(h) YRCs shall comply with approved corrective action plans and directed corrective action plans.

(i) YRCs may request informal dispute resolution when they disagree with an area of non-compliance issued by the unit on a statement of findings.

(j) When requesting informal dispute resolution, the YRC shall:

(1) Submit a written notice to the unit requesting informal dispute resolution no later than 14 days from the date of issuance of the statement of findings; and

(2) Include in the notice the reason(s) why the YRC believes that the unit erroneously cited the area(s) of non-compliance as noted in the statement of findings.

(k) The unit shall provide a written notice of decision within 30 days from receipt of the request and receipt of any information provided to support the reasons for the dispute.

(l) Informal dispute resolution shall not be an option for any applicant or licensee against whom the unit has imposed an administrative fine, or initiated action to suspend, revoke, deny, or refuse to issue or renew a license.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.10 Enforcement Action and Administrative Appeals.

(a) The department shall deny an application, suspend, or revoke a license in accordance with RSA 170-E:68 if the YRC:

(1) Neglects or abuses children in care;

(2) Does not comply with RSA 170-E:53-a through RSA 170-E:69 or He-C 4003;

(3) Violates any provision of RSA 170-E:53-a through RSA 170-E:69 , or is unable to meet and maintain compliance with He-C 4003;

(4) Substantially or repeatedly violates any provisions of the license issued;

(5) Furnishes or makes any misleading or any false statement or report to the department ;

(6) Refuses or fails to submit any reports or to make available to the department any records required by it in making an investigation of the facility for licensing purposes;

(7) Refuses or fails to submit to an investigation or to the required visits by the department;

(8) Refuses or fails to admit authorized representatives of the department at any time the camp is in operation for the purpose of investigation or visit;

(9) Fails to provide, maintain, equip, and keep in safe and sanitary condition premises established or used for recreation camps as required in He-C 4003 or as otherwise required by any law, rule, ordinance, or term of the license applicable to the location of such facility; or

(10) Retaliates against an employee who in good faith reports a suspected violation of RSA 170-E:53-a through RSA 170-E:69 and He-C 4003.

(b) The department shall notify applicants or licensees of a decision of the department to deny, revoke, or suspend a license of their right to an administrative hearing in accordance with RSA 541-A:30, RSA 541-A:31, and the provisions of He-C 200 applicable to adjudicative proceedings.

(c) Any licensee who has been notified of the department’s intent to revoke or suspend a license may continue to operate during the appeal process except as specified in (d) below.

(d) When the department includes in its notice of revocation or suspension an order of immediate closure, pursuant to RSA 541-A:30, III, the YRC shall immediately terminate its operation and not operate while an administrative hearing is pending, except under court order or as provided by RSA 541-A:30, III.

(e) Any suspension of a license for which an administrative hearing has not been requested, or any suspension of a license that has been upheld by an administrative hearing shall remain in effect until the department notifies the YRC whose license was suspended that the suspension has been removed because the non-compliance which resulted in the suspension is corrected.

(f) No ongoing enforcement action shall preclude the imposition of any remedy available to the department under RSA 170-E, RSA 541-A, He-C 4003, or other applicable rule or law.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.11 Complaints and Investigations.

(a) The department or unit shall investigate any complaint that meets the following conditions:

(1) The complaint is based upon the complainant’s first-hand knowledge regarding the allegation(s) or on information reported directly to the complainant by a person who has first-hand knowledge regarding the allegation(s); and

(2) There is sufficient specific information for the department or unit to determine that the allegation(s), if proven to be true, would constitute a violation of any of the provisions of RSA 170-E or He-C 4003.

(b) When practicable, the complaint shall be in writing and contain the following information:

(1) The name and address of the YRC, or the alleged unlicensed individual or entity;

(2) The name, address, and telephone number of the complainant; and

(3) A description of the situation that supports the complaint and the alleged violation(s) of RSA 170-E or He- C 4003.

(c) Investigations shall include all techniques and methods for gathering information, which are appropriate to the circumstances of the complaint, including:

(1) Requests for additional information from the complainant or the licensee;

(2) A physical inspection of the premises;

(3) Review of any records that might be relevant, including video recordings if applicable and available; and

(4) Interviews with individuals who might have information that is relevant to the investigation.

(d) For the licensed YRC, the unit shall:

(1) Provide written notification of the results of the investigation to the licensee along with a statement of findings if areas of non-compliance with He-C 4003 were found as a result of the investigation;

(2) Notify any other federal, state, or local agencies of the alleged non-compliance of their statutes or rules based on the results of the investigation, as appropriate;

(3) Notify the licensee in writing and take no further action if the unit determines that the complaint is unfounded; and

(4) If applicable, require the licensee to submit a corrective action plan in accordance with He-C 4003.09.

(e) For the unlicensed individual or entity, the department shall provide written notification to the camp administrator, camp director, or person responsible that includes:

(1) The date of the inspection;

(2) The reasons for the inspection; and

(3) Whether the inspection resulted in a determination that the services being provided require licensing under RSA 170-E:56, I.

(f) The unlicensed individual or entity shall be allowed 3 days from the date of receipt of the notice required by (e) above to respond to a finding that they are operating without a license or submit a completed application for a license in accordance with He-C 4003.

(g) If the unlicensed individual or entity does not comply with (f) above, or if the department does not agree with the response, the department shall issue a written warning immediately to comply with RSA 170-E:56, I and He-C 4003.

(h) Any unlicensed individual or entity who fails to comply after receiving the notice in (e) and (f), shall be subject to action by the department for injunctive relief under RSA 170-E:65.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.12 Confidentiality.

(a) The department shall keep confidential all information submitted by the YRC during the application process and any records in its possession regarding the admission, progress, health, and discharge of campers.

(b) The exceptions to the release of information submitted during the application process referenced in (a) above shall be:

(1) Upon the department’s receipt of a written request from the applicant, licensee, or their designated legal representative to release to the requestor information obtained during the application process, except for information pertaining to background checks; or

(2) During an administrative proceeding against the applicant or licensee.

(c) In an adjudicative proceeding, any oral or documentary evidence may be received and shall not be considered confidential, including, but not limited to information obtained during regular investigations and complaint investigations. Information submitted during an adjudicative proceeding shall be subject to rules of privilege recognized by law and any protected health information shall be de-identified.

(d) Complaint investigation files shall be confidential in accordance with RSA 170-E:69 and shall not be disclosed publicly.

(e) The complaint investigation files in (d) above shall only be released by the department, by written request:

(1) To the department of justice when relevant to a specific investigation;

(2) To law enforcement when relevant to a specific criminal investigation;

(3) When court of competent jurisdiction orders the department to release such information; or

(4) To any party or intervenor in connection with an adjudicative proceeding relative to the licensee.

(f) Applicants, licensees, and all YRC staff shall keep confidential all records required by the department pertaining to the admission, progress, health, and discharge of campers under their care and all protected health information, and personally identifiable information.

(g) The department shall have access to all YRC records required by rule or statute to be kept, as necessary, to determine compliance with He-C 4003.

(h) YRC staff shall release information regarding a specific camper only as directed by a parent or guardian of that camper, upon receipt of written authorization to release such information, signed by the parent or guardian of the camper.

(i) In addition to the confidentiality requirements above, YRC staff shall discuss or share information regarding the admission, progress, behavior, health, or discharge of a camper with the camper’s parent(s) or guardians(s) in a manner that protects and maintains confidentiality for both the camper and the camper’s parent(s) or guardian(s).

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.13 Duties and Responsibilities of the YRC.

(a) The YRC shall comply with all applicable federal, state, and local laws, rules, regulations, and ordinances.

(b) The YRC shall abide by the provisions specified on the license.

(c) Records for all staff and campers and written policies required by He-C 4003 shall be maintained on file and on the premises for review or provided within 48 hours of a request by the unit.

(d) The YRC shall retain all records required by He-C 4003 for 2 years from the date created or obtained.

(e) The YRC shall have and implement policies and procedures prohibiting abuse, neglect, corporal punishment, rough handling, or other harsh treatment of campers by YRC staff.

(f) The YRC shall cooperate with the unit during all inspections and complaint investigations, including but not limited to inspecting the facilities, reviewing records required pursuant to (d) above, and providing the identity of and contact information for parents of campers currently or previously enrolled in the camp who may have information relevant to the investigation.

(g) The YRC staff shall not:

(1) Make false or misleading statements to the department or unit, whether verbal or written; or

(2) Falsify any documents, other written information, or reports issued by or required by the department under He-C 4003.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.14 Notice and Reporting Requirements.

(a) A licensee shall notify the unit via the NHCIS portal, or in writing via email:

(1) Within 2 business days when there is a change in mailing address, email address, or phone number; and

(2) Within 48 hours of a camper sustaining a serious injury, pursuant to He-C 4003.03(ad).

(b) A YRC shall notify the unit in writing via email:

(1) Prior to changing the name of the YRC or advertising under a new name, so that the unit can issue a revised license reflecting the name change;

(2) Within 5 business days prior to the vacancy, when known, or within 5 business days of the date of the vacancy of the camp administrator or camp director;

(3) Within 24 hours when the licensee voluntarily ceases operations;

(4) Within 24 hours of any changes in operation due to an emergency, such as a natural disaster;

(5) No later than the next business day after calling law enforcement or emergency responders to the YRC for incidents or events involving campers, except as required in (6) below;

(6) Within 24 hours after searching the buildings and grounds and determining that a camper is or was missing; and

(7) Within 24 hours of the death of a camper and provide the unit a written report within 72 hours, detailing the circumstances that led up to the death.

(c) As mandated reporters, all YRC staff shall report to DCYF at 1-800-894-5533 if they suspect that a youth is being abused or neglected, in accordance with RSA 169-C:29.

(d) The YRC shall notify the parent(s) or guardian(s) of a camper immediately:

(1) When it identifies suspected abuse or neglect of a camper by YRC staff or that abuse or neglect occurred while in the care of the YRC;

(2) When a camper sustains a serious injury;

(3) After calling the police when the YRC determines that the camper is missing after searching the buildings and grounds;

(4) When a camper was the victim of corporal punishment, rough handling, or other harsh treatment by YRC staff;

(5) When staff has administered epinephrine to a camper; and

(6) When a camper dies while under the care of the YRC.

(e) In addition to (d) above, the YRC shall have and implement policies and procedures to include when and how the YRC will contact parents or guardians when their child needs to be removed from the YRC due to illness, in accordance with He-C 4003.39 and He-C 4003.40.

(f) Day camps shall notify parents or guardians upon picking up their child that the child has ingested or had contact with a known allergen that did not require administration of epinephrine or calling emergency responders.

(g) Within 48 hours of the incidents described in (d) above, the camp administrator, camp director, or designee shall provide to the parents or guardians of the camper or campers involved, a written description of the incident, including how the YRC staff responded.

(h) In addition to the circumstances for notifying emergency services as prescribed in first aid and CPR training, the camp administrator, camp director, or designee shall notify the police or emergency services:

(1) In the event of a missing camper;

(2) Immediately whenever epinephrine is administered to a camper and YRC does not have medical staff; and

(3) Immediately when a camper dies.

(i) The department shall notify the camper’s parents or guardians when it is determined that a camper was the victim of abuse, neglect, corporal punishment, or other harsh treatment by YRC staff or while in the care of YRC staff, if a camper was injured because they were not supervised, or if the camper’s health, safety, or well-being was otherwise jeopardized due the YRC’s non-compliance with licensing rules and statutes.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.15 Camp Directors.

(a) Each YRC shall have a camp director who is at least 21 years of age.

(b) The camp director of a residence camp shall have at least 2 seasons of previous administrative or supervisory experience in residential youth recreation camping.

(c) The camp director of a day camp shall have at least 2 seasons of previous administrative or supervisory experience in youth recreation camping, youth education and development, or other youth recreation programs.

(d) No individual shall be a camp director who has a criminal conviction for any offense involving:

(1) Causing or threatening direct physical injury to any individual;

(2) Causing or threatening harm of any nature to any youth; or

(3) Unlawfully taking property of another, whether through force, threat of force, or deception.

(e) No individual shall be a camp director who is listed on the central registry of founded reports of abuse and neglect.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.16 Counselors, Counselors-In-Training, and Junior Counselors.

(a) At least 80 percent of all counselors at a residence camp shall be 18 years of age or older.

(b) At least 80 percent of all counselors at a day camp shall:

(1) Be 16 years of age or older; and

(2) Be at least 2 years older than the campers with whom they are working.

(c) Each counselor, CIT, and JC shall attend a comprehensive training program provided by or through the YRC before commencing any activities with campers.

(d) The YRC shall have and implement policies and procedures for staff supervision of campers, including requirements and procedures for overnight supervision of campers, as applicable.

(e) Residence camps shall have a minimum staff to camper ratio as follows:

(1) One staff for every 6 campers ages 5 years to 8 years;

(2) One staff for every 8 campers ages 9 years to 14 years; and

(3) One staff for every 10 campers ages 15 years to 17 years.

(f) Day camps shall have a minimum staff to camper ratio of one staff to 15 campers.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.12)

He-C 4003.17 Verification of Staff Qualifications.

(a) The YRC owner or camp administrator shall verify that the camp director meets the qualifications specified in He-C 4003.15.

(b) Subject to (c) through (f), below, the camp administrator or camp director shall require all YRC staff, as defined in He-C 4003.03(al), to:

(1) Authorize or submit the results of a criminal background check in each state where the YRC staff member has lived, which may be done through a national database if the database includes all such states;

(2) Authorize or submit the results of a check of the National Sex Offender Registry;

(3) For each YRC staff who currently resides, or has resided in NH during the previous 7 years, complete and submit a notarized Form 2501 “DCYF Central Registry Name Search Authorization Release of Information to Third Party" (June 2020) certifying that:

“I acknowledge that the results of this search can only be released to myself or a Child-Placing Agency pursuant to NH RSA 170-E, the Department of Health and Human Services pursuant to RSA 170-G:8-c, or another state’s Child Welfare Agency or Private Adoption Agency pursuant to NH RSA 169-C:35. I understand and authorize the results of this search to be provided to the person/agency listed below if in compliance with the aforementioned laws. Any entity listed below that is not governed under these laws will not be sent the results”; and

(4) Provide references and a listing of all previous employment and volunteer positions.

(c) Any counselor, CIT, or JC who is younger than 18 years old who will be left alone with youth, in lieu of the background check requirements specified in (b)(1) above, shall provide at least 2 references to the YRC.

(d) One reference shall be from a non-relative, and attest to:

(1) Their knowledge of the minor’s character;

(2) Whether the minor has caused or threatened to cause direct physical injury to any other individual, or harm of any nature, to any youth; and

(3) Their opinion on whether the minor is a good candidate to work directly with campers.

(e) The background check required to obtain a VISA for a counselor, CIT, or JC who enters the United States under the auspices of any international counselor exchange program shall meet the requirements of (b) above.

(f) The YRC shall accept the background check required for licensure for any licensed practitioner who holds a current license as proof of compliance with (b)(1) above. If the background check required for an applicant who is a licensed practitioner does not include a check of the national sex offender public registry, then the owner or designee, camp administrator, or camp director shall check the licensed practitioner’s name against the national sex offender public registry prior to employing the applicant.

(g) For any YRC that is a certified provider under RSA 170-G:4, XVIII, the background check required for such certification may be used to satisfy the requirement of (b)(1) above.

(h) The camp administrator or camp director shall:

(1) Review the results of the background checks and certifications;

(2) Review the submitted references and previous employment and volunteer information and check enough to become satisfied as to the individual’s suitability to work at the YRC; and

(3) Conduct a personal interview with each individual hired or otherwise engaged as YRC staff.

(i) A YRC shall not employ, or otherwise engage YRC staff, who:

(1) Has a criminal conviction for any offense involving:

a. Causing or threatening direct physical injury to any individual;

b. Causing or threatening harm of any nature to any youth; or

c. Unlawfully taking property of another, whether through force, threat of force, or deception; or

(2) Is listed on the central registry of founded reports of abuse and neglect; or

(3) Is listed on the National Sex Offender Registry.

(j) An applicant may begin employment pending the receipt of notice regarding the check of the NH central registry for child abuse and neglect, provided the applicant has passed all other required background checks specified in He-C 4003.

(k) The applicant referenced in (j) above shall never be alone with campers pending the YRC’s receipt and review of the results of the NH central registry check required in accordance with (h) and (i) above.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.14)

He-C 4003.18 Sleeping Areas; Privacy Areas.

(a) For purposes of this section, the following definitions shall apply:

(1) “Privacy area” means a designated private or semi-private area at a camp, such as a room or other space that has permanent or temporary side walls, in which campers or YRC staff are expected to undress or change clothes. The term includes sleeping areas and changing areas associated with showers or other bathing facilities, or with swimming, boating, or other athletic facilities;

(2) “Session” means a period of time established by the camp administrator or camp director for which a camper is enrolled at a camp; and

(3) “Sleeping area” means a tent, cabin, room, or other designated private or semi-private area at a residence camp in which an individual is intended to sleep.

(b) Subject to (c), below, no member of the YRC staff, including the camp director, counselors, activity leaders, instructors, licensed practitioners, office personnel, managers, kitchen staff, and maintenance staff, shall enter a privacy area unless:

(1) The privacy area is a sleeping area to which the YRC staff member is assigned;

(2) Such entry is necessary to protect the health and safety of the occupants, such as in the case of a fire or a situation requiring urgent medical attention; or

(3) The YRC staff member first announces their intent to enter and proceeds only after the occupants give audible approval.

(c) The provisions of (b), above, shall not apply to a camp attended by campers with a disability if:

(1) The YRC staff member enters the privacy area at the same time as the campers in order to assist a camper with a disability;

(2) The other campers are aware of the YRC staff member’s presence and have the opportunity to wait until the YRC staff member departs to disrobe or are otherwise provided privacy in which to disrobe; and

(3) The camp has a written policy in place to ensure the safety of the campers in such situations and specifically covers the policy in the training provided pursuant to He-C 4003.16(c).

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.15)

He-C 4003.19 Camp Facilities.

(a) All camp facilities and grounds shall be maintained in good repair to ensure safe and sanitary conditions.

(b) Ventilation in camp facilities shall provide a movement of air to assure the comfort and protection of the occupants.

(c) Doors, windows, and other outer openings of camp facilities used for food storage, preparation, or consumption shall be equipped with screens with a mesh having at least 18 strands by 16 strands per square inch in all but the following circumstances:

(1) First floor windows if designated for use as emergency egress;

(2) Doors which are opened for normal or emergency ingress or egress; and

(3) Any other time when such openings are ajar for a specific purpose at such times of the day or seasons of the year so as not to allow insects into the affected room(s).

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.16)

He-C 4003.20 Vehicles. Any vehicle used to transport campers shall meet the applicable safety and operator requirements established by the NH department of safety.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.17)

He-C 4003.21 Sleeping Areas.

(a) Each permanent building in which individuals sleep shall demonstrate compliance with applicable provisions of the state life safety code through an inspection undertaken pursuant to He-C 4003.29.

(b) Sleeping areas in buildings shall meet the following criteria:

(1) Sleeping units shall be arranged to provide a minimum floor area ratio of 40 square feet per single bunk and 60 square feet per double bunk;

(2) Suitable protection shall be provided against insects;

(3) A distance of at least 6 feet shall be provided between the heads of sleepers; and

(4) A distance of at least 30 inches shall be provided between the sides of 2 adjacent beds.

(c) The number of campers in a tent shall not exceed the manufacturer’s rating for the tent.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.22 Assembly Areas. Assembly areas shall comply with applicable provisions of the state life safety code.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.19)

He-C 4003.23 Water Supply and Septic Systems.

(a) Water used at the YRC for drinking, food preparation, and cleanup shall comply with the drinking water standards for bacteria and nitrates specified in Env-Dw 700.

(b) No cross-connection shall exist between approved and unapproved sources of water supply. Fixtures shall be constructed as to involve no interconnections and no hazard of back-siphonage, as specified in Env-Dw 505.

(c) All plumbing, including drinking water fountains, shall conform to the applicable requirements of the state building code as established in RSA 155-A.

(d) If the YRC does not receive drinking water from a PWS, the YRC’s source of drinking water shall be:

(1) Located to avoid contamination from buildings or wastewater disposal, if a surface water source; or

(2) Constructed in accordance with the standards for drinking water wells established by the NH water well board in We 100-1000.

(e) Drinking water shall not be obtained from a source by dipping or drawing by a bucket.

(f) The distance between the YRC water supply and sanitary waste disposal shall meet the criteria set forth in Env-Wq 1000 unless the commissioner of the department of environmental services grants a waiver pursuant to Env-Wq 1001.03.

(g) A seasonal camp with its own independent water supply that is not considered to be a public water system as defined in RSA 485:1-a, XV and confirmed by the NH department of environmental services (NHDES) shall have its drinking water analyzed for bacteria and nitrates within 30 days prior to the opening date of the camp season.

(h) A year round camp with its own independent water supply that is not considered to be a public water system as defined in RSA 485:1-a, XV and confirmed by the NHDES shall have its drinking water analyzed for:

(1) Bacteria every 3 months; and

(2) Nitrates annually.

(i) The analyses required by (g) or (h), above shall be conducted by a laboratory accredited under the environmental laboratory accreditation program in accordance with Env-C 300.

(j) The results of the analyses shall be kept on file for review by the department.

(k) A YRC that does not have a public water system as described in (g) and (h) above whose water test results has exceeded the maximum contaminant levels established in Env-Dw 700 or action levels established in Env-Dw 714 shall immediately contact the unit to report that finding and provide the unit with a plan for how it will ensure that campers will not be at risk from exposure to the unsafe water.

(l) Within 30 days of the date the YRC learns that they have failed a water test as described in (k) above, the YRC shall submit to the unit a corrective action plan in accordance with He-C 4003.09(d) and (e).

(m) The unit shall extend the deadline in (l) above if it determines that the YRC can demonstrate that it has made a good faith effort to develop and submit the corrective action plan within the 30-day period but has been unable to do so and that the health, safety, or well-being of campers will not be jeopardized by granting the extension.

(n) When a YRC fails to submit a written proposed corrective action plan within 30 days of receiving the unacceptable test result under (l) above, the department or unit shall initiate action to suspend the license or permit in accordance with He-C 4003.10(e), which shall remain in effect until such time as laboratory results meeting those requirements are received by the unit and the department or unit notifies the YRC that it may resume operations under the license.

(o) A YRC shall ensure that there are functional sewage disposal facilities.

(p) A YRC whose septic system is showing signs of failure, which cannot be immediately repaired, shall immediately provide an interim corrective action plan to the unit and the local health officer, which includes a timeline for repairs and how it will ensure that campers will not be exposed to any risks from the failing septic system.

(q) If a YRC determines that it cannot comply with the timeline for repairs as required in (p) above, it shall request an extension from the unit.

(r) The unit shall grant the extension in (q) above if the YRC provides a written plan for completion of the repairs, and the safety and well-being of the campers is maintained.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.20)

He-C 4003.24 Natural Waters, Beaches, Swimming Pools, and Water Activities.

(a) A beach that is part of the YRC property shall meet the following health criteria:

(1) The shore shall be free of litter;

(2) Domestic animals shall be prohibited from the beach and swimming area; and

(3) Detergents, personal bathing, and vehicle washing shall be prohibited in the water.

(b) Beach structures shall meet the following criteria:

(1) Diving boards shall:

a. Be firmly affixed to a dock or float; and

b. Have a top surface that is slip-resistant; and

(2) Docks, floats, and platforms shall be maintained in good repair so that they are free of splinters, cracks, sharp edges, or protruding hardware.

(c) Safety systems and procedures for use of the beach and swimming pools shall be as follows:

(1) A first-aid kit shall be available onsite, equipped with such items as lifeguard staff deem necessary to address emergency situations that are likely to occur;

(2) All water activities shall be permitted only under the supervision of an American Red Cross certified lifeguard or another individual certified in an equivalent national recognized course having standards no less stringent than the lifeguard course offered by the American Red Cross;

(3) There shall be one certified lifeguard for every 25 campers participating in water activities;

(4) There shall be at least one YRC staff member or certified lifeguard for each 10 campers participating in water activities;

(5) There shall be a safety accounting system in place for supervising and checking campers participating in water activities;

(6) A check of campers participating in water activities shall be made at least every 15 minutes and referenced against the safety accounting system during non-instructional time;

(7) There shall be supervised entrances and exits and a lifeguard station providing an unobstructed view of the swimming area; and

(8) The YRC shall have a lost-swimmer plan detailing procedures to follow in an emergency.

(d) Safety systems and procedures for boating activities shall be as follows:

(1) There shall be at least one YRC staff member for every 10 campers participating in the boating activity;

(2) YRC staff member shall be trained in First Aid and CPR;

(3) YRC staff member shall be skilled in the safe operation of the craft for the specific activity; and

(4) There shall be a safety accounting system in place for supervising and checking campers participating in boating activities no less than every 15 minutes.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.25 Requirements for Playgrounds and Athletic Equipment.

(a) Athletic equipment used for gymnastics, volleyball, basketball, football, hockey, soccer, archery, and other sports shall be set up and maintained in accordance with the manufacturer's guidelines.

(b) All playing fields shall be maintained in usable and safe condition.

(c) Playground equipment including, but not limited to, climbing apparatus’, slides, and swing sets shall:

(1) Be installed and maintained in accordance with the manufacturer’s guidelines;

(2) Be free of rough edges, splintery wood, protruding bolts, and entrapment hazards;

(3) Be free of asphalt or concrete surface under or around it; and

(4) Have canvas or other pliable seats on swings.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.26 Toilet Facilities.

(a) Toilet facilities shall:

(1) Include one toilet for every 10 campers in a resident camp;

(2) Include one toilet for every 30 campers in a day camp;

(3) Be located, constructed, and maintained to ensure safe and sanitary conditions; and

(4) Contain at least one toilet for each gender with a door or curtain for privacy.

(b) Urinals may be substituted for up to 1/3 of the toilets in toilet facilities for males.

(c) Floors and walls in toilet facilities shall be sealed with polyurethane or paint up to a height of not less than 48 inches.

(d) Badly worn or chipped toilet seats shall be repaired or replaced.

(e) All toilet facilities shall always be supplied with toilet paper.

(f) A sink for hand washing with soap and single use towels, cloth towels specific to each camper and changed daily, or hand dryers shall be available within or immediately outside the toilet facility.

(g) Privies shall meet the following conditions:

(1) The privy shall be constructed in accordance with Env-Wq 1022.01;

(2) Privies shall be located:

a. At least 100 feet from any place where food is prepared or served;

b. At least 75 feet from any surface water; and

c. At least 200 feet up-gradient of any well or spring;

(3) Privy contents shall be:

a. Removed as often as necessary to prevent the pit from being filled to within one foot of the top of the pit; and

b. Disposed of in accordance with Env-Wq 1600.

(4) The contents of the pit shall be covered daily with lime or other suitable agent to eliminate insects and odors;

(5) The materials for liming and disinfection shall be kept in proximity to the privy so as to be readily available for use;

(6) The privy and the pit shall be made fly-tight and provided with self-closing lids; and

(7) Clean and sanitary conditions shall always be maintained.

(h) Chemical toilets shall be maintained and pumped by a septage hauler licensed by the department of environmental services in accordance with Env-Wq 1600.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.24)

He-C 4003.27 Garbage and Waste Disposal; Toxic Chemical Storage.

(a) Garbage and refuse shall be disposed of in durable, easily cleanable, insect-proof, and rodent-proof containers that do not leak and do not absorb liquids. Plastic bags or wet-strength paper bags shall be used to line such containers when maintained inside the areas used for food storage, preparation, or consumption.

(b) Garbage and refuse containers stored outdoors and dumpsters, compactors, and compactor systems shall be:

(1) Easily cleanable;

(2) Provided with tight fitting lids, doors, or covers; and

(3) Kept covered when not in actual use.

(c) For any container equipped with a drain, the drain plug shall be in place at all times, except during cleaning.

(d) Cleaning materials, flammable materials, and toxic materials shall be:

(1) Stored in properly labeled and safe containers;

(2) Stored in an area separate from food; and

(3) Used only by or under the supervision and direction of YRC staff.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.26)

He-C 4003.28 Notification to Emergency Responders.

(a) Subject to (d), below, the camp administrator, camp director, or designee shall notify the local police, fire, and rescue departments regarding their operating dates in accordance with the following:

(1) Annually for year-round camps; and

(2) Immediately prior to opening for seasonal camps.

(b) The notification required by (a), above, shall:

(1) Be in writing;

(2) Include the opening and closing dates for seasonal camps; and

(3) Be delivered in hand or sent via private delivery service, U.S. Postal Service, or email.

(c) The YRC owner, camp administrator, or designee, shall:

(1) Retain a paper copy of the notification; and

(2) Provide it upon request to unit personnel.

(d) For any YRC located within an area that is served by full-time, non-volunteer emergency response personnel even when the YRC is not in operation, notice as specified in (a) above shall be required only if requested by the local emergency response agencies.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.27)

He-C 4003.29 Fire Safety Inspections and Compliance.

(a) The camp administrator, camp director, or designee shall contact local fire officials to schedule such periodic fire safety inspections as are required by local ordinances or the state fire code.

(b) The camp administrator or camp director shall make the results of the inspection available to the department upon request.

(c) If the results of the inspection conducted by local fire officials show that the YRC did not pass the inspection, the camp administrator, camp director, or designee shall provide a copy of the follow-up inspection report to the department within 10 days of receiving it.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.28)

He-C 4003.30 Storage, Handling, and Preparation of Food; Food Service; Kitchens. YRC staff shall assure that all food and drink served to campers is:

(a) Safe for human consumption and free of spoilage or other contamination;

(b) Stored, prepared, and served in a manner consistent with safe food handling practices for the prevention of food borne illnesses, including those set forth in He-P 2300; and

(c) Stored in a way to protect it from dust, insects, rodents, overhead leakage, unnecessary handling, and all other sources of contamination.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.29)

He-C 4003.31 Required Health Care Staffing: Day Camps.

(a) A day camp shall, whenever campers are present at the camp, have at least one adult staff member present who is certified in age-appropriate first aid and CPR.

(b) In addition to (a) above, a day camp that is operated for campers with a disability shall, whenever campers are present at the camp, have a licensed practitioner on the premises of the camp.

(c) The YRC staff member certified in first aid and CPR whose training is used to meet the requirements of (a) above shall have been certified or had such certification renewed within 24 months of the opening of the YRC for the season.

(d) Each licensed practitioner shall post a copy of their NH license(s) in a conspicuous location in the camp office or infirmary. A copy of the license verification as obtained through the New Hampshire’s on-line license verification system may be substituted for a copy of the license.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.30)

He-C 4003.32 Required Health Care Equipment: Day Camps.

(a) A day camp shall have either:

(1) A first aid cabinet as specified in He-C 4003.35(a)(1); or

(2) At least one first aid kit containing such items as health staff deem necessary to address health issues likely to arise at the YRC.

(b) Excluding epinephrine devices or asthma inhalers possessed pursuant to RSA 170-E:59 through RSA 170-E:64, all medications or prescription drugs shall be kept in a container that is:

(1) Inaccessible to campers and unauthorized YRC staff;

(2) Stored in a secondary container separate from food if in a refrigerator; and

(3) Labeled with the camper’s name to ensure identification of the medication.

(c) All medications belonging to YRC staff shall be stored separately from the campers’ medications, such as in a clearly labeled container or on a separate labeled shelf, in an area that is inaccessible to unauthorized individuals.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.31)

He-C 4003.33 Required Health Care Staffing: Residence Camps.

(a) A residence camp that is not operated for campers with a disability where the total number of campers and YRC staff is 75 or fewer shall have, whenever campers are present at the camp, the following on-site medical staff:

(1) An adult YRC staff member who is certified in age-appropriate first aid and CPR; and

(2) An adult YRC staff member who is:

a. Certified as an emergency medical technician (EMT);

b. Certified in wilderness and remote first aid;

c. Certified as an emergency medical responder; or

d. A NH licensed practitioner.

(b) A residence camp that is not operated for campers with a disability where the total number of campers and YRC staff is at any time greater than 75 shall have, whenever campers are present at the camp, the following on-site medical staff:

(1) A NH licensed practitioner;

(2) An adult YRC staff member who is certified in age-appropriate first aid and CPR; and

(3) If the nearest emergency medical services are greater than 20 minutes from the camp by automobile, an adult YRC staff member who is:

a. Certified as an EMT;

b. Certified in wilderness and remote first aid; or

c. Certified as an emergency medical responder.

(c) A residence camp that is operated for campers with a disability shall have, whenever campers are present at the camp, the following on-site medical staff:

(1) A NH licensed practitioner;

(2) An adult YRC staff member who is certified in age-appropriate first aid and CPR; and

(3) An adult YRC staff member who is:

a. Certified as an EMT;

b. Certified in wilderness and remote first aid; or

c. Certified as an emergency medical responder.

(d) The YRC staff member who is certified in first aid and CPR and the YRC staff member who qualifies under (a)(2), (b)(1) or (3), or (c)(1) or (3), above, may be the same individual.

(e) The YRC staff member certified in first aid and CPR whose training is used to meet the requirements of (a)(1), (b)(2), or (c)(2), above, shall have been certified or had such certification renewed within 24 months of the opening of the YRC for the season.

(f) The YRC staff member who qualifies under (a)(2), (b)(3), or (c)(3), above, shall have been certified or had such certification renewed within 3 years of the opening of the YRC for the season.

(g) If a physician’s assistant (PA) is used to satisfy the requirements of (a)(2), (b)(1), or (c)(1), above, the PA shall provide to the YRC a copy of the written agreement with the PA’s supervising NH-licensed physician.

(h) Each licensed practitioner shall post their NH license(s) in a conspicuous location in the camp office or infirmary. A copy of the license verification as obtained through the New Hampshire’s on-line license verification system may be substituted for a copy of the license.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.32)

He-C 4003.34 Medical Supervision at Residence Camps.

(a) All residence camps shall provide by contract for 24-hours per day, 7-days per week on-call medical service and supervision of all first aid and health services in the YRC by:

(1) A physician or APRN licensed to practice in New Hampshire; or

(2) A hospital emergency service.

(b) If a physician or APRN licensed to practice in New Hampshire and having at least one of the certifications listed in He-C 4003.33(a) or (b)(1)-(3) is in residence at and employed by a YRC, the requirements of (a) above shall be deemed to have been met.

(c) The physician or APRN under contract pursuant to (a) or (b) above shall issue written instructions, signed by the physician or APRN, to the individual responsible for providing first aid, to be followed in the absence of the physician or APRN.

(d) The camp administrator or camp director shall post the instructions prepared pursuant to (c), above, in a conspicuous place in the infirmary.

(e) The camp administrator or camp director shall provide a telephone or other means of emergency communication in the YRC or ensure that such communication is available within 10 minutes travel time from the YRC.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.33)

He-C 4003.35 Required Health Care Equipment and Facilities: Residence Camps.

(a) If the YRC is a residence camp, the director shall always maintain the following first aid related items at the YRC:

(1) A first aid cabinet, which shall be:

a. Always be kept fully equipped with such items as health staff deem necessary to address health issues likely to arise at the YRC; and

b. If containing prescription or non-prescription medications, locked when not in use; and

(2) A backboard with head blocks and straps and proper immobilization equipment, such as straps, cervical collar, or blankets.

(b) Camp facilities shall take isolation precautions when necessary to prevent the spread of infectious agents. Isolation precautions include, but are not limited to, standard precautions such as hand hygiene, using personal protective equipment (PPE) when necessary, and proper handling of equipment and environmental surface.

(c) Where the YRC provides an infirmary building or room, such quarters shall:

(1) Be isolated from the regular living and sleeping quarters to insure both quiet to the patient and safety to others; and

(2) Not be used for any other purposes.

(d) Excluding epinephrine devices or asthma inhalers possessed pursuant to RSA 170-E:59 through RSA 170-E:64, all prescription and non-prescription medications shall be:

(1) Kept in the original container with the prescription label or manufacturer’s label for over-the-counter medications; and

(2) Kept in a locked container that is:

a. Inaccessible to campers and unauthorized YRC staff;

b. Stored in a secondary container separate from food if in a refrigerator; and

c. Labeled with the camper’s name.

(e) All medications belonging to YRC staff shall be stored separately from the campers’ medications in a container or area that is inaccessible to unauthorized individuals.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.34)

He-C 4003.36 Required Health Care Staffing: Off-Site Trips.

(a) YRC staff supervising any off-site trip with campers shall carry a first aid kit equipped with such items as the YRC licensed practitioner deems necessary to address emergency situations that might occur.

(b) At least one YRC staff member on an off-site trip with campers shall be certified in:

(1) First aid or CPR; or

(2) Wilderness and remote first aid.

(c) Subject to (d), below, on any off-site trip with campers involving boating or swimming, at least one YRC staff member shall be:

(1) Certified as a lifeguard by the American Red Cross; or

(2) Certified in an equivalent nationally recognized course based on standards that are no less stringent than the lifeguard course offered by the American Red Cross.

(d) Having a YRC staff member be a certified lifeguard shall not be required if a certified lifeguard engaged by the owner or operator of the boating or swimming site or facility is on duty at the site or facility when the campers are boating or swimming, as applicable.

(e) Drinking water obtained during the trip from a source other than a public water system shall be considered as unsafe unless:

(1) Disinfected by adding chlorine or iodine;

(2) Filtered by the use of a drinking water filtration device intended to remove microorganisms; or

(3) Disinfected by achieving a rolling boil for one minute.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.35)

He-C 4003.37 Communicable Diseases Prevention, Isolation, and Reporting.

(a) As required by He-P 301.03, any case or suspected case of a reportable disease, as listed in He-P 301.02, shall be reported by:

(1) The licensed practitioner who assessed, diagnosed, or treated the individual believed to have or suspected of having a reportable disease; or

(2) When no licensed practitioner is present, the camp director.

(b) The report identified in (a), above, shall include all of the information required by He-P 301.03, including the name and home address of the individual known to have or suspected of having the reportable disease.

(c) An individual with a communicable disease at a residence camp shall be placed in isolation and not leave or be removed from strict isolation without permission of the YRC licensed practitioner.

(d) The YRC shall have and implement written policies and procedures for YRC staff for the prevention, control, and reporting of infectious and communicable diseases.

(e) The written policies and procedures shall include:

(1) Proper hand washing techniques;

(2) The utilization of universal precautions;

(3) The management of campers with infectious or contagious diseases or illnesses;

(4) The handling, storage, transportation, and disposal of those items identified as infectious waste in Env-Sw 904; and

(5) The reporting of infectious and communicable diseases as required in (a) and (b) above.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.36)

He-C 4003.38 Reporting of Other Illnesses. When an outbreak of suspected food poisoning or other unusual prevalence of any illness occurs in which headache, muscle stiffness, general malaise, fever, diarrhea, sore throat, vomiting, or jaundice is a prominent symptom, the licensed practitioner or camp director shall immediately report the existence of such an outbreak or disease as required by He-P 300.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.37)

He-C 4003.39 Required Health Information.

(a) Each camper shall provide a health history and statement of health status to the camp director prior to entering the YRC. As specified in RSA 170-E:58, the examination on which the statement of health status is based may be conducted by a licensed practitioner.

(b) The health history and statement of health status required by (a), above, shall include the following:

(1) A certification that the physical examination was completed within 2 years prior to YRC entrance;

(2) A description of any camp activities from which the camper is exempt from for health reasons;

(3) Unless exempted in accordance with RSA 141-C:20-c, documentation of immunization as specified in He-P 301.14.

(4) A list of all known or suspected allergies;

(5) If the YRC will provide food, identification of all dietary restrictions and any food allergies not listed under (4), above;

(6) A list of all prescribed or over-the-counter medications being taken by the camper; and

(7) To the extent not covered by (2) - (6) above, a description of any current physical, mental, or psychological conditions that require medication, treatment, or special restrictions or considerations while at the YRC, including the need for specially trained personnel and proper equipment to meet camper’s needs.

(c) The camp administrator or camp director shall retain all documentation required by (b) above for 2 years, which shall be made available to the department upon request.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.38)

He-C 4003.40 Administration of Medication.

(a) The availability, use, and possession of epinephrine devices and asthma inhalers shall be as specified in RSA 170-E:59 through RSA 170-E:64.

(b) Prescription medications other than those listed in (a), above, and non-prescription medications other than topical substances shall be administered to campers only by authorized staff and only in accordance with the applicable medication order as specified in (f) below.

(c) If a camper’s parent or legal guardian provides written permission, YRC staff who have not been trained as specified in He-C 4003.43(n) may administer non-prescription topical substances to the camper.

(d) Authorized staff shall administer only those prescription medications for which there is a prescription label, or written directions provided by a licensed practitioner who is legally authorized to write the prescription, and written permission from the camper’s parent or legal guardian.

(e) Medication orders shall be valid for no more than one year.

(f) Each medication order shall legibly display the following information:

(1) The camper’s name;

(2) The name, strength, prescribed dose, and method of administration of the medication;

(3) The frequency of administration of the medication, or if the medication is to be used on an as-needed, pro re nata (PRN) basis, the information specified in (g), below; and

(4) The dated signature of the camper’s parent or legal guardian or a licensed practitioner for orders other than as shown on the prescription label.

(g) A medication order from a parent or legal guardian or a licensed practitioner regarding any medication to be administered PRN shall include:

(1) The indications and any special precautions or limitations regarding administration of the medication;

(2) The maximum dosage allowed in a 24-hour period;

(3) The dated signature of the parent or legal guardian for topical substances and non-prescription medication; and

(4) For orders other than as shown on the prescription label, the dated signature of the licensed health care practitioner for prescription medication.

(h) A written order regarding prescription medication shall not be changed except by a licensed practitioner having legal authority to prescribe.

(i) All prescription medications, including physician medication samples, shall:

(1) Bear a label that legibly displays the information described in (f)(1)-(3), above; and

(2) Be stored, dispensed, and administered in accordance with:

a. RSA 318 and requirements adopted pursuant thereto by the NH board of pharmacy; and

b. RSA 326-B and requirements adopted pursuant thereto by the NH board of nursing.

(j) All non-prescription medication and topical substances shall be kept in the original containers and properly closed after each use.

(k) The YRC may provide age-appropriate non-prescription topical substances, such as sunscreen, insect repellent, and over-the-counter anti-itch or anti-bacterial creams or ointments, and common non-prescription medications such as over-the-counter pain relievers and gastro-intestinal calming agents to a camper with the written permission of the camper’s parent or legal guardian.

(l) Any items provided pursuant to (k), above, shall be stored and administered as specified on the product label and in this section.

(m) The camp administrator or camp director shall return any remaining medication and topical substances provided by a camper’s parent or legal guardian to the parent or legal guardian when the camper departs the YRC.

(n) Prior to administering prescription or non-prescription medication to any camper, YRC staff shall:

(1) Complete and document training on medication safety and administration or training delivered by a physician, an APRN, an RN, or an LPN practicing under the direction of an APRN, RN, or physician; or

(2) Successfully complete a nationally recognized course on medication safety and administration having standards that are no less stringent than the Academy of Pediatrics on-line course, Medicine Administration in Early Education and Child Care.

(o) YRC staff administering medications shall complete training in medication safety and administration every 3 years.

(p) For each camper receiving medication, the YRC’s licensed practitioner shall maintain the following information on file:

(1) For each medication prescribed for a camper, the written medication order as specified in He-C 4003.40 and any special considerations for administration of the medication;

(2) Written authorization from the camper’s parent or legal guardian to administer the medication, which includes a statement that the camper has received the specific medication prior to entering the YRC;

(3) The name and contact information of the camper’s parent or legal guardian who is to be notified if required by (s), below; and

(4) Any allergies the camper is known to have or is suspected to have.

(q) The record required by (p), above, shall be updated with a written record of each dose of medication, excluding topical substances, administered to the camper.

(r) The written record required by (p), above, shall:

(1) Be completed by the YRC staff who administered the medication immediately after the medication is administered; and

(2) For each administered medication, include:

a. The name of the camper;

b. The date and time the medication was taken;

c. A notation of any deviation from the medication order provided pursuant to He-C 4003.40 in the administration of a medication and the reason why the medication was not taken as ordered or approved;

d. The dated signature of the authorized staff who administered the medication to the camper;

e. For administration of an as-needed medication, the reason for administration; and

f. Any other information that is relevant to the administration of the medication.

(s) In the event of any deviation from the administration of medication as described in (2)c., above, the camp director or designee shall:

(1) Note the deviation in the record required by (s), above; and

(2) Notify the camper’s parent or legal guardian immediately.

(t) In the event of an error in the documentation of the administration of medication, the camp director or designee shall identify the error and provide correct information in the record as soon as the error is identified.

(u) YRCs that opt to obtain epinephrine devices for use in emergencies, shall have and abide by a policy for the storage, maintenance, control, and general oversight of epinephrine devices acquired by the residence camp, for compliance with RSA 329:1-h, III.

(v) Pursuant to RSA 329:1-h, V., YRCs that opt to obtain a prescription for epinephrine devices under (u) above shall designate and train YRC staff to administer epinephrine in accordance with the following:

(1) YRC staff shall complete an anaphylaxis training program at least every 2 years, following completion of the initial anaphylaxis training program;

(2) Such training shall be conducted by a nationally recognized organization experienced in training unlicensed persons in emergency health care treatment or an entity or individual approved by the board of medicine;

(3) Training may be conducted online or in person and, at a minimum, shall cover:

a. How to recognize signs and symptoms of severe allergic reactions, including anaphylaxis;

b. Standards and procedures for the storage and administration of an epinephrine device; and

c. Emergency follow-up procedures; and

(4) The certificate of completion for the training shall be on file for review by the units.

(w) YRCs shall obtain written authorization from the parent or guardian of a camper prior to administering epinephrine devices.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14046, EMERGENCY RULE, eff 8-8-24, EXPIRES: 2-4-25; ss by #14155, eff 12-21-24; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.39)

He-C 4003.41 Limitations on the Use of Restraint and Seclusion.

(a) For the purposes of this section, the following shall apply:

(1) “Restraint” means bodily physical restriction, mechanical devices, or any device that immobilizes a camper or restricts the freedom of movement of the torso, head, arms, or legs;

(2) Restraint shall not include:

a. Physical devices used to permit a camper to participate in activities without the risk of physical harm;

b. The use of seat belts, safety belts, or similar passenger restraints during the transportation of a camper in a motor vehicle;

c. Physical devices, such as orthopedically prescribed appliances, surgical dressings and bandages, and supportive body bands, or other physical holding when necessary for routine physical examinations and tests or for orthopedic, surgical, and other similar medical treatment purposes, or when used to provide support for the achievement of functional body position or proper balance or to protect a camper from falling out of bed;

d. Brief touching or holding to calm, comfort, encourage, or guide a camper;

e. The use of physical intervention as an emergency response to ensure the immediate physical safety of individuals when there is an imminent risk of serious bodily harm to the camper or others; or

f. The use of force by a YRC staff to defend themself or a third person from what the YRC staff reasonably believes to be the imminent use of unlawful force by a camper, when the YRC staff uses a degree of such force which they reasonably believe to be necessary for such purpose and the YRC staff does not immobilize a camper or restrict the freedom of movement of the torso, head, arms, or legs of any camper;

(3) “Seclusion” means the involuntary confinement of a camper alone in any room or area from which the camper is unable to exit, either due to physical manipulation by a person, lock, or other mechanical device or barrier; and

(4) Seclusion shall not include the voluntary separation of a camper from a stressful environment for the purpose of allowing the camper to regain self-control, when such separation is to an area which a camper is able to leave, there is no physical barrier, and the camper is physically able to leave, or involuntary confinement of a camper to a room or area with an adult who is actively engaged with the camper to assist the camper with de-escalation.

(b) The use of seclusion and restraint shall not be permitted unless a YRC is operated by a NH licensed residential child care agency as defined in RSA 170-E:25, II (a) and (c)-(f).

(c) In accordance with the rules established in He-C 4001, before any YRC staff participates in a restraint or the use of seclusion, they shall have completed a curriculum in restraint and seclusion techniques that are designed to protect the camper from risk of serious bodily harm to the camper or others.

(d) Restraint and seclusion techniques used shall be consistent with the curriculum required in (c) above and be reviewed at least annually with YRC staff to maintain competency.

(e) YRC programs operated by a NH licensed residential child care agency as defined in RSA 170- E:25, II (a) and (c)-(f), shall comply with RSA 126-U and He-C 901 if seclusion or restraint is used, including completion of all reports and reporting requirements to the department and parents or legal guardians of campers.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14046, EMERGENCY RULE, eff 8-8-24, EXPIRES: 2-4-25; ss by #14155, eff 12-21-24; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4003.42 Waivers.

(a) The unit shall grant a waiver to accommodate situations and circumstances at YRCs where strict compliance with all requirements established herein may not be necessary for the protection of the safety and health of the individuals who attend or provide services at such camps.

(b) A request for a waiver shall be filed with the application for a YRC license or as soon thereafter as the need for the waiver is identified.

(c) The person requesting the waiver shall include the following information with each such request:

(1) A specific reference to the section of the rule for which a waiver is being sought;

(2) A full explanation of why a waiver is necessary;

(3) A full explanation of the alternative(s) proposed to be implemented if a waiver is granted, if any;

(4) Whether the waiver is needed for a limited time and, if so, what that time period is; and

(5) A full explanation of why granting the waiver will not jeopardize the health and safety of the individuals who attend or provide services to the YRC, as applicable.

(d) Subject to (e), below, the unit shall grant a waiver if it determines that granting a waiver will not jeopardize the health and safety of the individuals who attend or provide services to the YRC, as applicable. In granting a waiver, the unit shall impose such conditions, including time limitations, as the unit deems necessary to ensure that the health and safety of the individuals who attend or provide services to the YRC, as applicable, are protected.

(e) No waiver shall be granted if the effect of the waiver would be to waive or modify a statutory requirement, unless the statute expressly provides that the requirement may be waived or modified.

(f) If the waiver request is denied, the unit shall notify the person requesting the waiver in writing of the decision and the reason(s) for the decision.

(g) A waiver shall be permanent unless the unit specifically places a time limit on the waiver.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35 (formerly He-C 4003.42)

He-C 4003.43 Administrative Fines.

(a) The department shall assess administrative fines in accordance with RSA 170-E:66, II.

(b) The department shall send a notice of intent to impose a fine by certified mail and email, or by hand delivery to any person, applicant or licensee.

(c) The written notice required under (b) above shall include:

(1) The amount of the fine, the area(s) of non-compliance, and dates, if applicable, for which the fine is being assessed;

(2) Information regarding the right to an administrative hearing, including the name, address, phone number, and email of the hearings unit, and deadline by which to request a hearing;

(3) Information about the option of reducing any assessed fine by 25% by submitting to the department, no later than 10 days from receipt of the notice, payment of the reduced fine, and a written statement waiving the right to an administrative hearing regarding the fine, signed by the applicant or licensee; and

(4) The name of a contact person within the office of legal and regulatory services, bureau of facility licensing and certification.

(d) If the applicant or licensee does not appeal the department’s decision to impose a fine, the fine shall become final after the 10-day period specified in (c)(3) above and the fine shall be paid to the department no later than 10 days from that date.

(e) When an administrative hearing is conducted and the department’s decision to impose a fine is upheld, the fine shall be due and payable within 10 days of the date of the hearing officer's decision.

(f) The imposition of fines shall not prohibit the department from enforcing any conditions or any other enforcement action available to it under He-C 4003 or RSA 170-E.

(g) The department shall impose fines, not to exceed $2,000.00 per offense, in accordance with the following:

(1) For failure to comply with the provisions of a license, in violation of He-C 4003.13(b), the fine shall be $500.00. Each day the YRC fails to comply with the provisions of a license shall be considered a separate offense and shall be subject to a daily fine of $100.00 until the department determines that the YRC is in compliance with the provisions of a license;

(2) For a repeat area of non-compliance for failure to comply with the provisions of a license, in violation of He-C 403.13(b), the fine shall be $500.00, plus $100.00 for each day that the YRC fails to comply with the provisions of a license or permit, after receipt of a statement of findings and provision of an approved corrective action plan. Each day the YRC fails to comply with the provisions of a license shall be considered a separate offense and shall be subject to a daily fine of $100.00 until the non-compliance is corrected;

(3) For operating a YRC without a license, in violation of RSA 170-E:56, I, the fine shall be $500.00. Each day the program continues to operate shall be considered a separate offense and shall be subject to a daily fine of $100.00 until the non-compliance is corrected;

(4) For continuing to operate a YRC after suspension, revocation, or denial of a license or permit, in violation of He-C 4003.10, the fine shall be $2,000.00. Each day the former licensee continues to operate shall be considered a separate offense and shall be subject to a daily fine of $500.00 until the non-compliance is corrected;

(5) For failure to submit any requested reports or failing to make available any records required by the department for investigation, monitoring, or licensing purposes in violation of He-C 4003.13(d), the fine shall be $500.00, per offense, plus $100.00 per day, per offense, for each day for which the department does not receive the requested documents. Each day the noncompliance continues to exist shall be considered a separate offense and shall be subject to a daily fine of $100.00 until the noncompliance is corrected;

(6) For falsifying any documents, other written information, or reports issued by or required by the department, in violation of He-C 4003.13(f)(2), the fine shall be $1,000.00 per offense. Each falsified document or report shall be considered a separate offense;

(7) For failure to cooperate during any visit authorized under He-C 4003, in violation of He-C 4003.13(e), the fine shall be $1,000.00;

(8) For failure to submit a corrective action plan, in violation of He-C 4003.09(d), the fine shall be $200.00;

(9) For failure to implement or maintain the corrective action plan that has been approved or issued by the department, in violation of He-C 4003.09(h) the fine shall be $250.00 per area of non-compliance;

(10) For failure to supervise each camper in care, in violation of He-C 4003.16(d), the fine shall be $750.00;

(11) For abusing or neglecting a camper or campers, or using corporal punishment on a camper or campers, in violation of He-C 4003.13(d), the fine shall be $1,000.00;

(12) For areas of non-compliance with RSA 170-E:56, II and He-C 4003.17(b), regarding completion of required background record checks and He-C 4003.17(i), regarding employing staff with a background check that prohibits them from employment, the fine shall be $500.00. Each day that an employee, household member, or other individual continues to work in the YRC without having completed a background check or with a background check that prohibits them from employment shall be considered a separate offense and shall be subject to a daily fine of $100.00 until the non-compliance is corrected;

(13) When an inspection results in a determination that non-compliance with RSA 170-E or He-C 4003 is a repeat area of non-compliance of any of the rules specified in (g)(1) through (12) above, the fine shall be twice the amount as the original fine assessed, not including any applicable daily rates; and

(14) For non-compliance with any statute or rule, which exposes or results in one or more campers experiencing imminent death, loss, or injury, the department shall assess a fine of $2,000.00 for each non-compliance. Each day the non-compliance continues to exist shall be considered a separate offense and shall be subject to a daily fine of $500.00 until the non-compliance is corrected.

Source. #14256, eff 5-23-25, EXPIRES: 5-23-35

PART He-C 4004 CERTIFICATION REQUIRED FOR YOUTH SKILL CAMPS

He-C 4004.01 Purpose. The purpose of this part is to implement the requirements in RSA 170-E:56, II relative to conducting background checks for youth skill camps (YSCs).

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4004.02 Applicability.

(a) These rules shall apply to all YSCs as defined in He-C 4004.03(h).

(b) These rules shall not apply to:

(1) Any recreation camp as defined in RSA 170-E:55, I , and regulated under He-C 4003;

(2) Any child day care agency as defined in RSA 170-E:2, IV;

(3) Any private home in which a skill is taught to a child pursuant to an agreement between the child’s parent or guardian and the instructor; and

(4) Any class or program that otherwise would qualify as a YSC as defined in He-C 4004.03(h) that is conducted or offered by an educational institution regulated under Title XV of New Hampshire’s codified statutes, including public and nonpublic institutions, provided that:

a. A criminal history records check as described in RSA 189:13-a is completed on each employee and volunteer of the public or nonpublic institution who might be left alone with a youth during the class or program; and

b. A check of the national sex offender public registry is completed for each employee and volunteer covered by a. above.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4004.03 Definitions. For purposes of this part, the following definitions shall apply:

(a) “Background check policy” means the policy required by RSA 170-E:56, II relative to background checks for all camp staff who might be left alone with any youth;

(b) “Camp staff” means the owner and operator of a YSC and any employee, volunteer, or other individual employed or otherwise associated with the YSC, whether for pay or not, to interact directly with youths in a setting where a single staff member might be left alone with any youth;

(c) “Program” as used in the definition of “youth skill camp” means an entity which provides a specific curriculum that:

(1) Has been developed by individuals knowledgeable and experienced in the field to impart a specific skill over a period of 3 or more consecutive days; and

(2) Is taught by at least one instructor who is knowledgeable and experienced in the skill being imparted;

(d) “State of residence” means a state in which an individual who is subject to the background check required by RSA 170-E:56, II currently lives or has lived, whether on a permanent or temporary basis, after attaining the age of 18 years;

(e) “Youth” means individuals who are under 18 years of age who attend a YSC. This term includes “child”, “children”, and “minor”;

(f) “Youth skill camp (YSC)” means “youth skill camp” as defined in RSA 170-E:55, II, namely “a nonprofit or for-profit program that lasts 8 hours total or more in a year for the purpose of teaching a skill to minors. Such camps include, but are not limited to, the teaching of sports, the arts, and scientific inquiry” that is not also a recreation camp as defined in RSA 170-E:55, I;

(g) “YSC operator” means the person that has primary responsibility for the day-to-day operation and management of a YSC. The YSC operator might also be the YSC owner;

(h) “YSC owner” means the person that owns and is ultimately responsible for the operation and management of a YSC. The YSC owner might also be the YSC operator; and

(i) “Validated database” means a database that includes:

(1) Felonies and misdemeanors in each state other than New Hampshire; and

(2) Felonies in New Hampshire.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4004.04 Required Background Check Policy.

(a) The background check policy required by RSA 170-E:56, II(a) shall be adequate to ensure that no camp staff has a criminal conviction for any of the offenses listed therein, specifically:

(1) Causing or threatening direct physical injury to any individual; or

(2) Causing or threatening harm of any nature to any youth.

(b) A background check policy shall be deemed to meet the requirement of (a), above, if it:

(1) Requires all camp staff who might be left alone with a youth to be subject to a background check, as described in He-C 4004.05, prior to initially being left alone with a youth and not less than once in each calendar year thereafter;

(2) Prohibits any staff member who has not been subject to the required background check from working directly with any youth(s) unless a staff member for whom the background check has been completed is also present;

(3) Requires the YSC operator to review:

a. The results of the background checks and certifications, for compliance with the established YSC policy and RSA170-E:56, II(a); and

b. Any references, employment history, and volunteer history submitted by or for each camp staff member, to determine whether to allow the individual to work directly with youths at the YSC;

(4) As required by RSA 170-E:56, II(e), identifies the frequency of the background checks and the sources used to conduct the background checks; and

(5) Requires the YSC operator to maintain an up-to-date listing of all staff members who are in a position such that it is possible they could be left alone with youth, together with the status of their background checks.

(c) As specified in RSA 170-E:56, II(d), a background check policy shall only include more stringent requirements for background checks than specified in (b), above, provided:

(1) The requirement of (a), above, is met; and

(2) The more stringent requirements are explicitly identified in the policy and in the certification explained in He-C 4004.07.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4004.05 Background Checks.

(a) Subject to (b) through (d), below, the background check required by each YSC’s background check policy shall comprise:

(1) A criminal background check in each state of residence of the potential staff member, which may be done through a validated database that includes current information for each such state of residence or through the state identification bureau of each state of residence; and

(2) A check of the national sex offender public registry.

(b) For any volunteer or employee who is younger than 18 years old who will be left alone with a youth, the background check policy shall require the minor to provide a minimum of 2 written references to the YSC operator.

(c) One of the references shall be from a non-relative, and attest to:

(1) Their knowledge of the volunteer’s or employee’s character;

(2) Whether the minor has caused or threatened to cause direct physical injury to any other individual, or harm of any nature, to any youth; and

(3) Their opinion on whether the volunteer or employee is a good candidate to work directly with youth.

(d) The YSC may accept the background check required for licensure for any licensed health professional who holds a current license as proof of compliance with (a)(1) above. If the background check required for an applicant who is a licensed health professional does not include a check of the national sex offender public registry, then the owner or designee shall check the person’s name against the national sex offender public registry prior to employing the applicant.

(e) The YSC operator may rely on the background check required to obtain a visa for any camp staff who enters the country to be a camp counselor through organizations such as the International Camp Counselor Program (ICCP), Camp America, British University North America Club (BUNAC), Camp Leaders, or Camp Counselors USA (CC USA).

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4004.06 Release of Information Regarding Background Checks.

(a) Each YSC owner and each YSC operator, if different from the owner, shall maintain the information received as a result of performing background checks as confidential information.

(b) The YSC operator shall provide information as to whether a background check has been completed on camp staff to any parent or guardian of a youth who requests the information.

(c) The YSC operator shall provide a copy of the listing required by He-C 4004.04(b)(5) to the department for review upon request.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4004.07 Required YSC Certification.

(a) The YSC operator shall make the certification required by RSA 170-E:56, II(a) by providing the following information to the unit:

(1) The calendar year for which the certification is being made;

(2) The complete legal name of the YSC, including any trade name or other name used by the YSC;

(3) The municipality of each location in New Hampshire where the YSC operates or will operate;

(4) The name, primary mailing address, physical address if different, and daytime telephone number, including area code, of the YSC operator and an e-mail address, if any;

(5) If the YSC operator is other than an individual, the name, title, daytime telephone number, and, if available, e-mail address for an individual authorized by the YSC operator to act on the operator’s behalf;

(6) If the YSC operator is not the YSC owner, the name, primary mailing address, and daytime telephone number, including area code, of the YSC owner and an e-mail address, if any;

(7) The YSC web or social media network site addresses, if any; and

(8) The anticipated number of sessions to be offered, the anticipated length of each session, and the general area in which a skill will be taught, such as computer programming, music, or a specific sport.

(b) The YSC operator or authorized representative shall sign and date the completed certification and print or type their name on the certification prior to submitting it to the unit.

(c) The signature required by (b), above, shall constitute certification that:

(1) The signer is the YSC operator or has been authorized by the YSC operator to sign the certification;

(2) A background check policy that meets the requirements of RSA 170-E:56, II and He-C 4004 is in place;

(3) Background checks for the camp staff who might be left alone with a youth have been conducted and reviewed as required by RSA 170-E:56, II and He-C 4004;

(4) Background checks will be conducted and reviewed for all new camp staff brought on after the date of the initial certification as required by RSA 170-E:56, II and He-C 4004;

(5) The information provided is true, complete, and not misleading to the knowledge and belief of the signer; and

(6) The signer understands that they are subject to the penalties for unsworn falsification specified in RSA 641:3 or any subsequent statute if the information is false, incomplete, or misleading.

(d) If any camp staff is added subsequent to filing the required certification, the YSC operator shall conduct a background check for such staff prior to the staff working directly with any youth(s) unless a staff member for whom the background check has been completed is also present.

(e) The YSC operator shall submit the certification information required in He-C 4004.07(a):

(1) Prior to any youth arriving at the YSC in each calendar year that the YSC operates; and

(2) Subject to (f), below, with the fee required by RSA 170-E:56, II(b), which if paid by check or money order shall be made payable to “Treasurer - State of New Hampshire”.

(f) No fee shall be required if the YSC operator is a political subdivision.

(g) The required certification shall be valid only for the calendar year in which it is submitted.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

He-C 4004.08 Review and Availability of YSC Policies. The YSC owner or operator shall:

(a) Review the background check policy each year prior to the opening of the YSC camp and make adjustments if needed;

(b) Make the policy available through the YSC’s web or social media network site, if the YSC has a web presence; and

(c) Provide the unit with the policy, which shall be posted on the unit’s website.

Source. #12981, INTERIM, eff 1-24-20, EXPIRED: 7-22-20

New. #13073, eff 7-23-20; ss by #14256, eff 5-23-25, EXPIRES: 5-23-35

APPENDIX B

Location of Incorporated by Reference Document	Title of Document to be Incorporated by Reference	Cost and How to Obtain the Document
He-C 4001.15(ad)	U.S Environmental Protection Agency’s, “How to Dispose of Medicines Properly” (April 2011)	Publisher: U.S. Environmental Protection Agency Cost: Free of Charge The incorporated document is available at: https://www.epa.gov/sites/default/files/2015-06/documents/how-to-dispose-medicines.pdf
He-C 4001.29(x)(1)	U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Evidence-Based Practices Resource Center” , as accessed and printed on January 27, 2025	Publisher: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration Cost: Free of Charge The incorporated document is available at: https://www.samhsa.gov/libraries/evidence-based-practices-resource-center?f%5B0%5D=resource_topic%3A20277 or A read-only, printed copy of the webpage, as accessed and printed on January 27, 2025, is available to view at the department.
He-C 4001.29(y)(1)	The American Society of Addiction Medicine’s “The ASAM Criteria” (Fourth Edition)	Publisher: The American Society of Addiction Medicine Cost: Member $85.00/ Non-Member $95.00
He-C 4001.29 (y)(2)	U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Knowledge Application Program (KAP) Resource Documents and Manuals” (July 2020)	Publisher: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration Cost: Free to the Public The incorporated document is available at: https://www.samhsa.gov/kap/resources
He-C 4002.23(h)(2)c.	ASTM International’s, “ASTM F1292 Standard Specification for Impact Attenuation of Surfacing Materials Within the Use Zone of Playground Equipment” (2022 Edition)	Publisher: ASTM International Cost: $76.00 The incorporated document is available at: https://www.document-center.com/standards/show/ASTM-F1292

APPENDIX A

Rule	Specific State or Federal Statute or Regulation the Rule Implements
He-C 4001.01	RSA 170-E:24; RSA 170-E:25; RSA 170-E:34
He-C 4001.02	RSA 170-E:28; RSA 170-E:29-a; RSA 170-E: 31, III and V
He-C 4001.03	RSA 170-E:28; RSA 170-E:29; RSA 170-E:29-a; RSA 170-E:30; RSA 170-E:32
He-C 4001.04	RSA 541-A:29
He-C 4001.05	RSA 170-E:30; RSA 170-E:34, I(a)(12); RSA 541-A:29
He-C 4001.06	RSA 170-E:25, V; RSA 170-E:31, IV; RSA 170-E:32; RSA 170-E:40, II
He-C 4001.07	RSA 170-E:29, IV; RSA 170-E:29-a, VI ; RSA 170-E:34, I(e); RSA 170-E:40; RSA 170-E:49
He-C 4001.08	RSA 170-E:34, I(e); RSA 541-A:30-a
He-C 4001.09	RSA 170-E:27, II; RSA 170-E:29, III and IV; RSA 170-E:29-a; RSA 170-E:34, I(d); RSA 170-E:35; RSA 170-E:36; RSA 170-E:37; 541-A:30, III; RSA 541-A:30-a
He-C 4001.10	RSA 170-E:29-a, I; RSA 170-E:30; RSA 170-E:34, I(a)(1), (7); RSA 170-E:34, I(c)
He-C 4001.11	RSA 170-E:34, I(a)(2); RSA 141-C; RSA 141-F:8
He-C 4001.12	RSA 170-E:34, I(a)(4); RSA 170-E:34, I(a)(5); RSA 170-E:34, I(b); RSA 170-E:42; RSA 141-C
He-C 4001.13	RSA 170-E:34, I(a)(4); RSA 170-E:34, I(a)(5)
He-C 4001.14	RSA 170-E:34, I(a)(3), (4), (8); RSA 170-E:34, I(b); RSA 170-E:42; RSA 126-U:7, II
He-C 4001.15	RSA 170-E:34, I(a)(4), (5), (6), (7); RSA 170-E:42; RSA 329:1-h
He-C 4001.16	RSA 170-E:34, I(a)(4); RSA 126-U:5-b
He-C 4001.17	RSA 170-E:34, I(a)(4), (5)
He-C 4001.18	RSA 170-E:34, I(a)(4)
He-C 4001.19	RSA 170-E:34, I(a)(2); RSA 170-E:34(b)
He-C 4001.20	RSA 170-E:34, I(a)(2), (3); RSA 170-E:34, I(b)
He-C 4001.21	RSA 170-E:34, I(a)(5), (7); RSA 170-E:34, I(b); RSA 170-E:42-a
He-C 4001.22	RSA 170-E:34, I(a)(9); RSA 170-E:34, I(j); RSA 126-U; RSA 126-U:7
He-C 4001.23	RSA 170-E:34, I(a)(7), (8); RSA 170-E:34(b); RSA 126-U:7; RSA 126-U:10
He-C 4001.24	RSA 170-E:34, I(a)(5)
He-C 4001.25	RSA 170-E:34, I(a)(5); RSA 265:107-a; RSA 126-U:12
He-C 4001.26	RSA 170-E:25, II(d); RSA 170-E:34, I(a); RSA 170-E:34, I(a)(1), (5)
He-C 4001.27	RSA 170-E:34, I(a); RSA 170-E:34, I(a)(1), (5)
He-C 4001.28	RSA 170-E:25, II(f); RSA 170-E:27-a; RSA 169-C:16, II; RSA 169-C:29 and 39; RSA 169-D:9-c, I; and 42 USC 11431 et seq.
He-C 4001.29	RSA 170-E:25, II(e); RSA 170-E:34, I(b)
He-C 4001.30	RSA 170-E:25, II(e); RSA 170-E:34, I(a)(5); RSA 170-E:34, I(b); RSA 169-C:24-b
He-C 4001.31	RSA 170-E:29-a, I and I-a, IV-a, V, and VI; RSA 170-E:34, I(a)(1), (2), (11)
He-C 4001.32	RSA 170-E:34, I(a)(14)
He-C 4001.33	RSA 170-E:34, I(j) and RSA 170-E:45-a
He-C 4002.01	RSA 170-E:2; RSA 170-E:11
He-C 4002.02	RSA 170-E:6; RSA 170-E:8; RSA 170-E:9; RSA 170-E:11, I(1); RSA 541-A:30, I
He-C 4002.03	RSA 541-A:29
He-C 4002.04	RSA 170-E:11, I(m)
He-C 4002.05	RSA 170-E:7, I; RSA 170-E:6-b; RSA 170-E:11, I(a) and (b); RSA 170-E:11, I(h); 45 CFR 98.41(e)
He-C 4002.06	RSA 170-E:8, III; RSA 170-E:10; RSA 170-E:11, I(h); RSA 170-E:11, IV
He-C 4002.07	RSA 170-E: 10-a; RSA 170-E:11, IV; RSA 541-A:30-a
He-C 4002.08	RSA 170-E:11, I(c) and (d)
He-C 4002.09	RSA 170-E:11, I(b)
He-C 4002.10	RSA 170-E:11, I(a), (f), and (g); 45 CFR 98.41(a)(1)(i)(C); RSA 140-C:20-a; RSA 141-C:20-b
He-C 4002.11	RSA 170-E:11, I(a), (d), and (g); 45 CFR.98.41(a)(1)(i)
He-C 4002.12	RSA 170-E:11, I(a), (d), (g), and (h); 45 CFR 98.33(a)(5)(ii)
He-C 4002.13	RSA 170-E:11, I(d), (e), and (f)
He-C 4002.14	RSA 170-E:11, I(a), (d), and (g); 45 CFR 98.41(a)(1)(iv) or (vii)
He-C 4002.15	RSA 170-E:11, I(a), (d), (g), and (i); 45 CFR 98.41(a)(1)(i)(C); 45 CFR 98.16(hh)
He-C 4002.16	RSA 170-E:11, 1(a), (d), (g), and (h); 45 CFR 98.41(a)(1)(vii)
He-C 4002.17	RSA 170-E:11, I(a)-(e), and (i); 45 CFR 98.16(hh); 45 CFR 98.41(a)(1)(vi)
He-C 4002.18	RSA 170-E:11, I(a), (d), and (e)
He-C 4002.19	RSA 170-E:11, I(a), (d), (g), and (h); 45 CFR 98.41(a)(1)(iv); 45 CFR 98.41(a)(1)(x)
He-C 4002.20	RSA 170-E:11, I(a), (b), (d), (e), (g), and (h); 45 CFR 98.41(a)(1)(iii); RSA 329:1-h
He-C 4002.21	RSA 170-E:11, I(d); 45 CFR 98.41(a)(1)(v); RSA 170-E:6, 8, and 9
He-C 4002.22	RSA 170-E:11, I(d) and (e); 40 CFR 745.90(a) and (b); 45 CFR 98.41(a)(1)(v)
He-C 4002.23	RSA 170-E:11, I(d) and (e); 45 CFR 98.41(a)(1)(v)
He-C 4002.24	RSA 170-E:11, I(d) and (e); 16 CFR 1500
He-C 4002.25	RSA 170-E:11, I(d) and (e); 16 CFR 1219 and 1220; 45 CFR 98.41(a)(1)(ii)
He-C 4002.26	RSA 170-E:11, I(d), (e), and (h); RSA 170-E:6; 45 CFR 98.41(a)(1)(v)
He-C 4002.27	RSA 170-E:11, I(d), (e) and (h); RSA 170-E:6
He-C 4002.28	RSA 170-E:11, I(d) and (e); RSA 170-E:6
He-C 4002.29	RSA-170-E:11, I(d) and (e)
He-C 4002.30	RSA-170-E:11, I(d) and (e)
He-C 4002.31	RSA-170-E:11, I(a) through (e); RSA 265:107-a; 45 CFR 98.41(a)(1)(ix); 45 CFR 98.41(d)
He-C 4002.32	RSA-170-E:11, I(b) through (e); 45 CFR 98.41(a)(1); 45 CFR 98.44
He-C 4002.33	RSA-170-E:11, I(b); 45 CFR 98.41(d)
He-C 4002.34	RSA 170-E:11, I(b); 45 CFR 98.41(d)
He-C 4002.35	RSA 170-E:11, I(a) and (c); 45 CFR 98.41(d)
He-C 4002.36	RSA 170-E:11, I(a) and (c); 45 CFR 98.41(d)
He-C 4002.37	RSA 170-E:11, I(a) and (c); 45 CFR 98.41(d); RSA 170-E:2, IV(f)
He-C 4002.38	RSA 170-E:11, I(a), (c), and (e); 45 CFR 98.41(d)
He-C 4002.39	RSA 170-E:11, I(a), (c), and (e); 45 CFR 98.41(d)
He-C 4002.40	RSA 170-E:11, I(b) and (h); RSA 170-E:7; 45 CFR 98.43
He-C 4002.41	RSA 170-E: 11, IV; RSA 170-E:17, II and III; RSA 170-E:23
He-C 4002.42	RSA 170-E:7; RSA 170-E:11, I(a) and (h); RSA 170-E:17, III; RSA 170-E:23; 45 CFR 98.43(e)(2)
He-C 4002.43	RSA 170-E:11, I(a) and (h); RSA 170-E:11, IV and V; RSA 170-E:12; RSA 170-E:13
He-C 4002.44	RSA 170-E:11, II, VI and VII; RSA 170-E:21-a
He-C 4003	RSA 170-E:53-a; RSA 170-E:54; RSA 170-E:56, I; RSA 170-E:67 – 69; and RSA 126-U
He-C 4004	RSA 170-E:53-a; RSA 170-E:54; and RSA 170-E:56, II(a)