Start a Daycare in Montana – Licensing – Regulations – Laws

The Department of Public Health and Human Services of Montana have different programs which aims to expand the access and improve the quality of education and care for children especially for preschoolers.

The Bureau of Early Childhood Services of the Human and Community Services Division Department are offering these services:

The Child Care Licensing Program of the Department of Quality Assurance Division is to monitor and regulate the facilities of child care to attain safety, health, and well being of the children in Montana. They have their regular survey on the facilities of child care and they also conducts investigations on the complaints against the staffs and facilities.

The department also offers Best Beginnings for child care scholarships to the qualified families with low income who are sending thier children to licensed day care centers, registered group, or the family child-care homes, or even the legally unregistered providers. These scholarships are available to the families who are enjoying cash assistance through Temporary Assistance for Needy Families or TANF program while they are participating in the activities of Family Investment Agreement and demonstrating a strong need for a child care.

According to the National Resource Center for Health and Safety in Child Care and Early Education (NCRHSCC) the different regulations of child care in Montana, which are current as of March 26, 2009, are the following:

Regulations on health and safety of child care in Montana Effective Date
Licensing Requirements for Child Day Care Centers> 9/1/2006
Requirements for Registration of Family and Group Day Care Homes 9/1/2006
Chapter 95 – Licensure of Day Care Facilities 6/30/2006

The different links to Montana state child care contacts are:


AAP State Chapter
Head
Start State Collaboration Office

Healthy Child Care America

State Maternal and Child Health Director

State Child Care and Development Fund
State Child Care Resource and Referral Agency
State Early Learning Guidelines

REQUIREMENTS ON HEALTH CARE IN DAY CARE

The name of health care facility or physician must be provided by the parents upon admission of the child to know who will be contacted in case of emergencies.

If the child gets sick (especially if it is a communicable disease) while he is in day care, it must be reported to health department of the state then the parents must be informed and they are responsible in taking home their child.

The day care owner must assign a staff to daily monitor the health of each child prior to his entry. All those who show symptoms will be isolated. The guidelines for this are:

  • (a) There must be no sign of fever of the children. Its temperature must be lower than 101ºF.
  • (b) The children must not have diarrhea or not vomiting within 24 hours before returning to day care.
  • (c) The children with bacterial infections have to be treated with antibiotics within 24 hours. Some of the bacterial infections are strep throat, impetigo, scarlet fever, bacterial conjunctivitis (pinkeye), and some skin infections like infected wounds or draining burns.
  • (d) Rashes which cover multiple body parts have to be evaluated by health care professional to know the possible cause before the child is returned home.
  • (e) Children with signs of chickenpox are refused to be admitted until all the sores are totally dry and this usually last for five to seven days. Children, recovering from chickenpox, must not be exposed to other children even the parents allow it.
  • (f) Sick children must be isolated right away until the health care provider determines the cause and he also authorizes if the children need to be taken home.
  • (g) Sick children, with illness like uncontrolled coughing, breathing, stiff neck, difficulty or wheezing, poor intake of food or fluid, irritability, or seizure, have to be evaluated first by a health care provider before sending them home.
  • (h) Do not isolate a child if there is only discharge from nose but with no fever.

If after leaving the child by the parent or guardian and some signs of illness are seen, the day care must:

  • Isolate immediately the child in designated area for sick children;
  • Inform right away the parent / guardian and request that the child must be picked up.
  • Report any case of incidence of communicable disease to the health authority on the same day that signs or symptoms are detected.

If the child did not attend the class, the child care provider must know the cause so that he will be aware whether there is already an existence of a communicable disease. After knowing that there is a possibility of communicable disease, it must be reported right away to the health authority. The child must not be admitted without knowing the reason why he was absent.

The child can be admitted again if: it does not show signs of illness; he has no fever, diarrhea, and not vomiting within 24 hours; and has taken antibiotic for 24 hours.

The parent / guardian have to provide a certification of health signed by licensed physician, except:

If there is salmonella or shigellosis of the child. He will not be admitted unless he has no fever or diarrhea. It is required that there is written proof that the 2 stool samples are negative from salmonella or shigellosis and the health authority had released an approval so that the child can be admitted again.

If the child have virus in hepatitis A, he must either be excluded for one week or be immune to globulin.

IMMUNIZATION

A child, who is below five years old and he has to attend a day care facility in Montana, has to be provided with HPS-101 or the Montana Certificate of Immunization that requires the information such as birth date, name of vaccine given, and complete date of administering the vaccine. He has to be immunized with mumps, measles, diphtheria, pertussis, tetanus, rubella, Haemophiles influenza type B.

If not, he may initially attend to the day care facility on a conditional status if:

he received a dose for each required vaccines;

he has filed to the daycare facility about his conditional immunization status and it is attached to the certificate of immunization of Montana

the next required vaccine is not yet past due as indicated in the conditional enrollment form.

The following are the required vaccines upon entry of the child:

Age during Entry (months) Type of Vaccine with Number of Doses
below 2 no required vaccine
3

1 dose polio vaccine

1 dose DTP vaccine

1 dose
5

2 doses polio vaccine

2 doses DTP vaccine

2 doses of Hib vaccine
7

2 doses polio vaccine

3 doses DTP vaccine

*2 or 3 doses Hib vaccine
16

2 doses polio vaccine

3 doses DTP vaccine

1 dose MMR vaccine which was administered not earlier than 12 months old

*1 dose Hib vaccine which was given after 12 or 15 months old
19

1 dose varicella vaccine

3 doses polio vaccine

4 doses DTP vaccine

1 dose MMR vaccine which was administered not earlier than 12 months old

*1 dose Hib vaccine which was given after 12 or 15 months old

(*) it depends on the type of vaccine used

A child must receive vaccine upon entry (if he still not yet receive one) if he is 12 month old but not above 60 months. However, this vaccine is not recommended for children aged five years and above.

DTP vaccine which is given to the child below 7 years old is only acceptable if it is accompanied by medical exemption that meets the requirements set by ARM 16.28.707 that exempts him from pertussis vaccination.

The doses for MMR vaccine must be administered not earlier than 12 months, and if he does, he will be given another shot before attending.

The following are the required vaccines and the appropriate age to be administered:

Type of Vaccine Required Dosage by Age
Polio Minimum of three doses of vaccine is required to administer and the last one is given beyond four years old.
DTP or DTaP (diphtheria, tetanus and pertussis

Minimum of four doses of this vaccine must already be given at the age of four and the last one is given before seven years old unless medical exemption is provided for pertussis part of the vaccine.

In case medical exemption is issued for the pertussis, the four doses must be given before the child turned four and the last one must be received before the age four but not beyond seven years old.

DTP and DTaP vaccines are not recommended for children that are seven years old therefore, Td vaccine (tetanus and diphtheria vaccine which are intended for persons who are seven years old and above) must be given if he not yet received any dose of DTP or DTaP and has to be administered right away.
Td (tetanus diphtheria) The Td vaccine must be given to the child below seven years old as booster unless DTP, DTaP, DT or Td was given to the child within five years of age or if the child had received Td during seven years old or beyond.

The child must continuously receive immunization shots when attending a day care because he will be immediately excluded if he does not do so. In case a communicable disease (which requires immunization) occurred in the daycare, all infected individuals and those who were not immunized completely with the disease are required to be isolated to avoid the spread of disease.

Written records of immunization are required for each child that are enrolled in the day care. And these must be available in case the local health authority requires them.

ADMINISTRATION OF MEDICATION AND STORAGE

There must always be a written authorization, signed by the parents or guardians, before administering medications to children. The validity of the authorization must be clearly indicated including the name of child and dosage instructions.

But in case of emergency and the parent or guardian is not available, the center may administer the medicine if:

  • (a) there is written authorization from a medical practitioner
  • (b) there is a verbal instruction given by the emergency service provider, medical practitioner, or the 911 responder to urgently administer medicine to the child provided that the child be immediately transported to the nearest health facility or medical practitioner for follow up.

The following documents are needed when administering medicine to children:

  • (a) medication record which includes parent’s written authorization, prescription of health care provider, and record on medication administration;
  • (b) written policy on medication administration like the kinds of medication that can be administered, amount, frequency, and duration; and
  • (c) medication and health care plan for the children who have special medical needs or those with chronic health conditions.

The medicines must be properly labeled and these must be in their original container. The required information that must be indicated in the labels are the full name of the child, date of prescription, name of the health provider, and the expiration date of medication, instructions on administering, storage and disposal.

In case the medicine does not require prescriptions, it must be labeled with the full name of the child, date of medication, instructions for storing and administering, and name of the person who recommends it.

Expired medicines must not be used and all the medications, whether refrigerated or not, must have protective caps, kept in orderly way, stored in a place which is separate from the food, and also beyond the reach of children.

REQUIREMENTS FOR FIRST AID

The child care must follow the policies regarding first aid. It must be in accordance with the recommendations of American Red Cross. The policy includes the following:

  • procedures of handling the medical emergencies like calling the Emergency Montana Poison Control Center in 1 (800) 222-1222 if there is incidence of indigestion of toxic or poisonous substances of the child is when; and
  • directions in contacting the parents / guardians or somebody who is responsible if a child is injured or sick.

The first aid kit has to be kept in area that is easily seen and it must contain the following:

  • one ounce bottle of ipecac syrup that may be given in case directed by the Montana Poison Control or directed by the local emergency service program such as 911 operator, physician, or local hospital;
  • absorbent and sterile bandages;
  • tapes and different varieties of band-aids;
  • scissors and tweezers; and
  • disposable gloves.

The toll free number of Emergency Montana Poison Control Center is 1(800) 222-1222. The provider must notify immediately the department in case there are environmental hazards or danger in the facility which affects the welfare, safety, and health of the children.

The provider must report to the authority within the day of the incidence of accident which caused injury to the child that resulted to either hospitalization of the child, required ambulance intervention, treatment by physician, or incidence of fire in the premise of the day care. The parents must be provided with the copy of the written report.

All injuries that occurred to the child must be indicated in the medical record of the child which includes the date, time, treatment, details of injury, and whether the incidence was notified to the parent.

HEALTH HABITS

The day care must establish good health habits like washing of hands which must be part of their everyday activity. Hand washing must be done before eating, before participating in the preparation of food, and after going to the toilet.

The provider must:

  • exclude the children with communicable disease, cold, sore throat, and with fever of 101°F or greater;
  • wash the exposed portion of the arms and hands by rubbing vigorously the surfaces for not less than 20 seconds and rinsing thoroughly with clean water especially those between the finger and underneath the nails every : after touching the bare body parts other than hands and arms; after changing diapers; after going to the toilet; after sneezing, coughing, or using disposable tissue or handkerchief; before and during food preparation; before feeding; and after contaminating the hands due to other activities.
  • give documentation of the complete immunizations on mumps, rubella, and measles, and boosters on diphtheria and tetanus within 10 years before they work, volunteer, or reside in the day care.

SPACES FOR SUPPORT SERVICES

There must be enough space in day care center and the right equipment and furniture must be provided for the support functions to attain maximum convenience and comfort of the parents and staff.

There must be enough work areas and storage which are accessible to the area for other related functions conducted such as:

  • Administrative functions in the office like storage for records, venue for staff’s meeting, or private conversation with the parents.
  • Preparation of food and serving;
  • Custodial services;
  • Laundry;
  • Rest area of staff during break time periods; and
  • Storage for curriculum materials and alternative toys.

EQUIPMENT AND MATERIALS

The available equipment and materials have to meet the children’s developmental needs. This depends on its amount, variety, use, and arrangement. The criteria for approving for this aspect are:

  • (a) There should be individual areas for housekeeping, quiet section or library, creative arts, building block, and for table activities (for plating manipulative toys). These must be arranged in such a way that active areas are not in conflict with quiet sections;
  • (b) The equipment and materials must be enough and with good quality to stand to multiple and excessive use of many children and to give them different experiences which satisfy their unique interests;
  • (c) The furniture must be safe, clean, durable, child age appropriate;
  • (d) The provided shelves for storage must be at children’s level.

There should be items in the materials and equipment that enhances the six categories of development of children which includes tactile, visual, cognitive, auditory, large muscle, and development in dramatic role playing.

The high chairs must have safety straps and wide base. The equipment intended for resting must be age appropriate, clean and sanitized. Blanket, mat, bed, cot, or crib must be available.

There must be telephone for each facility and the phone numbers of ambulance, hospital, fire department, police station, poison center, and parents must be visibly seen. The contact number of the Emergency Montana Poison Control Center is 1 (800) 222-1222.

CHILD-TO-STAFF RATIOS

The following are the required ratio for child and staff:


Age Range Ratio For Center-based Care
Infants (0 – 23 months) (1:4)
Toddlers (2 – 3 years old) (1:8)
Preschool (4 – 5 years old) (1:10)
School-aged (6 years and above) (1:14)

Age Range
Ratio For Family Child Care

All ages

(1:6) includes provider’s children who are under 6 years old

In determining the required number of staffs, the director, primary care-givers, and aides are considered staff.

TOILET TRAINING

The day care should have adequate supply of clean diapers and a child should be changed as frequent as needed. Disposable diapers or reusable diapers can be used. Sometimes parents are the one who is supplying them. If you are using non-disposable diapers, there should be a facility to wash them. They should be washed and sanitized using a germicidal process which is approved by the local health department.

For the soiled reusable diapers, they should be in separate covered container with waterproof lining when transporting them to the laundry. These containers should be emptied, cleaned, and sanitized everyday. However, for soiled disposable diapers, it should be disposed immediately outside the premises or if not wrap it in securely tied plastic bag then dispose it indoors until outside disposal is possible. Either reusable or disposable diapers are used, they should be removed from the establishment daily.

Diaper changing surfaces should be cleaned and sanitized in each use. The surface should be washed and sanitized or change the disposable pad or sheet every after usage.

Clean towels, reusable or disposable, should be used in cleaning or drying each baby. Safety pin should be kept out of children’s or baby’s reached.

Children should be supervised carefully specially in areas where they might fall.

Each toiletry should be separated and tagged or put the name for each child, they should be stored in sanitized area. Diaper changing area and toilet area should have a wash basin that is not to be used for food preparation.

Toilet training should be initiated depending on the child’s readiness and with parents’ consent. Do not attempt training the child under 18 months of age.

CLOTHING

When the child gets wet or soiled, they should be changed as soon as possible and parents should provide clean clothes for their children. If an older child, who is already toilet trained, accidentally wet their clothes, change them promptly.

FEEDING

Follow each child’s diet and feeding schedule according to the written plan given by their parents or physician, any changes that you are going to do should be noted on each child and notify their parents.

Parents should prepare one day formula milk or breast milk in nursing bottles. Each feeding bottle should be labeled properly, named and dated and then refrigerated. Instructions should be noted carefully specially for the formula milk which is requiring dilution in preparation. After each use of the bottle, they should be rinsed thoroughly before returning them to their parents at the end of the day. If special dietary food is needed by the infant or a child, these should be prepared by parents.

There are different ways of feeding a child according to their age bracket, infants who are too young to sit down should be in semi-sitting position, never let a child drink from their bottle lying on their backs. Older infants of toddler, who can sit, should be fed in secured high chairs or baby tables. At this age, they can grab or prefer to hold their bottles therefore you can allow this but with close supervision. Removed bottles when the child finishes feeding and whenever the bottle is empty while they are asleep.

If the child’s parents fail to bring enough formula milk or breast milk, the day care should have their prepared emergency formula milk too. And if older infant or toddler ran out of food, the day care should have food that is suitable and readily available for them. However, excess food or leftover food for infant should be kept in original container, sealed or covered and kept in proper storage as well as the dry foods like cookies, crackers, cereals, breads, and similar foods.

If the formula milk does not have sanitized feeding bottle or there is failure of the parents to bring bottles and nipples, you should prepare them or transfer them in proper, sanitary manner in the kitchen. It must be in sterilized feeding bottles and these should be refrigerated right away. If these are not consumed within 12 hours, you need to dispose it properly.

Bottles and nipples that will be used in the day care center should be washed, cleaned, and sterilized by boiling water at least for 5 minutes prior to usage. One step or terminal sterilization of these feeding bottles and nipples is also acceptable.

BATHING

Bathing a child is not usually done in day care but sometimes if needed, you may follow these guidelines:

  • Child should be closely monitored in the bathing area.
  • Bathing materials should be washed, cleaned and sanitized after each and every use.
  • Hypoallergenic soap should be used.
  • Water that will be used in bathing the child should not be over 120°F.
  • Dry the child immediately after bath.

SLEEPING

There should be adequate time for a child to rest and sleep according to their needs. Infants should be placed in their backs on a firm sleeping surface to avoid the risk of Sudden Infant Death Syndrome or SIDS unless noted otherwise from parents or any health care provider.

Each infant should have individual crib or play pen for sleeping unless different instructions from the parents or health provider that they should be laid in cot or mat.

  • a child should be routinely allowed to sleep in a car seat, infant swing, or the like equipment
  • the mat or cot should be made of plastic or canvas or any material which can be easily cleaned, sanitized, and dried

Cribs should be made of nontoxic, durable, and washable material; it should have secure device; and the vertical slats should not be more than 2 and 3/8 inches in spacing. The crib mattress should be waterproof and easily cleaned and sanitized. The mattress should also fit properly to prevent a child or infant being caught in between mattress and crib side railing. These sleeping materials, cots, cribs,
mats and mattresses should be cleaned and sanitized before assigning to another child or infant.

The sleeping materials should have proper spacing from each other when they are in use to allow proper ventilation and easy access for each child. Stackable cribs for infants are also allowed until they reached 1 year of age or when they reached 26 pounds of weight, or either of the two that comes first.

Remove all objects from the crib, cots, or play pen when not in use, examples are pillows, comforters, stuffed toys or any soft material. If they are going to use blankets during sleep, the infant’s head should not be covered.

Parents should provide clean and washable blanket or sleeping materials and each bedding should be stored separately from others. When an infant, toddler, or a child cries during their sleep it should be investigated.

ACTIVITIES

All infants or toddlers should be allowed to move freely like crawling, creeping, rolling, and or walking, but just make sure that the place or area is clean, safe, and sanitized.

If a child is awake, do not let them stay in cribs, cots, play pens, high chairs, walkers, or jump chairs more than 30 minutes. An infant should have personal contacts and attention from the same person regularly at least once every hour or as needed by the child especially when they are not asleep. Personal contacts should include holding, playing, talking, and rocking the child. You can also take them on a walk inside or outside the center’s premises. Make sure that your day care should have enough staff and employee to supervise the children under your care.

Allow infants or children to safely explore and investigate their environment, they should be taken outside the day care premises each day in good weather.

Each child is different, allow them to have their own sleeping and waking pattern and or otherwise upon parents instructions or health care personnel.

OUTDOOR ACTIVITIES

When you plan activity of a child outside the day care building or establishment, make sure that they are protected and should avoid prolonged exposure from the sun. For children more than 6 months old and with parents’ permission, they should be applied with sunscreen.

Every time children are outside the day care facility, they should be closely supervised and monitored. Make sure that you will have the outdoor activity on a fenced and safe area adjacent to your establishment. The children should have adequate protection from insect bites. Plan their outside activity in both sunny or shady area of your day care establishment and with close supervision.

REQUIREMENTS ON PUBLIC HEALTH

Solid Waste

All the solid wastes in day care must be properly collected, stored, and disposed. The center must therefore:

  • keep all the solid wastes in containers with lids, water tight, fly tight, rodent proof, and corrosion resistant;
  • clean and sanitize frequently all the containers of the solid waste;
  • use collection stands of the containers to avoid tilting of containers, to protect from further deterioration, and to facilitate easy cleaning around and below the containers; and
  • transport the waste weekly through in covered containers or covered vehicle.

Laundry

To prevent hazardous effects to children caused by soiled laundries, the day care must:

  • (a) avoid putting soiled laundry in areas that have direct contact with food like areas used for dining, food storage, and food preparation and be sure that the soiled laundry is beyond the reach of children;
  • (b) have enough space for the sorting of soiled laundry and storing clean clothes so that these do not contact with one another;
  • (c) machine wash all the laundry with minimum temperature of water of 140F and the minimum time is eight minutes then tumble dry them using hot air dryer which is vented outside the building;
  • (d) for the beddings:

    • wash the beddings when soiled and periodically air them out to avoid mildew; and
    • beddings that are used by other child can be used by another child unless it is washed;

  • (e) handle properly the reusable diapers which is prescribed in the ARM 37.95.210.

General Housekeeping

For the measures on general housekeeping, the day care has to ensure that:

  • (a) the grounds and building are free from insects, rodents, and other related creatures;
  • (b) the walls, floors, furnishings, ceilings, and equipment are kept clean and easy to clean;
  • (c) there are always soap, disposable towels, or any hand-drying devices available in all the washing sinks. It is prohibited to use a towel common to all;
  • (d) toilet tissues are provided in all toilets;
  • (e) the maintained temperature is at least 65ºF in all areas that are used in daycare;
  • (f) all the toys must be regularly cleaned and sanitized in the solution which contains ¼ cup bleach and one gallon water. The toys must be thoroughly rinsed and must be air dried;
  • (g) the facilities for bathing and hand sinks must be provided with hot water (100ºF and not more than 120ºF);
  • (h) there must be germicide or fungicide to the cleaning solution that are used to clean the showers, bathtubs, urinals, sinks, floors, toilet seats, and toilet bowls;
  • (i) the cleaning devices that are used for the tubs, toilets, and sinks must be kept separately with one another, then the devices used for urinals, toilet seats, and toilet bowls must not be used for other purposes and must be beyond the reach of children;
  • (j) dry mops and cloths are prohibited to use; and
  • (k) the pesticide and cleaning compounds must be used, stored (separately and must be inaccessible to children), and disposed in conformity with the instructions in the manufacturer’s manuals.

Just like any other state,Montana also gives importance on providing quality child care services to its constituents. It has different agencies to be contacted for specific needs.

These are the following:

Child Care Licensing Agency
Montana Department of Public Health
2401 Colonial Drive
P.O. Box 202953
Helena, MT 59620-2953
Phone: (406) 444-2012 or (406) 256-7062
Fax: (406) 444-1742
Montana Daycare Listings

Head Start – State Collaboration Office
Department of Health and Human Services Cogswell A-116
Early Childhood Services Bureau
P.O. Box 202952
Helena, MT, 59620-2952
Phone: (406) 444-0589
Fax: (406) 444-2547

State Child Care Resource & Referral Contact
127 East Main St., Suite 217
Missoula, MT 59802
Phone: 406-549-1028
Toll Free: (866) 750-7101
Fax: (406) 541-9028

Child Care Subsidy Agency
Montana Department of Public Health and Human Services
Human and Community Services Division
P.O. Box 202952
Helena, MT 59620-2952
Phone: (406) 444-1828
Fax: (406) 444-2547

Child Care Food Program Agency
Department of Public Health & Human Services
1400 Broadway
Cogswell Building A-16
Post Office Box 202952
Helena, Montana 59604
Phone: (406) 444-4347 or (888) 307-9333
Fax: (406) 444-2547

Office of Child Support Enforcement
Department of Public Health & Human Services
3075 N. Montana Ave. Suite 112
Helena, Montana
Phone: (800) 346-5437
Fax: (406) 444-1370

Hotline for Reporting Child Abuse

  • 866-820-KIDS (5437)
  • national child abuse information: 1-800-4-A-CHILD or 1-800-2-A-CHILD (T.D.D) (USA
    National Child Abuse Hotline)

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