.04 Child Records.

A. For each child admitted to, or continuing in care, the operator shall maintain written records, on forms provided or approved by the office, that meet the requirements of this regulation.

B. Each child's written records shall be:

(1) Readily accessible to all staff members providing care to the child; and

(2) Kept on file at the center during the period of a child's enrollment and for 2 years after the child's disenrollment.

C. The operator shall obtain and maintain emergency information from the child's parent that:

(1) Includes the child's name and date of birth;

(2) Includes the parent's full name, current address, and home and work telephone numbers;

(3) Includes the name and telephone number of the individual who is authorized to pick up the child each day;

(4) Includes the name and telephone number of at least one individual who is authorized to pick up the child in an emergency;

(5) Includes the name, address, and telephone number of the child's physician or other health care provider;

(6) If the child has a special health condition, includes emergency medical instructions for that condition;

(7) Is signed and dated by the child's parent;

(8) Is updated as needed, but at least annually; and

(9) Is readily accessible to each staff member supervising the child, including during an off-site activity.

D. Unless a parent objects to a child's medical examination because of bona fide religious beliefs and practices, a health assessment of the child shall be provided by the child's parent that:

(1) Includes a parental statement of the child's health status;

(2) If applicable, includes a statement of allergies; and

(3) Includes a medical evaluation, signed and dated by a physician, that states the child is medically cleared to attend child care and is based on an examination completed by the physician within the last:

(a) 2 months before admission for a child younger than 9 months old;

(b) 3 months before admission for a child between 9 and 24 months old; or

(c) 12 months before admission for a child 2 years old or older.

E. The operator shall maintain documentation that, as required by COMAR 10.11.04, each child admitted to, or continuing in, care has received:

(1) An appropriate lead screening, if the child is younger than 6 years old and was born before January 1, 2015; or

(2) A lead test when the child is 12 months old and again when the child is 24 months old, regardless of where the child resides, if the child was born on or after January 1, 2015.

F. A medical evaluation and, if applicable, documentation of an appropriate lead screening or test that are transferred directly from a registered family child care home, another licensed child care center, or a public or nonpublic school in Maryland may be accepted as meeting the requirements of §§D(3) and E of this regulation.

G. Unless a school-age child attends a school-age program located in the child’s school, the operator shall obtain, and maintain at the center, an immunization record showing that:

(1) The child has had immunizations appropriate for the child's age which meet the immunization guidelines set by the Maryland Department of Health;

(2) The child has had at least one dose of each vaccine appropriate for the child's age before entry and is scheduled to complete the required immunizations;

(3) A licensed physician or a health officer has determined that immunization is medically contraindicated according to accepted medical standards; or

(4) The parent objects to the child's immunization because it conflicts with the parent's bona fide religious beliefs and practices.

H. If a parent objects to a child's immunization or medical examination, or both, because of the parent's bona fide religious beliefs and practices, an operator shall require the parent to provide a health history of the child and sign a statement indicating that to the best of the parent's knowledge and belief, the child is in satisfactory health and free from any communicable disease.

I. The operator shall record or maintain on file:

(1) Each incidence of acute illness requiring exclusion of the child from care pursuant to COMAR 13A.16.11.01;

(2) Each injury or accident required by Regulation .06C and D of this chapter to be reported;

(3) Child medication records required by COMAR 13A.16.11.04A(1) and D;

(4) If the child requires a modified diet, the prescription from the child's health practitioner or the written instructions from the child's parent, pursuant to COMAR 13A.16.12.02;

(5) If program activities away from the center are provided, prior written permission from the child's parent to take the child to those activities; and

(6) If applicable, documentation that the parent of a toddler or an infant who is 12 months old or older has requested a crib for the child's rest periods.

J. Written information about the child's individual needs that is supplied by the parent by the time of the child's admission to care shall be reviewed by the operator and the parent at least every 12 months after the child's admission to care.

K. An operator shall maintain daily records of the amounts and kinds of liquids and solid food consumed by each infant and toddler. These records shall be:

(1) Dated and kept on file for at least 4 weeks;

(2) Available in the infant or toddler feeding area; and

(3) Made available to the child's parent.