10a NCAC 09 .0802         EMERGENCY MEDICAL CARE

(a)  Each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan:

(1)           The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed:

(A)          first aid given at the center for an injury or illness needing only minimal attention; and

(B)          calling 911 in accordance with CPR or First Aid training recommendations.

(2)           The name of the person and one alternate, at the center responsible for:

(A)          ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility;

(B)          accompanying the ill or injured child to the medical facility;

(C)          notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment;

(D)          obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and

(3)           A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency.

(b)  One person identified as the person or alternate responsible for carrying out the emergency medical care plan and ensuring that appropriate medical care is given shall:

(1)           be on the premises at all times; and

(2)           accompany children for off-premises activities.

(c)  Emergency medical care information shall be on file for each child. That information shall include:

(1)           the name, address, and telephone number of the parent or other person to be contacted in case of an emergency;

(2)           the responsible party's choice of health care professional;

(3)           any chronic illness and any medication taken for that illness; and

(4)           any other information that has a direct bearing on ensuring safe medical treatment for the child.

This emergency medical care information shall be on file in the center on the child's first day of attendance and shall be updated as changes occur and at least annually.

(d)  Each child's parent, legal guardian, or full-time custodian shall sign a statement authorizing the center to obtain medical attention for the child in an emergency. That statement shall be on file on the first day the child attends the center. It shall be easily accessible to staff so that it can be taken with the child whenever emergency medical treatment is necessary.

(e)  The child care provider shall complete an incident report each time a child is injured as a result of an incident occurring while the child is in care. This incident report shall include:

(1)           facility identifying information;

(2)           the child's name;

(3)           date and time of the incident;

(4)           witness to the incident;

(5)           time the parent is notified of the incident and by whom;

(6)           piece of equipment involved, if applicable;

(7)           cause of injury, if applicable;

(8)           type of injury, if applicable;

(9)           body part injured, if applicable;

(10)         where the child received medical treatment, if applicable;

(11)         description of how and where the incident occurred, and the First Aid received; and

(12)         steps taken to prevent reoccurrence.

This report shall be signed by the person completing it and by the parent, a copy given to the parent or the parent declining a copy and the report maintained in the child's file. A copy of the form may be found on the Division's website at http://ncchildcare.ncdhhs.gov/pdf_forms/DCDEE-0058.pdf.

(f)  When medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven calendar days after the incident.

(g)  An incident log shall be completed any time an incident report is completed. This log shall:

(1)           include the name of the child;

(2)           include the date of the incident;

(3)           include the date the incident report was submitted to the Division, if applicable;

(4)           include the name of the staff member who complete the incident report;

(5)           be cumulative and maintained in a separate file; and

(6)           be available for review by a representative of the Division.

This log shall be completed on a form provided by the Division. A copy of the log may be found on the Division's website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/I/incident_log_i.pdf?ver=2017-05-16-105723-723.

(h)  A First Aid information sheet shall be posted in a place for referral. The information sheet shall include first aid guidance regarding burns, scalds, fractures, sprains, head injuries, poisons, skin wounds, stings and bites. An information sheet may be requested free of charge from the North Carolina Child Care Health and Safety Resource Center at 1-800-367-2229.

History Note:        Authority G.S. 110-85; 110-91(1),(9); 143B-168.3;

Eff. January 1, 1986;

Amended Eff. July 1, 2010; July 1, 1998; January 1, 1996; October 1, 1991; November 1, 1989;

Readopted Eff. October 1, 2017;

Amended Eff. February 1, 2021; September 1, 2019.