Subchapter H. Minimum Standard Rule Revisions that May Affect Compliance

Caring for Infants

See and Hear

746.2403 How must I arrange the infant care area?

In addition to replacing the term "children" with "infants", this rule has been amended to change the requirement for arranging the room in a way that makes it possible for caregivers to "see and/or hear" all infants at a glance to arranging the room in a way that makes it possible for caregivers to "see and hear" all infants at a glance.

From "see and/or hear"

To "see and hear"

This means that your infant care area must be arranged in a way that allows caregivers to see and hear infants at a glance and be able to intervene when necessary.

Infant Room Arrangement

As you evaluate your infant room to determine whether it is arranged in a way that ensures caregivers can see and hear infants at a glance, consider the following:

  • How large is your infant care area?
  • Is the infant care room shaped in a way that allows sight from one end to the other?
  • If your infant room is shaped in a way that does not allow complete supervision from one side to the other (for example, L shaped), is it arranged in a way that ensures supervision.
  • Is your infant room divided by shelves or partial walls?
  • If so, are the shelves or partial walls low enough to ensure caregivers can see and hear infants?
  • If you have a partial wall that is higher, does it have cut outs that allow caregivers to see and hear infants on both sides?

Answering these questions may help you determine whether your infant care area is arranged in the best possible way to meet minimum standard rule requirements and ensure optimal supervision of infants at your operation.

 

746.2419 Are there specific requirements for feeding infants?

In addition to replacing the terms "child" and "children" with "infant" and "infants", this rule has been amended to clarify that bottles cannot be propped or supported by an object. The images below show instances of propping, none of which are allowed.

Bottle Propping

Bottle Propper

Bottle Propper

 

Furnishings and Equipment

746.2405 What furnishings and equipment must I have in the infant care area?

This rule has been amended to:

• replace the term "children" with "infants";

• clarify that cribs are to sleep in; and

• specify that cribs are required for non-walking infants younger than 12 months of age.

 

How is this different?

Instead of requiring a crib for each non-walking infant (0-17 months), cribs will be required for non-walking infants younger than 12 months of age.

Read the following scenarios and select those that require a crib.

[mark all correct answers]

 
 
 
 
 

 

Bouncer

746.2407 Must the equipment I use for infants be equipped with safety straps?

This rule has been amended to specify that if the manufacturer requires safety straps on a chair, swing, stroller, infant carrier, bouncer seat, or similar type of equipment, then the safety straps must be fastened whenever an infant is using the equipment.

 

What does this mean?

If any equipment you use at your operation includes safety straps, the safety straps must be fastened whenever a child is using the equipment; however, you may also use infant equipment that does not come with or require safety straps by the manufacturer.

 

Can I choose to purchase or make safety straps for pieces of infant equipment that do not have them?

No. You should not attempt to purchase or create safety straps for any piece of equipment unless specifically required by the manufacturer.

 

If any piece of infant equipment comes with safety straps, the safety straps must be fastened whenever an infant is using the equipment.

 
 

 

According to 746.2407, which of the following answer options is an acceptable reason for not fastening safety straps when using infant equipment?

 
 
 

 

746.2409 What specific safety requirements must my cribs meet?

In addition to replacing the term "child" with "infant", this rule has been amended to:

• clarify that this rule applies to all full-size and non-full-size cribs;

• incorporate information regarding "port-a-cribs" (which are "non-full-size" cribs as defined by CPSC);

• clarify that cribs must be labeled with the infant's name; and

• add the requirement that only mattresses designed specifically for use with the crib model type may be used.

For full-size, non-full-size and stackable cribs, the mattress you use with the crib must meet manufacturer specifications. The image below shows an example of a manufacturer's guide. Notice that this manufacturer identifies their product as CPSC certified and outlines the dimension requirements for mattresses used with this crib model.

Crib Manufacturer Specifications

 

Play Yard

746.2411 Are play yards allowed?

In addition to changing the rule question (formerly Are mesh cribs or port-a-cribs allowed?), this rule has been amended to:

• remove content specific to "port-a-cribs" because these cribs must meet all of the requirements in 746.2409 What specific safety requirements must my cribs meet?;

• add the term "play yard", which are mesh or fabric sided cribs;

• specify that play yards must be used according to the manufacturer's instructions, including the cleaning of the play yard;

• specify that play yards must have a firm, flat mattress that snugly fits the sides of the play yard, the mattress must be designed by the manufacturer specifically for the play yard model number that is being used and the mattress must not be supplemented with additional foam material or pads; and

• specify that play yard sheets must be designed specifically for the size and type of play yard and play yard mattress that it is being used, be tight fitting and thin and not be designed to make the sleep surface softer.

 

Are non-full-size cribs and play yards the same?

No. This is why non-full-size cribs, which include port-a-cribs, will no longer be a part of this rule. The purpose is to distinguish the difference between non-full-size cribs, like port-a-cribs, from play yards. If it has mesh sides it is a play yard.

 

746.2413 Are stacking wall cribs allowed?

In addition to replacing the term "child" with "infant" and modifying wording for easier readability, this rule has been amended to clarify that stacking wall cribs are allowed only for infants who cannot stand or infants who are able to stand without hitting their heads on either the top of the crib or the ceiling above the top crib.

 

Technical Assistance: Stacking cribs are most useful for younger infants who are not exploring mobility, which increases the likelihood of accidentally bumping their heads from attempts to pull up. Also consider the size and weight of the infant in the top crib in relation to the height and physical abilities of your caregivers.

Stacking Crib

 

A Guide to Crib Types

Full-Size

Non-Full-Size

Stackable

Play Yard

Characteristics

• May or may not have wheels

• May or may not be collapsible

• Hard sides

• May or may not have wheels

• May or may not be collapsible

• Hard sides

• May be a non-traditional shape (oval)

• May be full-size or non-full-size

• Two cribs stacked one on top of the other

• Wheels on lower crib

• Hard sides

• May be used for sleep only or may be used for a combination of sleep and exploration

• Mesh sides

• May or may not have wheels

• Collapsible and portable

Distinguishing Features

Interior dimensions of 28 5/8 inches in width and 52 2/3 inches in length

Larger or smaller than full-size crib dimensions

Two cribs stacked one on top of the other

mesh sides, foldable

Also Known As

"standard"

"port-a-crib", "mini", "portable"

"stacking", "double decker", "bunkie", "space saver"

"playard", "play pen", pack n' play"

 

746.2415 What specific types of equipment am I prohibited from using with infants?

This rule has been amended to specify that cribs must be bare when occupied by an infant younger than 12 months of age with exception to a crib mattress cover that is designed specifically for the size and type of crib and crib mattress, be tight fitting and thin and not be designed to make the sleep surface softer.

 

What does it mean to be bare?

Bare means the crib should be free of any additional items, including those soft bedding items previously listed in the rule—soft, loose bedding, blankets, sleep positioning devices, stuffed toys, quilts, pillows, bumper pads and comforters.

 

How is this different?

The intention of the rule is the same. The language of the rule has been updated to more accurately reflect the intent, which is to ensure cribs occupied by infants younger than 12 months of age are bare or free of any additional items, including those soft bedding items previously listed in the rule—soft, loose bedding, blankets, sleep positioning devices, stuffed toys, quilts, pillows, bumper pads and comforters.

 

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Infant Safe Sleep

746.2426 May I allow infants to sleep in a restrictive device?

This new rule has been added to clarify that infants are not allowed to sleep in restrictive devices unless Infant Sleep Exception, Form 2710, is completed by a health-care professional stating that sleeping in a restrictive device is medically necessary. If an infant falls asleep in a restrictive device, the infant must be removed from the device and placed in a crib as soon as possible.

746.2427 Are infants required to sleep on their backs?

In addition to replacing the term "child" with "infant" and clarifying that infants must sleep in their own cribs, this rule has been amended to clarify that infants not yet able to turn over must be placed in a face-up sleeping position unless Infant Sleep Exception, Form 2710, is completed by a health-care professional stating a different sleeping position is medically necessary.

746.2428 May I swaddle an infant to help the infant sleep?

This rule has been amended to clarify that swaddling is only allowed if Infant Sleep Exception, Form 2710, is completed by a health-care professional stating that swaddling a specific child for sleeping purposes is medically necessary.

Alert

Your Licensing inspector has just entered your operation's infant room where caregiver, Sarah, is caring for three infants.

For which of the following scenarios might your inspector cite minimum standard rule 746.2426 May I allow infants to sleep in restrictive devices?.

[mark all correct answers]

 
 
 

 

If a parent requests a sleeping position for their infant that is not allowed by minimum standard rules, what should my operation tell the parent?

 If a parent requests her infant be placed in a sleeping position or in a device that is not allowed by minimum standard rules, your operation must inform the parent of the requirement to have their infant's health care professional complete Infant Sleep Exception, Form 2710, based on the infants medical need. Once the parent brings the completed sleep exception form, you can review it to ensure it is complete.

 

What is the Infant Sleep Exception, Form 2710 Where can I obtain a copy?

The Infant Sleep Exception, Form 2710, is a new form created to serve as the written medical statement from a health-care professional required for exceptions to the three rules above, which outline infant sleep requirements.You can access this form on the DFPS Internet.

 

Does my operation have to accept and allow Infant Sleep Exceptions?

No. Your operation may choose whether Infant Sleep Exceptions will be allowed. In addition, your operation can choose whether to accept infant sleep exceptions on an individual basis.

Your operation just received a completed Infant Sleep Exception from Nicole's dad. After reviewing the exception and discussing Nicole's health and sleeping patterns with her caregiver, you determine that the risk outweighs the benefits and decide not to sign and allow the sleep exception.

Is your operation allowed to decide whether to accept an Infant Sleep Exception from the infant's health-care professional?

 
 

Your operation has received Infant Sleep Exception, Form 2710, from Ben's parents, which has been completed by Ben's health-care professional.

The form indicates that the sleep exception can begin immediately and can remain effective for two weeks.

At the end of the two week period, both Ben's parents and caregivers feel that Ben would benefit from extending the exception for an additional week and decide to continue following the recommendations on the sleep exception that just ended.

Is this an acceptable practice?

 
 

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