Child care centers: Health and safety topics

By the first date of attendance, the center must obtain documentation of a child’s current immunization information according to Minnesota Statutes, section 121A.15. Each child two months of age and older must be appropriately immunized against certain diseases or have a medical or non-medical exemption.

The Minnesota Department of Health (MDH) has a website, Child Care Provider Information for Minnesota’s Immunization Law, where providers can find additional information including fact sheets, resources, and tips. See Are Your Kids Ready? Child Care and Early Childhood Programs Immunization Law (PDF) (Updated 8/16/24) Use this document to see what vaccines are required for children to enroll in child care and early childhood programs in Minnesota, and to document medical and non-medical exemptions.

Additional resources:

• The Docket app from the Minnesota Department of Health provides an option for parents to securely access their children's immunization history by downloading the app and creating an account. Parents will need to download a PDF of the immunization record and print to give to the licensed center.
• Licensed child care centers can access MIIC directly to look up immunization records. Contact the MIIC Help Desk at 651-201-5207 for assistance, or go to MIIC and Child Care Resources.
• Licensed child care centers need to complete the Child Care Annual Immunization Status Report (AISR). Go to Child Care Providers Immunization Reporting for more information.

Legal authority: Minn. Rule 9503.0125, Minn. Rule 9503.0140, subpart 5 and Minn. Stat. 121A.15, subd. 1

• Monthly Crib Safety Inspection (PDF)
• Optional Form for Parent Statement: Infant Less Than Six Months of Age Regularly Rolling Over (DHS-7219) (PDF)
• Swaddling Consent for an Infant (DHS-7218) (PDF) 
• Directive for Alternative Infant Sleep Position (DHS-7216) (PDF)
• Helmet Approval for Sleeping Infant (DHS-8531) (PDF)

The Department of Human Services (DHS) may grant a variance within the Provider Hub to a license holder to permit the use of a cradleboard in a licensed setting, when requested by a parent or guardian for a cultural accommodation, pursuant to Minnesota Statutes, section 245A.1435 (g) and Minnesota Statutes, section 245A.16, subd. 1 (a) (9).

• Parent Cradleboard Request and Monthly Cradleboard Check Form (DHS-8536) (PDF)

When a license holder admits a child with special needs, the licensed child care center must ensure that an individual child care program plan is developed to meet the child’s individual needs. The individual child care program plan must be reviewed and followed by all staff who interact with the child. The DHS licensing Individual Child Care Program Plan (ICCPP) is an interactive form that can be used by child care centers to meet and document these requirements. For additional information on the requirements associated with enrolling a child with special needs, centers should review Minn. Rule 9503.0065, subp. 3.

Legal authority: Minn. Rule 9503.0065, subp. 3

Before admitting a child for care, the center must obtain documentation of any known allergy from the child's parent or legal guardian or the child's source of medical care. If a child has a known allergy, the center must maintain current information about the allergy in the child's record and develop an individual child care program plan as specified in Minnesota Rules, part 9503.0065, subpart 3. The DHS licensing Individual Child Care Program Plan (ICCPP) can be used by child care centers to meet these requirements.

To comply, providers must:

• Create a policy for preventing and responding to allergies that complies with the requirements. It is recommended you work with your health consultant when creating this policy.
• Train all staff on your allergy policy during orientation training and at least once per calendar year. Training must be documented in each staff person’s personnel file.
• For each child with a known allergy, maintain current allergy information in the child's record and develop an individual child care program plan as required under Minnesota Rules, part 9503.0065, subpart 3. The individual child care program plan must include but not be limited to a description of the allergy, specific triggers, avoidance techniques, symptoms of an allergic reaction, and procedures for responding to an allergic reaction, including medication, dosages, and a doctor's contact information.
• Ensure that each staff person who is responsible for carrying out an individual child care program plan for a child with a known allergy reviews and follows the plan. Maintain documentation of each staff person's review of the individual child care program plan on site.
• At least once each calendar year, review the child's individual child care program plan, update if needed, and train each staff person who is responsible for carrying out the plan. This documentation must be kept onsite.
• Following any changes made to the child's individual child care program plan, inform each staff person who is responsible for carrying out the plan of the change. This documentation must be kept onsite.
• Ensure that a child's allergy information be available at all times including on site, when on field trips, or during transportation. A child's food allergy information must be readily available to a staff person in the area where food is prepared and served to the child.
• Contact the child's parent or legal guardian as soon as possible in any instance of exposure or allergic reaction that requires medication or medical intervention. Call emergency medical services when epinephrine is administered to a child in the center’s care.

Legal authority: Minn. Stat. 245A.41, subd. 1

Centers must have an emergency preparedness plan for emergencies that require evacuation, sheltering, and other protection of children. The plan must be written on a Child Care Emergency Plan PDF form developed by the commissioner and updated at least annually. Keeping Kids Safe DHS-7414 (PDF) includes detailed emergency planning resources for licensed child care centers.

Licensed centers must conduct monthly fire drills and document the time and date of the drills. Licensed centers must also conduct monthly tornado drills from April to September and document the time and date of the drills. DHS has created the Licensed Child Care Center Drill Log form DHS-8339 that centers may use to document required drills.

Legal Authority: Minn. Stat. 245A.41, subd. 3 and Minn. Rule 9503.0110, subp. 3

Centers must develop a risk reduction plan as specified in Minnesota Statutes, section 245A.66, subdivision 2 that identifies the general risks to children served by the center with a plan to minimize those risks. Centers may use the DHS Risk Reduction Plan form to meet this requirement. 

In addition to current requirements for first aid and safety policies and diapering procedures, centers must meet requirements for handling and disposing of potentially infectious bodily fluids, such as blood and vomit.

The licensed child care center must comply with the following procedures for safely handling and disposing of bodily fluids:

• Surfaces that come in contact with potentially infectious bodily fluids, including blood and vomit, must be cleaned and treated to reduce microorganism contamination after an object has been cleaned. Disinfection must be done by rinsing or wiping with a solution of one-fourth cup chlorine bleach plus water to equal one gallon, or an equivalent product or process approved by your health care consultant.
• Blood-contaminated material must be disposed of in a plastic bag with a secure tie.
• Sharp items used for a child with special care needs must be disposed of in a "sharps container." The sharps container must be stored out of reach of a child.
• The license holder must have the following bodily fluid disposal supplies in the center: disposable gloves, disposal bags, and eye protection and
• The license holder must ensure that each staff person follows universal precautions to reduce the risk of spreading infectious disease.

Legal authority: Minn. Stat. 245A.41, Subd. 2; Minn. Rules 9503.0005, subp. 11 

By law, a number of infectious diseases must be reported to the Minnesota Department of Health. Learn more about what to report and the methods for reporting.

For purposes of licensed child care centers, "supervision" means when a program staff person:

• Is accountable for the child's care.
• Can intervene to protect the health and safety of the child and
• Is within sight and hearing of the child at all times except as described in the following situations.
  • When an infant is placed in a crib room to sleep, supervision occurs when a program staff person is within sight or hearing of the infant. When supervision of a crib room is provided by sight or hearing, the center must have a plan to address the other supervision components.
  • When a single school-age child uses the restroom within the licensed space, supervision occurs when a program staff person has knowledge of the child's activity and location and checks on the child at least every five minutes. When a school-age child uses the restroom outside the licensed space, including but not limited to field trips, supervision occurs when staff accompany children to the restroom.
  • When a school-age child leaves the classroom but remains within the licensed space to deliver or retrieve items from the child's personal storage space, supervision occurs when a program staff person has knowledge of the child's activity and location and checks on the child at least every five minutes.
  • When a single preschooler uses an individual, private restroom within the classroom with the door closed, supervision occurs when a program staff person has knowledge of the child’s activity and location, can hear the child, and checks on the child at least every five minutes.

Legal Authority: Minn. Stat. 245A.02, subd. 18

Centers must allow an enrolled child’s parent or legal guardian access to their child at any time while the child is in care. This is in addition to the requirement to allow parents or legal guardians of enrolled children to visit the center any time during the hours of operation as specified in Minnesota Rules, part 9503.0095.

Legal authority: Minn. Stat. 245A. 14, subd. 15

Centers must use the fillable form Child Care Center Serious Injury and Death Reporting Form (PDF) to report any serious injury or death of a child in care.

The PDF version (when opened in Internet Explorer) is the preferred version for centers to use since it will automatically create an email and attach the completed form once the submit button is clicked. If you are unable to open in Internet Explorer or you need to use the Word DOC version, you will have to manually attach the completed form to the email before sending.

A serious injury is an injury that requires treatment by a physician or dentist. This means that if a child sees a physician or dentist for evaluation of an injury, but no treatment is given, the injury does not meet the definition of serious and does not need to be reported to DHS. Treatment does not include application of or recommendation to use nonprescription medication or diagnostic testing (such as x-rays).

For additional information on other child care center reporting requirements, please see Minnesota Rules, part 9503.0130.  The Child Care Center Serious Injury & Death Reporting Form is to be used for reporting serious injuries and deaths only.  Other types of information required to be reported to DHS under 9503.0130 can be done by submitting your center-specific form by email or fax, by calling the center’s assigned licensor or by calling the main Licensing Division number at 651-431-6500.

Each licensed child care center is required to have a health consultant to review all of the center’s health policies and practices. A health consultant is a physician, public health nurse, or registered nurse.

The center must have a health consultant review the center's health policies and practices and certify that they are adequate to protect the health of children in care.

The review must be done before initial licensure, submitted with the application for initial licensure and repeated every year after the date of initial licensure. For programs serving infants, this review must be done initially and monthly thereafter. Additionally, the license holder must request a review by the health consultant of the center's health policies and practices if there is a proposed change in the center's health policies or practices or an outbreak of contagious reportable illness. A copy of the consultant's findings must be placed in the center's administrative record.

Legal Authority: Minn. Rule 9503.0140 subp. 2

Minnesota Department of Health has created an optional guidance document for professionals, providers, and others working with children in schools and child care settings, Minnesota Outdoor Air Quality Guidance for Schools and Child Care. The goal of the outdoor guidance is to lower the risk of negative impacts to children’s health due to poor air quality events.