Chapter 40.1. TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS SUBCHAPTER 55-40.1 CHILD CARE STANDARDS RULES AND REGULATIONS Part 001 General Provisions § 55-40.1-206 Information on Owner or § 55-40.1-001 Definitions Operator § 55-40.1-208 Change in Services Part 100 Rules Governing the § 55-40.1-210 Information and Records on Licensing of Day Care Centers, Group Child Each Child Care Homes, Family Day Care Homes, § 55-40.1-212 Disclosure of Information on Family, Friends and Neighbor Care, Infant the Child and Toddler Child Care Center, Summer § 55-40.1-214 Information and Records on Day Program/Summer Day Camp, and Facility Before and After School Programs § 55-40.1-216 Transportation Provisions Subpart A Licensing Procedures Subpart B Program Requirements § 55-40.1-100 Licensed Required § 55-40.1-218 Program Provision § 55-40.1-101 Application Requirements § 55-40.1-102 Non-Discrimination § 55-40.1-220 Communication with Parents § 55-40.1-103 Registered Licensed-Exempt and Child Care Providers Care § 55-40.1-222 Program Materials and § 55-40.1-105 Fees Equipment § 55-40.1-110 Inspection and Issuance of § 55-40.1-224 Transition to a New Facility or Child Care Licenses School Setting § 55-40.1-115 Fire and Health Inspections Subpart C Staffing Requirements § 55-40.1-116 Right of Entry and Violations § 55-40.1-226 Staff Training, Experience, § 55-40.1-120 Denial, Suspension, Revocation Qualifications, and Comprehensive of Child Care License, and Hearings Background Check § 55-40.1-125 Report of a Critical Incident § 55-40.1-228 Staff-child Ratio § 55-40.1-130 Reporting Child Abuse Subpart D Health Standards for Children § 55-40.1-135 Licensing Complaints § 55-40.1-230 Health Consultation Provisions § 55-40.1-140 Posting of Licensing § 55-40.1-232 Evidence of Child’s Health Information § 55-40.1-234 Emergency Care Provisions § 55-40.1-145 Confidentiality of Records § 55-40.1-236 Pediatric First Aid and § 55-40.1-146 Standard Operating Procedures/ Cardiopulmonary Resuscitation Administrative Procedures § 55-40.1-238 Admission of Ill Children § 55-40.1-150 Parental Accessibility § 55-40.1-240 Non-admission of Ill Children § 55-40.1-155 Perjury Statement § 55-40.1-242 Admission of Children with § 55-40.1-160 Civil Penalty Disabilities § 55-40.1-243 Admissions of Children Part 200 Day Care Center & Group Child Experiencing Homelessness Care Homes, Before and After School § 55-40.1-244 Daily Nutritional Needs Programs § 55-40.1-246 Drinking Water Provisions Subpart A Administration Requirements § 55-40.1-248 Integration of Mental Health § 55-40.1-201 Supervision of Children Concepts § 55-40.1-202 Age of Children in Care § 55-40.1-249 Hand Washing Policy for § 55-40.1-204 Statement of Operation Policies Children © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 1 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Subpart E Health Standards for Staff § 55-40.1-310 Information and Records on § 55-40.1-250 Providers’ Health Standards Each Child § 55-40.1-251 Hand Washing Policy for Staff § 55-40.1-312 Disclosure of Information on § 55-40.1-252 Personal Health Habits of Staff the Child § 55-40.1-253 Health and Safety § 55-40.1-314 Information and Records on Requirements Facility Subpart F Environmental Health § 55-40.1-316 Transportation Provisions Standards Subpart B Program Requirements § 55-40.1-254 Emergency, Preparedness, § 55-40.1-318 Program Provisions Recovery, and Response Plan (EPRRP) § 55-40.1-320 Communication with Parents § 55-40.1-256 Accidental Injury Precautions and Guardians § 55-40.1-258 Environmental Hazards § 55-40.1-322 Program Materials and § 55-40.1-260 Water Supply Equipment § 55-40.1-262 Toilet and Lavatory Facilities § 55-40.1-324 Transition to a New Facility or § 55-40.1-264 Food Preparation School Setting § 55-40.1-266 Food Protection Subpart C Staffing Requirements § 55-40.1-268 Cleaning of Premises § 55-40.1-326 Staff Training, Experience, and § 55-40.1-270 Public Beaches, Swimming Qualifications Activities and Wading Pools § 55-40.1-328 [Repealed] Subpart G Physical Facilities Standards § 55-40.1-330 Staff-child Ratio § 55-40.1-272 Building Safety Codes and Subpart D Health Standards for Children Space Requirements § 55-40.1-332 Health Policies and § 55-40.1-273 Child Care Facilities Safety Consultation Provisions Requirements § 55-40.1-334 Evidence of Child’s Health Subpart H Program Modifications § 55-40.1-336 Emergency Care Provisions § 55-40.1-274 Program Modifications for § 55-40.1-338 Pediatric First Aid and Drop-in Care Cardiopulmonary Resuscitation § 55-40.1-276 Program Modifications for § 55-40.1-340 Admission of Ill Children Night Care § 55-40.1-342 Admission of Children with § 55-40.1-278 Program Modification for Disabilities Emergency Child Care § 55-40.1-344 Daily Nutritional Needs § 55-40.1-280 Program Modification for § 55-40.1-346 Drinking Water Provisions Summer Day Program/Summer Day Camp § 55-40.1-348 Integration of Mental Health Concepts Part 300 Family Day Care Homes and Subpart E Health Standards for Provider Family, Friend, Neighbor Care Homes and Others in the Home Subpart A Administration Requirements § 55-40.1-350 Hand Washing § 55-40.1-300 Supervision of Children § 55-40.1-352 Provider’s Health Standards § 55-40.1-301 Number and Age of Children in § 55-40.1-354 Personal Health Habits of Care Provider § 55-40.1-302 Certain Provider’s Children Not Subpart F Environmental Health Included Standards § 55-40.1-304 Statement of Operation Policies § 55-40.1-355 Health and Safety § 55-40.1-306 Information on Owner or Requirements Operator § 55-40.1-356 Emergency, Preparedness, § 55-40.1-308 Change in Services Recovery, and Response Plan (EPRRP) © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 2 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS § 55-40.1-358 Accidental Injury, Precautions Background Check § 55-40.1-360 Environmental Hazards § 55-40.1-426 Staff-child Ratio and Group § 55-40.1-362 Water Supply Size § 55-40.1-364 Toilet and Lavatory Facilities § 55-40.1-428 Staffing Patterns § 55-40.1-366 Food Preparation and Subpart D Health Standards for Infants Protection and Toddlers § 55-40.1-368 Cleaning of Premises § 55-40.1-430 Health Policies and § 55-40.1-370 Swimming Activities and Consultation Provisions Wading Pools § 55-40.1-432 Evidence of Child’s Health Subpart G Physical Facility Standards § 55-40.1-434 Emergency Care Provisions § 55-40.1-372 Building Safety Codes and § 55-40.1-436 Pediatric First Aid and Space Requirements Cardiopulmonary Resuscitation § 55-40.1-373 Child Care Facilities Safety § 55-40.1-438 Admission of Ill Infants and Requirement Toddlers Subpart H Program Modifications § 55-40.1-440 Admission of Infants and § 55-40.1-374 Program Modifications for Toddlers with Disabilities Drop-in Care § 55-40.1-441 Admission of Children § 55-40.1-376 Program Modifications for Experiencing Homelessness Night Care § 55-40.1-442 Daily Nutritional Needs § 55-40.1-443 Handwashing Policy for Part 400 Infant and Toddler Child Children Care Centers § 55-40.1-444 Drinking Water Provisions Subpart A Administration Requirements § 55-40.1-446 Integration of Mental Health § 55-40.1-400 Supervision of Children Concepts § 55-40.1-401 Age of Children in Care Subpart E Health Standards for Staff § 55-40.1-402 Statement of Operation Policies § 55-40.1-448 Staff Health Standards § 55-40.1-404 Information on Owner or § 55-40.1-450 Personal Health Habits of Staff Operator Subpart F Sanitation Standards § 55-40.1-406 Change in Services § 55-40.1-452 Handling of Diapers, Training § 55-40.1-408 Information and Records on Pants, Linen, and Toys Each Child § 55-40.1-454 Hand Washing Policy for Staff § 55-40.1-410 Disclosure of Information on § 55-40.1-455 Infants’ and Toddlers’ Hygiene the Child Bathing § 55-40.1-412 Information and Records on § 55-40.1-456 General Housekeeping Facility § 55-40.1-458 Emergency, Preparedness, § 55-40.1-414 Transportation Provisions Recovery, and Response Plan (EPRRP) Subpart B Program Requirements Subpart G Environmental Health § 55-40.1-416 Program Provisions Standards § 55-40.1-418 Communication Between § 55-40.1-459 Health and Safety Parents and Child Care Providers Requirements § 55-40.1-420 Program Activities, Materials § 55-40.1-460 Accidental Injury Precautions and Equipment § 55-40.1-462 Environmental Hazards § 55-40.1-422 Transition to a New Facility § 55-40.1-464 Water Supply Subpart C Staffing Requirements § 55-40.1-466 Toilet and Lavatory Facilities § 55-40.1-424 Staff Training, Experience, and § 55-40.1-468 Food Preparation and Qualifications and Comprehensive Protection © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 3 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Subpart H Physical Facility Standards Drop-in Care § 55-40.1-470 Building Safety Codes and § 55-40.1-474 Program Modifications for Space Requirements Night Care § 55-40.1-471 Child Care Facilities Safety § 55-40.1-476 Program Modification for Requirements Emergency Child Care Subpart I Program Modifications § 55-40.1-472 Program Modifications for Subchapter Authority: 1 CMC § 2354; 1 CMC ’§ 2371-2380; 3 CMC ’§ 1405(a) and 1406. Subchapter History: Amdts Adopted 47 Com. Reg. 52163 (July 15, 2025); Amdts Proposed 47 Com. Reg. 52321 (June 15, 2025); Amdts Adopted 38 Com. Reg. 38410 (Aug. 28, 2016); Amdts Proposed 38 Com. Reg. 38393 (July 28, 2016); Amdts Adopted 36 Com. Reg. 34843 (Mar. 28, 2014); Amdts Proposed 35 Com. Reg. 34212 (Aug. 28, 2013); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Commission Comment: 1 CMC § 2351 creates the Department of Community and Cultural Affairs (DCCA). The Department has certain duties enumerated in 1 CMC § 2353, including responsibility for youth services. See 1 CMC § 2353(f). 1 CMC § 2354 directs DCCA to adopt rules and regulations regarding activities over which the Department has jurisdiction. 1 CMC ’§ 2371-2380 create the Division of Youth Services within DCCA and authorize the Division to provide programs and services to the youth of the Commonwealth. For a complete history of the authority of DCCA, see the general comment to chapter 55-10. PL 4-67 (effective Sept. 10, 1985), the AChild Care Standards Act of 1985,@ codified as amended at 3 CMC ’§ 1401- 1409, provides for the development of comprehensive child care standards and the licensing of day care centers. 3 CMC § 1404 designates DCCA as the agency responsible for licensing day care facilities and directs DCCA to develop policies, procedures and regulations with regard to day care licensing and operation. See also 3 CMC ’§ 1405(a) and 1406. On November 17, 1986, DCCA published proposed ARules and Regulations Governing the Licensing of CNMI Day Care Facilities.@ See 8 Com. Reg. 4805 (Nov. 17, 1986). A notice of adoption for the 1986 proposed regulations was never published. Part 001 - General Provisions § 55-40.1-001 Definitions For the purpose of this subchapter and all sections: (a) “Acting director” means a person who assumes the responsibilities of director of the child care facility in the absence of the director. (b) “After school care” means child care provided after the close of the regular school day during the academic year, summer and school holidays for children ages four years and nine months and older (up to age 13) who are enrolled in public or private elementary schools. (c) “Applicant” means the person(s) who is applying for license to operate Day Care Centers or group child care center, Infant and Toddler Child Care Center, Family Day Care Home, Family, Friend and Neighbor Care Home, Summer Day Program/Summer Day Camp, Before and After © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 4 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS School Programs, and as a Registered License-Exempt Care. (d) “Approved child development or early childhood training courses” means child development or early childhood courses taken from accredited institutions of higher learning and other agencies or organizations authorized by the department which are automatically accepted. Other courses, workshops, or seminars shall be subject to approval by the department. (e) “Before school care” means child care provided before the opening of the regular school day during the academic year for children ages four years and nine months and older (up to age 13) who are enrolled in public or private elementary schools. (f) “Building code” means the CNMI building code used by the Department of Public Works. (g) “Caregiver” or “provider” means any person who is responsible for the physical well-being, direct care, health, safety, supervision, and guidance of children in child care. (h) “Child” means any person who has not reached the age of eighteen. (i) “Child care” means the provision of care for children by persons other than parents or guardians with or without compensation, for less than 24 hours. (j) “Child Care Advisory Committee” means a group of people appointed by the Secretary, Department of Community and Cultural Affairs, to advise the Department on matters regarding child care, including child care rules. (k) “Child care aide,” “aide,” or “child care assistant,” “floater”, means any person who helps the teacher or teacher assistant with all aspects of the planned program. (l) “Child care center” or “group child care center” means a place maintained by any individual, organization, or agency for the purpose of providing child care to children between ages of 2 and 16. The term child care center shall include day nurseries, nursery school groups, preschool child play groups, parent cooperatives, drop-in child care centers, group child care homes, or other similar units operating under any name. (m) “Child care license” means certificate of approval issued by the Child Care Licensing Program (CCLP), Office of the Secretary, Department of Community & Cultural Affairs authorizing the operation of a specified type of child care facility i.e. day care center, infant and toddler child care center, group child care center, family home child care and family, friend and neighbor home care, summer day/summer day camp, and before and after school programs. (n) “Child development associate” means any person credentialed by the council for early childhood professional recognition (national association for the education of young children) to assume primary responsibility for a group of young children in a developmental early childhood program. (o) “Child with a disability” means a child who is evaluated in accordance with § 300.304 © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 5 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS through §300.311 as having an intellectual disability, a hearing impairment (including deafness), a speech or language impairment, a visual impairment (including blindness), a serious emotional disturbance (referred to in this part as “emotional disturbance”), an orthopedic impairment, autism, traumatic brain injury, and other health impairment, a specific learning disability, deaf-blindness, or multiple disabilities, and who, by reason thereof, needs special education and related services (IDEA, 2018).. (p) “Children with special needs” means children with special needs which requires* modification of care or services not regularly available. (q) “Compliance” means conformity in fulfilling formal or official requirements of all sections of this subchapter. (r) “Critical incident” is a serious life safety or potential life safety incident or concern that poses a danger to the life, health, and/or well-being of a child or children at the center/child care home or of a staff member at the center/child care home. (s) “Criminal records check” means obtaining a police clearance, FBI background check and an examination of local records. (t) “Demonstration project” means any place providing child care which is operating with special approval of the department for exemptions to specific registration rules. (u) “Day care” means provisions of care and supervision for children in a place other than in a child’s home or children’s home with or without charging a fee. (v) “Department” refers to the Department of Community and Cultural Affairs (DCCA). (w) “Director,” “principal,” Ahead teacher,” or “operator,” means the person at the facility having responsibility for the administration of a child care center and its program. (x) “Drop-in care” means child care where children are permitted to arrive and leave at irregular, non-scheduled times during the facility’s operating hours. (y) “Drop-in child care center” means a facility, which accepts children for drop in care. (z) “Emergency” means an unforeseen combination of circumstances, which calls for immediate action. (aa) “Facility” means all the physical parts belonging to, or which are a part of, a place in which child care is provided including enclosed areas, lanais, and outdoor areas. (bb) “Family day care home” or “family child care” means child care licensed or a registered license-exempt in any private home maintained by an individual which provides care to three and no more than six children during any part of a twenty-four hour day, and where the relationship of child and family child care provider is not by blood, marriage, or adoption. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 6 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (cc) “First aid kit” means the collection of supplies, the materials and equipment in one location in a suitable container to give immediate medical treatment, primarily to treat injuries and other mild or moderate medication emergencies. A first aid kit shall be of the type approved by the American Red Cross, or the CHCC. (dd) “Group child care home” means child care provided by any individual in a facility that may be an extended or modified family child care home which provides care to no more than twelve children during any part of a twenty-four hour day. Group child care homes are licensed under the rules for group child care centers. (ee) “Guardian” means a person other than a child’s parents who has legal authority over and responsibility for a child. (ff) “Illness” means a subjective term that shall be defined by each provider with regard to admitting or not admitting sick children to child care. (gg) “Immunization form” means a printed form made available by the Commonwealth Health Center, department of health or the department of education to record a child’s immunizations and health record. (hh) “Infant” means children who are newborn up to age one (through the twelfth month). (ii) “Infant nursery” or “infant center” means a center that provides care for children between the age of 6 weeks and 12 months. (jj) “Irregular” means varying from the typical or normal pattern of the child care center, group child care home, or family care home, or a practice of schedule that varies from the routine or uniform and is not subject to explained or rational variations. (kk) “Lavatory” means a vessel or basin for washing, which is in conformity with plumbing codes. (ll) “Local sanitary codes” means the specific rules promulgated by the CHCC and pursuant to the Commonwealth Health and Sanitation Act of 2000. (mm) “New hire” means a person seeking to be a child care provider for the first time in the Commonwealth of the Northern Marianas Islands, either as an applicant or prospective employee of a child care center. (nn) “Night care” means child care provided to children who stay at night or overnight at a group child care center, group child care home, or family child care home. Care shall not be provided for twenty-four consecutive hours. (oo) “Panic hardware” means a standard device on doors that permit quick and safe exits upon emergencies (push bars and plates). © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 7 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (pp) “Primary caregiver” means the individual in the infant and toddler child care center to whom the care of a specific child and family is assigned. Primary care is defined as direct care, primary responses to infant or toddler’s physical and emotional needs while in the center and continued interaction with parents concerning the child. (qq) “Policy” means a principal plan for the management of a child care facility. (rr) “Provider” any* person 18 years or older, whose duties include direct care, supervision, and guidance of children in child care. (ss) “Provisional license” or “temporary permit” means a temporary license issued at the discretion of the department for a period of three months to any child care facility which is unable to conform to all the rules at the time the license or certificate of child care license is issued. (tt) “Qualified trainer” means a person who has twelve credits in early childhood or child development or related fields such as human development, psychology, social work, or nursing and a combined total of three years of experience in training adults who work with children or has six credits in early childhood or child development or related fields such as human development, psychology, social work, or nursing, and a combined total of five years of experience in training adults who work with children. (uu) “Qualified nutrition consultant” means a dietitian or nutritionist who meets the advanced educational requirements for membership in the American Dietetic Association and is eligible for registration; or one who has a master’s degree in public health nutrition or nutritional sciences. (vv) “Rehire” means an applicant or prospective employee of a family child care home who is seeking to operate or be employed in a family child care home following termination of employment of more than six months and who has been out of Commonwealth of Northern Marianas Islands during this break in employment. (ww) “Rules” means the rules developed by the Child Care Licensing Program, Office of the Secretary, Department of Community and Cultural Affairs to set minimum standards of care and safety for the protection of children in child care. (xx) “Sanitary codes” means the special rules set up by a sanitation office, the department of health, or a comparable federal agency, which govern aspects of health and safety. (yy) “Single service utensils” means the supplies or equipment used once to serve food (paper plates cups*, disposable forks). (zz) “Staff member” means administrative, child care, clerical, and maintenance personnel who are employed by the child care facility. (aaa) “Substitute” means a person who serves as a replacement when another caregiver is absent. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 8 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (bbb) “Teacher assistant” means any person who works with the guidance of the teacher and director to carry out the program of the center. (ccc) “Temporary permit” (see provisional license). (ddd) “Toddler” means a child who is twelve to thirty-six months of age. (eee) “Toddler nursery” or “toddler center” means any child care center that provides care for children age 12 months (walking independently) and 36 months. (fff) “USDA Child Care Food Program” means the food standards established by the United States Department of Agriculture. (ggg) “Volunteer” means a person offering services to a child care facility without remuneration, except for reimbursable personal expenses allowed by the caregivers. (hhh) “Center-based child care” means a licensed child care and early education services that provides care in a dedicated facility, as opposed to in-home care. (iii) “Child abuse and neglect” means (1) Willfully and intentionally strikes, beats or by any other act or omission inflicts physical pain, injury or mental distress upon a child under the age of 18 who is in the person’s custody or over which the person occupies a position of authority, such pain or injury being clearly beyond the scope of reasonable corporal punishment, with the result that the child’s physical or mental health and well-being are harmed or threatened; (2) Through willful or negligent act or omission fails to provide a child under the age of 18, who is in the person’s custody or over which the person occupies a position of authority, with adequate supervision, medical care, food, clothing or shelter with the result that the child’s physical or mental health and well-being are harmed or threatened; or (3) Commits any act that would constitute a criminal offense under 6 CMC §§ 1306-1311 against a child under the age of 18 who is in the person’s custody or over which the person occupies a position of authority. (jjj) “Child Care Licensing Program” refers to the program authorized by Public Law 04-67 to license day care facilities in the Commonwealth of the Northern Mariana Islands. (kkk) “Child Care Program” means the CNMI Department of Community and Cultural Affairs that shall administer and implement the Child Care and Development Fund activities and provide assistance in compliance with federal regulations. (lll) “Child care provider” means any person, 18 years and older, or an agency, or organization and their employees who provide direct care, supervision, and guidance to children apart from and in the absence of the child’s parent(s). Child care providers are regulated by CCLP and must comply with applicable federal, state, and local requirements for the provision of child care services. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 9 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (mmm)“Child Experiencing Homelessness” means a child who is homeless as defined in section 725 of Subtitle VII-B of the McKinney-Vento Act (42 U.S.C. 11434a). Children and youth who lack “a fixed, regular, and adequate nighttime residence,” including shelters, transitional housing, unsheltered locations, public places, “sharing the housing of others due to loss of housing, economic hardship, or similar reason,” and living in motels “due to lack of adequate alternative accommodations.” 42 USC § 11434(a)(2). (nnn) “Comprehensive background check” means obtaining a national background check (FBI check with fingerprint and NCIC National sex offender registry check), local or state background check (criminal records check with fingerprint, police clearance, in-state sex offender registry check, in-state child abuse and neglect registry check), and inter-state background checks (inter- state criminal history check, inter-state sex offender registry check, and inter-state child abuse and neglect registry check). (ooo) “Early Childhood Education” means the formal and informal educational programs that guide the growth and development of children throughout their preschool years (birth to age five). (ppp) “Elementary education” means teaching children in kindergarten through fifth grades (ages five to eleven). (qqq) “Emergency child care services or back-up care” means a child care center that provides temporary and reliable care for children and their families in the event of an emergency or unforeseen disruption of their regular schedule. (rrr) “Enrollment means” a child whose parent or legal guardian has submitted to the day care center a signed document which indicates that the child is enrolled for child care. (sss) “Family, Friend and Neighbor Care Home (FFN)” - means that FFN is a registered license- exempt provider that provides supervision, guidance, and care for family members, friends, and neighbors in their home. FFN providers include grandparents, uncles and aunts, older siblings, friends, neighbors, and others who help families by providing child supervision, guidance and care. (ttt) “Handwashing” means to cleanse the hands with soap and warm running water for at least 20 seconds. (uuu) “Lanai area” means roofed, open-walled porches attached to the main home or building. (vvv) “License” means a certificate of approval issued by the Child Care Licensing Program authorizing the operation of a child care center. (www) “Licensed-Exempt Care” means child care to less than 5 children which is exempt from licensure pursuant to CNMI law and the current state plan and is registered by the Child Care Licensing Program. (xxx) “Lead caregiver” means the caregiver who oversees the planning, implementation, and evaluation of the childcare program, oversee childcare staff, and the overall care and supervision © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 10 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS of children. (yyy) “McKinney-Vento Homeless Assistance Act (McKinney-Vento Act) (42 United States Code § 11431-11435)” is federal legislation that ensures the educational rights and protections of children and youth experiencing homelessness. (zzz) “Means of egress” means an unobstructed path to leave buildings, structures, and spaces. A means of egress is comprised of exit access, exit and exit discharge. (aaaa) “Mixed age or Multi age grouping” means placing children whose age range spans more than two years within the same group of class. (bbbb) “Physical punishment” means inflicting any kind of physical pain or discomfort on a child that include but are not limited to hitting, slapping, spanking, punching, shaking, kicking, or biting. (cccc) “Policy” means a principal plan for the management of a child care facility. (dddd) “Preparedness” means that preparedness takes place before an emergency. It includes being informed about any likely emergencies in your area; mitigating any existing concerns at your facility that could make an emergency worse; making plans to respond to emergencies before they happen; and building, maintaining, and updating supply kits you will take or keep with you during an emergency. (eeee) “Preschool age” means the age range of a child is three (3) to five (5) years old. (ffff) “Recovery” means recovery which happens as soon as the emergency is over, when efforts are focused on food, water, shelter, safety, and the emotional needs of those affected. Recovery is also the process of rebuilding the child care program and returning to normalcy after an emergency, which is why it can last hours, weeks, months, or even years in the most extreme cases. (gggg) “Registered license-exempt care” means the legal document issued to a license-exempt care by the Child Care Licensing Program which means that the child care provider has met the minimum health and safety standards. (hhhh) “Response” means that response begins the moment you are alerted to an impending emergency and continues as the emergency occurs. (iiii) “School age” means children from six (6) to twelve (12) years of age. (jjjj) “Serious injury(ies)” means any event in which a child requires professional medical attention other than routine illness. An injury is serious when it is beyond routine superficial cuts, scrapes, and bug bites. Serious injuries include but are not limited to: (1) A laceration that requires stitches; or is large, deep, or won’t stop bleeding. (2) Dislocation. (3) Fractured bone. (4) Nursemaid elbow. (5) A human or animal bite that breaks the skin. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 11 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (6) Injuries to the mouth including loose or chipped teeth and/or a tear in the mouth. (7) Any injury that results in the child losing consciousness, having labored breathing, crying incessantly, exhibiting the inability to speak, vomiting, becoming lethargic, falling asleep at an inappropriate time or unexpectedly, or is difficult to arouse or awaken. (8) Any head injury (a head injury may be accompanied by swelling or bruising in the affected cranial area coupled with decreased alertness, increased confusion, headache, vomiting, or difficulty walking). An injury to a non-verbal child where the child appears to be suffering increased pain that would not typically accompany the type of injury sustained. (9) Any burns, scalding, and heat-related injuries. (10) Electric shock. (11) Poisonings (suspected or known), including toxic exposure by inhalation, ingestion, or through the skin. (12) Insect bites that result in a typical reaction such as anaphylactic shock. (13) Allergic reaction including anaphylactic shock. (14) Many injury that may result in a sprain, dislocation, or a broken bone. (15) Any injury that may result in child complaining of severe pain, or losing the ability to stand, walk, or use their arms or legs in a normal function. (16) Injuries related to the exposure to extreme temperatures including hypothermia, dehydration, severe sunburn, or frost bite. (17) Loss of sight. (18) Near-drowning. (19) Choking that resulted in the use of life saving measures or a loss of consciousness. (kkkk) “Substantiated child abuse” means the abuse or neglect was severe due to the type of abuse or neglect or because of other things, such as the child’s age or the effects of the abuse on the child. (1) Circumstances that are absolutely substantiated include: (i) Death or near death of the child, (ii) Sexual abuse, (iii) Abuse or neglect so severe that the child had to be hospitalized, (iv) Repeated physical abuse, (v) Failure of a parent to protect a child from abuse or neglect that he or she was or should have been aware of. (vi) Neglect so severe it caused or could have caused serious harm. (llll) “Substantiated complaint” means a complaint which has been investigated by the Child Care Licensing agency, and as a result, a violation of regulations has been found. (mmmm) “Summer day program/Summer day camp” means a recreation program that offers care to school-age children and operates a summer day program/summer day camp for less than four consecutive months per year. (nnnn) “Teacher” means a person who instructs, guides, and contributes to learners’ development. (oooo) “Unsubstantiated complaint” means that on the basis of a thorough investigation by the Child Care Licensing Program, there is insufficient evidence to determine the facts of the complaint and that it may or may not have occurred. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 12 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS

So in original. Modified, 1 CMC § 3806(a), (g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 36 Com. Reg. 34843 (Mar. 28, 2014); Proposed 35 Com. Reg. 34212 (Aug. 28, 2013); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Part 100 - Rules Governing the Licensing of Day Care Centers, Group Child Care Homes, Family Day Care Homes, Family, Friend and Neighbor Care Home, Infant and Toddler Child Care Center, Summer Day Program/Summer Day Camp, Before and After School Programs, and Registered License-Exempt Purpose The purpose of these rules and regulations is to formulate standards for licensed Day Care Centers Facilities and Group Child Care Homes, Family Day Care Homes and Family, Friend and Neighbor Care Home, Infant and Toddler Child Care Center, Summer Day Program/Summer Day Camp, Before and After School Programs, and Registered Licensed-Exempt that will protect and promote the health, safety, and positive development of children being served. Applicability The general regulations in this section shall apply to all child care facilities licensed or required to be licensed or a registered licensed-exempt. The licensee shall ensure compliance with all applicable laws and regulations of the CNMI and federal governments Subpart A - Licensing Procedures § 55-40.1-100 License Required (a) Any person, association, corporation, or partnership shall first obtain a license from the Child Care Licensing Program to operate a child care facility, providing services either with or without compensation. (b) Any person, association, corporation, or partnership found to be operating or conducting a child care facility without a license shall be found in violation of these rules and regulations and must cease operations immediately until compliance is met. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-101 Application (a) The application to obtain a child care license to operate a day care center, group child care home, family day care home, family, friend, and neighbor care home, infant/toddler child care center, summer day program/summer day camp, before and after program(s) and registered license exempt shall be made on forms supplied by the Child Care Licensing Program (CCLP) and shall be completed in a manner prescribed thereon and submitted with the appropriate fee a minimum of sixty calendar days prior to the proposed opening date. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 13 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (b) Applicants submitting an application to operate a day care center, group child care home, family day care home and family, friend and neighbor care home, infant/toddler child care center summer day program/summer day camp, and before and after school program shall provide criminal history, background, employment information, and consent to conduct checks as may be required by PL 4-67, as amended by PL 4-69 [3 CMC § 1401-1409]. Records of such information and consent shall be maintained by the facility and available for inspection by the Department. (c) The CCLP shall conduct employment history, background checks, and criminal history checks on all applicants. Applicant shall maintain accurate records, e.g. employment application, comprehensive background and criminal history, police clearance, and diplomas if any. The type of criminal offense, when it occurred and evidence of rehabilitation may be considered in determining whether the criminal history record poses a risk to the health, safety or well-being of children in care. (d) A review and evaluation of the child care licensing application will occur only after all required documents are complete and application and appropriate fees are received by the CCLP. (e) Multiple licenses shall be required as follows: (1) If a licensee wishes to assume child care responsibility in more than one classification of care, separate application, fees, and licensing evaluation are required for each classification; or (2) If a licensee wishes to operate more than one facility of the same classification but at different locations, a separate application, fee, and evaluation are required for each location. (f) There shall be no child facility operated or maintained unless licensed or registered as a license-exempt provider by the CCLP. (1) All licensed and registered license-exempt providers shall complete fifteen hours annually of health and safety training in at least five of the following topics: (i) Prevention and control of infectious diseases (including immunization). (ii) Prevention of sudden infant death syndrome and use of safe sleeping practices. (iii) Administration of medication, consistent with standards for parental consent. (iv) Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular. (g) A completed application to operate a day care center, group child care home, family day care home and family, friend and neighbor care home, infant/toddler child care center, summer day program/summer day camp, and before and after school program(s) must include the following: (1) A signed Child Care Licensing Program application form; (2) A written statement of operation policies; (3) Verification that the facility meets the applicable state and local codes; (4) Completed employment history clearance forms; (5) Results of a comprehensive background check as indicated in (a) and (b) below: traffic;* (i) Applicants and employees shall provide criminal history records, child abuse/neglect history, employment information and consent to conduct such checks as may be required by state or federal law. Such information and consent shall be given upon forms supplied by the Child © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 14 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Care Licensing Program; (ii) The Child Care Licensing Program shall conduct criminal history, employment history, and child abuse/neglect history checks on all applicants and their employees; applicants shall conduct employment history and background checks on prospective employees; (iii) The date of application shall be the date a signed application form and all required information and documentation are received by the CCLP; (iv) Notification of the disposition of the completed application for certificate of approval shall be issued no later than sixty days from the date the completed application; (v) Prevention of shaken baby syndrome and abusive head trauma; (vi) Emergency Preparedness, Recovery, and Response; Prevention of and response to emergencies due to food and allergic reactions; (vii) Handling and storage of hazardous materials and the appropriate disposal of bio- contaminants; (viii) Pre-cautions in transporting children; (ix) Pediatric First Aide and Child Cardiopulmonary Resuscitation (CPR); and (x) Child Development; and Child Abuse and Neglect.

So in original. Modified, 1 CMC § 3806 (g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-102 Non-Discrimination (a) A child care facility shall not discriminate against any person on the grounds of race, color, national origin, age, sex, religion or disability in admission to, participation in, or receipt of the services and benefits of any of its programs and activities, or in employment. (b) Furthermore, a child care facility shall not deny or provide for the access and accommodation of persons with disabilities in compliance with the Americans with Disabilities Act of 1990 (Title 42 United States Code, Section 12101), the Rehabilitation Act of 1973, Individual Disabilities Education Improvement Act of 2014, and the Child Care Development Block Grant. (c) Child care facilities shall also conform to any laws in the CNMI and applicable rules and regulations governing persons with disabilities and other protected groups. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-103 Registered License-Exempt Care Application (a) All registered license-exempt care providers (under the Child Care Development Fund [CCDF]) are required to register with the Child Care Licensing Program. (b) The application to operate a registered license-exempt care shall be made on forms supplied © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 15 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS by the Child Care Licensing Program and shall be completed in a manner prescribed thereon and submitted with the appropriate fee a minimum of sixty calendar days prior to the proposed opening date. A completed application must include the following: (1) A signed Child Care Licensing Program registered license-exempt care application form. (2) Verification that the facility meets the applicable state and local codes. (3) Completed employment history clearance forms. (4) Results of a comprehensive background check. (c) All registered license-exempt care providers that receive subsidy funds from CCDF shall comply to the following: (1) Complete 15 hours of required Health and Safety training. (2) All new providers and director shall complete 12 Pre-service Training topics within 90 days of approval from the Child Care Licensing Program for licensed program and once receipt of approval to operate for licensed-exempt home-based providers. (3) Complete comprehensive background check. (4) Submit to CCLP annual monitoring inspection that they are meeting the basic health and safety requirements. (5) Shall provide CCLP with the most current health and safety monitoring report assuring that their facility has passed inspection and/or requirements by the regulatory agency(s). (d) Type of criminal offense, when it occurred and evidence of rehabilitation may be considered in determining whether the criminal history record poses a risk to the health, safety or well-being of children in care. The CCLP shall conduct a comprehensive employment history, background checks, and criminal history checks on all applicants. (e) Applicant shall maintain accurate records, e.g., employment application, police clearance, and diplomas if any. (f) CCLP shall conduct one annual visit to all registered licensed-exempt care. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-105 Fees (a) The appropriate application fee outlined in this section must be submitted to the CCLP with the application for a child care license at least sixty calendar days prior to the opening date of the facility. (b) The appropriate application fee outlined in this section must be submitted to the CCLP annually, at least sixty calendar days prior to the expiration date of the license, along with a completed continuation declaration. (c) Following is a schedule of original, annual and renewal fees for all types of child care facilities and agencies: Licensing Fee Chart © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 16 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS TYPE ENROLLMENT FEE Initial/Renewal 1 – 6 children $25.00 I ni t ia l / R e n e w a l 5-20 c hi l d re n$ 75.00 Initial / Renewal 21 – 50 children $100.00 I ni t ia l / R e n e w a l 51-100 c hi l d re n$ 125.00 Initial / Renewal 101 – 150 children $150.00 I ni t ia l / R e n e w a l 151-250 c hi l d re n$ 175.00 Initial / Renewal 251 – 400 children $200.00 I ni t ia l / R e n e w a l 401 or m orec hi l d re n$ 250.00 Changes to Licenses (capacity and/or number of children) $15 D u pl i c a t e L i ce n ses$ 10 Annual Listing Fee $20 Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-110 Inspection and Issuance of Child Care Licenses (a) In exercising its authority to license day care centers or group child care center or family day care home, family, friend, and neighbor care home, summer day program/summer day camp, before and after school programs, or registered license-exempt care of any type or renew, suspend, or revoke the certificate of child care licenses, the CCLP shall review the qualifications of providers of child care, review the written policies and program provisions, and conduct inspection(s) of the facility or home. Authorized representatives of the CCLP and parents or guardians of children in care may visit a child care center at any time during the hours of child care operation for purposes of observing, monitoring and inspecting the facilities, activities, staffing, and other aspects of the child care center. (b) The applicant or licensee shall cooperate with the CCLP by providing access to its facilities, records, and staff. Failure to comply with reasonable requests may constitute grounds for denial, suspension, or revocation of the child care license. (c) After the approval of child care license, the licensee shall ensure that the facility has the required employees to operate. (d) The CCLP shall request the applicant to terminate the employment of an employee who has a criminal history, employment history, or background, which poses a risk to children in care. Any such request shall be in writing and shall state with specificity those criminal convictions, employment history, or background information, which indicates a risk to children. A due process heating will be held if requested by the employee. (1) When the applicant does not terminate the employment of the employee, the applicant shall © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 17 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS notify the CCLP not later than five working days of receipt of the request. The notification shall be in writing and shall state the reasons for the decision; (2) Refusal to terminate the employment of an employee, when requested under this section, may be grounds for revocation or suspension of a child care license. (e) The CCLP shall issue a child care license under the following conditions; (1) A regular child care license shall be issued if the result of the CCLP’s evaluation indicates compliance with the applicable rules as established by the CCLP; or (2) A provisional child care license shall be issued, provided that requested documents shall be met on or before the three months allowed for a regular child license to be issued. (3) A registered licensed-exempt provider shall be issued a registered license-exempt certificate if the result of the Child Care Licensing Program’s evaluation indicates compliance with health and safety standards, and administrative requirements under Subpart A of § 55-40.1-214 (a- d), § 55-40.1-206 (a-b), § 55-40.1-226 (c.1-4) (f) The length of the child care license period shall be as follows: (1) Regular certificates of child care license shall be valid for one year unless subsequently suspended or revoked. When a regular child care license is issued after provisional certificate, the expiration date of the regular child care license shall be one year from the issuance date of the provisional child care license; or (2) Provisional child care license may be issued for no more than three months; and (3) Child care license shall be renewed only upon application and upon the CCLP’s approval. (g) Each child care license shall clearly state the type of program the licensee is permitted to operate, the address and location of the licensee, and the number and types of children who can be cared for at the facility. (h) The operation of a family child care center without a license is a violation of Child Care Standards Act of 1985 and shall be punishable in accordance with this Act by imprisonment of not more than one year, or a fine of not more than $2,000 or both. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-115 Fire and Health Inspections Prior to the original license being issued, or following the renovation of the facility that would affect the licensing of the facility and every year thereafter, all day care facilities and licensed family day care home facilities, except registered license-exempt care must be inspected and obtain an approving inspection report from the Commonwealth Healthcare Corporation, Tinian Health Car, Rota Health Care, and from the Department of Fire and Emergency Medical Services. A copy of these reports shall be submitted to the Child Care Licensing Program and a copy must be kept on file at the facility or home. Should the fire inspection not be completed, the director or authorized representative of the facility must advise the Department as to when the inspection should be completed for submission. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 18 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (a) Registered licensed-exempt providers shall complete a self-certified assessment that they adhere to health, safety and fire standards on a form provided by the Child Care Licensing Program. This self-certified assessment shall be submitted at least 30 days following registration as a license-exempt provider. (b) All licensed providers shall submit a copy of their Fire inspection, Building Code Inspection, and Bureau of Environmental Health inspection reports to CCLP upon completion of inspections conducted by the regulatory agency(s). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-116 Right of Entry and Violations Right of Entry: Child Care Licensing Program staff and/or an authorized regulatory agency representative (i.e., BEH, DPW, DFEMS) may enter any child care facility for inspections or investigations to determine compliance with these regulations. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-120 Denial, Suspension, Revocation of Child Care License, and Hearings (a) The conditions for denial, suspension, or revocation of a child care license application and the action to be taken by the CCLP are as follows: (1) The CCLP may deny, suspend, or revoke the child care license, if an applicant or licensee does not comply with the rules of the CCLP respecting child care facilities; (2) The CCLP shall suspend registration if the violation of the minimum requirement is the first violation of the provider does not warrant revocation; (3) The CCLP may revoke child care license application if the provider has violated any minimum requirement to such an extent or of a nature that the provider is unfit to be trusted with the care of children, or if the provider=s application has been suspended at least once previously; (4) An applicant or licensee whose child care license is about to be denied, suspended, or revoked shall be given written notice by certified or registered mail addressed to the location shown on the child care license application; (5) The notice shall contain a statement of the reasons for the proposed action and shall inform the applicant of the right to appeal the decision to the Office of the Secretary, Department of Community & Cultural Affairs, no later than ten working days after acknowledgment of the notice of the proposed action; (6) The applicant has twenty days from receipt to make a written request for a hearing; the Secretary of the Department shall give written notice to the applicant of a time and place for a hearing before a hearing officer. On the basis of the evidence adduced at the hearing, the hearing officer shall make the final decision of the Department as to whether the application or child care license shall be denied, suspended, or revoked; and (7) If no timely written request for a hearing is made, processing of the application shall and or the child care license shall be suspended or revoked as of the termination of the ten day period. (b) The immediate suspension of the child care license shall be ordered if conditions exist which the Department determines constitute an imminent danger to the health, welfare, or safety © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 19 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS of the children. The Department shall take the following actions: (1) Provide the applicant written notice of the order by personal service or by certified or registered mail addressed to the location shown on the child care license application; (2) Provide a statement of the reasons for the suspension in the notice and inform the applicant of the right to petition the Department to reconsider the order not later than ten working days aider mailing of the notice; (3) Declare that all operations shall cease as of the date of receipt of the notice, give the applicant reasonable notice upon receiving a written petition, and provide an opportunity for a prompt hearing before a hearing officer with respect to the order of suspension of the child care license application. On the basis of the evidence adduced at the hearing, the hearing officer shall make the final decision of the Department as to whether the order of suspension shall be affirmed or reversed; and (4) Notify the parent or legal guardian of each child who is provided care in the family child care home of the suspension or revocation. (c) At any hearing provided for by this section, the applicant or licensee may be represented by counsel and has the right to call, examine, and cross-examine witnesses. Evidence may be received even though inadmissible under rules of evidence applicable under court procedures. Hearing officer decisions shall be in writing, shall contain findings of fact and conclusions of law, and shall be mailed to the parties to the proceedings by certified or registered mail to the last known address as may be shown in the application, on the child care license, or otherwise. The Administrative Procedure Act [1 CMC ’§ 9101, et seq.] shall also be applicable at any hearing. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-125 Report of a Critical Incident Within 24 hours, excluding weekends and holidays, of the occurrence of a critical incident at the facility, the applicant must report in writing to the CCLP the following critical incidents involving a child in the care of the facility or a staff member on duty: (a) The death of a child or staff member as a result of an accident, suicide, assault, or any natural cause while at the facility, or while on authorized or unauthorized leave from the facility. (b) An injury to a child or staff member that requires emergency medical attention by a health care professional or admission to a hospital. (c) A mandatory reportable illness, as required by the Commonwealth Healthcare Corporation, Tinian Health Care, and Rota Health Care, of a child or staff member that requires emergency medical attention by a health care professional or admission to a hospital. (d) Any allegation of physical, sexual, or emotional abuse or neglect to a child that results in reporting to a law enforcement or social services agency. (e) Any fire that is responded to by the Department of Fire and Emergency Medical Services. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 20 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (f) Any major threat to the security of a facility including, but not limited to, a threat to kidnap a child, riots, bomb threats, hostage situations, use of a weapon, or drive by shootings. (g) A drug or alcohol related incident involving a staff member or a child that requires outside medical or emergency response. (h) An assault, as defined by law, by a child upon a child, a child upon a staff member, or a staff member upon a child which results in a report to law enforcement. (i) Felony, theft, or destruction of property by a child while in care at the facility for which law enforcement is notified. (j) A suicide attempt by a child at the facility, which requires emergency intervention. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-130 Reporting Child Abuse and Neglect (a) A child care facility must require each staff member of the facility to be knowledgeable, to read and sign a statement clearly defining child abuse and neglect pursuant to state law and outlining the staff member’s personal responsibility to report all incidents of child abuse or neglect to the Division of Youth Services and in accordance to state law. (b) Any caregiver or staff member in a child care facility who has reasonable cause to know or suspect that a child has been subjected to abuse or neglect or who has observed the child being subjected to circumstances or conditions that would reasonably result in abuse or neglect must be reported within 24 hours or cause a report to be made of such fact to the Division of Youth Services or local law enforcement agency. (c) At the time of admission the facility must give the child’s parent or guardian information that explains how to report suspected child abuse or child neglect. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-135 Licensing Complaints Child care facilities must provide written information to parents at the time of admission and staff members at the time of employment on how to file a complaint concerning suspected licensing violations. The information must include the complete name, mailing address, and telephone number of the Department of Community and Cultural Affairs, Office of the Secretary, Child Care Licensing Program. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 21 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS § 55-40.1-140 Posting of Licensing Information (a) At all times during the operating hours of the center or home care, the center or home care shall post the current child care license or registration of license-exempt in a prominent and conspicuous location easily observable by those entering the facility or home care. (b) At all times during the operation of a child care center or home care, the center or home care shall post in a prominent and conspicuous location information regarding the procedures for filing a complaint with the Department of Community and Cultural Affairs, Child Care Licensing, including the telephone number and mailing address. (c) The following documents shall be displayed in all licensed child care facilities: (1) License to Operate a Child Care Center or home care; (2) Sanitary Permit; (3) Copy of Health Certificates; (4) Daily Schedule; (5) Fire Evacuation Plan; (6) Fire Extinguisher Signs; (7) Earthquake Preparedness Procedures; (8) Exit Signs; (9) Daily Menu (If applicable); (10) Inspection certificates conducted by the Bureau of Environmental Health, Department of Fire and Emergency Medical Services, and the Department of Public Works; (11) Grading Placards issued by the Bureau of Environmental Health; (12) No Smoking Signs; (13) First Aid Kit Signs; (14) Communicable Disease Prevention Poster; (15) Emergency phone numbers, to include, but not be limited to, the fire department, the police and emergency medical services, and be placed conspicuously next to all operating phone lines; and (16) Other emergency procedures established by the child care center or home care. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-145 Confidentiality of Records (a) The records concerning the applicant of a facility and agencies are open to the public except as provided below. (b) Anyone wishing to review a record must submit a written request to the Department. (c) The following documents are confidential and shall not be available for review: (1) Information identifying children or their families. (2) Scholastic records, health reports, social or psychological reports. (3) Personal references requested by the CCLP. (4) Reports and records received from other agencies, including police and child protection © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 22 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS investigation reports. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-146 Standard Operating Procedures/Administrative Manual All child care centers shall provide their Standard Operating Procedures (SOP) to the Child Care Licensing Program, staff, parents, and agencies that monitor the health and safety of children under their care. The SOP shall also be available for site inspections, monitoring, and unannounced monitoring visits by CCLP personnel, building code, fire and health personnel. The SOP shall closely adhere to the Child Care Licensing Program license requirements. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-150 Parental Accessibility (a) During hours of operation, a facility must allow access to parents and guardians having legal custody of a child in care to those areas of the center that are licensed for child care. (b) During the hours of operation, the center’s most recent licensing, fire department, and health department inspection reports must be accessible to parents and legal guardians of children in care or their designee and to parents and legal guardians considering placing their children in care at the center. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-155 Perjury Statement Every application used in the Commonwealth for employment with a child care provider or day care center, shall include the following notice to the applicant: (a) “Any applicant who knowingly or willfully makes a false statement of any material fact or thing in the application is guilty of perjury and shall be subject to the Penalty for Perjury Act, and, upon conviction thereof, shall be punished accordingly.” History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-155 Civil Penalty The operation of a day care center and family day care home without a license is a violation of the Child Care Standards Act of 1985 and shall be punishable in accordance with this Act by imprisonment of not more than one year, or a fine of not more than $2,000 or both. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 23 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Part 200 - Day Care Center & Group Child Care Homes, Before and After School Programs Subpart A - Administration Requirements § 55-40.1-201 Supervision of Children All child care facilities shall adequately supervised children being educated and cared for at all times and are protected from harm and hazards. It is the responsibility of each applicant to provide supervision to all children from the time children are dropped off at the facility until the time children are dismissed from the facility to go home. All staff members who are entrusted with supervisory responsibility shall exercise reasonable care in the discharge of supervisory duties. Applicants shall formulate, distribute and explain to the children’s parents and guardians procedures regulating children’s behavior on the premises accordingly. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-202 Age of Children in Care A child care center or group child care home may provide care to children aged two years (twenty-four months) and older (up to age 13). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-204 Statement of Operation Policies (a) A facility shall have written operation policies. Written policies shall be available to the CCLP, caregiver staff, and parents or guardians of children for whom care is, or may be, available, and shall cover the following areas: (1) Ages of children accepted; (2) Maximum number of children permitted by license; (3) Specific hours of day, night, holiday, and vacation operation; (4) Whether or not meals are served; (5) Type of child care services to be offered; e.g. Day Care Centers, Group Child Care Homes, Infant and Toddler Child Care Center, Family Day Care Home, Family, Friend and Neighbor Care Home, Summer Day Program/Summer Day Camp, Before and After School Programs, and as a Registered License-Exempt Care. And types of educational programs and activities; e.g. daily routines, language, arts, math, children’s progress, communication with parents, educational field trips and show & tell; (6) Provisions which may be made for children with disabilities; (7) Admission requirements and enrollment procedures; (8) Fees and plan for payment, including fees for different types of child care service and refund policy; (9) Policy and plan for emergency medical care; (10) Insurance coverage - each facility shall inform parents or guardians in writing of its policy relating to liability insurance; at all times during operations and at the time of a child’s enrollment © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 24 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS for child care services. A facility is subject to revocation, suspension or denial of child care license if it violates the requirements for liability insurance coverage-referred in § 55-40.1-125 Denial, Suspension, Revocation of Child Care License, and Hearings; (11) Rules concerning personal belongings brought to the facility; (12) Transportation arrangements; (13) Parental permission for trips and related activities outside the facility; (14) Fund raising campaigns - children and staff shall not be exploited in fund raising activities which would be detrimental to the children or the program; (15) Policy regarding admission of sick or moderately sick, children with disabilities; and (16) Other policies, which may be required by the Department; (17) Written plan to cover emergencies and disasters. (b) Written policies and procedures shall be reviewed with each caregiver in the facility. (c) Written policies shall be made available for review by parents or guardians at the time of enrollment of the children in the child care center or home care. (d) Written notification of changes in the services offered by the facility shall be provided to the CCLP, and to parents or guardians of the children enrolled in the facility at least four weeks prior to the effective date of change. Modified, 1 CMC § 3806 (g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-206 Information on Owner or Operator (a) The name, physical address, business mail address, email address, and telephone number of the facility shall be supplied to the CCLP. (b) The name, physical address, building mailing address, email address, business address, and business telephone number of the persons bearing the responsibility for the child care facility shall be supplied to the CCLP. (c) The name, physical address, business mailing address, email address, and business telephone number of the persons having specific authority and responsibility for overall administration and the services offered shall be supplied to the CCLP. (d) The name of the owner or sponsoring agency (privately owned, church or agency owned, etc.) physical address, business mailing address, email address, and business telephone number of the facility shall be supplied to the CCLP. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-208 Change in Services © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 25 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS A facility shall notify parents or guardians and the CCLP of any changes in the child care services and staffing pattern it provides as follows: (a) Written notification of changes in the services offered and staffing by the facility shall be provided to the CCLP and to parents or guardians of children enrolled in the facility; and (b) Notification of any changes in service shall be made no later than thirty days after the date of the change and shall be included in the facility’s operating policies. Significant changes include, but are not limited to, the following: (1) Relocation of the child care facility; (2) Renovation to existing structure; (3) Increase/decrease in child capacity; (4) Changes in staffing pattern; (5) Changes in policies and procedures; (6) Changes in ownership; (7) Changes in the name of the business operation; and (8) Changes to the facility layout. (c) Notification of any changes in service shall be made in writing no later than thirty days after the date of the change and shall be included in the facility’s operating policies. (d) Such changes shall be taken into consideration at the discretion of the Child Care Licensing Program to determine status of the license for continued or discontinued operations of services upon meeting requirements and qualifications in accordance to these rules and regulations as deemed necessary. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-210 Information and Records on Each Child (a) Admission procedures shall require that sufficient information and instruction from the parents or guardians be furnished to enable the director and the appropriate staff members of the child care facility to make decisions or act on behalf of the child. (b) Prior to admission of a child to a facility, the provider shall obtain in writing from the child’s parents or guardians the following information: (1) The child’s full legal name, birth date, current address, primary language spoken, current mailing and physical addresses, and preferred names; (2) The name and physical address, mailing address, and email address of the parents or guardians who are legally responsible for the child; (3) Telephone numbers or instructions as to how the parents or guardians may be reached during the hours the child is in the child care center; (4) The name, physical address, mailing address, email address, and telephone number of persons who shall assume responsibility for the child if for some reason the parents or guardians cannot be reached immediately in an emergency; (5) The names, physical addresses, mailing address, email address, and telephone numbers of © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 26 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS persons authorized to take the child from the facility; (6) Health information concerning the child, as required by § 55-40.1-232 and 55-40.1-234; (7) Written authorization for emergency care, including provision of health insurance information; and (8) Child health report, that includes the child’s immunization record, and other pertinent information regarding the health of the child (i.e. last physical examination report, tuberculin test, allergies, etc.). (c) The information shall be available on facility forms and shall be updated as necessary. (d) The child care facility shall require a completed application with at least one (1) parent’s or guardian’s signature for each child to be kept on file. (e) These records shall be kept confidential, and information provided only to the child care facility director or authorized staff operating the facility with a need to know, in the event of an emergency, or other staff with written consent of the parents. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-212 Disclosure of Information on the Child (a) Information pertaining to an individual child or parents or guardians of the child shall not be disclosed to persons other than the facility director or authorized staff members, unless the parents or guardians of the child submit a signed consent form granting written permission for the disclosure or an emergency arises necessitating release of the information. (b) The parents or guardians shall be informed in writing of the child care facility’s policy regarding disclosure of information. (c) The Office of the Attorney General may, by written request obtain disclosure of information required to be kept by the regulations in this subchapter when it appears that a violation of the criminal law may have occurred and such information may reasonably be needed to investigate such an allegation. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-214 Information and Records on Facility Written information and records on the facility shall be maintained and made available to the CCLP. The facility shall maintain current records and information including: (a) Roster of enrolled children; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 27 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (b) Daily attendance records by names of children; (c) Daily menu; and (d) Daily schedule of activities. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-216 Transportation Provisions When transportation is provided by a facility, children shall be protected by adequate supervision, safety precautions, and liability and medical insurance coverage as follows: (a) For transportation to and from school the vehicle and driver shall satisfy all relevant school bus and traffic laws of the Northern Mariana Islands. (b) During any field trip or excursion operated or planned by the facility, the staff-child ratios as provided in § 55-40.1-228 shall apply; and (c) Children shall be instructed in safe transportation conduct as appropriate for age and stage of development. (d) Drivers shall: (1) Be at least 18 years of age; (2) Hold a current driver’s license; (3) Maintain a safe driver record; (4) The provider must take precautions to protect children from vehicular traffic; (5) No use of alcohol, drugs, or any substance that could impair abilities before or while driving; (6) No tobacco use while driving; (7) No medical condition that would compromise driving, supervision, or evacuation capability; and (8) Valid pediatric first aid and cardiopulmonary resuscitation (CPR) certificate if transporting children. (e) The director shall obtain a copy of the driving/traffic record from the court for each staff whose job includes driving duties. The driving/traffic record shall be updated annually. (f) The vehicle shall be: (1) In compliance with all applicable state and local motor vehicle laws; and (2) Maintain a safe operating condition. (g) The driver’s license number and date of expiration, vehicle insurance information, and verification of current state vehicle inspection should be on file in the child care facility. (h) Child Passenger Safety © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 28 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (1) When transporting children for any and all purposes: (i) Children shall be transported only in sections of vehicles designed for and equipped to carry passengers; (ii) A seat that fully supports the passenger shall be provided for each child; (iii) All children, shall be transported in accordance with § 4108.* Safety Belts on Passenger Vehicles 9 CMC §1103(f); (iv) All children should be transported only if they are restrained in a developmentally appropriate car safety seat, booster seat, seat belt, or harness that is suited to the child’s weight and age in accordance with state and federal laws and regulations; (v) No child shall be left unattended inside or outside a vehicle; and (vi) Children shall not be allowed to ride in the back of a pick-up truck at all times. (i) Interior Temperature of Vehicles (1) The interior of vehicles used to transport children for field trips and out of program activities should be maintained at a temperature comfortable to children. All vehicles should be locked when not in use, head counts of children should be taken before and after transporting to prevent a child from being left in a vehicle, and children should never be left in a vehicle unattended. (j) Passenger Vans (1) Child care facilities that provide transportation for any purpose to children, parents/legal guardians, staff and others should not use 15-passenger vans when avoidable. (k) The child care facility shall maintain a written plan for transportation. (l) The child care provider and all staff members must take precautions to protect children from vehicular traffic.

So in original. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart B - Program Requirements § 55-40.1-218 Program Provision Requirements The program conducted in the child care facility shall implement developmentally appropriate practices, provide for staff supervision at all times and an environment and experiences, which are aimed at promoting the individual child’s physical, intellectual/cognitive, social-emotional, mental health development, and social well-being and growth. This shall be done in the following ways: (a) The child care director shall provide the CCLP with a brief written description of the facility’s program goals and how the daily activities of the center satisfy the physical, intellectual/cognitive, social-emotional, mental health development, social development, and social well-being and developmental growth of the child; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 29 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (b) Activities which promote physical development shall include but not limited to: (1) Daily opportunities for running, climbing, and other age-appropriate physical activities; (2) Varied physical activities; and (3) Opportunities for children to learn about the health, development, and care of the children=s bodies, including exercise, nutrition, and hygiene; (c) Programs to promote intellectual/cognitive development shall include, but not limited to: (1) Provide that a variety of learning materials are introduced and are available to the children; and (2) Include first-hand experiences for children to learn about the world; (3) Reading aloud to children, developing listening and speaking skills, teaching about sounds of spoken language, print books, letters, building children’s background knowledge and thinking skills, teaching about numbers and counting and checking children’s progress; (d) Programs to promote emotional development shall provide that, but not limited to: (1) There are opportunities for individual self-expression; (2) Each child is recognized as an individual; (3) The child is afforded constructive guidance and the setting of clear-cut limits which foster the child’s ability to be self-disciplined; (4) Each child’s personal privacy is respected; (e) Providers shall not use: (1) Physical punishment; (2) Methods of influencing behavior which are frightening, humiliating, damaging, or injurious to the child’s health or self-esteem; or (3) Shaking and child maltreatment are prohibited behaviors; (f) Providers respect each child’s cultural, ethnic, and family background, as well as the child’s primary language or dialect; (g) Providers shall promote social development and interact with the children in ways which emphasize and foster attitudes of mutual respect between adults and children; and (1) Providers behave in ways that help the children develop attitudes of respect for all other persons as individuals and develop an appreciation of cultural and ethnic diversity; (2) Children are guided in developing and working out ways of getting along with each other; (h) The activities and experiences provided by the program are appropriate to the developmental level of the children; (i) The program encourages the development of the children’s special interests and abilities; (j) The program provides a balance of active and quiet activities; and (k) The program shall provide for the self-direction of the children by: (1) Affording children opportunities to choose activities according to personal desires and interests and to move from one activity to another; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 30 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (2) Encouraging children to do things independently; and (3) Providing children opportunities to be involved in decision making about group and individual activities. (l) Programs to promote mental growth and well-being shall be provided, but not limited to (1) The opportunity for the child to build self-confidence and self-esteem; (2) Encourage the child to participate in positive routines; (m) Child care providers shall seek authorization from the parent or legal guardian of a child who has an Individualized Family Service Plan or Individualized Education Plan to assist in meeting the developmental and educational needs of a child with disability. (n) Providers shall have a written policy and procedure to identify the prevention of shaken baby syndrome, abusive head trauma, and child maltreatment. The policy must include the following: (1) How the child care facility will ensure that all early childhood teachers and caregivers are knowledgeable about and able to recognize the signs and symptoms of shaken baby syndrome and abusive head trauma; (2) Procedures for coping with a crying, fussing, or distraught infant or child; (3) Mandatory reporting of suspected child abuse and neglect as defined in § 55-40.1-001(i)(1- 3); and (4) All child care staff must sign an acknowledgment indicating that they have read, understood, and agree to follow the child care facility’s policy. Modified, 1 CMC § 3806 (g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-220 Communication with Parents and Child Care Providers Child care providers shall communicate and maintain an open-door policy to promptly and directly exchange information with parents or guardians about the children, including, but not limited as follows: (a) Plans shall be made and followed daily with parents or guardians to exchange information about each child; and (b) Child care providers shall relay concerns about the health, development, or behavior of the child to the parents or guardians promptly and directly. (c) Child care providers shall partner with parents and guardians in helping to get the children ready for future school success. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-222 Program Materials and Equipment © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 31 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (a) The selection, quantity, arrangement, and the use of available materials and equipment shall be age-appropriate, durable and meet the recommendations of the US Consumer Product Safety Commission (CPSC), including the latest version of the CPSC Handbook for Public Playground Safety, (Appendix F), and meet the recommendation of the American with Disabilities Act (ADA) for all children, including children with disabilities in care. (b) The quantity of materials and equipment shall be sufficient to: (1) Avoid excessive competition between the children and to avoid long waits, for use of the materials and equipment; (2) Provide for a variety of experiences and appeal to the individual interests, culture, age, gender, language, and abilities of the children; and (3) Support the curriculum, meet the goals and objectives of the program, and foster desired outcomes for children. (c) Protected areas where equipment and materials will be used with minimal interference or interruption shall be provided. (d) Materials shall be kept in good repair and shall be accessible to children. The materials shall be stored in an orderly way and shall be arranged to allow children to select, remove, and replace the materials either independently or with assistance. (e) Grass, soft media, or other protective measures shall be used under swings, slides, jungle gyms, and other similar outdoor play equipment. (f) Equipment for both indoor and outdoor play shall allow children to use small and large muscles for imaginative play and creative activities. (g) Provision for individual storage spaces of children’s clothing and personal belongings shall be available and labelled accordingly. (h) Storage spaces for other play materials and equipment used by the children shall be available. (i) The following sleeping equipment shall be safe, sturdy, clean, age-appropriate and available: (1) Individual bed, cot, crib, mat, sleeping bag, or pad for each child who rests; and (2) A clean sheet or cover to be used on the bed, cot, crib, mat, sleeping bag, or pad for each child. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-224 Transition to a New Facility or School Setting (a) Provision shall be made to assist the child in making the transition from the child care setting to a new child care, a kindergarten, or school setting. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 32 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (b) Provision shall be made for cooperation between the child care provider and parents or guardians when information is requested which may assist a child to adjust to a new environment as allowed by § 55-40.1-210. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart C - Staffing Requirements § 55-40.1-226 Staff Training, Experience, and Qualifications, and Comprehensive Background Check (a) Each child care provider shall be qualified through training, experience, and professional qualities for the age group for which the person works. All child care service staff must annually participate in at least 15 hours of health and safety training as approved and monitored by the Child Care Licensing Program. (b) Staff growth and development shall be encouraged. The director shall make information about workshops, seminars, training sessions, or courses available to all staff and volunteers. (c) Applicants, child care directors, all employees, and volunteers shall be of reputable and responsible character and shall not have a criminal history record, employment history or background which poses a risk to children in care. (1) Conviction of a crime involving violence, alcohol or drug abuse, sex offense, offense involving children and any other conviction, the circumstances of which indicate that the applicant, child care director or any employee may pose a danger to children, are grounds for denial or revocation of a license or a reason to request termination of an employee under § 55-40.1-110(d). (2) Type of criminal offense, when it occurred and evidence of rehabilitation may be considered in determining whether the criminal history record poses a risk to the health, safety or well-being of children in care. (3) An employment history indicating violence, alcohol or drug abuse and any other violation of employer rule or policy, the circumstances of which indicate that the applicant or employee may pose a danger to children, may be grounds for denial or revocation of a license or a reason to request termination of an employee under § 55-40.1-110(d). (4) A comprehensive background information which shows that the individual has been identified as and substantiated to be the perpetrator of child abuse or neglect may be a basis for denial or revocation of a license or a reason to request termination of an employee under § 55- 40.1-110(d). (d) All applicants, child care directors, their employees, and anyone else at the facility whose activities involve the care or supervision of children or unsupervised access to children shall provide a criminal background check. (1) The criminal background check shall include the following: (i) A fingerprint background check from any available CNMI Government criminal database. (ii) A fingerprint background check done on any available federal database as recommended by the FBI. (iii) A criminal background check on the CNMI Government Child Abuse and Neglect © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 33 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Registry. (iv) A criminal background check on the National Sex Offender Registry if the CNMI Government has the capability of accessing this. (v) An annual CNMI police clearance. (2) These checks shall be done before a person is allowed to work or perform services at the daycare facility. For those who are already working or providing services at a licensed daycare facility at the time of adoption of this regulation, then these background checks will have to be submitted before Nov. 1, 2017. (3) These background clearances will be good for a period of seven years, after which they will have to be renewed. (e) The comprehensive background check shall include the following: (1) National Background Checks: (i) National Federal Bureau of Investigation criminal history check with fingerprint background check. (ii) A criminal background check on the National Crime Information Center (NCIC) Sex Offender Registry (NSOR) check. (2) In-state (CNMI) Background Checks: (i) In-state Criminal History Check, with fingerprint background check. (ii) In-state Sex Offender Registry Check. (3) Inter-state (out of the CNMI) Background Checks: (1) Inter-state Criminal History Check (2) Inter-state Sex Offender Registry Check. (3) Inter-state Child Abuse and Neglect Registry Check. (f) Child care directors, teachers, teachers’ assistants, and child care aides/floaters employed in a licensed facility shall be required to have adequate minimum qualifications for the type of staff position occupied. (g) The age requirements for staff shall be as follows: (1) All staff in positions other than child care aide, volunteer, or maintenance personnel shall be at least eighteen years old; and (2) A child care aide shall be at least sixteen years old to be counted in the staff-child ratio. (h) The director of a facility licensed for six or more children shall have the following qualifications: (1) A bachelor’s degree from an accredited college or university preferably with courses in early childhood education, child development, or related fields, and two years of work experience with children; or (2) Combination of two years of college education or child development associate (CDA) certification, or early childhood education certification, and four years of work experience with children; and (3) In either case, at least one year of experience shall be with children of the appropriate age for the child care center being directed. (i) A teacher shall meet one of the following qualifications: © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 34 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (1) An associate degree in child development or early childhood education from an accredited college or university, and three months working experience in an early childhood program; or (2) Post secondary credential in child development associate program or organized two-year (sixty credit) college program and certificate in early childhood education, plus one year supervised teaching experience in an early childhood program; or (3) A baccalaureate in elementary education from an accredited college or university plus three months working in an early childhood program; or early childhood education from an accredited college or university or program, plus six credit - semester or equivalent approved child development program or early childhood training courses, (may be included as part of bachelors of arts or bachelors of science degree); or (4) Baccalaureate (bachelor=s degree) in any field from an accredited college or university plus three months working in an early childhood program, or twelve credits—semester or equivalent approved child development or early childhood training courses, (may be included as part of bachelor of arts or bachelor of science degree). (j) An assistant teacher shall meet one of the following qualifications: (1) Post secondary credential in child development associate program (CDA); or (2) Associate of arts degree and certificate in early childhood education from an accredited college or university; or (3) Must have completed six credits semester or equivalent approved child development or early childhood training courses; and (4) In all cases, have three months’ work experience in an early childhood education program and must work under the direction of a teacher. (k) Waivers for teacher or assistant teacher positions may be granted by the Department if there are no qualified applicants available for the position, provided: (1) The position vacancy has been advertised in the classified ad section of the newspaper or on the CNMI Department of Labor website; (2) The prospective employee meets the requirement for the next lower position; (3) There is a written plan presented to the Child Care Licensing Program Supervisor on the steps to be taken to bring the employee up to the proper qualifications for the position; and (4) Approval for a waiver has been received prior to the hiring of the non-qualified teacher or assistant teacher. (l) A child care aide/floater shall meet one of the following qualifications: (1) High school vocational child care training course; and (2) Complete an orientation training course at the center of employment. (3) High school diploma or high school equivalency diploma (GED). (m) Volunteers shall: (1) Participate in and complete an orientation training course in the child care center of volunteer work; or (2) Be a participant in a high school program which includes child care training or related field; and (3) Meet the requirements of regular staff members to be counted in the staff-child ratio. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 35 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (n) Temporary hires shall meet qualifications of positions for which hired. (o) Substitutes for teachers and assistant teachers shall be at least eighteen years of age and shall have participated and completed an orientation training course program at the child care center. The center’s director shall closely supervise the curriculum, lesson plans, and daily activities assigned to the substitute. (p) Substitutes for director shall meet qualifications for director. (q) Substitutes for child care aides/floaters shall meet the qualifications of a child care aide/floater. (r) Substitutes may be granted an extension to serve in the same position upon consultation with and approval of the CCLP Supervisor.

So in original. Modified, 1 CMC § 3806(a), (g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 38 Com. Reg. 38410 (Aug. 28, 2016); Proposed 38 Com. Reg. 38393 (July 28, 2016); Adopted 36 Com. Reg. 34843 (Mar. 28, 2014); Proposed 35 Com. Reg. 34212 (Aug. 28, 2013); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-228 Staff-child Ratio (a) The staff-child ratio shall be met and maintained by all facilities. (b) The staff-child ratio shall be in writing and shall be made available to the CCLP. Distribution of staff may include a team comprised of teacher, teacher assistant, and child care aides/floaters. The staff members shall be on site and shall be assigned to a group of children to be included in the staff-child ratio. Other hired staff members that do not provide direct care and education to children shall not be counted in the staff-child ratio (i.e. Custodians/maintenance, cooks/food servers, and bus drivers). (c) The director may teach and may be counted in the staff-child ratio as follows: (1) In a center with less than fifty children, the director may teach and may be counted in the staff-child ratio; and (2) In a center with fifty or more children the director may teach but shall not be included in the staff-child ratio. (i) Exception may be made and the director may be included in the staff-child ratio in cases of emergency or in special situations. (d) The following staff-child ratio shall be maintained and implemented at all times when providing child care services to enrolled children. Staff-Child Ratio Chart I © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 36 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Age Number of Children Per Staff Member 0 - under 24 mos. Not Permitted 24 months to 36 months 1:4 2 year olds 1:7 3 year olds 1:8 4 year olds 1:10 5 years and older 1:10 6-year-olds to 8-year-olds 1:15 9-year-olds to 11-year-olds 1:20 12-year-olds to 13-year-olds 1:20 14-year-olds to 16-year-olds 1:20 (1) Unless specific instructional curriculum and related provisions specify mixing the ages and excepting nap time, the number of children assigned to a staff member shall be determined by the age of the youngest child in the group. (2) In those facilities in which an instructional curriculum as well as classroom environment and teacher training specifically require mixing the ages, the number of children per staff member shall be determined by the average of the staff-child ratios according to the chart above. (3) During nap time or night care when children of various ages are mixed together: (i) The number of children per staff member shall be determined by the average of the staff-child ratios according to the chart above; (ii) Non-teaching staff members at the center may be included in the staff ratios. (4) Children ages two years eight month or older, who are enrolled in the center on or between September and December 31 of any year and whose birthdays fall on or between these dates may be considered part of the next older age group when determining staff ratios. (e) The following chart reflects minimum requirements for the grouping of children of a certain age in units so that one unit of two-year-olds will be eight children, one unit of three-year-olds will be twelve children, one unit of four-year-olds will be sixteen children. One teacher shall be mandated for the first unit, three or more units require the addition of an assistant teacher plus aides as needed to meet the ratio. Ratio Chart II Minimum Staff Employment Sequence Age of No. of Teacher Teacher Aide/ Total Children Children Assistant Floater Staff © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 37 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS 2-year-olds 1-7 1 1 8-15 1 1 2 16-23 1 1 1 3 24-31 1 1 2 4 32-39 2 1 2 5 40-47 2 2 2 6 48-55 2 2 3 7 Ratio Chart III Minimum Staff Employment Sequence Age of No. of Teacher Teacher Aide/ Total Children Children Assistant Floater Staff 3-Year-Olds 1-78 1 1 8-15 1 1 2 16-23 1 1 1 3 24-31 1 1 2 4 32-39 2 1 2 5 40-47 2 2 2 6 48-55 2 2 3 7 Ratio Chart IV Minimum Staff Employment Sequence Age of No. of Teacher Teacher Aide/ Total Children Children Assistant Floater Staff 4-year-olds 1-10 1 1 11-21 1 1 2 22-32 1 1 1 3 33-43 1 1 2 4 © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 38 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS 44-54 2 1 2 5 55-65 2 1 3 6 66-76 2 2 3 7 Ratio Chart V Minimum Staff Employment Sequence Age of No. of Teacher Teacher Aide Total Children Children Assistant Staff 5-year-olds 1-10 1 1 11-21 1 1 2 22-32 1 1 1 3 33-43 1 1 2 4 44-54 1 1 2 5* 55-65 1 1 3 6* (g) Every facility that provides child care where preschool age children or school age children are combined with children of another age group shall provide a written plan to CCLP as to how the child care provider shall provide separate space and separate programs to meet the developmental needs of all the children. (h) The multi-age or mix age grouping of children shall be well-planned around the developmental needs of children, and the program shall be consistent for the preschool and school age children brought together in the group. The written plan shall include: (1) Time of day when the mixed age group applies; (2) Proposed staff-to-child ratio and group size; (3) Description of the use of space and program to ensure the needs of all children are met; and (4) Reasons for wanting to introduce a mixed age group and the benefits to children. (i) The staff assigned to multi-age or mix-age grouping of children shall be knowledgeable about child development and use this knowledge to plan daily routines and activities that are respectful and responsive to all children in the group. (j) The following criteria shall apply to multi-age or mix-age grouping of children and the number of children per staff member according to the staff-child Ratio Charts I and II: © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 39 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (1) The multi-age or mix age group ratio is 1:8 with a maximum group size of 8 for children ages 2 and 3. (2) The multi-age or mix age group ratio is 1:10 with a maximum group size of 10 for children ages 4, 5 and 6. (3) The multi-age or mix age group ratio is 1:15 with a maximum group size of 15 for children ages 7, 8 and 9. (4) The multi-age or mix age group ratio is 1:20 for school-age children at 9 years old to 11 years old with a maximum group of 20 children. (5) The multi-age or mix age group ratio is 1:20 for school-age children at 11 years old to 13 years old with a maximum group of 20 children. *So in original. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart D - Health Standards for Children § 55-40.1-230 Health Policies and Consultation Provisions All child care centers and child care homes shall have one of the following provisions for health consultation to assist in developing health policies and in keeping them current: (a) The child care center and group child care homes shall have on file written evidence that an arrangement has been made with a physician in private practice to provide consultation, and that this arrangement is satisfactory with parents of the children; (b) The child care center has made a contractual arrangement with a private physician or non-profit health organization in the community to provide health care for children in the program; (c) There is already a procedure existing in the community for the provision of health consultation service and arrangements have been made for use of these services; or (d) The child care centers or group child care homes shall have a health advisory group that may serve in such a capacity. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-232 Evidence of Child’s Health (a) The child care facility shall obtain from the parent(s) or guardian(s), a health record of the child that complies with the provisions of this section, which relate to the school entry examination requirements for tuberculosis clearance, immunization, and physical examination. (1) Written evidence of a school entry examination obtained within two months of admission © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 40 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS to the facility; (2) Written evidence that the toddler has received a tuberculin test indicating that the infant or toddler is free from tuberculosis in a communicable form; and (3) Initial and continuous written evidence that immunizations are current; or (4) A written statement from a licensed physician certifying that the physical condition of the toddler is such that immunizations would endanger the toddler’s life or health; or (5) A written statement from a parent or guardian requesting exemption from the required immunizations on the grounds that such immunizations conflict with the parent or guardian=s bona fide religious tenets and practices. (6) Parents or guardians shall be given a grace period, not to exceed 2 weeks from the last assessment of the child’s immunization record, to obtain required immunization(s) (Title 3 Division 1 §1151 Immunization). (b) The facility shall have in writing: (1) The name, physical address, email address, and telephone number of a physician or health resource that shall be called in case of emergency; and (2) Permission of the parent or guardian to call the physician or health resource, or another source of care if the parent or guardian cannot be reached in the case of a health emergency. (c) The records of the child in the program shall include pertinent information about health status, developmental progress, and any accommodations, modifications, and efforts necessary to meet these needs. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-234 Emergency Care Provisions Every facility shall have the following provisions for emergency care of children requiring treatment at a hospital or clinic away from the child care setting and for care of children who become ill after arrival: (a) The facility shall have one of the following written policies which indicate that: (1) The responsible individual in the child care setting, director, child care provider, or health-trained caregiver, has obtained the name of the nearest hospital or clinic where such care may be provided and has obtained written permission from each parent or guardian to provide emergency care for the child; (2) The facility’s health consultant has made arrangements for emergency coverage, and written permission from each parent or guardian shall be on file in the child care setting; or (3) Health care shall be provided in the child care setting, and the written permission from the parent or guardian covering all aspects of healthcare shall be on file in the child care setting. (b) An adult shall accompany a child to the source of emergency care. The adult shall stay with the child until the parent or parent’s designee assumes responsibility for the child=s care. The selection of the adult shall not compromise the supervision of the other children in the program; and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 41 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (c) Physical arrangements for children who become ill after arrival at the facility shall be taken care of and be placed at the resting area away from other children. The parents or legal guardians shall be notified for alternative arrangements. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-236 Pediatric First Aid and Child Cardiopulmonary Resuscitation (CPR) (a) There shall be at least one adult caregiver with a current certificate in pediatric and child cardiopulmonary resuscitation at the facility when children are present. (b) A first aid kit shall be available at the facility at all times. (c) The pediatric first aid and child CPR course must be provided by the American Red Cross, American Heart Association, or any organization whose infant and child CPR certification standards are equivalent to the American Red Cross or American Heart Association standards. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-238 Admission of Ill Children (a) When health policies of the facility allow ill children to be admitted or to remain in the facility, medical consultation shall be available regarding special care and medication. When medication prescribed by a physician is administered in the facility: (1) The medication shall be kept in the original container bearing the prescription label which shows the date filled, the physician’s directions for use, and the child’s name; (2) Medication shall be kept out of reach of children and shall be returned to parents or guardians when no longer in use; and (3) There shall be an authorization signed by the parent or guardian for the administration of medication by the facility. (b) Both the provider and the parents or guardians shall be familiar with special policies of the facility relevant to ill children. Special policies regarding illnesses shall be explained to the parent or guardian at the time of enrollment of the child. (c) Provisions shall be made to allow the facility’s medical consultant and the child=s regular source of health care to communicate in order to preserve continuity and consistency of care. (d) The child care facility shall have, in writing, the name, physical address, email address, and telephone number of a physician or health resource that shall be called in case of emergency. Written permission of the parent or guardian to call upon the physician or health resource, or another responsible source of care, if the parent or guardian cannot be reached, shall be required. (e) The facility shall, in consultation with its health consultant, establish a re-admission policy for children who have been absent because of illness. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 42 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003) § 55-40.1-240 Non-admission of Ill Children If children with illness are not allowed admission into a group child care center or a group child care home, this policy shall be clearly stated in writing and made known to parent or guardian at the time of enrollment. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-242 Admission of Children with Disabilities (a) When children with a disability are admitted into a group child care center or group child care home, the facility shall provide for the needs of each child according to the individual education plan (IEP) for school-age children. (b) The disabled child shall be admitted only after consultation with the child’s source of health care and the program’s health consultant occurs. The consultation shall include written recommendations to cover the child’s educational plan in the facility. (c) If the child’s health care source considers it advisable, the staff of the program shall receive training related to the nature of the child’s disability and the child’s potential for growth and development. (d) Where the nature of the child’s disability or the number of disabled children in the program necessitates added care, staff and appropriate assistive technology and equipment shall be available to support these requirements. (e) Child care providers must not exclude a child with a disability from their programs based on their disability, or separate that child from their nondisabled peers. (f) Child care providers must make an individualized assessment about whether they can meet the particular needs of a child with a disability. The assessment shall include written recommendations in consultation with the Public School System’s Special Education Division, Part C – Early Intervention and the Special Education Division, Part B – children and youth ages 3 to 21 for special education and related services. (g) Make reasonable modifications to their policies and practices to allow for children with disabilities to participate. Here are examples of some common reasonable modifications: (1) Change a toilet training policy to assist a child with Down syndrome who, due to his or her disability, requires assistance with going to the bathroom. (2) Change a discipline policy to ensure that a child with autism has equal access to the program with appropriate supports, such as training staff to aid the child in deescalating behavior when the child acts out. (3) Change a medication policy so that a trained staff person may assist a child with diabetes © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 43 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS in the administration of insulin or Glucagon, an emergency, life-saving medication for individuals with diabetes. (4) Provide appropriate aids and services needed to effectively communicate with children or adults with disabilities. (5) If a child care center is closing early due to bad weather, that may mean using different methods—not just calls but emails or text messages—to communicate with deaf or hard of hearing parents or guardians. (6) If a child care center is using websites or parent portals to keep parents informed concerning their child’s participation in the program, all such technology must be accessible to those with hearing, vision, or speech disabilities (for example, those who use screen readers). (7) Make sure physical spaces are accessible. Remove architectural barriers that interfere with or prevent children from fully participating (or parents, guardians, or prospective customers with disabilities) if removing the barriers is readily achievable, meaning if it can be easily accomplished without much difficulty or expense. Modified, 1 CMC § 3806(a). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-243 Admission of Children Experiencing Homelessness (a) When children experiencing homelessness are admitted to a child care facility, the facility shall provide for the needs of each child according to the McKinney-Vento Act. (b) Child care providers shall offer children secure, quality and nurturing care that promotes resiliency, health development and growth by: (1) Offering stable and familiar routines such as regular nap times and feeding schedules. (2) Providing structured learning activities and time for open play. (3) Preparing opportunities for physical activity and spending time outside. (c) Child care providers shall coordinate services with other agencies/organizations so that families with children experiencing homelessness can get the help that they need. (d) Child care providers shall extend a grace period or flexibility to obtain immunizations and other documents needed so that can children experiencing homelessness can be served more quickly. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-244 Daily Nutritional Needs (a) Meals and snacks of a quantity to supplement food served at home shall be available to meet the daily nutritional needs of the child. Foods related to the cultural and ethnic background of the children in the program and locality shall be part of meal planning. (b) The child care facility shall have access to nutritional information provided by a qualified nutritionist, dietitian, or other community resources approved by the Commonwealth Healthcare Corporation, Tinian Health Center, or Rota Health Center. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 44 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (c) To the extent possible, information provided by parents or guardians concerning the child’s eating habits, food preferences, or special dietary requirements shall be considered in child care feeding schedules and menus. Children shall be encouraged but shall not be required to eat the food offered by the facility. (d) In a facility providing meal service, the minimum meal components and food amounts required by the United States Department of Agriculture (USDA) child care food program shall be met. The facility shall offer and provide the following combination of meals and snacks for children in care: (1) Two to four hours one snack; (2) Four to eight hours one snack or breakfast and lunch or supper; (3) Eight hours or more one snack or breakfast and lunch or supper and one additional snack (unless the eight hours or more extend into the evening hours when the child may be asleep); (4) When two snacks are required as in subsection (d)(3) above, at least one of those snacks shall include the provision and offering of milk or its calcium equivalent; and (5) Local ethnic foods may be added or substituted for quantity (for allowable food reimbursement, facilities shall consult with the USDA). (e) In a facility where parents or guardians are allowed to provide food (i.e. sack lunches or snacks) the facility, in addition to food the child brings, shall provide the minimum amounts required by the USDA child care food program by offering and providing children in care: (1) Four to eight hours - morning snack or breakfast or afternoon snack; (2) Eight hours or more - morning snack or breakfast and afternoon snack (unless the eight hours or more extend into the evening hours when the child may be asleep); (3) When two snacks are required as in subsection (e)(2) above, at least one of those snacks shall include the provision and offering of milk or its calcium equivalent; and (4) Local ethnic foods may be added or substituted for quantity (for allowable food reimbursement, facilities shall consult with the USDA). (f) Children shall not be offered food to which they are allergic or, to which they object for religious reasons. Provision shall be made to secure such information from the parent or legal guardian and that the facility shall arrange for nutritious substitute foods. (g) School aged children in after school care for two to four hours shall be offered a nutritious snack which may be provided by the facility or brought from home. (h) Food shall not be used as a punishment or reward. (i) A qualified nutrition consultant engaged by the center or provided by an appropriate community resource shall review the facility’s food service annually. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-246 Drinking Water Provisions © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 45 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS There shall be drinking fountains or another device or system whereby drinking water shall be readily accessible to all children. The Rules and Regulations Governing Schools and Child Care Facilities [NMIAC, title 140, subchapter 20.4] promulgated by the Department of Health pursuant to the Commonwealth Environmental Health and Sanitation Act of 2000 shall apply as well. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-248 Integration of Mental Health Concepts Mental health aspects of each child’s development shall be integrated into the program as follows: (a) At least one parent, guardian, foster parent, or social worker shall be interviewed by a designee prior to a child’s admission to the facility. The personal interview shall be conducted to secure pertinent information on the child’s overall development and behavior and to acquaint the parent or guardian with the facility’s program and policies; (b) The facility shall provide its staff with annual orientation to state or on other mental health services for children, or otherwise familiarize its staff with consultative and clinical services and programs for early identification of social, emotional, intellectual/cognitive, and behavioral problems of children; and (c) The facility shall refer parents or guardians to sources of professional consultation in mental health upon the parents’ or guardians’ request or upon the recommendation of the facility’s staff. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-249 Hand Washing Policy for Children (a) The facility shall have a written policy that specifies when hand washing is required for children, defines the hand washing procedure, and provides continuous monitoring to assure that the hand washing procedure is followed. (b) The hand washing policy for children shall require that hand washing is done: (1) Before drinking; (2) Before and after meals; (3) Before handling clean utensils; (4) After going to the bathroom; (5) After contact with body secretions – e.g., mucus, saliva, or drainage from wounds; and (6) After outdoor play. (c) Children who self-feed in any manner shall have their hands washed with soap and water before and after eating and after toileting. (d) Hand washing may be done with cold water and drying hands may be done with disposable © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 46 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS paper towels or an individual hand towel that will be taken home for laundry at the end of each day. (e) Liquid soap should be used and placed in a pump dispenser and shall be replaced or cleaned as necessary. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 36 Com. Reg. 34843 (Mar. 28, 2014); Proposed 35 Com. Reg. 34212 (Aug. 28, 2013). Subpart E - Health Standards for Staff § 55-40.1-250 Providers’ Health Standards Evidence that providers are free from health problems which would have a harmful effect on the children or would interfere with effective functioning shall be maintained at the child care facility as follows: (a) The results of employment physical examinations and health clearance certificate and/or food handler certificate of each person employed in the center and each volunteer who serves ten or more hours per week shall be on file at the facility; (b) Written evidence that each member of a child care center staff or volunteer is free from communicable tuberculosis as a result of a negative tuberculin skin test or a satisfactory chest x-ray taken within six months before beginning child care shall be on file at the facility. The tests shall be repeated in compliance with the rules of the Commonwealth Healthcare Corporation, Tinian Healthcare Center, and Rota Healthcare Center; (c) Each child care provider with an identified health problem shall provide the facility with a written statement from a physician that the child care provider is able to care for young children; (d) The facility shall have provisions for substitution of staff who are too ill to function effectively or who present a serious health hazard to others in the facility; (e) Group child care home caregivers providing care in a residence shall have on file with the CCLP written evidence that each member of the household, even though the member may not be a child care provider, is free from communicable tuberculosis. Upon request of the CCLP, additional reports with reference to the health of the other members of the household shall be made available to the CCLP; and (f) When volunteers provide direct care of ten hours or more per week, the volunteers shall be subject to the same requirements for health and personal habits as the provider. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-251 Hand Washing Policy for Staff © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 47 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (a) The facility shall have a written policy that specifies when hand washing is required for staff, defines the hand washing procedure, and provides continuous monitoring to assure that the hand washing procedure is carried out. (b) The hand washing policy for staff shall require that hand washing is done: (1) Before eating, drinking, or smoking; (2) Before handling clean utensils and equipment; (3) Before handling food; (4) Before and after assisting or training the child in feeding and in toileting; (5) After going to the bathroom; (6) After contact with body secretion – e.g., blood, urine, feces, mucus, saliva, or drainage from wounds; (7) After handling soiled diapers, clothes, equipment, or menstrual pads; and (8) After removing disposable gloves. (9) After smoking. (c) Staff should wash hands with soap and running water. (d) Hand washing may be done with cold water and drying hands may be done with disposable paper towels or an individual hand towel that will be taken home for washing at the end of each day. (e) Liquid soap in a pumped dispenser should be used which shall be replaced or cleaned as necessary. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 36 Com. Reg. 34843 (Mar. 28, 2014); Proposed 35 Com. Reg. 34212 (Aug. 28, 2013). § 55-40.1-252 Personal Health Habits of Staff (a) The personal health habits of all providers shall not interfere with the protection of the health of the children: (b) The facility shall have written policies, which have been developed with the assistance of the facility’s health consultant and which minimally require that: (1) Staff with a fever, other symptoms of illness, or an altered physical or mental state, shall not be allowed to work; (2) Staff with visible skin conditions, such as lesions, boils, or dermatitis, shall not prepare or serve food or handle utensils and feeding equipment; (3) Staff’s appearance shall reflect good grooming habits and personal hygiene, including clean and neat hair and nails, appropriate clothing, and good oral hygiene; (4) Smoking shall not be allowed in the facility; nor in any parts of the building or at the premises at all times, which are used for child care, during the hours of child care operation. The facility shall adhere to the Smoke Free Act of 2008; (5) Tobacco, alcoholic beverages and detrimental/illegal drugs are prohibited on the premises (both indoor and outdoor environments) and in any vehicle used by the program © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 48 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS at all times; and (6) Staff shall take appropriate measures to manage stress by maintaining good mental and physical health. (c) In-service training shall be provided to staff on various aspects of personal health care and healthy lifestyle, such as care of head lice (ukus), impetigo, viral infections, risk factors, and stress management. (d) Volunteers shall be subject to the same requirements for health and personal health habits as the care giving staff. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart F - Environmental Health Standards § 55-40.1-253 Health and Safety Requirements (a) Situations that Require Hand Hygiene (1) All staff, volunteers, and children should abide by the following procedures for hand washing, as defined by the U.S. Centers for Disease Control and Prevention (CDC): (i) Upon arrival for the day, after breaks, or when moving from one group to another. (ii) Before and after: (A) Preparing food or beverages; (B) Eating, handling food, or feeding a child; (C) Brushing or helping a child brush tooth; Giving medication or applying a medical ointment or cream in which a break in the skin (e.g., sores, cuts, or scrapes) may be encountered; (D) Playing in water (including swimming) that is used by more than one person; and Diapering. (iii) After: (A) Using the toilet or helping a child use a toilet; (B) Handling bodily fluid (mucus, blood, vomit); (C) Handling animals or cleaning up animal waste; (D) Playing in sand, on wooden play sets, and outdoors; and (E) Cleaning or handling the garbage. (b) Situations or times that children and staff should perform hand hygiene should be posted in all food preparation, diapering, and toileting areas. (c) Prevention of Exposure to Blood and Body Fluids (1) All child care facilities should adopt the use of Standard Precautions, developed by the Centers for Disease Control and Prevention (CDC), to handle potential exposure to blood and other potentially infectious fluids. (2) Child care providers and teachers are required participate in a staff development program on Standard Precautions annually and thereafter. (3) Training should comply with requirements of the Occupational Safety and Health © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 49 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Administration (OSHA). (d) Routine Cleaning, Sanitizing, and Disinfecting (1) Programs should follow a routine schedule of cleaning, sanitizing, and disinfecting. (2) Cleaning, sanitizing, and disinfecting products should not be used in close proximity to children, and adequate ventilation should be maintained during use. (e) Environmental Audit of Site Location (1) An environmental audit should be conducted before construction of a new building; renovation or occupation of an older building; or after a natural disaster to properly evaluate and, where necessary, remediate or avoid sites where children’s health could be compromised. (2) A written report that includes any remedial action taken should be kept on file. (3) The audit should include assessments of: (i) Potential air, soil, and water contamination on program sites and outdoor play spaces; (ii) Potential toxic or hazardous materials in building construction, such as lead and asbestos; and (iii) Potential safety hazards in the community surrounding the site. (f) Integrated Pest Management Child care providers shall adopt an integrated pest management program to ensure long-term, environmentally sound pest suppression through a range of practices including pest exclusion, sanitation and clutter control, and elimination of conditions that are conducive to pest infestations. (g) Use and Storage of Toxic Substances All toxic substances should be inaccessible to children and should not be used when children are present. Toxic substances should be used as recommended by the manufacturer and stored in the original labeled containers. The telephone number for the poison control center should be posted and readily accessible in emergency situations. Modified, 1 CMC § 3806(a). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-254 Emergency Preparedness, Recovery, and Response Plan (EPRRP) Each facility shall have a disaster plan an emergency preparedness, recovery, and response written plan to cover emergencies such as fire, flood, or natural disaster. The components of the EPRRP plan shall include: (a) Evacuation, relocation, shelter-in-place, and lock-down procedures, and procedures for communication and reunification with families, continuity of operations, and accommodation of infants and toddlers, children with disabilities, and children with chronic medical conditions (b) Written procedures for accounting for all in attendance including: (1) The location of the children, staff, volunteer and visitor attendance lists; and (2) The name of the person responsible for bringing the children staff, volunteer and visitor attendance lists in the event of an emergency. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 50 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (c) A description for how and when children shall be transported. (d) Methods for communicating with parents and emergency personnel or law enforcement. (e) A description of how children’s nutritional and health needs will be met. (f) The relocation and reunification process. (g) Emergency telephone numbers. (h) Evacuation diagrams showing how the staff, children, and any other individuals who may be present will evacuate during and emergency. (i) The date of the last revision of the plan. (j) Specific considerations for non-mobile children and children with disabilities. (k) The location of an Emergency-to-Go File. An Emergency-to-Go File means a collection of information on children, staff and the facility, to utilize, if an evacuation occurs. (l) The Emergency-to-Go File shall include: (1) A copy of the Emergency Preparedness and Response Plan. (2) Contact information for individuals to pick-up children. (3) Each child’s Application for Child Care. (4) Medication authorizations and instructions. (5) Any action plans for children with special health care needs. (6) A list of any known food allergies of children and staff. (7) Staff contact information. (8) Incident Report forms. (9) An area map. (10) Emergency telephone numbers. (m) Guidelines for the continuation of child care services in the period following the emergency or disaster, which may include the provision of emergency and temporary child care services, and temporary operating standards for child care providers during that period. (n) Procedures for staff and volunteer emergency preparedness training and practice drills shall include the following: (1) Existing child care centers shall have one person on staff who has completed the EPRRP in child care training. (2) New child care centers shall have one person on staff who has completed the EPRRP in child care training within one year of the effective date of the initial license. When the trained staff member leaves employment, the center shall ensure that another staff member completed the required training within four months of the vacancy. (3) Documentation of completion of the training shall be maintained in the individual’s © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 51 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS personnel file or in a file designated for EPRRP documents. Upon completion of the EPRRP in child care training, the trained staff shall develop the EPRRP plan. (4) The EPRRP means a written plan that addresses how a child care center will respond to both natural and man-made disasters, such as fire, tornado, flood, power failures, chemical spills, bomb threats, earthquakes, nuclear disasters, or a dangerous person or persons in the vicinity, to ensure the safety and protection of the children and staff. (5) The EPRRP must be on a template provided by the Child Care Licensing Program and completed within four months of completion of the EPRRP in child care training. (6) The trained staff shall review the EPRRP document annually, or when information in the plan changes, to ensure all information is current. (7) All staff shall review the center’s EPRRP during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual’s personnel file or in a file designated EPRRP documents. (8) All substitutes and volunteers counted in ratio shall be informed of the child care center’s EPRRP document and its location. Documentation of this notice shall be maintained in the individual personnel files or in a file designated for EPRRP documents. (o) The Emergency Preparedness Recovery and Response written plan which shall be reviewed and approved by the Child Care Licensing Program in consultation with the first inspector, building code inspector, the health consultant, or the Red Cross. (p) The Emergency Preparedness Recover and Response drills shall be practiced at regular intervals. (q) The EPRRP guidelines, procedures and evacuation maps shall be posted in classrooms, administrative reception area, dining area, and lounge area where staff, students, and visitors are able to see. (r) Each facility shall comply with the Department of Fire and Emergency Medical Services Fire Code and Safety Code on fire safety and fire evacuation plans. An approved fire safety and evacuation plan including the means of egress by the CNMI DFEMS Fire Marshal shall be supplied to the Child Care Licensing Program. Written evidence that the fire safety device/system has been inspected and approved by the Fire Marshal and shall be supplied to the CCLP and on file at the facility. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-256 Accidental Injury Precautions The facility shall ensure that the child care program staff minimize the risk of accidental injury in the following manner: (a) Child care activities and premises shall take precautions not to expose children to situations which may be hazardous to the particular age or capacity of the child; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 52 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (b) The program shall help children to increase awareness of safety practices and accident hazards and to teach the children how to avoid such hazards; and (c) Accident prevention practices and polities shall be available in writing. The practices and policies shall be reviewed annually and the staff shall become familiar with the policies and practices. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-258 Environmental Hazards The indoor and outdoor premises of a child care facility shall be free of environmental hazards, shall be clean and comfortable, and shall provide for adequate space to meet the needs of the children as follows: (a) The facility shall be protected against rodents and insects; (b) The outdoor space shall be fenced or shall have natural barriers to deter children from getting into unsafe areas; (c) There shall be no open drainage ditches, wells, or holes into which children may fall; (d) Drainage shall be adequate to prevent stagnant pools of water from accumulating; (e) Garbage and trash shall be stored in covered containers out of reach of the children and shall be removed frequently; (f) Open fireplaces shall not be used. Floor heaters and all heating elements including hot water pipes shall be insulated or installed in a manner which makes the pipes inaccessible to children; (g) Floor space shall be arranged to provide areas for active play, quiet rest, and individual activities; (h) Furniture, equipment, and toys shall be sturdily constructed, without sharp edges, and shall present minimal hazards to children; (i) Lead based paint shall not be used on surfaces accessible to children. Professional assistance shall be requested during routine inspections; (j) Poisonous plants shall be out of reach of children on the premises; (k) Pets, animals, and fowl shall be maintained in a safe and sanitary manner at all times; and (l) If a lodging house, boarding house, or any other business conflicts with the regular © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 53 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS operation of the child care facility, the lodging house, the boarding house, or other business shall not be conducted at the facility. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-260 Water Supply The Rules and Regulations Governing Schools and Child Care Facilities [NMIAC, title 140, subchapter 20.4] promulgated by the Commonwealth Healthcare Center pursuant to the Commonwealth Environmental Health and Sanitation Act of 2000 shall apply. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-262 Toilet and Lavatory Facilities (a) The Rules and Regulations Governing Schools and Child Care Facilities [NMIAC, title 140, subchapter 20.4] promulgated by the Commonwealth Healthcare Center pursuant to the Commonwealth Environmental Health and Sanitation Act of 2000 shall apply as well; (b) If toilet training chairs are provided for use by children, the toilet training chairs shall be emptied promptly and sanitized after use; (c) Lavatories shall be provided in quantities commensurate with toilet facilities. Hot water temperatures shall not exceed 100 degrees Fahrenheit, 38 degrees Celsius, at outlets accessible to children; and (d) Toilet facilities shall be child sized, or safe, sturdy step stools shall be provided to allow standard sized toilets and lavatories to be used. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-264 Food Preparation Food preparation shall be carried out in a kitchen with proper equipment and cleanup facilities required for the number of children in care as follows: (a) All dishwashing shall be performed in a sanitary manner. A domestic dishwasher shall be acceptable, but if it is not available, the dishes shall be washed and rinsed in a sanitizing solution; (b) In a facility caring for less than thirteen children, a family kitchen in good repair, separate from other rooms, shall be available; (c) In a child care facility caring for thirteen or more children, where food is prepared on the premises, adequate sized equipment for the size of the program shall be available. An approved dishwasher or a three-compartment sink shall be used. Both the dishwasher and the three- © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 54 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS compartment sink shall require approval by the Department of Health; (d) When food is prepared off the premises and is transported to the child care facility from a licensed preparation source, the foods shall be kept in a safe and sanitary condition; (e) When single service utensils are used, the utensils shall be stored and handled in a sanitary manner and discarded after a single use; and (f) Cooking utensils used in food preparation and service shall be cleaned stored in a sanitary manner. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-266 Food Protection Food protection shall be carried out as follows: (a) Policies and practices shall be developed and carried out in a manner that insures that all food is protected from contamination during storage, preparation, and service; and (b) Food protection policies shall comply with accepted practices of local sanitary codes and shall be adapted to fit the needs of the program except as indicated in the rules in this subchapter. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-268 Cleaning of Premises (a) All necessary cleaning equipment shall be available on the premises and a plan for regular cleaning shall be established to protect the health of the children and all child care staff. (b) Toys, tabletops, furniture, and other similar equipment used by children shall be washed daily. Plain soap and water shall be an adequate cleansing agent. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-270 Public Beaches, Swimming Activities and Wading Pools (a) When swimming or wading pools are part of the facility, equipment, or program, swimming pools shall be constructed, maintained, and operated in accordance with building and health rules. (b) When swimming or wading activities are included in the child care program, the following safety practices shall be observed: (1) A certified lifeguard, who may be the provider, shall be on duty at all times when swimming pools are in use; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 55 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (2) Wading pools less than twenty-four inches at the deepest part shall be exempt from the requirements of subsection (b)(1). However, children shall be personally attended by a responsible adult at all times; (3) Wading pools exempt under subsection (b)(2) shall be emptied immediately after each use; and (4) Legible safety rules for the use of all types of pools shall be posted in a conspicuous location and read and reviewed at regular intervals by the provider responsible for the care of children. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart G - Physical Facilities Standards § 55-40.1-272 Building Safety Codes and Space Requirements (a) Child care facilities shall conform to the zoning, building, electrical, and plumbing codes of the Commonwealth of the Northern Mariana Islands in which the facility is located and to state rules as may be applicable to the facility. (b) The facility shall: (1) Be located in a safe and sanitary area; (2) Have a sunny exposure and be well lighted and ventilated; and (3) Be located in a reasonably quiet area or employ suitable noise control devices to limit noise exterior to the child care operation. (c) All buildings, building appurtenances, outdoor space, equipment, and all other parts of the facility shall be kept repaired, safe, and sanitary at all times. (d) The space requirements, enclosed areas, and outdoor areas, of the facility shall be as follows: Standards for Space Requirements (1) Enclosed Areas: (i) Daytime Care: There shall be thirty-five square feet per child of unencumbered instructional or play area exclusive of bathrooms, kitchens, cupboard space, and hallways. The thirty-five square feet per child requirement shall be a general area definition of the square footage of the entire center, not describing the square footage of each classroom. Lanai area may be counted for not more than thirty percent of required area. (ii) Nighttime Care: In rooms used for sleeping, there shall be fifty square feet per child exclusive of lanai area. (iii) Requirements During Naptime: All child care facilities shall meet the following requirements for naptime: (A) A selection of toys for quiet activities shall be available; (B) Comfortable individual beds or cots that may be cleaned and sanitized shall be available or supplied by parents; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 56 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (C) Individual beds or cots shall be placed at least three feet apart or have a solid barrier between each bedding or 2 feet apart if placed end to end (head to toe) position; and (D) Lighting levels should be appropriate for napping and specific activities including naptime, but must allow for children to be visible at all times. (2) Indoor and Outdoor Areas: (i) All facilities must have a designated area for indoor and outdoor play. Both must meet the Program Requirements under § 55-40.1-218 (b) Activities which promote physical development. (ii) At a minimum, these designated indoor and outdoor areas shall be 35 square feet for indoor daycare activities per child of unencumbered instructional or play area exclusive of bathrooms, kitchens, cupboard space, and hallways, 55 square feet indoor night care per child, and 50 square feet outdoor space requirement per child on the premises for each child using the space at a given time. (iii) The total number of children on the playground cannot exceed the number of children the space will accommodate at 50 square feet per child. (iv) Lanai area, when not included in the required enclosed area space, may be counted as an outdoor area. (e) The facility shall be equipped with toilets and lavatories as follows: Number of Children Minimum Toilets Minimum Lavatory(ies) 1-12 1 1 13-30 2 2 31-45 3 3 46-60 4 4 61-75 5 5 76-90 6 6 91-105 7 7 106-120 8 8 121-135 9 9 136-150 10 10 151-165 11 11 166-180 12 12 © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 57 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS 181-195 13 13 196-210 14 14 211-225 15 15 Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 36 Com. Reg. 34843 (Mar. 28, 2014); Proposed 35 Com. Reg. 34212 (Aug. 28, 2013); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-273 Child Care Facilities Safety Requirements (a) Cleaning materials, flammable liquids, detergents, aerosol cans, and other poisonous and toxic materials must be kept in their original containers and in a place inaccessible to children. They must be used in such a way that will not contaminate play surfaces, food, food preparation areas, or constitute a hazard to the children. Bio-contaminants including blood, bodily fluids, and other infectious materials must be properly disposed of. (b) No extension cord will be used as permanent wiring. All appliances, lamp cords, and exposed light sockets must be suitably protected to prevent electrocution. (c) Any pet or animal, present at the facility, indoors or outdoors, must be in good health, show no evidence of carrying disease, and be a friendly companion of the children. The provider is responsible for maintaining the animal’s vaccinations and vaccination records. The provider must make reasonable efforts to keep stray animals off the premises. (d) Guns and any types of weapons are off limits in the facilities. (e) The indoor and outdoor play areas must be clean, reasonably neat, and free from accumulation of dirt, rubbish, or other health hazards. (f) Any outdoor play area must be maintained free from hazards such as wells, machinery, and animal waste. If any part of the play area is adjacent to a busy roadway, drainage or irrigation ditch, large holes, or other hazardous areas, the play area must be enclosed with a fence in good repair that is at least four feet high without any holes or spaces greater than four inches in diameter or natural barriers to restrict children from these areas. (g) Outdoor play areas shall be designed so that all parts are always visible and easily supervised by staff. (h) Outdoor equipment, such as climbing apparatus, slides, and swings, must be anchored firmly, and placed in a safe location according to manufacturer’s instructions. All playground equipment should be placed over a shock-absorbing material that is either the unitary or the loose- fill type extending beyond the perimeter of the stationary equipment. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 58 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (i) Trampolines are prohibited for use by children in care. (j) For emergency assistance, call Department of Fire and Emergency Medical Services at 670-234-0911 or Emergency Department at the Commonwealth Healthcare Corporation at 670- 236-8390/1 or 670-234-8950 Ext. 2360/1 and must be posted visibly in the facility. The Poison Help Center is available on line at https://www.poisonhelp.org at no cost for expert advice. (k) Use of waterbeds, water mattresses, gel pads, or sheepskin covers for children’s sleeping surface is prohibited. (l) In an emergency, all occupants must be able to escape from the facility, whether a home or building in a safe and timely manner: (i) All facilities must have two accessible exits on each level. The two exits must be far enough apart from one another to avoid having them both blocked by fire and smoke. Aisle ways and corridors leading to the exits must be kept clear of obstructions. (ii) If the provider chooses to lock the facility door to prevent unauthorized access to the facility or to prevent a child from escaping, the facility shall have no lock or fastening device which prevents free escape from the interior. (iii) Installation of locking devices may not prohibit access by parents. A facility may not utilize locking devices in a manner to prevent unannounced access by authorized individuals, including parents. If a lock is used, the provider must make adequate provision to allow authorized persons unannounced access to the facility and must provide authorized personnel including parents with information on how to gain access. (iv) Exit doors, windows, and their opening hardware must be maintained in good repair at all times. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). Subpart H - Program Modifications § 55-40.1-274 Program Modifications for Drop-in Care (a) All requirements set forth in this section shall be met by the facility. (b) A child care center offering drop-in care shall be prepared to adjust its staffing to meet the program modifications which result when drop-in care is provided. (c) Children receiving drop-in care shall be cared for in separate areas or groups. (d) If a center serves both drop-in children and children who attend regularly, the grouping of the children and the program shall be planned so that the needs of both groups are met. (e) The facility shall have the following information in writing: (1) The ages of children accepted for drop-in care; (2) The procedures for admittance and release of drop-in children; and (3) Arrangements for staffing and separate activities for drop-in children. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 59 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-276 Program Modifications for Night Care A child care facility offering night care shall meet the requirements of this subchapter in addition to those contained in Parts 300 and 400 and to the following requirements: (a) In consultation with parents, special attention shall be given by the caregiver to provide for a transition into night care; (b) A selection of toys for quiet activities shall be available; (c) Comfortable beds or cots, complete bedding and night clothes shall be available or supplied by the parents; (d) Beds shall be placed at least three feet apart; (e) Staff shall be available to assist children during eating and pre-bedtime hours and during the morning period when dressing. All child care works on duty shall remain awake, available, within call and able to respond to the needs of the children during night care. During sleeping hours, staff shall be within listening distance to provide for the needs of children and to respond to an emergency; (f) A child shall not sleep in a building detached from the main facility; (g) Night care facilities shall include at least one shower, bathtub, or bathing facility for the children; (h) There shall be a night light or other mechanism to illuminate hallways leading to stairs and/or the restroom. (i) Each child shall have individual toilet articles such as comb, toothbrush, towel, and washcloth. (j) No child under 5 years of age is to be left unattended while in the bathtub. (k) Health care routines at bedtime and/or upon rising shall include: (1) Brushing teeth at bedtime and upon rising; (2) Brushing or combing the hair upon rising; and (3) Establishing a routine for toileting at bedtime and upon rising. (l) The child care facility shall serve meals and snacks that supplement food served at home. (m) An evening meal that meets nutritional requirements shall be served at a regular time each evening and shall be available to children who may arrive without having first eaten. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 60 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (n) A bedtime snack shall be served, unless contraindicated by parents or physician. (o) Children who remain overnight and go to school directly from the day care home shall have breakfast, including juice or fruit, unless they are receiving breakfast at school. (p) A child care facility offering night care shall meet the following additional requirements: (1) When the same premises is used for the operation of both day care and night care, the number of children during any overlapping of the day care and night care periods may not exceed the maximum licensed capacity of the center. (2) Minimum staff-to-child ratios and group sizes as specified in § 55-40.1-228 Staff- Child Ratio shall be maintained during night care; (3) Unrelated children over 4 years of age may not share a bedroom overnight with children of the opposite sex; and (4) A center in which children sleep for more than three consecutive hours shall be provided with a smoke detector installed in consultation with a fire inspector. Modified, 1 CMC § 3806(a). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-278 Program Modification for Emergency Child Care (a) All requirements set forth in this section shall be met by the facility. Childcare providers offering emergency child care or back-up care are subject to the same licensing requirements as set forth in Parts 100 and 200. (b) Licensed child care providers may offer an emergency child care or back-up day care where and when it is needed as a substitute childcare plan. Working parents and employers may need an emergency child care or back-up day care due to situations such as school vacation and holiday breaks, inclement weather, in-service days, emergency or unexpected event. (c) If a center serves both emergency child care or back-up day care and children who attend regularly, the grouping of the children and the program shall be planned so that the needs of both groups are met. (d) The facility shall have the following information in writing: (1) The ages of children accepted for emergency child care services or back-up care; (2) The procedures for admittance and release of children; and (3) Arrangements for staffing and activities for children receiving emergency child care services or back-up care. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-280 Program Modification for Summer Day Program/Summer Day Camp (a) The purpose of this section is to establish requirements and to protect and promote the © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 61 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS health, safety and welfare of children being cared for in a summer day program/day camp. (b) Summer day programs/day camp for children shall be designed to provide opportunities for the social, physical recreational, cultural, and educational development of children. Programs should provide a safe and welcoming environment. Programs must strive to remove barriers that would prevent the full participation of all children, regardless of race, ethnicity, class, gender, ability, and family income. (c) A center offering summer day program/day camp may not exceed the maximum licensed capacity of the center. (d) Children must be supervised at all times to ensure safety. This supervision may vary according to the ages and individual needs of the children. (e) A summer day program/day camp may provide care to children ages 6 years and older (up to age 13). (f) A summer day program/day camp schedule is a seasonal program between June and August. (g) Program Requirements (1) A licensed summer day program/day camp requirement are: (i) An approved building, fire and sanitation inspection (ii) A written planned activity, which are appropriate to the ages and abilities of the children. These activities must offer choice and variety (e.g. individual, small group, large group, quiet, active, etc.). (iii) There must be sufficient equipment/materials available to carry out the plans; (A) Developmentally appropriate activities; (B) Nutritious meals and snacks; (C) Healthy and safety training; (D) Criminal record checks for all staff; (E) Education and/or experience requirements; and (F) Additional health and safety requirements must be met for the equipment, materials and the location where the children receive care. (h) Sites/Recreational Space/Facilities (1) A center offering summer day program/day camp at the child care facility may not exceed the maximum licensed capacity of the center. (2) If the summer day program/day camp will be hosted off-site from the child care facility, the child care provider shall: (i) Identify a base camp that provides an environment that allows the program to be oriented to the out-of-doors. The base camp shall be maintained in a clean and sanitary condition at all times. (ii) The base camp shall have a building or shelter for use by the camp during inclement weather. If the shelter is not enclosed, the camp shall implement a procedure for ensuring that children are protected from the elements. (iii) The base camp shall be located on a well-drained site not subject to flooding. The premises © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 62 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS shall be properly graded to prevent the accumulation of storm or other waters that may create hazards to the property or to the health or safety of the occupants. No camp may be located in an area that is situated so that drainage for any source of filth, such as garbage or animal waste disposal, can be deposited on the site. (iv) Make sure that the children are cared for in a healthy environment with access to water, toilets, a telephone, fire extinguisher, and complete first aid kit(s). Make sure that the total area of a tent space is a minimum area of 500 square feet per tent if children are expected to learn how to set up a tent during the day camp. (i) Off-Site Trips and Outings (1) Summer day program/day camp activities can vary greatly depending on the interests and age range of the participants. The following requirements are expected regarding off site trips and outings during the summer day program/day camp: (i) Site must be familiar to at least some of the staff and a pre visit is recommended; (ii) All swimming facilities visited must have qualified lifeguards with current certification; (iii) First aid kits must be taken on all outings; (iv) Information about children (parent/guardian phone numbers, health numbers, allergies, etc.) must be taken on outings; (v) Trip forms (generic or trip-specific) must be signed by parent/guardian prior to trips; (vi) A copy of a list of who is on the trip must be left at the child care facility; (vii) Staff and children must discuss procedures for lost children prior to each trip; (viii) If return from trip site is delayed, the CCLP must be notified; and (ix) Children should carry identification to include the name of child, phone number in case of emergency, child care center name and phone number. (j) Food Where the length of day warrants it, snacks should be provided either by the parents/guardian or the program. Emergency food supply should be available in the event a child forgets to bring snack or lunch. If parents/guardians are required to provide lunch, they should be given guidelines regarding nutrition and safety when food cannot be refrigerated. (k) Staffing and Training (1) Minimum staff-to-child ratios and group sizes as specified in § 55-40.1-228 Staff-child Ratio shall be maintained during summer day program/day camp. (2) It is the responsibility of each child care provider to ensure that all summer staff has received appropriate training prior to their working with children. Minimum training period of one week are recommended. Such training shall include: (i) Orientation to agency/program mandate, policies and practices; (ii) Certified first aid training; a minimum of emergency pediatric first aid and CPR; Child safety precautions, guidelines re: allergies or medical needs; (iii) Health and food related illnesses, food handling; (iv) Emergency procedures, reporting of serious incidents; (v) Program planning; (vi) Behavior guidance philosophy and procedures; (vii) Conflict resolution; (viii) Child abuse and neglect protocol; and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 63 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (ix) Procedures for outings and field trips including expectations regarding water-based activities. (l) Administrative Procedures and Logistics (1) Programs must have written policies and procedures on: (i) Behavior guidelines outlining both acceptable and unacceptable practices; Child abuse (both the reporting of suspected child abuse and accusations of child abuse against staff); (ii) Children who do not arrive at camp program on scheduled date/time; (iii) Information about trips, outings, including waiver, or individual waivers per outing policy; (iv) CCLP staff access to information on children’s forms; (v) Communicating relevant information to parent/guardian; (vi) Media releases; and (vii) Appropriate Liability insurance coverage. (m) Student Registration (1) Registration forms must be designed in such a manner so that staff has sufficient information about a child to ensure their health and safety. They should not be unnecessarily intrusive and should be written in clear language with translations where needed. (2) Summer Day Program/Day Camp forms shall include: (i) Child’s name, date of birth; (ii) Parent/legal guardian’s name, address, phone number, alternate phone number; (iii) In the event parent/guardian cannot be reached, emergency contact name, phone number and relationship to child; (iv) Emergency medical consent; (v) Any health information the staff need to know (e.g. allergies, medications, other); (vi) Information about any special considerations for the child; (vii) Health card number; (viii) Safe arrival/departure information: who normally picks up and drops off child; is there anyone who should not be allowed to pick up child; and (ix) Procedure for calling if child does not arrive at camp program on scheduled date/time. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). Part 300 - Family Day Care Homes and Friend, Family, and Neighbor Care Home Applicability of Rules Part 300 – Family Day Care Home, and Friend, Family, and Neighbor Care Home (FFN) requirements are set forth by the Child Care Licensing Program for the inspection and licensing of family day care home, and FFN subject to Commonwealth of the Northern Mariana Islands’ laws governing child care facilities. Subpart A - Administration Requirements § 55-40.1-300 Supervision of Children All family day care home and FFN care home shall adequately supervised children being cared for © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 64 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS at all times and are protected from harm and hazards. It is the responsibility of each provider to provide supervision to all children from the time children arrive at the family day care home or FFN care home until the time the children go home. All caregivers who are entrusted with supervisory responsibility shall exercise reasonable care in the discharge of supervisory duties. Providers shall formulate, distribute and explain to the children’s parents and guardians the procedures regulating children’s behavior on the premises accordingly. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-301 Number and Age of Children in Care (a) A family day care home and FFN care home shall provide care for no more than six children at the same time. (b) No more than two children under twenty-four months of age shall be permitted in the family day care home and FFN care home at the same time. Should there be additional adult help in the home, there may be up to four children under twenty-four months of age. (c) Restrictions as to the number of children permitted shall be made in certain conditions as identified in § 55-40.1-330: staff-child ratio. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-302 Certain Provider’s Children Not Included The following provider’s children are not included in this total: (a) Children six years of age or older; and (b) Children under six years of age who are in school or attending a child care facility, such as a child care center, more than six hours per day. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-304 Statement of Operation Policies (a) A family day care home and FFN care home shall have written operation policies. Family day care home and FFN care home policies shall include: (1) Ages of children accepted; (2) Maximum number of children permitted by certificate of child care licensing program; (3) Specific hours of day, night, holiday, and vacation operation; (4) Whether or not meals are served; (5) Fees and the plan for payment, including fees for different types of child care services and refund policy; (6) Policy and plan for emergency medical care; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 65 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (7) Insurance coverage - provider shall inform parents or guardians in writing of its policy regarding liability insurance; each family day care home and FFN care home shall carry a liability insurance coverage at all times during operations and at the time a child’s enrollment for child care services. A family day care home and FFN care home is subject to revocation, suspension or denial of child care license if it violates the requirements for liability insurance coverage referred in § 55- 40.1-125 Denial, Suspension, Revocation of Child Care License, and Hearings; (8) Transportation arrangements; (9) Parental permission for trips and related activities outside the facility; (10) Policy regarding admission of sick, moderately sick, or handicapped children; and (11) Other policies which may be required by the Department; (12) Emergency preparedness, response, recovery, and resources plan which is a written plan to cover emergencies and disasters; (13) Each family day care home and FFN care home must provide their Standard Operating Procedures (SOP) to the Child Care Licensing Program, parents, and agencies that monitor the health and safety of the children under their care. The SOP shall also be available for site inspections, monitoring, and unannounced monitoring visits by the CCLP personnel. The SOP shall closely adhere to the CCLP basic licensing requirements. (b) The provider shall review the policies with each parent or guardian at the time of enrollment of a child. Modified, 1 CMC § 3806(f). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-306 Information on Owner or Operator (a) The name, physical address, mailing address, email address, and telephone number of the family day care home and FFN care home shall be provided to the Department. (b) The name, physical address, mailing address, email address, and telephone number of any sponsoring agency shall be provided to the Department. (c) The name, physical address, mailing address, email address, and telephone number of the persons bearing the responsibility for the family day care home and FFN care home shall be supplied to the CCLP. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-308 Change in Services (a) A family day care home and FFN care home shall notify parents or guardians, and the CCLP with the Department of Community and Cultural Affairs of any changes in the child care services it provides. Notification of any changes in service shall be made no later than thirty days after the date of the change and shall be included in the family day care home and FFN care home operating policies. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 66 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (b) No changes shall be made unless approved by the CCLP and requirements for changes have been met as determined by the CCLP. (c) If the significant change affects the continued operation of the facility, then necessary corrective action must be completed within the prescribed timeframe to come into compliance or sooner as determined by the family day care home and FFN care home provider. (d) Significant changes include, but are not limited to, the following: (1) Relocation of the child care facility; (2) Renovation to existing structure; (3) Increase/decrease in child capacity; (4) Changes in staffing pattern; (5) Changes in policies and procedures; (6) Changes in ownership; (7) Changes in the name of the business operation; (8) Changes to the facility layout. (e) Such changes shall be taken into consideration at the discretion of the CCLP to determine status of the license for continued or discontinued operations of services upon meeting requirements and qualifications in accordance to these rules and regulations as deemed necessary. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-310 Information and Records on Each Child (a) Admission procedures shall require that sufficient information and instruction from the parents or guardians be furnished to enable the provider to make decisions or act on behalf of the child. (b) Prior to admission of a child to a family day care home or FFN care home, the provider shall obtain the following information from the child=s parents or guardians; (1) The child’s full legal name, birth date, current physical address, mailing address, primary language spoken and preferred names; (2) The name and physical home address of the parents or guardians who are legally responsible for the child; (3) Telephone numbers or instructions as to how the parents or guardians may be reached during the hours the child is in the facility; (4) Health information concerning the child, as required by subpart E. (5) Written authorization for emergency care, including provision of health insurance information; (6) Child health report, that includes the child’s immunization record, and other pertinent information regarding the health of the child (i.e., last physical examination report, tuberculin test); and (7) These records shall be kept confidential, and information provided only to the family day care and FFN care home caregiver operating the care home with a need to know, in the event of © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 67 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS an emergency, or other caregiver members with written consent of the parents or legal guardians. (c) The information shall be maintained in writing and shall be updated as necessary. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-312 Disclosure of Information on the Child Information pertaining to an individual child or parents or guardians of the child shall not be disclosed to persons other than the authorized family day care or FFN home care provider, unless the parents or guardians of the child submit a signed consent form granting written permission for the disclosure or when an emergency arises necessitating release of the information. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-314 Information and Records on Facility Written information and records on the facility shall be maintained and made available to the CCLP. Current records and information, shall include: (a) Roster of enrolled children; (b) Daily attendance record by names of children; and (c) Child health and safety incident reports affecting the health and safety of children in the family day care home care or FFN care home. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-316 Transportation Provisions When transportation is provided by a family day care home or FFN care home, children shall be protected by adequate supervision, safety precautions and liability and medical insurance coverage as follows: (a) The vehicle and driver providing transportation shall be in compliance with all relevant motor vehicle laws; (b) No more than six children under the age of six years shall be transported when only one adult is in the vehicle; (c) Children shall be instructed in safe transportation conduct as appropriate for age and stage of development; and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 68 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (d) All children under three years of age shall be in federally approved child safety seats. All other children and adults shall be secured by seat belts at all times when driving. (e) Children shall not be allowed to ride in the back of pick-up trucks. (f) The family day care home or FFN care home shall obtain a copy of the driving/traffic record from the court for each provider whose job includes driving duties. The driving/traffic record shall be updated annually. (g) The vehicle shall be: (1) Maintained and kept in a safe operating condition at all times; and (2) The driver’s license number and date of expiration, vehicle insurance information, and verification of current state vehicle inspection should be on file in the child care facility. (h) During any field trip or excursion operated or planned by the facility, the staff-child ratios as provided in § 55-40.1-330 shall apply. (i) Child Passenger Safety (1) When transporting children for any and all purposes: (i) Children shall be transported only in sections of vehicles designed for and equipped to carry passengers; (ii) A seat that fully supports the passenger shall be provided for each child; (iii) All children, shall be transported in accordance with § 4108*. Safety Belts on Passenger Vehicles 9 CMC §1103(f); (iv) All children should be transported only if they are restrained in a developmentally appropriate car safety seat, booster seat, seat belt, or harness that is suited to the child’s weight and age in accordance with state and federal laws and regulations; (v) No child shall be left unattended inside or outside a vehicle; and (j) Interior Temperature of Vehicles The interior of vehicles used to transport children for field trips and out of program activities should be maintained at a temperature comfortable to children. (k) All vehicles should be locked when not in use, head counts of children should be taken before and after transporting to prevent a child from being let in a vehicle, and children should never be left in a vehicle unattended. (l) Passenger Vans Family day care home and FFN care home that provide transportation for any purpose to children, parents/legal guardians, staff and others should not use 15-passenger vans when avoidable. (m) The child care facility shall maintain a written plan for transportation. (n) Drivers shall: © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 69 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (1) Be at least 18 years of age; (2) Hold a current driver’s license; (3) Maintain a safe driver record; (4) The provider must take precautions to protect children from vehicular traffic; (5) No use of alcohol, drugs, or any substance that could impair abilities before or while driving; (6) No tobacco uses while driving; (7) No medical condition that would compromise driving, supervision, or evacuation capability; and (8) Valid pediatric first aid and child cardiopulmonary resuscitation (CPR) certificate if transporting children.

So in original. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart B - Program Requirements § 55-40.1-318 Program Provisions There shall be a provider or a responsible adult, designated by the family day care home or FFN care home provider, supervising the children at all times. The provider or responsible adult shall always be within sight or hearing distance to provide for the needs of the children and to respond to an emergency. The program shall also provide an environment and experiences that are aimed at promoting the individual child’s physical, intellectual/cognitive, social-emotional, and well-being, mental and developmental and growth. This shall be done in the following ways: (a) Activities which promote physical development shall include, but not limited to: (1) Daily opportunities for running, climbing, and other vigorous and varied physical activities; and (2) Opportunities for children to learn about the health, and care of the their bodies, to include exercise, nutrition, and hygiene; (b) Programs to promote intellectual/cognitive development shall include, but not limited to: (1) Provide that a variety of learning materials are introduced and are available to the children; (2) Include first-hand experiences for children to learn about the world; and (3) Reading aloud to children, developing listening and speaking skills, teaching about sounds of spoken language, print books, letters, building children’s background knowledge and thinking skills, teaching about numbers and counting and checking children’s progress. (c) Programs to promote social-emotional development shall be provided, but not limited to, that: (1) There are opportunities for individual self-expression; (2) Each child is recognized as an individual; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 70 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (3) The child is afforded constructive guidance and the setting of clear-cut limits which foster the child’s own ability to be self-disciplined; (4) Each child’s personal privacy is respected; (5) Providers shall not use: (i) Physical punishment, or (ii) Methods of influencing behavior which are frightening, humiliating, injurious, or damaging to the child=s health or self-esteem; and (6) Providers respect each child=s cultural, ethnic, and family background, as well as the child=s primary language or dialect; (d) Programs to promote social development shall provide that: (1) Children are guided in learning to get along with each other; (2) Providers interact with children in ways which promote mutual respect between adults and children; and (3) Providers behave in ways which help the children develop attitudes of respect for all other persons as individuals and develop an appreciation of ethnic and cultural diversity; (e) The activities and experiences provided by the program shall be appropriate to the developmental level of the children; (f) The program shall encourage the development of the children’s special interests and abilities; (g) The program shall provide a balance of active and quiet activities; and (h) The program shall provide for the self-direction of the children by: (1) Affording children opportunities to choose activities according to personal desires and interests and to move from one activity to another, (2) Encouraging children to do things independently; and (3) Providing children opportunities to be involved in decision making about group and individual activities. (i) Programs to promote mental growth and well-being shall be provided, but not limited to: (1) The opportunity for the child to build self-confidence and self-esteem; (2) Encourage the child to participate in positive routines. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-320 Communication with Parents and Guardians Caregivers shall exchange information with parents or guardians about the children as follows: Caregivers shall communicate and maintain an open-door policy exchange information with parents or guardians about their children including, but limited as follow: (a) Plans shall be made and followed with parents or guardians for any information about each child; and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 71 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (b) Caregivers shall relay concerns about the health, or behavior of the child to the parents or guardians promptly and directly. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-322 Program Materials and Equipment (a) The selection, quantity, arrangement, and use of available the materials and equipment shall be appropriate to the ages of the children in care for a variety of indoor and outdoor activities. (b) The quantity of materials and equipment shall be sufficient to: (1) Avoid excessive competition between the children and to avoid long waits for use of the materials and equipment; (2) Provide to the individual interests of the children; and (3) Provide a wide variety of choices for play and learning. (c) Protected areas where equipment and materials will be used with minimal interference or interruption shall be provided. (d) Materials shall be stored in orderly way, shall be kept in good repair, and shall be accessible to children. The materials shall be arranged to allow children to select, remove, and replace the materials either independently or with assistance. (e) Grass, soft media, or other protective measures shall be used under swings, slides, jungle gyms, and other similar outdoor play equipment. (f) Equipment for both indoor and outdoor play shall allow children to use small and large muscles for imaginative play and creative activities. (g) Provision for individual storage of children’s clothing and personal belongings shall be available. (h) Storage space for play materials and equipment used by the children shall be made available. (i) The following sleeping equipment shall be safe, sturdy, clean, age-appropriate, and available: (1) Individual bed, crib, cot, mat, sleeping bag, or mat for each child who rests; and (2) A clean sheet or cover to be used on the bed, crib, cot, mat, sleeping bag or mat for each child. (j) Storage spaces for other equipment, materials, and supplies used by staff shall be available, but secure and out of children’s reach. (k) Materials and equipment must help provide many experiences that support all children’s © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 72 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS physical, intellectual/cognitive, social-emotion, mental growth and well-being. (l) All toys and equipment used by children are sturdy, safely assembled, hazard-free, and not recalled. Toys and equipment must not cause children to become trapped or have rough edges, sharp corners, pinch or crust points, splinters, exposed bolts, or small loose pieces. (m) The family day care home and FFN care home shall ensure that children under three years old do not have access to empty plastic bags, Styrofoam objects/cups/bowls/toys, latex ballons, and objects less than one inch wide. Modified, 1 CMC § 3806(a). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-324 Transition to a New Facility or School Setting (a) Provision shall be made to assist the child in making the transition from the family day care home and FFN care home setting to a new child care, a kindergarten, or school setting. (b) Provision shall be made for cooperation between the caregiver and parents, guardians, or kindergartens when information is requested which may assist a child to adjust to a new environment as allowed by § 55-40.1-310. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart C - Staffing Requirements § 55-40.1-326 Staff Training, Experience, and Personal Qualifications and Comprehensive Background Checks (a) Each provider shall be qualified through training experience, and personal qualities for the age group with which the person works. (b) All providers other than volunteers assisting providers shall be at least eighteen years old. (c) Written references from two of the following categories of persons shall be submitted to the Department with an application; (1) A neighbor or personal friend; (2) A person in a professional capacity such as a teacher, doctor, minister, or social worker, (3) The parent of any child who has previously been in the provider=s care, if applicable. (d) Applicants, family day care home and FFN care home care givers, employees and volunteers shall be of reputable and responsible character and shall not have a criminal history record, employment history, or background which poses a risk to children in care as referred to in § 55-40.1-110(d). (1) Conviction of a crime involving violence, alcohol or drug abuse, sex offense, offense © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 73 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS involving children, and any other conviction, the circumstance of which indicate that the applicant or employee may pose a danger to children, are grounds for denial or revocation of a certificate of child care license or a reason to request termination of an employee under § 55-40.1-110(d); (2) The type of criminal offense, when it occurred, and evidence of rehabilitation shall be considered in determining whether the criminal history record poses a risk to the health, safety, or well-being of children in care; (3) An employment history indicating violence, alcohol or drug abuse, and any other violation of an employer’s rule or policy, the circumstances of which indicate that the applicant or employee may pose a danger to children, may be grounds for denial or revocation of a certificate of child care license or a reason to request termination of an employee under § 55-40.1-110(d); (4) A comprehensive background information which shows that the individual has been identified as and substantiated to be the perpetrator of child abuse or neglect may be a basis for denial or revocation of a certificate of child care license or a reason to request termination of an employee under § 55-40.1-110(d); and (5) In accordance with section 658H(i)(1), the background check requirements in the CCDBG Act apply to all licensed, regulated, or registered child care providers, regardless of whether they receive CCDF funds, and all license-exempt providers that receive CCDF (with the exception of individuals who are related to all children for whom child care services are provided). (e) All family day care home and FFN care home staff must annually participate in at least 15 hours of health and safety training as approved and monitored by the Child Care Licensing Program. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-328 [Reserved] History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-330 Staff-child Ratio (a) A family day care home and FFN care home shall provide care for no more than six children at the same time. The following provider’s children are not included in this total: (1) Children six years of age or older, and (2) Children under six years of age who are in school or attending a child care facility, such as a child care center, more than six hours per day. (b) No more than two children under eighteen months of age shall be permitted in the family child care home at the same time. Should there be additional adult help in the home, there may be up to four children under eighteen months of age. (c) Restrictions as to the number of children permitted shall be made under the following conditions: (1) Space is unusually limited; (2) Provider has personal or physical limitations; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 74 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (3) There is an unusually wide range of ages of the children; or (4) There are disabled children requiring unusual amounts of special care. (d) The provider shall provide the CCLP with the name, physical address, email address, and telephone number of at least two substitutes for the provider, such as another family child care provider, a neighbor, or a hired person, who will be called in an emergency or other times when the regular provider is unable to provide care. A background check shall be administered before hiring and assignments are done on all substitutes. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart D - Health Standards for Children § 55-40.1-332 Health Policies and Consultation Provisions The family day care home and FFN care home shall make provision for health consultation to assist in developing health policies and keeping the policies current. The provider shall contact a local health resource for consultation in setting up and maintaining health standards. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-334 Evidence of Child’s Health (a) The family day care home and FFN care home shall require and obtain from the parent or guardian of each child entering child care the following documentation: (1) Child’s record of immunizations; (2) Evidence of the child’s good health; and (3) Signature of a physician or health agency, signed within one year prior to admission. (4) Written evidence that the child(ren) have received a tuberculin test indicating that the child is free from tuberculosis in a communicable form; (5) A written statement from a licensed physician certifying that the physical condition of the child(ren) is such that immunization would endanger the child’s(ren’s) life or health. (b) School aged children in before or after school care only, who satisfy health requirements for enrollment in school, are not required to furnish the material specified in subsection (a) above. (c) Parents or guardians shall be given a grace period, not to exceed 2 weeks from the last assessment of the child’s immunization record, to obtain required immunization(s). (Title 1. Division 1, §1151 Immunization). Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-336 Emergency Care Provisions © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 75 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Every family day care home and FFN care home shall have the following provisions for emergency care of children requiring treatment at a hospital or clinic away from the family day care and FFN care home setting and for care of children who become ill after arrival: (a) The provider shall obtain the name of a licensed physician or nearest hospital or clinic where care can be provided to the child; (b) The provider shall obtain written permission from the parents or guardians to allow the child to receive emergency care; (c) An adult shall accompany a child to the source of emergency care. The adult shall stay with the child until the parent or guardian or their designee assumes responsibility for the child’s care. The selection of the adult shall not compromise the supervision of the other children in the program; and (d) Physical arrangements for children who become ill after arrival at the facility shall be available for the care of the child until parents or guardians can be notified to provide alternative arrangements. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-338 Pediatric First Aid and Child Cardiopulmonary Resuscitation (CPR) (a) There shall be at least one adult provider who is trained in observation of symptoms of illness and with a current certificate in pediatric first aid and child care cardiopulmonary resuscitation (CPR). A current certificate means a training course competition certificate that is not expired. (b) The provider may be trained through a community health aide program or a program developed or endorsed by the American Red Cross, Commonwealth Healthcare Corporation, or nursing or medical agency in the community. (c) A first aid kit shall be available in the child care setting at all times. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-340 Admission of Ill Children (a) When health policies of the family day care home and FFN care home allow ill children to be admitted or to remain in the family day care home and FFN care home, medical consultation shall be available regarding special care and medication. (b) When medication prescribed by a physician is administered at the family day care home and FFN care home: (1) The medication shall be kept in the original container bearing the prescription label which shows a current date, the physician’s directions for use, and the child’s name; and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 76 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (2) Medication shall be kept in a locked cabinet or out of the reach of the children and shall be returned to parents or guardians when no longer in use. (3) There shall be an authorization signed by the parent or guardian for the administration of the medication by the care giver. (c) When over the counter medication is recommended by the child or family’s doctor, medication shall be administered at the facility as directed by the doctor or parent or guardian in writing. (d) Both the provider and the parents or guardians shall be familiar with special policies of the family day care home and FFN care home relevant to ill children. Special policies regarding illnesses are to be explained to the parent or guardian at the time of enrollment of the child. (e) The family day care home and FFN care home shall , in consultation with its health consultant, establish a re-admission policy for children who have been absent because of illness. (f) The family day care home and FFN care home shall have, in writing, the name, physical address, email address, and telephone number of a physician or health resource that shall be called in case of emergency. Written permission of the parent or guardian to call upon the physician or health resource, or another responsible source of care, if the parent or legal guardian cannot be reached, shall be required. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-342 Admission of Children with Disabilities (a) When children with disabilities are admitted into a family day care home and FFN care home shall provide for the needs of each child according to the individual family service plan (IFSP) (Early Intervention, Zero to Birth) and the individual education plan (IEP) (School-age children). (b) The disabled child shall be admitted in consultation with the child’s source of health care, the parent or guardian, and the provider. The consultation shall include written recommendations from the health source to cover the child’s special needs or to define the child’s capacities and limitations. (c) If the child’s health care source considers it advisable, the provider shall receive training related to the nature of the child=s disability and the child’s potential for growth and development. (d) Where the nature of the child’s disability or the number of disabled children in the program necessitates added care, additional adults and appropriate equipment shall be available to cover these requirements. (e) Child care givers must not exclude a child with disability from their programs based on their disability nor separate that child from their non-disabled peers. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 77 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (f) Child care givers must make an individualized assessment about whether they can meet the particular needs of a child with disability. The assessment shall include written recommendations in consultation with the Public School System’s Special Education Program Office, Pact C – Early Intervention – zero to birth, and the Special Education Program Office, Part B – children and youth ages 3 to 21 for special education and related services. (g) When children with disability are admitted into the family day care home and FFN care home, the care giver shall provide for the special needs of each child. (1) Make reasonable modifications to their policies and practices to allow for children with disabilities to participate. Here are examples of some common reasonable modifications: (i) Change a toilet training policy to assist a child with Down syndrome who, due to his or her disability, requires assistance with going to the bathroom. (ii) Change a discipline policy to ensure that a child with autism has equal access to the program with appropriate supports, such as training staff to aid the child in deescalating behavior when the child acts out. (iii) Change a medication policy so that a trained staff person may assist a child with diabetes in the administration of insulin or Glucagon, an emergency, life-saving medication for individuals with diabetes. (iv) Provide appropriate aids and services needed to effectively communicate with children or adults with disabilities. (v) If the family day care home and FFN care home are closing early due to bad weather, that may mean using different methods not just calls but emails or text messages to communicate with deaf or hard of hearing parents or guardians. (vi) If a family day care home and FFN care home are using websites or parent portals to keep parents informed concerning their child’s participation in the program, all such technology must be accessible to those with hearing, vision, or speech disabilities (for example, those who use screen readers). (viii) Make sure physical spaces are accessible. Remove architectural barriers that interfere with or prevent children from fully participating (or parents, guardians, or prospective customers with disabilities) if removing the barriers is readily achievable, meaning if it can be easily accomplished without much difficulty or expense. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-344 Daily Nutritional Needs (a) To the extent possible, information provided by parents or preferences, or special needs shall be considered in child care feeding schedules and menus. A child shall be encouraged but shall not be required to eat the food offered at the home. (b) The family day care home and FFN home shall have access to nutritional information provided by a qualified nutritionist, dietitian, or other community resource approved by the Commonwealth Healthcare Corporation, Tinian Health Center, or Rota Health Center. (c) In a family day care home and FFN home providing meal service, the minimum meal components and food amounts required by the United States Department of Agriculture (USDA) © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 78 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS child care food program shall be met. The home shall offer and provide the following combination of meals and snacks for children in care: (1) Two to four hours - one snack; (2) Four to eight hours - one snack or breakfast and lunch or supper; (3) Eight hours or more - one snack or breakfast and lunch or supper and one additional snack (unless the eight hours or more extend into the evening hours when the child may be asleep); (4) When two snacks are required as in subsection (c)(3) above, at least one of those snacks shall include the provision and offering of milk or its calcium equivalent; and (5) Local ethnic foods may be added or substituted for quantity (for allowable food reimbursement, provider shall consult with the USDA). (d) In a family day care home and FFN home where parents or legal guardians are allowed to provide food (i.e. sack lunches or snacks) the home, in addition to food the child brings, shall meet the minimum amounts required by the USDA child care food program by offering and providing children in care; (1) Four to eight hours - morning snack or breakfast or afternoon snack; (2) Eight hours or more - morning snack or breakfast and afternoon snack. (unless the eight hours or more extend into the evening hours when the child may be asleep); (3) When two snacks are required as in subsection (d)(2) above, at least one of those snacks shall include the provision and offering of milk or its calcium equivalent; and (4) Local ethnic foods may be added or substituted for quantity (for allowable food reimbursement, facilities shall consult with the USDA). (e) Children shall not be offered foods to which they are allergic or, for religious reasons. Provision shall be made to secure such information from the parent or guardians, and arrangement shall be made for nutritious substitute foods. (f) Infants shall be personally attended while being fed. (1) Infants unable to hold bottles shall have bottles held, not propped, by the caregiver. (2) Parents or guardians may assume full responsibility for the infants§ diet. (g) School aged children in before or after school care for two or more hours shall be offered a nutritious snack which may be provided by the facility or brought from home. (h) Food shall not be used as a punishment or reward. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-346 Drinking Water Provisions Water suitable for drinking shall be accessible to all children. The Rules and Regulations Governing Schools and Child Care Facilities [NMIAC, title 140, subchapter 20.4] promulgated by the Commonwealth Healthcare Corporation pursuant to the Commonwealth Environmental Health and Sanitation Act of 2000 shall also apply. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 79 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS § 55-40.1-348 Integration of Mental Health Concepts Mental health aspects of each child’s development shall be integrated into the program as follows: (a) At least one parent and a guardian, shall be interviewed prior to a child’s admission to the facility. The personal interview shall be conducted to secure pertinent information on the child’s overall development and behavior and to acquaint the parent or guardian with the facility’s program and policies; (b) The family day care and FFN care home shall provide its staff with annual orientation to state or other mental health services for children, or otherwise familiarize its staff with consultative and clinical services and programs for early identification of social, emotional, intellectual, and behavioral problems of children; and (c) The family day care and FFN care home shall refer parents or guardians to sources of professional consultation in mental health upon the parents§ or guardians§ request or upon the recommendation of the facility’s staff. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart E - Health Standards for Provider and Others in the Home § 55-40.1-350 Hand Washing (a) The family day care and FFN care home shall have a written policy that specifies when hand washing is required for staff and children, defines hand washing procedure, and provides continuing monitoring to assure that the hand washing procedure is carried out. (b) Hand washing policy for staff shall require that hand washing is done. Smoking should not be taking place on premises at all times. (1) Before eating, drinking, or smoking; (2) Before handling clean utensils or equipment; (3) Before handling food; (4) Before and after assisting or training the child in feeding and in toileting; (5) After going to the bathroom; (6) After contact with body secretions, i.e., blood, urine, faces*, mucus, saliva, or drainage from wounds; (7) After handling soiled diapers, clothes, equipment, or menstrual pads; (8) After removing disposable gloves; and (9) After smoking. (c) Infants and toddlers, who self-feed in any manner, shall have their hands washed with soap and water before and after eating and after toileting. (d) Hand washing does not require hot water and may be done with cold water and plain soap © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 80 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS and use of disposable paper towels for drying hands. (e) If bar soap is used, it shall be kept on racks that allow for water drainage. If liquid soap is used, the dispenser shall be replaced or cleaned, as necessary. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-352 Provider’s Health Standards Evidence that providers are free from health problems which would have a harmful effect on the children or which would interfere with effective functioning shall be maintained at the family day care home and FFN care home as follows: (a) The provider shall have a written report of a physical examination given within one year prior to beginning family day care and FFN care home which indicates the provider is in adequate physical health to care for children and a health permit issued by the Commonwealth Healthcare Corporation as required in the Commonwealth Environmental Health and Sanitation Act of 2000; (b) Any other person living in the home shall have a written report of a physical examination on file which was obtained within one year prior to the provider beginning family day care home and FFN care home or prior to the person’s occupancy in the home. For school aged children, this requirement is fulfilled by meeting the rules for school attendance; (c) Written evidence that each adult in the home is free from communicable tuberculosis as a result of a negative tuberculin skin test or a satisfactory chest x-ray taken within two years before beginning family day care home and FFN care home shall be on file at the facility. The tests shall be repeated in compliance with day care rules; and (d) When volunteers provide direct child care of ten hours or more per week, the volunteers shall be subject to the same requirements for health and personal habits as the provider. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-354 Personal Health Habits of Provider The personal health habits of all providers in the family day care home and FFN care home shall not interfere with the protection of the health of the children as follows: (a) The use of medications other than over-the-counter medication is permitted only when authorized by a physician; (b) The provider shall inform parents or guardians if any member of the household smokes; and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 81 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (c) Tobacco and alcoholic beverages shall be stored out of the reach of children and shall not be consumed during hours of the facility’s child care operation. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart F - Environmental Health Standards § 55-40.1-355 Health and Safety Requirements Situations that Require Hand Hygiene (a) All staff, volunteers, and children should abide by the following procedures for hand washing, as defined by the U.S. Centers for Disease Control and Prevention (CDC): (1) Upon arrival for the day, after breaks, or when moving from one group to another. (2) Before and after: (i) Preparing food or beverages; (ii) Eating, handling food, or feeding a child; (iii) Brushing or helping a child brush tooth; Giving medication or applying a medical ointment or cream in which a break in the skin (e.g., sores, cuts, or scrapes) may be encountered; (iv) Playing in water (including swimming) that is used by more than one person; and (v) Diapering. (3) After: (i) Using the toilet or helping a child use a toilet; (ii) Handling bodily fluid (mucus, blood, vomit); (iii) Handling animals or cleaning up animal waste; (iv) Playing in sand, on wooden play sets, and outdoors; and (v) Cleaning or handling the garbage. (b) Situations or times that children and staff should perform hand hygiene should be posted in all food preparation, diapering, and toileting areas. (c) Prevention of Exposure to Blood and Body Fluids (1) All child care facilities should adopt the use of Standard Precautions, developed by the Centers for Disease Control and Prevention (CDC), to handle potential exposure to blood and other potentially infectious fluids. (2) Child care providers and teachers are required participate in a staff development program on Standard Precautions annually and thereafter. (3) Training should comply with requirements of the Occupational Safety and Health Administration (OSHA). (d) Routine Cleaning, Sanitizing, and Disinfecting Programs should follow a routine schedule of cleaning, sanitizing, and disinfecting. Cleaning, sanitizing, and disinfecting products should not be used in close proximity to children, and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 82 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS adequate ventilation should be maintained during use. (e) Environmental Audit of Site Location An environmental audit should be conducted before construction of a new building; renovation or occupation of an older building; or after a natural disaster to properly evaluate and, where necessary, remediate or avoid sites where children’s health could be compromised. (f) A written report that includes any remedial action taken should be kept on file. (g) The audit should include assessments of: (1) Potential air, soil, and water contamination on program sites and outdoor play spaces; (2) Potential toxic or hazardous materials in building construction, such as lead and asbestos; and (3) Potential safety hazards in the community surrounding the site. (h) Integrated Pest Management Child care providers shall adopt an integrated pest management program to ensure long-term, environmentally sound pest suppression through a range of practices including pest exclusion, sanitation and clutter control, and elimination of conditions that are conducive to pest infestations. (i) Use and Storage of Toxic Substances All toxic substances should be inaccessible to children and should not be used when children are present. Toxic substances should be used as recommended by the manufacturer and stored in the original labeled containers. (j) The telephone number for the poison control center should be posted and readily accessible in emergency situations. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-356 Emergency Preparedness, Recovery, and Response Plan (EPRRP) Each family day care home and FFN care home shall have an emergency preparedness, recovery, and response written plan to cover emergencies such as fire, flood, or natural disaster and shall be posted on the wall for everyone to see. The plan shall include: (a) An exit plan for disasters that is practiced at regular intervals; (b) Informing parents or guardians of the plans at the time of enrollment; and (c) The components of the EPRRP plan shall include: (1) Evacuation, relocation, shelter-in-place, and lock-down procedures, and procedures for communication and reunification with families, continuity of operations, and accommodation of infants and toddlers, children with disabilities, and children with chronic medical conditions; (2) Written procedures for accounting for all in attendance including: (i) The location of the children, staff, volunteer and visitor attendance lists; and (ii) The name of the person responsible for bringing the children staff, volunteer and visitor © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 83 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS attendance lists in the event of an emergency. (3) A description for how and when children shall be transported; (4) Methods for communicating with parents and emergency personnel or law enforcement; (5) A description of how children’s nutritional and health needs will be met; (6) The relocation and reunification process; (7) Emergency telephone numbers; (8) Evacuation diagrams showing how the staff, children, and any other individuals who may be present will evacuate during and emergency; (9) The date of the last revision of the plan; (10) Specific considerations for non-mobile children and children with disabilities; and (11) The location of an Emergency-to-Go File. (i) An Emergency-to-Go File means a collection of information on children, staff and the facility, to utilize, if an evacuation occurs. The file shall include: (A) A copy of the Emergency Preparedness, Recovery and Response Plan. (B) Contact information for individuals to pick-up children. (C) Each child’s Application for Child Care. (D) Medication authorizations and instructions. (E) Any action plans for children with special health care needs. (F) A list of any known food allergies of children and staff. (G) Staff contact information. (H) Incident Report forms. (I) An area map, and (J) Emergency telephone numbers. (d) Guidelines for the continuation of child care services in the period following the emergency or disaster, which may include the provision of emergency and temporary child care services, and temporary operating standards for child care providers during that period, and* (e) Procedures for staff and volunteer emergency preparedness training and practice drills. (f) Existing family day care home and FFN care home shall have one person on staff who has completed the EPRRP in child care training. New family day care home and FFN care home shall have one person on staff who has completed the EPRRP in child care training within one year of the effective date of the initial license. When the trained staff member leaves employment, the family day care home and FFN care home shall ensure that another staff member completed the required training within four months of the vacancy. (g) Documentation of completion of the training shall be maintained in the individual’s personnel file or in a file designated for EPRRP plan documents. (h) Upon completion of the EPRRP in child care training, the trained staff shall develop the EPRRP. The EPRRP means a written plan that addresses how the family day care home and FFN care home will respond to both natural and man-made disasters, such as fire, tornado, flood, power failures, chemical spills, bomb threats, earthquakes, nuclear disasters, or a dangerous person or persons in the vicinity, to ensure the safety and protection of the children and staff. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 84 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (i) The EPRRP must be on a template provided by the CCLP and completed within four months of completion of the EPRRP in child care training. (j) The trained staff shall review the EPRRP annually, or when information in the plan changes, to ensure all information is current. (k) All staff shall review the family day care home and FFN care home’s EPRRP during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the family day care home and FFN care home in the individual’s personnel file or in a file designated for EPRRP documents. (l) All substitutes and volunteers counted in ratio shall be informed of the family day care home and FFN care home’s EPRRP and its location. Documentation of this notice shall be maintained in the individual personnel files or in a file designated for EPRRP documents. (m) The EPRRP written plan shall be reviewed and approved by the CCLP. (n) The EPRRP guidelines, procedures and evacuation maps shall be posted in the family day care home and FFN care home to include dining area, and other areas where child care giver, the children, and visitors are able to see. (o) Each facility shall comply with the Department of Fire and Emergency Medical Services Fire Code and Safety Code on fire safety and fire evacuation plans. An approved fire safety and evacuation plan including the means of egress by the CNMI DFEMS Fire Marshal shall be supplied to the CCLP. Written evidence that the fire safety device/system has been inspected and approved by the Fire Marshal and shall be supplied to the Child Care Licensing Program and on file at the facility.

So in original. Modified, 1 CMC § 3806(a), (g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-358 Accidental Injury, Precautions The provider shall ensure that the family day care home and FFN care home program and premises minimize the risk of accidental injury in the following manner: (a) Ensuring that family day care home and FFN care home program activities and premises shall take precautions and do not expose children to situations which may be hazardous to the particular age or capacity of the child; and (b) The family day care home and FFN care home program shall help increase the children’s awareness of safety practices and accident hazards, and helping the children to learn how to avoid such hazards. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 85 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-360 Environmental Hazards The premises, both indoor and outdoor, in which a family day care home and FFN care home program is carried out shall be free of environmental hazards, shall be clean and comfortable, and shall provide for adequate space to meet the needs of the children as follows: (a) The provider shall control rodents and insects; (b) The outdoor space shall be fenced or shall have natural barriers or other protective conditions to deter children from getting into unsafe areas; (c) There shall be no open drainage ditches, wells, or holes into which children may fall; (d) Drainage shall be adequate to prevent stagnant pools of water from accumulating; (e) Garbage and trash shall be stored in covered containers out of reach of the children and shall be removed frequently enough to avoid creating a health hazard or nuisances; (f) Poisons, drugs, harmful chemicals, and other dangerous articles such as cleaning fluid, matches, firearms, and tools shall be kept in a safe location, out of reach of children; (g) All rooms used for child care shall be lighted and ventilated; (h) Open fireplaces shall not be used. Floor heaters and all heating elements including hot water pipes shall be insulated or installed in a manner which makes the pipes inaccessible to children; (i) Floor space shall be arranged to provide areas for active play, quiet rest, and individual activities; (j) Furniture, equipment, and toys shall be sturdily constructed, without sharp edges, and shall present minimal hazards to children; (k) Lead based paint shall not be used on surfaces accessible to children. Professional assistance shall be requested during routine inspections to ensure that lead based paint does not exist at all in the facility. (l) Provision shall be made to eliminate the hazard of electrical outlets; (m) Poisonous plants shall be kept out of the reach of children; (n) Pets, animals, and fowl shall be maintained in a safe and sanitary manner at all times; and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 86 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (o) If a lodging house, boarding house, or other business conflicts with child care hours and responsibilities, the lodging house, the boarding house, or other business shall not be operated on the premises of the child care home. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-362 Water Supply The Rules and Regulations Governing Schools and Child Care Facilities [NMIAC, title 140, subchapter 20.4] promulgated by the Commonwealth Healthcare Corporation pursuant to the Commonwealth Environmental Health and Sanitation Act of 2000 shall apply to this section. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-364 Toilet and Lavatory Facilities The Rules and Regulations Governing Schools and Child Care Facilities [NMIAC, title 140, subchapter 20.4] promulgated by the Commonwealth Healthcare Corporation pursuant to the Commonwealth Environmental Health and Sanitation Act of 2000 shall apply. (a) If toilet training chairs are provided for use by children, the toilet training chairs shall be emptied promptly and sanitized after use; (b) Small children shall be assisted in washing to prevent accidental scalding; (c) Safe, sturdy step stools shall be provided to allow the use of standard sized toilets and lavatories; and (d) Children shall not share towels, toothbrushes, combs, and other necessary toilet articles. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-366 Food Preparation and Protection Food preparation and protection shall be carried out in a kitchen with proper equipment and cleanup facilities required for the number of children in care as follows: (a) All food shall be protected from contamination during storage, preparation, and service; and (b) All dishwashing shall be performed in a sanitary manner; (c) An adequate number of eating and drinking utensils shall be available for each child; (d) When single service utensils are used, the utensils shall be stored and handled in a sanitary © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 87 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS manner and discarded after a single use; and (e) Cooking utensils used in food preparation and service shall be cleaned and stored in sanitary manner. (f) Food protection policies shall comply with accepted practices of local sanitary codes and shall be adapted to fit the needs of the program except as indicated in the rules in this subchapter. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-368 Cleaning of Premises (a) All necessary cleaning equipment shall be available on the premises and provisions shall be made for regular cleaning of the premises to protect the health of the children and provider. (b) Storage of cleaning material shall be in a secured area which is inaccessible to the children. (c) There shall be a plan for regular cleaning of toys, table tops, furniture, and other similar equipment used by the children. (d) The Rules and Regulations Governing Schools and Child Care Facilities [NMIAC, title 140, subchapter 20.4] promulgated by the Commonwealth Healthcare Corporation pursuant to the Commonwealth Environmental Health and Sanitation Act of 2000 shall also apply. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-370 Swimming Activities and Wading Pools (a) When swimming or wading pools are part of the facility, equipment, or program, the swimming pools shall be constructed, maintained, and operated in accordance with building and health rules. (b) When swimming or wading activities are included in the child care program, the following safety practices shall be observed: (1) A certified lifeguard, who may be the provider, shall be on duty at all times when swimming pools are in use; (2) Wading pools less than twenty-four inches at the deepest part shall be exempt from the requirements of this section. However, children shall be personally attended by a responsible adult at all times and the wading pools shall be emptied immediately after each use; and (3) Legible safety rules for the use of all types of pools, excepting for wading pools, shall be posted in a conspicuous location and read and reviewed at regular intervals by the provider responsible for the care of the children. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 88 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Subpart G - Physical Facility Standards § 55-40.1-372 Building Safety Codes and Space Requirements Care Home and FFN Care homes shall conform to the zoning, building, electrical, and plumbing codes of the county in which the facility is located, to state rules as may be applicable to the facility, and the following: (a) The Child Care Licensing Program shall be notified of changes or renovations in the home; (b) Space requirements shall be as follows: (1) For daytime care, there shall be a minimum of thirty-five square feet of indoor area per child, excluding bathrooms, closets, office space and hallways; (2) For nighttime care, each room used for sleeping purposes for children in care shall have a minimum of fifty square feet per child, excluding kitchen, bathroom, closets, halls, and lanai area; and (3) For outdoor space, there shall be easy accessibility to adequate outdoor space and in all cases, a minimum of one hundred fifty square feet. For children twelve months or older there shall be a minimum of seventy-five square feet per child; and (c) All parts of the building, building appurtenances, outdoor space, equipment, and all other parts of the facility shall be kept repaired, safe, and sanitary at all times. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-373 Child Care Facilities Safety Requirements (a) Cleaning materials, flammable liquids, detergents, aerosol cans, and other poisonous and toxic materials must be kept in their original containers and in a place inaccessible to children. They must be used in such a way that will not contaminate play surfaces, food, food preparation areas, or constitute a hazard to the children. Bio-contaminants including blood, bodily fluids, and other infectious materials must be properly disposed of. (b) No extension cords will be used as permanent wiring. All appliances, lamp cords, and exposed light sockets must be suitably protected to prevent electrocution. (c) Any pet or animal, present at the facility, indoors or outdoors, must be in good health, show no evidence of carrying disease, and be a friendly companion of the children. The provider is responsible for maintaining the animal’s vaccinations and vaccination records. The provided must make reasonable efforts to keep stray animals off the premises. (d) Guns and any types of weapons are off limits in the family day care home and FFN care home. (e) The indoor and outdoor play areas must be clean, reasonably neat, and free from © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 89 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS accumulation of dirt, rubbish, or other health hazards. (f) Any outdoor play area must be maintained free from hazards such as wells, machinery, and animal waste. If any part of the play area is adjacent to a busy roadway, drainage or irrigation ditch, large holes, or other hazardous areas, the play area must be enclosed with a fence in good repair that is at least four feet high without any holes or spaces greater than four inches in diameter or natural barriers to restrict children from these areas. (g) Outdoor play areas shall be designed so that all parts are always visible and easily supervised by staff. (h) Outdoor equipment, such as climbing apparatus, slides, and swings, must be anchored firmly, and placed in a safe location according to manufacturer’s instructions. All playground equipment should be placed over a shock-absorbing material that is either the unitary or the loose- fill type extending beyond the perimeter of the stationary equipment. (i) Trampolines are prohibited for use by children in care. (j) For emergency assistance, call Department of Fire and Emergency Medical Services at 670-234-0911 or Emergency Department at the Commonwealth Healthcare Corporation at 670- 236-8390/1 or 670-234-8950 Ext. 2360/1 and must be posted visibly in the facility. The Poison Help Center is available on line at https://www.poisonhelp.org at no cost for expert advice. (l) Use of waterbeds, water mattresses, gel pads, or sheepskin covers for children’s sleeping surface is prohibited. (m) In an emergency, all occupants must be able to escape from the facility, whether a home or building in a safe and timely manner: (1) All facilities must have two accessible exits on each level. The two exits must be far enough apart from one another to avoid having them both blocked by fire and smoke. (2) Aisle ways and corridors leading to the exits must be kept clear of obstructions. (3) If the provider chooses to lock the facility door to prevent unauthorized access to the facility or to prevent a child from escaping, the facility shall have no lock or fastening device which prevents free escape from the interior. (n) Installation of locking devices may not prohibit access by parents. A facility may not utilize locking devices in a manner to prevent unannounced access by authorized individuals, including parents. If a lock is used, the provider must make adequate provision to allow authorized persons unannounced access to the facility and must provide authorized personnel including parents with information on how to gain access. (p) Exit doors, windows, and their opening hardware must be maintained in good repair at all times. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 90 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Subpart H - Program Modifications § 55-40.1-374 Program Modifications for Drop-in Care (a) All requirements set forth in this subchapter shall be met by the provider except for § 55- 40.1-301 and § 55-40.1-334. (b) A family day care home and FFN care home offering drop-in care shall be prepared to adjust its staffing to meet the program modifications which result when drop-in care is provided. (c) Children receiving drop-in care shall be cared for in separate areas or groups. (d) If a family day care home and FFN care home serves both drop-in children and children who attend regularly, the grouping of the children and the program shall be planned so that the needs of both groups are met. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-376 Program Modifications for Night Care A family day care home and a FFN care home offering night care shall meet the requirements of this subchapter in addition to the following requirements: (a) In consultation with parents, special attention shall be given to provide for a transition into night care; (b) Toys for quiet activities shall be available; (c) Comfortable beds or cots, complete with bedding, and night clothes shall be available or supplied by the parents; (d) The provider shall be available to assist children during eating and pre-bedtime hours and during the morning period when dressing. During sleeping hours, the provider shall always be within hearing distance to provide for the needs of children and to respond to an emergency; (e) A child shall not sleep in a building detached from the main facility; and (f) Night care facilities shall include at least one shower, bathtub, or bathing facility for young children. (g) There shall be a night light or other mechanism to illuminate hallways leading to stairs and/or the restroom. (h) Each child shall have individual toilet articles such as comb, toothbrush, towel, and washcloth. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 91 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (i) No child under 5 years of age is to be left unattended while in the bathtub. (j) Health care routines at bedtime and/or upon rising shall include: (1) Brushing teeth at bedtime and upon rising. (2) Brushing or combing the hair upon rising. (3) Establishing a routine for toileting at bedtime and upon rising. (k) The day care home shall serve meals and snacks that supplement food served at home. (l) An evening meal that meets nutritional requirements shall be served at a regular time each evening and shall be available to children who may arrive without having first eaten. (m) A bedtime snack shall be served, unless contraindicated by parents or physician. (n) Children who remain overnight and go to school directly from the day care home shall have breakfast, including juice or fruit, unless they are receiving breakfast at school. (o) A family day care home and FFN care home facility offering night care shall meet the following additional requirements: (1) Beds shall be placed at least three feet apart; (2) Unrelated children over 4 years of age many not share a bedroom overnight with children of the opposite sex. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Part 400 - Infant and Toddler Child Care Centers Subpart A - Administration Requirements § 55-40.1-400 Supervision of Children All child care facilities shall adequately supervise infants and toddlers that are in their care at all times and are protected from harm and hazards. It is the responsibility of each provider to provide supervision to all infants and toddlers from the time they arrived at the facility until the time they go home. All staff members who are entrusted with supervisory responsibility shall exercise reasonable care in the discharge of supervisory duties. Providers shall formulate, distribute and explain to the children’s parents and legal guardians’ procedures regulating children’s behavior on the premises accordingly. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-401 Age of Children in Care © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 92 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS An infant and toddler center shall provide care to children age six weeks and up to 36 months. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-402 Statement of Operation Policies The infant and toddler child care center shall have written operation policies which cover the following areas: (a) Admission requirements and enrollment procedures; (b) Ages of children accepted; (c) Maximum number of children permitted by license; (d) Specific hours of day, night, holiday, and vacation operation; (e) Type of child care services provided; e.g. program activities that promote cognitive, speech and language, fine motor and gross motor skills, physical, emotional, behavioral and mental development for infants and toddlers, daily routines, language, arts, math, children=s progress, communication with parents, show & tell and educational field trips; (f) Whether the infant and toddler child care provides meals and snacks for the infant or toddler, or parents are to provide the meals and snacks; (g) Fees and the plan for payment, including fees for different types of services and refund policy; (h) Insurance coverage - each infant and toddler child care shall inform parents or guardians in writing of its policy regarding liability insurance; at all times during operations and at the time of a child’s enrollment for child care services. A facility is subject to revocation, suspension or denial of child care license if it violates the requirements for liability insurance coverage referred in § 55-40.1-125 Denial, Suspension, Revocation of Child Care License, and Hearings ; (i) Rules concerning personal belongings brought to the facility; (j) Transportation arrangements and written parental permission for trips and related activities outside the facility, if applicable; (k) Provisions which may be made for special needs of individual children with disabilities; (l) Policy and plan for emergency medical care; (m) Admission and care of sick or children with disabilities; (n) Statement of policy on administering medication; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 93 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (o) Statement of policy and procedures for provision and management of diapers and other infant and toddler supplies; (p) Statement of procedures regarding sanitation practices; (q) Statement of grievance procedures; (r) Fund raising campaigns - children and staff shall not be exploited in fundraising campaign activities which would be detrimental to the children or the program; and (s) Other policies or procedures which may be required by the CCLP: (1) Written policies and procedures shall be reviewed with each caregiver in the facility. (2) Written policies shall be made available for review by parents or guardians at the time of enrollment of the infant or toddler. (3) Written notification of changes in the services offered by the infant and toddler child care center shall be provided to the CCLP, and to parents or guardians of the children enrolled in the infant and toddler child care center at least four weeks prior to the effective date of change. (4) Written plan to cover emergencies and disasters. (5) Each infant and toddler child care center must provide their Standard Operating Procedures (SOP) to CCLP, parents, guardians, and agencies that monitor the safety and health of the children under their care. The SOP shall also be available for site inspections, compliance monitoring, and unannounced compliance monitoring visits by CCLP personnel. The SOP shall closely adhere to the CCLP basic licensing requirements. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-404 Information on Owner or Operator (a) The name, physical address, mailing address, email address, and telephone number(s) of the facility shall be supplied to the CCLP. If there is more than one infant and toddler child care center, the information of all infant and toddler child care centers must be supplied by the owner or operator. (b) The name, physical address, business mailing address, email address and business telephone number(s) of the persons having authority over and responsibility for the overall administration and services shall be supplied to the CCLP. (c) The name of the owner or sponsoring agency (privately owned, church, or agency owned, etc.) of the facility shall be supplied to the CCLP. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-406 Change in Services The infant and toddler child care center shall notify parents or guardians and the CCLP of any © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 94 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS changes in the day care services it provides as follows: (a) Written notification of changes in the services offered by the infant and toddler child care center shall be provided to the CCLP and to parents and guardians of children enrolled in the infant and toddler child care center; and (b) Notification of any changes in service shall be made no later than thirty days after the date of the change and shall be included in the infant and toddler child care center’s operating policies. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-408 Information and Records on Each Child (a) Admission procedures shall require that sufficient information and instruction from the parents or guardians be obtained to enable the caregiver to make decisions or act on behalf of the child. (b) Prior to the admission of a child to a infant and toddler child care center, the provider shall obtain in writing from the child’s parents or guardians the following information: (1) The child’s full legal name, birth date, physical and mailing addresses, and preferred names; (2) The names and physical and mailing addresses, email addresses of the parents or guardians who are legally responsible for the child; (3) Telephone numbers or instructions as to how the parents or guardians may be reached during the hours the child is in the infant and toddler child care center; (4) The name, physical and mailing addresses, email addresses, and telephone number of person who shall assume responsibility for the child if for some reason the parent or guardian cannot be reached immediately in an emergency; (5) The names, physical and mailing addresses, email addresses, and telephone numbers of persons authorized to take the child from the infant and toddler child care center; and (6) The immunization and tuberculin information of the child, as required (by CMC, div. 2, ch. 1, § 2101 through § 2107) shall be available on infant and toddler child care center file and shall be updated periodically. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-410 Disclosure of Information on the Child (a) Information pertaining to an individual child or parents or guardians of the child shall not be disclosed to persons other than the authorized infant and toddler child care center staff, unless the parents or guardians of the child submit a signed consent form granting written permission for the disclosure or an emergency arises necessitating release of the information. (b) The parents or guardians shall be informed in writing of the infant and toddler child care center’s policy regarding disclosure of information. (c) The Office of the Attorney General may, by written request obtain disclosure of © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 95 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS information required to be kept by the regulations in this subchapter when it appears that a violation of the criminal law may have occurred and such information may reasonably be needed to investigate such an allegation. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-412 Information and Records on Infant and Toddler Child Care Center Written information and records on the infant and toddler child care center shall be maintained and made available to the CCLP. The infant and toddler child care center shall maintain current records and information including: (a) Roster of enrolled children; (b) Daily attendance records by names of children; (c) Daily plan for feeding the children; (d) Daily schedule of activities; and (e) A list of staff members, including each staff member’s position or title, training, experiences, health records, references, and verification of employment history, and a comprehensive background check. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-414 Transportation Provisions Infants and toddlers transported in vehicles by center staff, either to and from the center or for center program activities, shall be provided adequate supervision, safety precautions, and medical and liability insurance coverage. Infants and toddlers shall be secured by approved car seats or restraints. The infant and toddler child care center shall also comply with the requirements as stated in subpart C. (a) When transportation is provided by the infant and toddler child care center, the following requirements shall be met: (1) Drivers shall: (i) Be at least 18 years of age; (ii) Hold a current driver’s license; (iii) Maintain a safe driver record; (iv) The provider must take precautions to protect children from vehicular traffic; (v) No use of alcohol, drugs, or any substance that could impair abilities before or while driving; (vi) No tobacco uses while driving; (vii) No medical condition that would compromise driving, supervision, or evacuation capability; and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 96 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (v) Valid infant and child pediatric first aid and Cardiopulmonary Resuscitation (CPR) certificate if transporting children. (b) The director shall obtain a copy of the driving/traffic record from the court for each staff whose job includes driving duties. The driving/traffic record shall be updated annually. (c) The vehicle shall be: (1) In compliance with all applicable state and local motor vehicle laws; (2) Maintain a safe operating condition; and (3) The operator of the vehicle shall have CNMI driver’s license including the number and date of expiration, vehicle insurance information, and verification of current state vehicle inspection which shall be on file in the infant and toddler child care center. (d) During any field trip or excursion operated or planned by the facility, the staff-child ratios as provided in § 55-40.1-428 shall apply. (e) Child Passenger Safety (1) When transporting children for any and all purposes: (i) Children shall be transported only in sections of vehicles designed for and equipped to carry passengers; (ii) A seat that fully supports the passenger shall be provided for each child; (iii) All children, shall be transported in accordance with § 4108*. Safety Belts on Passenger Vehicles 9 CMC §1103(f); and (iv) All children should be transported only if they are restrained in a developmentally appropriate car safety seat, booster seat, seat belt, or harness that is suited to the child’s weight and age in accordance with state and federal laws and regulations. (f) No child shall be left unattended inside or outside a vehicle. (g) Interior Temperature of Vehicles The interior of vehicles used to transport children for field trips and out of program activities should be maintained at a temperature comfortable to children. All vehicles should be locked when not in use, head counts of children should be taken before and after transporting to prevent a child from being left in a vehicle, and children should never be left in a vehicle unattended. (h) Passenger Vans Infant and toddler child care centers that provide transportation for any purpose to children, parents/legal guardians, staff and others should not use 15-passenger vans when avoidable. (i) The infant and toddler child care center shall maintain a written plan for transportation. (j) For transportation to and from school the vehicle and driver shall satisfy all relevant school bus and traffic laws of the Northern Mariana Islands. (k) Children shall be instructed in a safe transportation conduct as appropriate for the age and stage of development. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 97 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (l) The child care provider must take precautions to protect children from vehicular traffic.

So in original. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart B - Program Requirements § 55-40.1-416 Program Provisions (a) The program conducted in the infant and toddler child care center shall provide for supervision of the infants and toddlers at all times and an environment and experiences which are developmentally appropriate and which promote the infant or toddler’s physical, emotional, intellectual/cognitive, social-emotional, mental health and social well-being and the developmental growth and integrity of the family unit. (b) The director of the infant and toddler child care center shall provide the CCLP with a brief written description of the infant and toddler child care center’s program goals and activities, which shall include the following: (1) Provisions for the promotion of physical development, which shall include but not limited to: (i) Varied, developmentally appropriate physical activities; and (ii) Opportunities for the infants and toddlers to learn about the health, development, and care of their bodies including exercise, safety, nutrition, and hygiene, as appropriate to their age (six weeks up to 36 months); (2) Provisions for the promotion of social-emotional development, which shall include but not limited to: (i) Staff recognition of the special difficulties of infant and toddler separations and assistance to families, infants, and toddlers to make the transition from home to facility as gently as possible, such as a phased-in orientation process to allow infants and toddlers to experience limited amounts of time at the facility before becoming fully integrated; (ii) Assignment of each infant or toddler to a primary caregiver who shall be responsible for care the majority of the time; (iii) Prompt response by all caregivers to an infant or toddler’s physical and emotional needs, i.e., feeding, diapering, holding, touching, and eye contact; and (iv) Recognition and care of each infant or toddler as an individual with opportunities for individual choices, self-expression, and some personal privacy; (v) Provision of constructive guidance and the setting of clearly defined limits which foster the infant or toddler=s ability to be self-disciplined, as appropriate to their age and development; (vi) Prohibition of use of: (A) Physical punishment; and (B) Methods of influencing behavior which are frightening, humiliating, damaging, or injurious to the infant or toddler’s health or self-esteem; and (C) Shaking and child maltreatment are prohibited behaviors. (vii) Respect for each infant or toddler’s cultural, ethnic, and family background, as well as the child’s primary language or dialect; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 98 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (3) Provisions for the promotion of intellectual/cognitive development, which shall include, but not limited to: (i) Offering of frequent, but paced, personal, verbal, and physical interaction between caregiver and infant or toddler as part of the daily routine; (ii) Availability of a variety of learning materials, which staff helps children to use; and (iii) Hands-on experiences, including both familiar and new activities, to enable the infant or toddler to learn about themselves and the world; and (4) Provisions for the promotion of social development, which shall include, but not limited to: (i) Caregiver behavior and interactions which emphasize and foster attitudes of mutual respect between adults and children and between children; (ii) Guidance to infants and toddlers to enable them to develop and work out ways of getting along with each other, including an appreciation of cultural and ethnic diversity, as appropriate to the infant or toddler’s level of understanding. (5) Programs to promote mental growth and well-being shall be provided but not limited to: (i) Provide opportunity for the child to build self-confidence and self-esteem; and (ii) Encourage the child to participate in positive routines. (iii) Make available activities and experiences that are appropriate to the developmental level of the children. (6) The program shall provide for the self-direction of the children, but not limited to by: (i) Affording children opportunities to choose activities according to personal desires and interests and to move from one activity to another; (ii) Encouraging children to do things independently; and (iii) Providing children opportunities to be involve in decision making about group and individual activities. (c) The program shall provide a balance of active and quiet activities and shall recognize the infants and toddlers’ need for uninterrupted sleep. (d) In drop-in centers, every effort shall be made to place an infant or toddler, who uses the center frequently, with the same caregiver. (e) The program shall provide information on and access to parenting resources (i.e., bulletin boards, classes, resource libraries, handouts). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-418 Communication Between Parents and Child Care Providers (a) Infant and toddler child care centers shall obtain from the parent or guardian a description of the infant’s or toddler’s daily routine and behavior patterns prior to enrollment; (b) Infant and toddler child care centers shall develop and follow a plan for regular contact with parents or guardians to exchange information about the infant’s or toddler’s needs and development; and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 99 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (c) Infant and toddler child care caregivers shall relay information and concerns about the health, development, or behavior of the infant or toddler, as well as positive experiences, directly to the parents or guardians on the day of the major change, symptom, or event. (d) Infant and toddler child care centers shall communicate and maintain an open-door policy to promptly and directly exchange information with parents or guardians. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-420 Program Activities, Materials and Equipment (a) The selection, quantity, arrangement and use of available activities, materials and equipment shall be developmentally age-appropriate, durable, meet the recommendation of the US Consumer Product and Safety Commission (CPSC), including the latest version of the CPSC Handbook for Public Playground Safety, Appendix F, and meet the recommendations of the American Disabilities Act (ADA) for all infants and toddlers, including children with disabilities. (b) The quantity of materials and equipment shall be sufficient to: (1) Avoid excessive competition among the children and long waits for use of the materials and equipment; and (2) Provide for a variety of experiences and appeal to the individual interests of the infants and toddlers. (c) Protected areas where equipment and materials will be used with minimal interference or interruption shall be provided. (d) Materials and equipment shall be kept clean and in good repair, stored in an orderly way, and arranged to allow children to select, remove, and replace the materials and equipment either independently or with assistance, as appropriate to their age and development. (e) Grass, soft media, or other protective measures shall be used under swings, slides, jungle gyms, and other similar outdoor play equipment. (f) Equipment for both indoor and outdoor play shall allow children to use small and large muscles for imaginative play and creative activities. (g) The following shall be available: (1) Individual provisions for safe, undisturbed sleep such as, crib, cot, or mat; (2) Clean bedding for each infant and toddler; (3) High chairs, safety seats, or size-appropriate low seating for individual feeding; (4) Adequate padding for safe floor play; (5) Rocking or comfortable chair for infant and toddler feeding and comforting; and (6) Individual storage spaces for children’s clothing and personal belongings shall be labeled. Storage spaces for other equipment, materials, and supplies used by staff shall be available, but secure and out of children’s reach. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 100 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (h) The activities for infants and toddlers shall be: (1) To allow to form and follow his or her own pattern of sleeping and waking periods; and (2) To give opportunities during each day to move freely by creeping and crawling in a safe, clean, open, warm, and uncluttered area. (i) Throughout the day, each child shall receive physical contact and individual attention (e.g., being held, rocked, talked to, sung to, and taken on walks inside and outside the center). (j) Routines relating to activities such as bedtime, feeding, diapering, and toileting shall be used as opportunities for language development, building the child’s self-esteem, and other learning experiences. (k) Children shall be encouraged to play with a variety of safe toys and objects. (l) Children shall be given appropriate opportunities to use the five senses through sensory play. (m) Infant and Toddler Sleep: (1) There must be adequate opportunities for sleep periods during the day suited to the infant’s and toddler’s individual needs. (2) Each infant must be provided with a crib or play pen for sleeping. At the discretion of the parent and provider, a cot or mat may be used once a child turns one year of age as long as a safe sleep environment is provided. (3) Children one year of age through 18 months who are placed on a mat must have a signed permission statement in the file indicating that the parent has given permission for their child to be placed on a mat. When cots and mats are used, an early childhood teacher must remain with the child while they are sleeping. (4) Unless the parent has provided medical documentation from a health care provider ordering otherwise, infants must be placed on their back and on a firm surface with no incline to reduce the risk of sudden infant death syndrome (SIDS). (n) The infant and toddler child care center must develop a written policy that describes the practices to be used to promote a safe sleep environment when children underage two are napping or sleeping. The policy should explain that these practices aim to reduce the risk of Sudden Unexpected Infant Death (SUIDs), including sudden infant death syndrome (SIDS), suffocation and other deaths that may occur when an infant is in a crib or asleep (o) All cries of infants and toddlers shall be investigated. (p) The following safe sleep practices must be followed: (1) Infants (children 12 months and below) shall be placed flat on their backs to sleep to lessen the risk of suffocation and Sudden-Infant-Death-Syndrome. (If a child rolls over on his/her own, the facility is not required to reposition the child.) If there is a medical reason a child cannot sleep on his/her back, then a signed statement from the child’s physician must be in the file stating that a different sleep position is indicated; (2) Each infant shall sleep in a crib, portable crib, bassinet or playpen with a clean, non- © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 101 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS absorbent mattress. All cribs, portable cribs, bassinets and playpens must comply with current Consumer Product Safety Commission (CPSC) standards. A copy of the requirements for full-size baby cribs and non-full-size baby cribs is available at https://www.cpsc.gov.; Bassinets may only be used until the infant is able to roll over on their own; (3) Each mattress shall: (i) Fit snugly; and (ii) Be covered by a tightly fitting sheet; (4) Infants must be placed on their backs on a flat surface for sleeping; (5) While on the child care premises, if an infant falls asleep in a place other than their crib, portable crib, bassinet or playpen, the caregiver must immediately move the infant to an appropriate sleep surface; (6) No child shall be routinely left in a crib, portable crib, bassinet or playpen except for sleep or rest; (7) There shall be no items in the crib, portable crib, bassinet or playpen with the infant, except a pacifier. All pillows, quilts, comforters, heavy blankets, sheepskins, bumper pads, stuffed toys, and other soft products must be removed from the crib and playpen when an infant is laid down for sleep; (8) Blankets of any weight must be removed when infants 12 months of age or under are laid down for sleep; (9) Toddlers must be provided a clean washable blanket or other suitable covering for their use while sleeping. Each child’s bedding shall be stored separate from bedding used by other children; (10) Swaddling or other clothing or covering that restricts the child’s movement is prohibited; (11) Clothing or items that could pose a strangulation hazard (e.g., teething necklaces, pacifier attachments, clothing drawstrings) are prohibited; and (12) Car seats are to be used for transportation only. Children who are asleep in a car seat must be removed upon arrival to the center and placed in an appropriate sleep surface. (q) The infant and toddler child care center should develop a written policy describing the practices to be used to promote safe sleep for infants. The policy should explain that these practices aim to reduce the risk of SUIDs, including sudden infant death syndrome (SIDS), suffocation and other deaths that may occur when an infant is in a crib or asleep. All early childhood teachers must sign an acknowledgement indicating that they have read and understood the infant and toddler child care center’s sleep policy. (r) Immediate attention shall be given to the emotional and physical needs of children. (s) Staff shall encourage the development of self-help skills (dressing, toileting, washing, eating) as children are ready. (t) Toddlers shall be given opportunities to participate in: (1) A variety of activities encouraging creative expression through the arts; and (2) Running, climbing, and other vigorous physical activities. (u) Infant’s and Toddler’s Activities (1) Infants and younger toddlers shall have an activity area not used by older children at the same time. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 102 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (2) All infants shall have ample opportunity during each day for freedom of movement, such as creeping or crawling or rolling in a safe, clean, open, and uncluttered area. (3) An infant or toddler who is awake shall not spend more than 30 minutes of consecutive time confined in a crib, playpen, jump-chair or high-chair. (4) Each infant and toddler shall have individual personal contact and attention by the same adult on a regular daily basis at least once each hour during non-sleeping hours. Examples of personal contact and attention include being held, rocked, taken on walks inside and outside the center, talked to, and played with. (5) There shall be sufficient staff so that an adult is always present and supervising. (6) There shall be provisions for the infant and toddler to safely explore and investigate the environment. (7) There shall be both stimulation and time for quiet activity. (8) Infants and toddlers shall be taken outside for some period during each day in good weather. (9) Each infant and toddler shall be allowed to maintain the child’s own pattern of sleeping and waking period according to instructions from the parents. (v) Infant’s and Toddler’s Outdoor Activities (1) Infants and toddlers shall be protected from prolong exposure to direct sunlight. With the parent’s written permission, sunscreen shall be applied to children over six months old when outdoor conditions dictate. (2) There must be an outdoor play area on the facility property. The play area must be fenced in and free of hazards which are dangerous to the health and safety of the children. (3) Supervision at all times must be provided when infants or toddlers are outdoors. (4) Adequate protection against insects shall be provided. (5) Provision shall be made for both sunny and rainy activity areas. (w) Infant’s and Toddler’s Equipment (1) Age-appropriate feeding equipment shall be provided for every infant or toddlers. This includes safe high chairs, baby feeding tables, booster seats, and child-size tables and chairs. These types of equipment must be used in accordance with the manufacturer’s instructions and must be appropriate for the age of the child using the equipment. Portable high chairs that hook on to tables are prohibited. (2) The facility shall provide adequate and safe equipment such as cribs, swings, playpens, and adult rocking chairs. All equipment must meet current federal safety regulations. Modified, 1 CMC § 3806(a). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-422 Transition to a New Facility (a) Facility shall have a written policy to assist the infant or toddler in making a transition from the infant and toddler child care setting to a new type of care by communicating what will happen at the infant’s or toddler’s level of awareness or understanding. (b) Provision shall be made for cooperation between caregiver and parents or other caregivers, © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 103 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS when information is requested to assist an infant or toddler to adjust to a new environment. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart C - Staffing Requirements § 55-40.1-424 Staff Training, Experience, and Qualifications and Comprehensive Background Check (a) Each care giving staff and/or provider shall be qualified through training, experience, and personal qualities for the age group with which the person works. All child care service staff must annually participate in at least 15 hours of health and safety training as approved and monitored by the Child Care Licensing Program. (b) Staff growth and development shall be encouraged. The director shall make information about workshops, seminars, training sessions, or other courses available to all staff and volunteers. (c) Applicants, employees and volunteers shall be of reputable and responsible character and shall not have a criminal history record, employment history, or background, which poses a risk to the infants and toddlers in care. These checks shall be done before a person is allowed to work or perform services at the daycare facility. (1) Conviction of a crime involving children, violence, alcohol or drug abuse, sex offense, or any other offense, the circumstances of which indicate that the applicant or employee may pose a danger to children, is grounds for denial or revocation of a license or a reason to request termination of an employee. (2) Type of criminal offense, when it occurred, and evidence of rehabilitation shall be considered in determining whether the criminal history record poses a risk to the health, safety, or well being of children in care. (3) An employment history indicating violence, alcohol or drug abuse, and any other violation of employer rule or policy, the circumstances of which indicate that the applicant or employee may pose a danger to children, may be grounds for denial or revocation of a license or a reason to request termination of an employee. (4) Background information which shows that the individual has been identified as and substantiated to be the perpetrator of child abuse or neglect may be a basis for denial or revocation of a license or a reason to request termination of an employee under § 55-40.1-110(d). (5) These background clearances will be good for a period of five years, after which they will have to be renewed. (6) All applicants, their employees, and anyone else at the facility whose activities involve the care or supervision of children or unsupervised access to children shall provide a comprehensive background check. The comprehensive background check shall include the following: (i) National Background Checks: (A) National Federal Bureau of Investigation criminal history check with fingerprint background check. (B) A criminal background check on the National Crime Information Center (NCIC) Sex Offender Registry (NSOR) check. (ii) In-state (CNMI) Background Checks: © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 104 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (A) In-state Criminal History Check, with fingerprint background check. (B) In-state Sex Offender Registry Check. (C) A criminal background check on the In-state Child Abuse and Neglect Registry Check. (D) An annual CNMI police clearance. (iii) Inter-state (out of the CNMI) Background Checks: (A) Inter-state Criminal History Check. (B) Inter-state Sex Offender Registry Check. (C) Inter-state Child Abuse and Neglect Registry Check. (d) The director of an infant and toddler child care center shall have: (1) A bachelor’s degree in early childhood education (ECE), child development associate (CDA), or related field from an accredited college or university, including in all cases, thirty hours of course work in infant and toddler development from an accredited teacher training institute or program and twelve months full time experience working with children under thirty six months of age in a licensed group care setting; or (2) Two years of college education in ECE or CD or related field, including in all cases, thirty hours of course work in infant and toddler development from an accredited teacher training institute or program, and, twenty four months full time experience working with children under thirty six months of age in a licensed group care setting. (e) A lead caregiver shall have: (1) A bachelor’s degree in ECE or CD or related fields, e.g., maternal-child health nursing, or human development, and, experience working with children under thirty six months of age in a licensed group care setting, and, twelve credits approved ECE or CD training courses (may be part of the bachelor’s degree) including thirty hours course work in infant and toddler development from an accredited teacher training institute or program; or (2) A high school diploma, or its equivalent and credential in child development associate program, and, experience working with children under five years of age in a licensed group care setting of which twelve months shall have been with children under thirty six months of age, and, twelve credits approved ECE or CD training courses, including thirty hours of course work in infant toddler development from an accredited teacher training institute or program; or (3) Two years of college, preferably in ECE or CD or related fields, and, working with children under five years of age in a licensed group care setting of which twelve months shall have been with children under thirty six months of age, twelve credits approved ECE or CD training courses including thirty hour course work in infant and toddler development from an accredited teacher training institute. (f) A caregiver shall have: (1) A high school diploma or its equivalent, and, experience working with children under thirty six months of age in a licensed group care setting or home care, or twelve credits approved ECE or CD training courses including thirty hours of course work in infant and toddler development from an accredited teacher training institute or program; or (2) A high school diploma or its equivalent, and, experience working with children under thirty six months of age in a licensed group care setting, and, thirty hours of course work in infant and toddler development from an accredited teacher training institute or program; or (3) No high school diploma, and, experience working with children under thirty six months of © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 105 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS age in a licensed group setting or home care., (g) A child care aide/floater shall have: (1) A high school vocational child-care training course; and (2) An orientation training in the center. (3) A high school diploma or high school equivalency diploma (GED). (h) A twelve month non-renewable waiver may be granted to new hires, rehires, and current staff in director, lead caregiver, or caregiver positions, who meet all other requirements except the thirty hours course work in infant and toddler development from an accredited teacher training institute or program, to complete this required course work while concurrently serving in the capacity of the facility=s director, leader caregiver, or caregiver. (i) All staff members required to complete the thirty hours of course work in infant and toddler development from an accredited teacher training institute or program, as stipulated in subsections (b) and (d) through (f), shall, within two years of completion of this course work, obtain fifteen additional hours of course work in infant and toddler development from an accredited teacher training institute or program. (j) The age requirements for staff shall be as follows: (1) Child care aide, volunteer, or maintenance personnel shall be at least eighteen years old, in order to be counted in the staff-child ratio. (k) Volunteers shall: (1) Participate in an orientation to the program at the infant and toddler child care center; or (2) Be a participant in a high school program which includes training in infant and toddler care; and (3) Meet the requirements of regular staff members to be counted in the staff child ratio. (1) Temporary hires shall meet qualifications of positions for which hired. (m) Substitutes for lead caregivers and caregivers shall be at least eighteen years of age and shall have participated in an orientation program of the infant and toddler child care center, and to include the curriculum, lesson plans, and daily activities assigned to the substitute shall be closely supervised by the center’s director or lead caregiver. (n) Substitutes for director shall meet the qualifications of a caregiver and shall have worked in the facility for at least six months. (o) Substitutes for aides shall meet the qualifications of an aide. (p) Substitutes may be granted an extension to serve in the same position for more than ten consecutive days upon consultation with and approval of the Department. Modified, 1 CMC § 3806 (g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 106 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-426 Staff-child Ratio and Group Size (a) The staff-child ratio and group size shall be met and maintained by the facility during all hours of operation. (b) The staff-child ratio shall be in writing and shall be available to the Department. (c) The staff member shall be on site and shall be regularly assigned to a particular group of children to be included in the staff-child ratio. (d) The director may serve as a caregiver, and shall not be included in the staff-child ratio, only when total infant and toddler child care center size does not exceed sixteen. In an infant and toddler program with more than sixteen children, the director may serve, as a caregiver shall not be included in the staff-child ratio. (1) Exception may be made and the director may be included in the staff-child ratio in cases of emergency or in special situations. (2) Exception may be made and the director of only those toddler and infant child care centers which operate full day may be included in the staff-child ratio during the regular operational day. (e) Custodians, cooks, and bus drivers shall not be counted in the staff-child ratio when performing regular duties. (f) The maximum group size is permitted provided that the infant and toddler child care center meets building safety code requirements of the CNMI Department of Public Works. The following staff-child ratios and group size shall be used in infant and toddler programs: Maximum Group Size Permitted Ages of children 6 8 10 12 (1 6 wk – 12 mos. 1:3 1:4 ) (2 12 mo. – 24 mos. 1:3 1:4 1:5 1:6 ) (3 18 mo. -36 mos. 1:3 1:4 1:5 1:6 ) (g) Group size refers to the specific number of children assigned to specific staff who occupy an individual classroom or well-defined physical space within a larger room; when groups are assigned space within a larger room, there shall be room dividers to ensure that children stay within their assigned group area and to keep the noise level down. (h) The ratios and group sizes in the table above shall apply, as stated, only to homogenous age groups. (i) Multi-age grouping is both permissible and desirable; however, the following requirements and restrictions apply: (1) Children who are between the ages of six weeks to eighteen months can be grouped © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 107 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS together; when this occurs, the ratio and group size shall be those required for the youngest child in the group according to the table above; or (2) Children who are between the ages of six months to thirty-six months can be grouped together; when this occurs, the ratio and group size shall be those required for the youngest child in the group according to the table above; or (3) In multi-age groups, the ratio and group size shall not exceed the ratio and group size for that of one age group higher than the youngest child in the group, and two thirds of the children must be in the oldest age group. (j) Under no circumstances shall there be more than two children under three months of age in any group. (k) Children with disabilities shall be admitted. The quality of care of the entire group shall continue and reasonable attempts shall be made to meet their needs. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-428 Staffing Patterns (a) There shall always be a minimum of two caregiver staff in the center when children are in care. (b) When only one staff is required to supervise the children, as based on the staff-child ratio, the second caregiver shall be readily accessible and available to the caregiver who is supervising the children. (c) For every group, there shall always be one staff who meets the qualifications of a lead caregiver or caregiver. (d) When the group size requires three staff, there shall minimally be one staff who meets the qualifications of a lead caregiver and one who meets the qualifications of a caregiver. (e) These staffing patterns shall be maintained at all times. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart D - Health Standards for Infants and Toddlers § 55-40.1-430 Health Policies and Consultation Provisions All programs shall have one of the following provisions for health consultation to assist in developing health policies and in keeping them current: (a) The infant and toddler child care center shall have on file written evidence that an arrangement has been made with a licensed physician or licensed physician assistant in private practice to provide consultation; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 108 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (b) The infant and toddler child care center has made a contractual arrangement with a private physician or non-profit health organization in the community to provide health care to the infants and toddlers in the program; (c) There is already a procedure existing in the community for the provision of health consultation service, and arrangements have been made for the use of this service; or (d) The infant and toddler program has a health advisory group that may serve in such a capacity. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-432 Evidence of Child’s Health (a) The infant and toddler child care center shall obtain from the parent(s) or guardian(s), a health record of the child that complies with the provisions of this section. Which* relate to the school entry examination requirements for tuberculosis clearance, immunization, and physical examination. (1) Written evidence of a school entry examination clearance obtained within two months of admission to the infant and toddler child care center; (2) Written evidence that the infant or toddler has received a tuberculin test indicating that the infant or toddler is free from tuberculosis in a communicable form; and (3) Initial and continuous written evidence that immunizations are current; or (4) A written statement from a licensed physician certifying that the physical condition of the infant or toddler is such that immunizations would endanger the infant or toddler’s life or health; or (5) A written statement from a parent or guardian requesting exemption from the required immunizations on the grounds that such immunizations conflict with the parent or legal guardian’s bona fide religious tenets and practices. (b) The facility shall have in writing: (1) The name, physical and mailing addresses, email address, and telephone number of a physician or health resource that shall be called/contacted in case of emergency; and (2) Permission of the parent or guardian to call the licensed physician or licensed physician assistant or health resource, or another source of care if the parent or guardian cannot be reached in the case of a health emergency. (c) The records of the child in the program shall include pertinent information about health status, developmental progress, and any accommodations or modifications and efforts necessary to meet these needs. (d) Parents or guardians shall be given a grace period, not to exceed 2 weeks from the last assessment of the child’s immunization record, to obtain required immunization(s).

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-434 Emergency Care Provisions (a) Every infant and toddler child care center shall have provisions for emergency care of an infant or toddler requiring treatment and for care of children who become ill after arrival, as follows: (1) The responsible individual in the infant and toddler child care center, i.e. director, caregiver or health-trained staff, has obtained the name of the nearest hospital or clinic where such care may be provided and has obtained written permission from each parent or guardian to provide emergency care to the infant or toddler at the hospital or clinic; or (2) The facility’s infant and toddler child care center’s health consultant has made arrangements for emergency coverage, and written permission from each parent or guardian for use of this alternative emergency coverage for their infant or toddler shall be on file at the infant and toddler child care center. (3) If health care is provided in the infant and toddler child care facility, the infant and toddler child care center shall have on file a written permission from each parent or guardian covering all aspects of health care which is provided at the infant and toddler child care center. (b) An adult shall accompany the infant or toddler to the source of emergency care. The adult shall stay with the infant or toddler until the parent or parent’s or guardian’s designee assumes responsibility for the child’s care. The selection of the adult shall not compromise the supervision of the other infants and toddlers in the program. (c) Physical arrangements for infants and toddlers, who become ill after arrival at the infant and toddler child care center, shall be available for their care until parents or guardians can be notified to provide alternative arrangements. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-436 Pediatric First Aid and Cardiopulmonary Resuscitation (CPR) (a) At all times during the operational day when children are in care, there shall be at least one adult caregiver present, who has been instructed in the observation of symptoms of illness in infants and toddlers and who has a current (less than three years old), certificate in pediatric first aid and cardiopulmonary resuscitation (CPR) certificate. (b) A first aid kit, as defined by the infant and toddler child care center’s health consultant for their infant and toddler child care, shall be available at the facility at all times. Guidelines for a first aid kit, as developed by the state Commonwealth Health Care Corporation, to assist at the infant and toddler child care facility in assembling a first aid kit. (c) There shall be at least one adult care-giver with a current certificate in pediatric first aid and cardiopulmonary resuscitation at the infant and toddler child care center when children are present. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 110 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (d) The pediatric first aid and cardiopulmonary resuscitation (CPR) course must be provided by the American Red Cross, American Heart Association, or any organization whose infant and child CPR certification standards are equivalent to the American Red Cross or American Heart Association standards. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-438 Admission of Ill Infants and Toddlers (a) Acutely ill infants and toddlers shall not be permitted to attend child care programs. Acutely ill is defined as temperature above 99 degrees (auxiliary) 100 degrees (oral), and 101 degrees (rectal) and other symptoms, such as vomiting, diarrhea, undiagnosed general rash, contagious disease, severe cough, or difficulty in breathing. (b) When health policies of the infant and toddler child care center allow ill infants or toddlers to be admitted to, or to remain in the infant and toddler child care center, medical consultation shall be available regarding special care and medication. (c) When medication prescribed by a physician is administered in the infant and toddler child care center: (1) The medication shall be kept in the original container bearing the prescription label, which shows the infant’s or toddler’s name, a current date, and the physician’s directions for use; (2) Medication shall be stored: (i) In a refrigerator, if refrigeration is required; medication shall be separated from food by being enclosed in a covered container; or (ii) In a cool, dry, dark, and secured enclosure, which is inaccessible to the infants and toddlers, if refrigeration is not required. (3) Medication shall be returned to parents or guardians when no longer in use; and (4) There shall be an authorization signed by the parent or guardian for the infant and toddler child care center staff to administer medication. (d) When over the counter medication is recommended by the infant’s or toddler’s doctor, parent, or guardian, medication shall be administered at the infant and toddler child care center as directed in writing by the doctor, parent, or guardian. (e) Both the care giving staff and the parents or guardians shall be familiar with policies of the infant and toddler child care center relevant to ill infants and toddler. (f) The infant and toddler child care center shall, in consultation with its health consultant, establish a re-admission policy for children who have been absent because of illness. (g) Children with any of the bacterial infections listed below must be treated with antibiotics for 24 hours before they return to the infant and toddler child care center: (1) Strep throat; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 111 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (2) Scarlet fever; (3) Impetigo; (4) Bacterial conjunctivitis (pink eye); and (5) Skin infections such as draining burn or infected wounds or hangnails. (h) Children with chicken pox may not be admitted to the infant and toddler child care center until their sores dry up, which usually takes five to seven days. (i) Children who are jaundiced must be excluded until a health care provider evaluates the cause and authorizes the child to return to the infant and toddler child care center. (j) Children with symptoms of severe illness, such as uncontrolled coughing, breathing difficulty or wheezing, stiff neck, irritability, poor food or fluid intake, or a seizure, must be evaluated by a health care provider before they may return to the infant and toddler child care center. (k) The infant and toddler child care center must have a plan for preventing and responding to emergencies due to food and allergic reactions. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-440 Admission of Infants and Toddlers with Disabilities (a) When infants and toddlers with disabilities are admitted to a infant and toddler child care center, the infant and toddler child care center shall provide for the special needs of each infant or toddler according to the individual family service plan (IFSP) or the individualized educational plan (IBP) in consultation with the Special Education Program at the Public School System. (b) The disabled infant or toddler shall be admitted upon consultation between the infant’s or toddler’s source of health care and the program’s health consultant. The consultation shall include written recommendations to cover the child’s special needs or to define the child’s participation in the program. (c) If the infant(s) or toddler(s) health care source considers it advisable, the staff of the program shall receive training related to the nature of the child’s disability before the infant or toddler is admitted to the infant and toddler child care center. (d) Where the nature of the infant(s) or toddler(s) disability or the number of disabled children in the program necessitates added care, staff and appropriate equipment shall be available to cover support these requirements. (e) Infant and toddler child care center providers must not exclude a child with a disability from their programs based on their disability, or separate that child from their nondisabled peers. (f) Infant and toddler child care providers must make an individualized assessment about whether they can meet the particular needs of a child with a disability. The assessment shall include written recommendations in consultation with the PublicSchool System’s Special Education Division, Part C – Early Intervention or Part B – School Age to cover the child’s special needs or © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 112 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS to define the child’s participation in the child care center program. (g) Make reasonable modifications to their policies and practices to allow for children with disabilities to participate. Here are examples of some common reasonable modifications: (1) Change a toilet training policy to assist a child with Down syndrome who, due to her/his disability, requires assistance with going to the bathroom. (2) Change a discipline policy to ensure that a child with autism has equal access to the program with appropriate supports, such as training staff to aid the child in deescalating behavior when the child acts out. (3) Change a medication policy so that a trained staff person may assist a child with diabetes in the administration of insulin or Glucagon, an emergency, life-saving medication for individuals with diabetes. (4) Provide appropriate aids and services needed to effectively communicate with children or adults with disabilities. (5) If a child care center is closing early due to bad weather, that may mean using different methods—not just calls but emails or text messages—to communicate with deaf or hard of hearing parents or legal guardians. (6) If the infant and toddler child care center is using websites or parent portals to keep parents informed concerning their child’s participation in the program, all such technology must be accessible to those with hearing, vision, or speech disabilities (for example, those who use screen readers). (7) Make sure physical spaces are accessible. Remove architectural barriers that interfere with or prevent children from fully participating (or parents, legal guardians, or prospective customers with disabilities) if removing the barriers is readily achievable, meaning if it can be easily accomplished without much difficulty or expense. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-441 Admission of Children Experiencing Homelessness When children experiencing homelessness are admitted to a child care facility, the facility shall provide for the needs of each child according to the McKinney Vento Act. (a) Child care providers shall offer children secure, quality and nurturing care that promotes resiliency, health development and growth by: (1) Offering stable and familiar routines such as regular nap times and feeding schedules; (2) Providing structured learning activities and time for open play; and (3) Preparing opportunities for physical activity and spending time outside. (b) Child care providers shall coordinate services with other agencies/organizations so that families with children experiencing homelessness can get the help that they need; and (c) Child care providers shall extend a grace period or flexibility to obtain immunizations and other documents needed so that can children experiencing homelessness can be served more quickly. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 113 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS § 55-40.1-442 Daily Nutritional Needs (a) Meals and snacks of a quantity to complement food served at home shall be provided by the parent, guardian, or the infant and toddler child care center to meet the daily nutritional needs of the infant or toddler. (b) In an infant and toddler child care center providing meal service, the infant and toddler child care center shall ensure that the minimum meal components and food amounts as required by the United States Department of Agriculture (USDA) Child Care Food Program. (c) In an infant and toddler child care center, where parents or guardians are allowed to provide food for their own child (i.e., formula or other foods for meals or snacks), the infant and toddler child care center, in addition to food the child brings, shall provide the minimum amounts required by the USDA Child Care Food Program, by offering and providing children in care: (1) Four to eight hours - morning snack or breakfast or afternoon snack; (2) Eight hours or more - morning snack or breakfast and afternoon snack, unless the eight hours or more extend into the evening hours when the children may be asleep. (d) For children twelve to thirty-six months of age, when two snacks are required, at least one of the snacks shall include the provision and offering of milk (or the individual child’s formula) or its calcium equivalent. (e) Infants and toddlers shall not be offered foods to which they are allergic or, for religious reasons.* Provisions shall be made to secure such information from the parent(s) or guardian(s) and agreement shall be made for nutritious substitute foods. *So in original. (f) Signs of food sensitivity or allergy shall be reported to the parent or guardian on the day this has been observed. (g) Infants and toddlers shall be encouraged but shall not be required to eat the food offered by the facility, as follows: (1) Caregiver shall be alert to and consider individual infant and toddler cues in determining amounts of food provided; (2) When solid foods are introduced, they shall be carefully selected and added one at a time with a few days span between each new addition; and (3) Food textures shall be adjusted to accommodate the individual child’s chewing ability, as well as preferences. (h) Infants and toddlers shall not be offered foods which pose safety hazards, e.g. hot dogs, coin sized foods, grapes, etc. (i) Food shall not be used as a punishment or reward. (j) Infants and toddlers feeding shall be personally attended while being fed. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 114 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (1) Infants being bottle fed shall have bottle held by the caregiver, not propped; and (2) Parents or guardians may assume full responsibility for the infant’s or toddler’s diet. (k) The infant and toddler child care center’s food service shall be approved and reviewed annually by a qualified nutrition consultant engaged by the facility or by the Commonwealth Healthcare Corporation, Tinian Healthcare, or Rota Healthcare. (l) The infant and toddler child care center shall have access to nutritional information provided by a qualified nutritionist, dietitian, or other community resources approved by the Commonwealth Healthcare Corporation, Tinian Healthcare, or Rota Healthcare. (m) The infant and toddler child care center shall make special handling for those children who may be getting breast feeding. (n) A day’s supply of formula or breast milk in nursing bottles or formula requiring no more preparation than dilution with water shall be provided by the parents, unless an alternative agreement is reached between the parents and provider ensuring that the infant’s nutritional needs are sufficiently met. (o) Bottles of formula or breast milk shall be clearly labeled with each infant’s name and date and immediately refrigerated. After use bottles shall be thoroughly rinsed before returning to the parent at the end of the day. (p) Special dietary foods required by infants and toddlers shall be prepared by the parents. (q) If the parent is unable to bring sufficient or usable formula or breast milk, the infant and toddler child care center may use commercially prepared and packaged formulas. Older infants and toddlers shall be provided suitable foods which encourage freedom in self-feeding. Unused food shall be stored in the original container and kept separate from other foodstuffs. Dry cereal, cookies, crackers, breads, and similar foods shall be stored in clean, covered containers. (s) If the container in which the formula was purchased does not include a sanitized bottle and nipple, then transfer of ready-to-feed formula from the bulk container to the bottle and nipple feeding unit must be done in a sanitary manner in the kitchen. Bottles filled on the premises of the infant and toddler child care center should be refrigerated immediately if not used and contents discarded if not used within 12 hours. (t) If bottles and nipples are to be used by the infant and toddler child care center, they must be cleaned and sanitized using generally accepted means of sanitation such as washing in a dishwasher or by washing in hot water, rinsing, and boiling for one minute. (u) Infants and Toddlers Bottle Feeding (l) Bottles shall not be propped. Infants too young to sit in high chairs shall be held in a semi- sitting position for all bottle feedings; (2) Infants and toddlers who use a bottle shall not be allowed to lie on their backs when drinking from the bottle; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 115 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (4) Infants six months of age or over who show a preference for holding their own bottles may do so provided an adult remains in the room and within observation of the infant; and (5) Bottles and spill-proof cups (sippy cups) must be taken from the infant or toddler when they finish feeding, when the bottle or cup is empty, and while they are sleeping. (v) Older infants and toddlers shall be provided age-appropriate feeding equipment when being fed. This includes safe high chairs, baby feeding tables, booster seats, and child-size tables and chairs. Use of these types of equipment must be used in accordance with the manufacturer’s instructions and must be appropriate for the age of the child using the equipment. (u) An individualized diet and feeding schedule shall be provided according to a written plan submitted by the parents or by the infant’s physician with the knowledge and consent of the parents, legal guardian, or placement agency. A change of diet and schedule shall be noted on each infant’s daily diet and feeding schedule. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-443 Hand Washing Policy for Infants and Toddlers (a) The infant and toddler child care center shall have a written policy that specifies when hand washing is required for infants and toddlers, defines the hand washing procedure, and provides continuous monitoring to assure that the hand washing procedure is followed. (b) The hand washing policy for infants and toddlers shall require that hand washing is done: (1) Before drinking; (2) Before and after meals; (3) Before handling clean utensils; (4) After going to the bathroom; (5) After contact with body secretions – e.g., mucus, saliva, or drainage from wounds; and (6) After outdoor play. (c) Infants and toddlers who self-feed in any manner shall have their hands washed with soap and water before and after eating and after toileting. (d) Hand washing may be done with cold water and drying hands may be done with disposable paper towels or an individual hand towel that will be taken home from laundry at the end of each day. (e) Liquid soap should be used and placed in a pump dispenser and shall be replaced or cleaned as necessary. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-444 Drinking Water Provisions © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 116 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS Drinking water shall be offered to infants and toddlers throughout the day in sanitized bottles and cups. [NM1AC, title 140, subchapter 20.4] promulgated by the Commonwealth Healthcare Corporation pursuant to the Commonwealth Environmental Health and Sanitation Act of2000 shall apply as well. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-446 Integration of Mental Health Concepts Mental health aspects of infant and toddler development shall be integrated into the program as follows: (a) At least one parent, guardian, foster parent, or social worker shall be interviewed prior to an infant’s or toddler’s admission to the infant and toddler child care center. The personal interview shall be conducted to secure pertinent information on the infant’s or toddler’s overall development and behavior and to acquaint the parent or guardian with the infant and toddler child care center’s program and policies; (b) The infant and toddler child care center shall provide its staff with annual orientation to state or other mental health services for infants and toddlers, or otherwise familiarize its staff with consultative and clinical services and programs for early identification of social, emotional, intellectual, and behavioral problems of infants and toddlers; and (c) The infant and toddler child care center shall refer parents or guardians to sources of professional consultation in mental health upon the parents§ or guardians request or upon the recommendation of the infant and toddler child care center’s staff. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart E - Health Standards for Staff § 55-40.1-448 Staff Health Standards (a) Evidence that staff is free from health problems, which would have a harmful effect on the infants and toddlers or which would interfere with effective functioning, shall be available at the facility as follows: (1) The infant and toddler child care center shall have on file the results of an employment health clearance, physical examination certificate and/or food handler certificate for each person employed in the facility and each volunteer who serves ten or more hours per week. These examinations shall have been taken within a year of beginning employment or volunteer service. (2) Written evidence that each employed staff and volunteer of an infant and toddler child care center is free from communicable tuberculosis as a result of a negative tuberculin skin test or a satisfactory chest x-ray taken within six months before beginning child care employment shall be on file at the infant and toddler child care center. The tests shall be repeated in compliance with administrative rules of the Commonwealth Healthcare Corporation; and (3) Each caregiving staff with an identified health problem shall provide the infant and toddler © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 117 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS child care center with a written statement from a licensed physician or licensed physician assistant that the caregiving staff is able to care for infants and toddlers. (b) The infant and toddler child care center shall have provisions for substitution of staff that is too ill to function effectively or who presents a serious health hazard to others in the infant and toddler child care center. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-450 Personal Health Habits of Staff (a) The facility shall have written policies, which have been developed with the assistance of the facility’s health consultant and which minimally require that: (1) Staff with a fever, other symptoms of illness, or an altered physical or mental state, shall not be allowed to work; (2) Staff with visible skin conditions, such as lesions, boils, or dermatitis, shall not prepare or serve food or handle utensils and feeding equipment; (3) Staff’s appearance shall reflect good grooming habits and personal hygiene, including clean and neat hair and nails, appropriate clothing, and good oral hygiene; (4) Smoking shall not be allowed in the infant and toddler child care center, nor in any parts of the building, or premises at all time which are used for child care, during the hours of child care operation; [The facility shall adhere to the Smoke Free Act of 2008]. (5) Tobacco, alcoholic beverages and detrimental drugs are prohibited on the premises (both indoor and outdoor environments) and in any vehicle used by the program at all times; and (6) Staff shall take appropriate measures to manage stress by maintaining good mental and physical health. (b) In-service training shall be provided to staff on various aspects of personal health care and healthy lifestyle, such as care of head lice (ukus), impetigo, viral infections, risk factors, and stress management. (c) Volunteers shall be subject to the same requirements for health and personal health habits as the caregiving staff. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart F - Sanitation Standards § 55-40.1-452 Handling of Diapers, Training Pants, Linen and Toys (a) Diapers, training pants, gloves and linen shall be handled in the following manner: (1) When disposable diapers are used, soiled diapers shall be placed in a plastic bag or a plastic lined receptacle; (2) When cloth diapers or training pants are used, diapers or training pants soiled with stool shall not be washed at the infant and toddler child care center; after the stool has been emptied into the toilet, using disposable plastic gloves, the diaper or training pants shall be put in a sealed plastic © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 118 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS bag to be picked up by the child’s parent or guardian at the end of the day; (3) When dealing with blood, sanitary/disposable gloves shall be worn at all times when administering aide to a child; (4) Sheets, diapers, and training pants soiled with blood, body fluids, or waste shall be handled as little as possible to prevent contamination of the area and of the staff handling the linen; and (5) Soiled sheets, diapers, and training pants, which are transported to a laundry area outside of the infant and toddler child care center, shall be placed in plastic bags while being transported from the child care facility to the laundry. (b) Toys shall be provided and handled in the following ways: (1) Each of the designated groups shall be provided with developmentally appropriate toys; (2) Toys shall not be shared between different groups of children, such as between infants and toddlers; (3) Only washable toys shall be used for infants and toddlers in diapers or training pants; and (4) Toys shall be washed or sanitized daily. (i) Toys shall be cleaned/washed and scrubbed with soap and water to remove germs, dirt, and impurities from surfaces. (ii) Toys shall be sanitized to reduce germs on surfaces to levels of public health codes or regulations considered safe. An appropriate and safe sanitizing solution or spray is recommended. (iii) Toys shall be disinfected to destroy any remaining germs on surfaces after cleaning. Generally high-touch surfaces and toys are more likely to have germs on them. (c) A sufficient supply of clean, dry diapers shall be available and diapers shall be changed as frequently as needed. Disposable diapers, a commercial diaper service, or reusable diapers supplied by the child’s family may be used. If non-disposable diapers are used, the infant and toddler child care center may launder the diapers using a germicidal process approved by the Bureau of Environmental Health Department. In the absence of such a process, the facility may not launder non-disposable diapers of enrolled children. (d) Soiled reusable diapers shall be placed into separate cleanable covered containers provided with waterproof liners prior to transport to laundry, parent, or acceptable disposal. These containers shall be emptied, cleaned and disinfected daily. (e) The following rules apply to infants and toddlers who wear diapers: (1) The provider shall ensure that each child’s diaper checked at least once every two hours; (2) The provider shall promptly change if wet or soiled; and (3) The provider shall check child’s diaper as soon as a sleeping child awakens. (f) Diaper-changing surfaces shall be smooth, waterproof, good repair, and cleaned after each use by washing or by changing a pad or disposable sheeting and sanitized or covered for reuse. (g) Soft, absorbent, disposal towels, or clean reusable towels which have been laundered between each use shall be used for cleaning the child. (h) Safety pins shall be kept out of reach of infants and toddlers. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 119 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (i) Infants and toddlers shall not be left unattended on a surface from which they might fall. (j) All toilet articles shall be specifically labelled for each infant and toddler. Each item must be separated and kept in a sanitary condition. (k) Diapering and toileting areas shall contain a wash basin that is separate from what is used for food preparation. (l) Toilet training shall be initiated when the toddler is ready and in consultation with the toddler’s parents or legal guardians. There shall be no routine attempt to toilet train children under the age of 18 months. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-454 Hand Washing (a) The infant and toddler child care center shall have a written policy that specifies when handwashing is required for staff and children, defines handwashing procedure, and provides continuing monitoring to assure that the handwashing procedure is carried out. (b) Handwashing policy for staff shall require that handwashing is done, smoking is prohibited on premises at all times. (1) Before eating, drinking, smoking is prohibited at all times in premises; (2) Before handling clean utensils or equipment; (3) Before handling food; (4) Before and after assisting or training the child in feeding and in toileting; (5) After going to the bathroom; (6) After contact with body secretions, i.e., blood, urine, feces, mucus, saliva, or drainage from wounds; (7) After handling soiled diapers, clothes, equipment, or menstrual pads; and (8) After removing disposable gloves. (9) After smoking. (c) Infants and toddlers, who self-feed in any manner, shall have their hands washed with soap and water before and after eating and after toileting. (d)(1) Handwashing does not require hot water and may be done with cold water and plain soap and use of disposable paper towels for drying hands. (2) If bar soap is used, it shall be kept on racks that allow for water drainage. If liquid soap is used, the dispenser shall be replaced or cleaned, as necessary. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 120 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS § 55-40.1-455 Infants’ and Toddlers’ Hygiene Bathing (a) General bathing of infants and toddlers shall not be done routinely by the infant and toddler child care center but if required or may be necessary for overnight care, toileting/and when soiled, or vomiting incidents. Bathing procedures and considerations include the following: (1) Written consent is supplied from the child’s parent or legal guardian; (2) The infant and toddler child care center are equipped with a bathtub or shower with a slip resistant surface; (3) Direct supervision and care are provided for infants and toddlers when being bathed; (4) Nonallergenic soap shall be used; (5) Each infant and toddler shall have his or her own clean towel and washcloth; (6) Bathing materials shall be sanitized after bathing an infant or toddler; (7) Arrangements shall be made so the infant or toddler cannot turn on hot water while being bathed. (8) Water supply to bathing area will not be over 100°F; and (9) The bathing area shall be out of drafts and provisions should be made so the infant or toddler maybe completely dried after a bath. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-456 General Housekeeping (a) Facilities shall have written policies for the routine cleaning and maintenance of the facility. These policies shall specify the type of disinfectant and cleaning agent used, method for cleaning, schedule for cleaning, storage of cleaning material and utensils, disposal of soiled items or spilled body fluids, and cleaning of equipment. (b) Storage of cleaning material shall be in a secured area which is inaccessible to the infants and toddlers. (c) As general housekeeping measures, infant and toddler child care centers must ensure that: (1) Its building and grounds are free, to the extent possible, or harborage for insects, rodents, and other vermin; (2) Its floors, walls, ceilings, furnishings, and other equipment are kept clean; and (3) Soap and disposable towels or other hand-drying devices are always available at all hand washing sinks. Common-use cloth towels are prohibited. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart G - Environmental Health Standards § 55-40.1-458 Emergency Preparedness, Recovery, and Response Plan (ERRRP) Each facility shall have an emergency preparedness, recovery, and response written plan to cover © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 121 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS emergencies and disasters such as fire, flood, or natural disaster. The plan shall include: (a) EPRRP written plan which shall be approved by the Child Care Licensing Program in consultation with the fire inspector, the health consultant, or the Red Cross, and which shall be practiced at regular intervals; (b) Posting the plan in a prominent place in the facility The EPRRP guidelines, procedures and evacuation maps shall be posted in classrooms, administrative-reception area, dining area, and lounge area where staff, students, and visitors are able to see. (c) Each infant and toddler child care center shall comply with the Department of Fire and Emergency Medical Services Fire Code and Building Safety Code on fire safety and fire evacuation plans. (d) An approved fire safety and evacuation plan including the means of egress by the CNMI DFEMS Fire Marshall shall be supplied to the Child Care Licensing Program. Written evidence that the fire safety device/system has been inspected and approved by the Fire Marshall and shall be supplied to the Child Care Licensing Program and on file at the facility. (e) The components of the written EPRRP plan at each infant and toddler child care center shall include: (1) Evacuation, relocation, shelter-in-place, and lock-down procedures, and procedures for communication and reunification with families, continuity of operations, and accommodation of infants and toddlers, children with disabilities, and children with chronic medical conditions; (2) Written procedures for accounting for all in attendance including: (i) The location of the children, staff, volunteer and visitor attendance lists; and (ii) The name of the person responsible for bringing the children staff, volunteer and visitor attendance lists in the event of an emergency; (iii) Methods for communicating with parents and emergency personnel or law enforcement; (iv) A description of how children’s nutritional and health needs will be met; (v) The relocation and reunification process; (vi) Plans for shelter in place and lock down; (vii) Emergency telephone numbers; (viii) Evacuation diagrams showing how the staff, children, and any other individuals who may be present will evacuate during and emergency; (ix) The date of the last revision of the plan; (x) Specific considerations for non-mobile children and children with disabilities; and (xi) The location of an Emergency-to-Go File. An Emergency-to-Go File means a collection of information on children, staff and the infant and toddler child care center, to utilize, if an evacuation occurs. The file shall include: (A) A copy of the Emergency Preparedness and Response Plan; (B) Contact information for individuals to pick-up children; (C) A copy of each child’s application for Child Care; (D) Medication authorizations and instructions; (E) Any action plans for children with special health care needs; (G) A list of any known food allergies of children and staff; (H) Staff contact information; © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 122 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (I) Incident Report forms; (J) An area map; and (K) Emergency telephone numbers. (f) Guidelines for the continuation of child care services in the period following the emergency or disaster, which may include the provision of emergency and temporary child care services, and temporary operating standards for child care providers during that period. (g) Plans for continuity of operations. (h) Procedures for staff and volunteer emergency preparedness training and practice drills. (i) Existing infant and toddler child care centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training. New infant and toddler child care centers shall have one person on staff who has completed the Emergency Preparedness and Response in Child Care training within one year of the effective date of the initial license. When the trained staff member leaves employment, the center shall ensure that another staff member completed the required training within four months of the vacancy. (j) Documentation of completion of the training shall be maintained in the individual’s personnel file or in a file designated for emergency preparedness and response plan documents. Upon completion of the Emergency Preparedness and Response in Child Care training, the trained staff shall develop the Emergency Preparedness and Response Plan. The Emergency Preparedness and Response Plan means a written plan that addresses how the infant and toddler child care center will respond to both natural and man-made disasters, such as fire, tornado, flood, power failures, chemical spills, bomb threats, earthquakes, nuclear disasters, or a dangerous person or persons in the vicinity, to ensure the safety and protection of the children and staff. (k) The Emergency Preparedness and Response Plan must be on a template provided by the Child Care Licensing Program and completed within four months of completion of the Emergency Preparedness and Response in Child Care training. (l) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. (m) All staff shall review the center’s Emergency Preparedness and Response Plan during orientation and on an annual basis with the trained staff. Documentation of the review shall be maintained at the center in the individual’s personnel file or in a file designated for emergency preparedness and response plan documents. (n) All substitutes and volunteers counted in ratio shall be informed of the child care center’s Emergency Preparedness and Response Plan and its location. Documentation of this notice shall be maintained in the individual personnel files or in a file designated for emergency preparedness and response plan documents. (o) The infant and toddler child care center must conduct eight emergency drills per year to © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 123 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS include: (1) Four fire drills. (2) Four disaster drills. (3) All emergency drills must be documented and include the following minimum information: (4) Who conducted the drill; (5) Date and time of drill; (6) The number of adults and children present during the drill; (7) The length of time to evacuate; and (8) Problems identified during the drill and corrective actions. (p) An approved fire safety and evacuation plan including the means of egress by the CNMI DFEMS Fire Marshal shall be supplied to the Child Care Licensing Program. Written evidence that the fire safety device/system has been inspected and approved by the Fire Marshal and shall be supplied to the Child Care Licensing Program and on file at the facility. Modified, 1 CMC § 3806(a), (g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-459 Health and Safety Requirements (a) Situations that Require Hand Hygiene (1) All staff, volunteers, and children should abide by the following procedures for hand washing, as defined by the U.S. Centers for Disease Control and Prevention (CDC): (i) Upon arrival for the day, after breaks, or when moving from one group to another. (2) Before and after: (i) Preparing food or beverages; (ii) Eating, handling food, or feeding a child; (iii) Brushing or helping a child brush tooth; Giving medication or applying a medical ointment or cream in which a break in the skin (e.g., sores, cuts, or scrapes) may be encountered; (iv) Playing in water (including swimming) that is used by more than one person; and diapering. (3) After: (i) Using the toilet or helping a child use a toilet; (ii) Handling bodily fluid (mucus, blood, vomit); (iii) Handling animals or cleaning up animal waste; (iv) Playing in sand, on wooden play sets, and outdoors; and v) (Cleaning or handling the garbage. (4) Situations or times that children and staff should perform hand hygiene should be posted in all food preparation, diapering, and toileting areas. (b) Prevention of Exposure to Blood and Body Fluids (1) All child care facilities should adopt the use of Standard Precautions, developed by the Centers for Disease Control and Prevention (CDC), to handle potential exposure to blood and other potentially infectious fluids. The standard precautions can be access at https://shorturl.at/JZmvF (2) Child care providers and teachers are required to participate in a staff development program on Standard Precautions annually and thereafter. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 124 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (3) Training should comply with requirements of the Occupational Safety and Health Administration (OSHA). Training information can be accessed at https://labor.cnmi.gov/divisions- programs/osha-on-site-consultation/ (c) Routine Cleaning, Sanitizing, and Disinfecting (1) Programs should follow a routine schedule of cleaning, sanitizing, and disinfecting. (2) Cleaning, sanitizing, and disinfecting products should not be used in close proximity to children, and adequate ventilation should be maintained during use. (d) Environmental Audit of Site Location (1) An environmental audit should be conducted before construction of a new building; renovation or occupation of an older building; or after a natural disaster to properly evaluate and, where necessary, remediate or avoid sites where children’s health could be compromised. (2) A written report that includes any remedial action taken should be kept on file. (3) The audit should include assessments of: (i) Potential air, soil, and water contamination on program sites and outdoor play spaces; (ii) Potential toxic or hazardous materials in building construction, such as lead and asbestos; and (iii) Potential safety hazards in the community surrounding the site. (e) Integrated Pest Management (1) Child care providers shall adopt an integrated pest management program to ensure long- term, environmentally sound pest suppression through a range of practices including pest exclusion, sanitation and clutter control, and elimination of conditions that are conducive to pest infestations. (f) Use and Storage of Toxic Substances (1) All toxic substances should be inaccessible to children and should not be used when children are present. (2) Toxic substances should be used as recommended by the manufacturer and stored in the original labeled containers. (3) The telephone number for the poison control center should be posted and readily accessible in emergency situations. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). § 55-40.1-460 Accidental Injury Precautions The provider shall ensure that the child care program staff minimize the risk of accidental injury in the following manner: (a) Ensuring that child care activities and premises do not expose children to situations which may be hazardous to the particular age or capacity of the child; and (b) Helping increase the children’s awareness of safety practices and accident hazards, and © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 125 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS helping the children to learn how to avoid such hazards. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-462 Environmental Hazards The premises, both indoor and outdoor, in which a child care program is carried out shall be free of environmental hazards, shall be clean and comfortable, and shall provide for adequate space to meet the needs of the children as follows: (a) The provider shall control rodents and insects; (b) The outdoor space shall be fenced or shall have natural barriers or other protective conditions to deter children from getting into unsafe areas; (c) There shall be no open drainage ditches, wells, or holes into which children may fall; (d) Drainage shall be adequate to prevent stagnant pools of water from accumulating; (e) Garbage and trash shall be stored in covered containers out of reach of the children and shall be removed frequently enough to avoid creating a health hazard or nuisances; (f) Poisons, drugs, harmful chemicals, and other dangerous articles such as cleaning fluid, matches, firearms, and tools shall be kept in a safe location, out of reach of children; (g) All rooms used for child care shall be lighted and ventilated; (h) Open fireplaces shall not be used. Floor heaters and all heating elements including hot water pipes shall be insulated or installed in a manner which makes the pipes inaccessible to children; (i) Floor space shall be arranged to provide areas for active play, quiet rest, and individual activities; (j) Furniture, equipment, and toys shall be sturdily constructed, without sharp edges, and shall present minimal hazards to children; (k) Lead based paint shall not be used on surfaces accessible to children. Professional assistance shall be requested during routine inspections to ensure that lead paint does not exist at all in the infant and toddler child care center; (l) Provision shall be made to eliminate the hazard of electrical outlets; (m) Poisonous plants shall be kept out of the reach of children; and (n) Pets, animals, and fowl shall be maintained in a safe and sanitary manner at all times. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 126 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-464 Water Supply The Rules and Regulations Governing Schools and Child Care Facilities [NMIAC, title 140, subchapter 20.4] promulgated by the Commonwealth Healthcare Corporation pursuant to the Commonwealth Environmental Health and Sanitation Act of 2000 shall apply to this section. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-466 Toilet and Lavatory Facilities The Rules and Regulations Governing Schools and Child Care Facilities [NMIAC, title 140, subchapter 20.4] promulgated by the Commonwealth Healthcare Corporation pursuant to the Commonwealth Environmental Health and Sanitation Act of 2000 shall apply. (a) If toilet training chairs are provided for use by children, the toilet training chairs shall be emptied promptly and sanitized after use; (b) Small children shall be assisted in washing to prevent accidental scalding; (c) Safe, sturdy step stools shall be provided to allow the use of standard sized toilets and lavatories; and (d) Children shall not share towels, toothbrushes, combs, and other necessary toilet articles. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-468 Food Preparation and Protection (a) Food preparation and protection shall be carried out in a kitchen with proper equipment and cleanup facilities required for the number of children in care as follows: (1) All food shall be protected from contamination during storage, preparation, and service; and (2) All dishwashing shall be performed in a sanitary manner; (3) An adequate number of eating and drinking utensils shall be available for each child; (4) When single service utensils are used, the utensils shall be stored and handled in a sanitary manner and discarded after a single use; and (5) Cooking utensils used in food preparation and service shall be cleaned and stored in sanitary manner. (b) Food protection policies shall comply with accepted practices of local sanitary codes and shall be adapted to fit the needs of the program except as indicated in the rules in this subchapter. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 127 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (c) Refrigeration shall be available for infant and toddler programs. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). Subpart H - Physical Facility Standards § 55-40.1-470 Building Safety Codes and Space Requirements (a) Infant and toddler child care centers shall conform to the zoning, building, electrical, plumbing, and fire codes of the Commonwealth of the Northern Mariana Islands in which the infant and toddler child care center is located and to state the rules as maybe applicable to the facility. (b) The infant and toddler child care center shall: (1) Be located in a safe and reasonably quiet area or employ suitable noise control devices to limit exterior noises to the child care operation; (2) Have a sunny exposure and be well lighted and ventilated; and (3) Keep all buildings, building appurtenances, outdoor space, equipment, and all other parts of the facility repaired, safe, and sanitary at all times. (c) The program areas specifically designated for infants and toddlers, both indoors and outdoors, shall be separated by permanent structural walls, fences, or other barriers in order to: (1) Protect the younger children from traffic and high activity levels of older age groups; (2) Minimize congestion and noise pollution; and (3) Avoid staff specifically assigned to infant and toddler care from being pulled from infant and toddler programs and into other areas at any time. (d) The space requirements for enclosed areas are as follows: (1) For daytime care: (i) There shall be thirty-five square feet per child of unencumbered instructional or play area exclusive of bathrooms, kitchens, cupboard space, hallways, and spaces consumed by cribs and playpens; (ii) The thirty-five square feet per child requirement can be based on the general square footage area of each classroom; and (iii) Lanai area, which has both a roof and finished flooring, may be counted for up to thirty percent of the required enclosed area; and (2) For nighttime care, there shall be fifty square feet per child, exclusive of lanai area, in rooms which are used for sleeping. (e) The space requirements for outdoor areas are as follows: (1) The infant and toddler child care center shall maintain, or have access to, an outdoor play area of at least seventy-five square feet for each child using the outdoor area at any one time; and (2) Lanai area, when not included in the required enclosed area space, may be counted for the required outdoor space. (f) The infant and toddler child care center shall be equipped with toilets and lavatories as © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 128 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS follows: Number of Minimum Minimum Children Toilets Lavatory(ies) 1-12 1 1 13-30 2 2 31-45 3 3 46-60 4 4 61-75 5 5 History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-471 Child Care Facilities: Safety Requirements (a) Cleaning materials, flammable liquids, detergents, aerosol cans, and other poisonous and toxic materials must be kept in their original containers and in a place inaccessible to children. They must be used in such a way that will not contaminate play surfaces, food, food preparation areas, or constitute a hazard to the children. Bio-contaminants including blood, bodily fluids, and other infectious materials must be properly disposed of. (b) No extension cord will be used as permanent wiring. All appliances, lamp cords, and exposed light sockets must be suitably protected to prevent electrocution. (c) Any pet or animal, present at the facility, indoors or outdoors, must be in good health, show no evidence of carrying disease, and be a friendly companion of the children. The provider is responsible for maintaining the animal’s vaccinations and vaccination records. The provider must make reasonable efforts to keep stray animals off the premises. (d) Guns and any types of weapons are off limits in the facilities. (e) The indoor and outdoor play areas must be clean, reasonably neat, and free from accumulation of dirt, rubbish, or other health hazards. (f) Any outdoor play area must be maintained free from hazards such as wells, machinery, and animal waste. If any part of the paly area is adjacent to a busy roadway, drainage or irrigation ditch, large holes, or other hazardous areas, the play area must be enclosed with a fence in good repair that is at least four feet high without any holes or spaces greater than four inches in diameter or natural barriers to restrict children from these areas. © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 129 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS (g) Outdoor play areas shall be designed so that all parts are always visible and easily supervised by staff. (h) Outdoor equipment, such as climbing apparatus, slides, and swings, must be anchored firmly, and placed in a safe location according to manufacturer’s instructions. All playground equipment should be placed over a shock-absorbing material that is either the unitary or the loose- fill type extending beyond the perimeter of the stationary equipment. (i) Trampolines are prohibited for use by children in care. (j) For emergency assistance, call Department of Fire and Emergency Medical Services at 670-234-0911 or Emergency Department at the Commonwealth Healthcare Corporation at 670- 236-8390/1 or 670-234-8950 Ext. 2360/1 and must be posted visibly in the facility. The Poison Help Center is available on line at https://www.poisonhelp.org at no cost for expert advice. (k) Use of waterbeds, water mattresses, gel pads, or sheepskin covers for children’s sleeping surface is prohibited. (l) In an emergency, all occupants must be able to escape from the facility, whether a home or building in a safe and timely manner: (1) All infant and toddler child care centers must have two accessible exits on each level. The two exits must be far enough apart from one another to avoid having them both blocked by fire and smoke. Aisle ways and corridors leading to the exits must be kept clear of obstructions. (2) If the provider chooses to lock the infant and toddler child care center door to prevent unauthorized access to the infant and toddler child care center or to prevent a child from escaping, the toddler and child care center shall have no lock or fastening device which prevents free escape from the interior. (3) Installation of locking devices may not prohibit access by parents. The infant and toddler child care center may not utilize locking devices in a manner to prevent unannounced access by authorized individuals, including parents. If a lock is used, the provider must make adequate provision to allow authorized persons unannounced access to the infant and toddler child care center and must provide authorized personnel including parents and legal guardians with information on how to gain access. (4) Exit doors, windows, and their opening hardware must be maintained in good repair at all times. Modified, 1 CMC § 3806(g). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). Subpart I - Program Modifications § 55-40.1-472 Program Modifications for Drop-in Care (a) All requirements set forth in this subchapter shall be met by the provider except for § 55- 40.1-401 and § 55-40.1-432. The infant and toddler child care does offer drop-in care and shall be prepared to adjust its staffing to meet the program modifications which remit when drop-in care is © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 130 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS provided. (b) Infants and toddlers child care centers that offer drop-in care and shall be prepared to adjust its staffing to meet the program modifications which result when drop-in care is provided. (c) Infants and toddlers receiving drop-in care shall be cared for in separate areas or groups from the other infants and toddlers who attend the program regularly. (d) If a facility serves both drop-in children and children who attend regularly, the grouping of the children and the program shall be planned so that the needs of both groups are met. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-474 Program Modifications for Night Care An infant and toddler child care center offering night care may serve no more than 20 children at any one time between 6:00 p.m. and 6:00 a.m. unless the building is equipped with emergency lighting supplied by a stand-by power source. (a) In consultation with parents, special attention shall be given by the caregiver to provide for a transition into night care; (b) A selection of developmentally appropriate toys for quiet activities shall be available; (c) Comfortable cribs, beds or cots, complete bedding and night clothes shall be available or supplied by the parents; (d) Cribs or beds shall be placed at least three feet apart; (e) Staff shall be available to assist the infants and toddlers, as required by their age and developmental level, during eating and pre-bedtime hours and during the morning period when dressing; (f) During sleeping hours, staff shall be within hearing distance to provide for the needs of infants and toddlers and to respond immediately in emergency; (g) An infant or toddler shall not sleep in a building detached from the main facility; and (h) Night care facilities shall include at least one shower, bathtub, or bathing facility for the infants and toddlers. (i) An infant and toddler child care center offering night care shall meet the requirements of this subchapter and the following additional requirements: (1) When the same premises is used for the operation of both day care and night care for infants and toddlers, the number of children during any overlapping of the day care and night care periods © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 131 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS may not exceed the maximum licensed capacity of the center. (2) Minimum staff-to-child ratios and group sizes as specified in § 55-40.1-226 Staff-Child Ratio shall be maintained during night care. (3) All child care workers on duty shall remain awake, available, within call and able to respond to the needs of the children during night care. During sleeping hours, staff shall be within listening distance to provide for the needs of children and to respond to an emergency. (4) Staff shall be available to assist children during eating and pre-bedtime hours and during the morning period when dressing. (5) There shall be a night light or other mechanism to illuminate hallways leading to stairs and/or the restroom. (6) Each child shall have individual toilet articles such as comb, toothbrush, towel, and washcloth. (j) No child under 5 years of age is to be left unattended while in the bathtub. (k) Health care routines at bedtime and/or upon rising shall include: (1) Brushing teeth at bedtime and upon rising. (2) Brushing or combing the hair upon rising. (3) Establishing a routine for toileting at bedtime and upon rising. (l) The infant and toddler child care center shall serve meals and snacks that supplement food served at home: (1) An evening meal that meets nutritional requirements shall be served at a regular time each evening and shall be available to children who may arrive without having first eaten; (2) A bedtime snack shall be served, unless contraindicated by parents or physician; and (3) Children who remain overnight and go to school directly from the day care home shall have breakfast, including juice or fruit, unless they are receiving breakfast at school. (m) Doors in rooms where children are sleeping shall remain open; (n) Program (1) Child care staff shall work with a child’s parent to coordinate how the child spends his or her time during night care at the infant and toddler child care center with the family’s schedule. (2) An infant and toddler child care center offering night care shall provide a self-contained room away from sleeping children where an awake child can engage in activities. (3) An evening and morning schedule of program activities shall be planned for the hours that children in night care are awake. (o) Preventive Measures (1) Child care workers shall be given training in techniques of evacuating sleeping children in an emergency during orientation to the job. (2) Infant and toddler child care centers operating during hours of darkness shall provide emergency lighting, such as an operable flashlight, for each self-contained room used by children. (3) Fire evacuation drills shall be practiced during night care hours at least 2 times per year. (p) Feeding (1) Breakfast shall be served to all children in care for the night, unless the parent specifies © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 132 of 133

TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS otherwise. (2) A nighttime snack shall be available to all children in care. (3) A child present at the time the evening meal is served shall be served the evening meal. (q) Sleep (1) Children who attend the infant and toddler child care center for the evening hours but not the whole night shall have an opportunity to sleep, as needed. (2) Sleep routines for individual children shall be based on information provided by the parents. (3) A bed, crib or cot with sheets and blankets or a sleeping bag, individual to each child, shall be provided in night care. (4) The infant and toddler child care center shall maintain a supply of extra sleeping garments and bedding for emergencies and accidents. (5) Children under 2 years of age in night care shall sleep in cribs. (6) Safe and sleep practices must be adhered to as defined in § 55-40.1-420 Program, Activities, Materials and Equipment, Section (m)(1-4). History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025); Adopted 25 Com. Reg. 20861 (Aug. 22, 2003); Proposed 25 Com. Reg. 20134 (May 29, 2003). § 55-40.1-476 Program Modification for Emergency Child Care (a) All requirements set forth in this section shall be met by the facility. Childcare providers offering emergency child care or back-up care are subject to the same licensing requirements as set forth in Part 200. (b) Licensed child care providers may offer an emergency child care or back-up day care where and when it is needed as a substitute childcare plan. Working parents and employers may need an emergency child care or back-up day care due to situations such as school vacation and holiday breaks, inclement weather, in-service days, emergency or unexpected event. (c) If an infant and toddler child care center serve both emergency child care or back-up day care and children who attend regularly, the grouping of the children and the program shall be planned so that the needs of both groups are met. (d) The infant and toddler child care center shall have the following information in writing: (1) The ages of children accepted for emergency child care services or back-up care; (2) The procedures for admittance and release of children; and (3) Arrangements for staffing and activities for children receiving emergency child care services or back-up care. History: Adopted 47 Com. Reg. 52163 (July 15, 2025); Proposed 47 Com. Reg. 52321 (June 15, 2025). © 2025 by The Commonwealth Law Revision Commission (July 15, 2025) Page 133 of 133

Source: CNMI Law Revision Commission

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TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS

Chapter 40.1. TITLE 55: DEPARTMENT OF COMMUNITY AND CULTURAL AFFAIRS

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