1 105 CMR 430.pdf

105 CMR: DEPARTMENT OF PUBLIC HEALTH

105 CMR 430.000: MINIMUM STANDARDS FOR RECREATIONAL CAMPS FOR CHILDREN

(STATE SANITARY CODE, CHAPTER IV)

Section

430.001: Purpose 430.010: Scope 430.020: Definitions 430.050: License Required 430.090: Background Information 430.091: Orientation and Training 430.093: Prevention of Abuse and Neglect 430.100: Camp Counselor and Junior Counselor Requirements 430.101: Required Ratio of Counselors to Campers 430.102: Camp Director Requirements 430.103: Supervision and Operation of Specialized High Risk Activities 430.140: Medical Waste 430.145: Maintenance of Records 430.150: Health Records 430.151: Physical Examinations by Physician and Certificate of Immunization 430.152: Required Immunizations 430.153: Physical Examination or Immunization Exemptions 430.154: Injury and Incident Reports 430.155: Medical Log 430.156: Availability of Health Records and Logs 430.157: Communicable Disease Reporting and Parental Education Requirements 430.159: Health Care Staff to Be Provided 430.160: Storage and Administration of Medication 430.161: Emergency/Medical Facilities and Equipment 430.162: Personal Hygiene and Laundry 430.163: Protection from the Sun 430.165: Tobacco Use 430.166: Alcohol and Recreational Marijuana Use 430.190: General Program Requirements 430.191: Requirements for Discipline 430.201: Riflery Program Requirements 430.202: Archery Program Requirements 430.203: Personal Weapons Restricted 430.204: Waterfront and Boating Program Requirements 430.205: Crafts Equipment 430.206: Playground, Athletic Equipment and Facilities Requirements 430.207: Storage and Operation of Power Equipment 430.208: Horseback Riding Program Requirements 430.209: Telephones Required 430.210: Plans Required to Deal with Natural Disasters or Other Emergencies (Residential and

Day Camps) 430.211: Special Contingency Plans for Day Camps 430.212: Field Trips 430.213: Emergency Communication System Required 430.214: Storage of Hazardous Materials 430.215: Fire Prevention 430.216: Smoke and Carbon Monoxide Detectors Required 430.217: Requirements for Tents 430.250: Vehicle Requirements 430.251: Transportation Safety 430.252: Qualifications of Driver 430.253: Automobile Insurance 430.300: Potable Water Required 430.301: Installation and Maintenance of Plumbing 430.302: Cross Connections Prohibited 430.304: Common Drinking Cup Prohibited

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(Mass. Register #1516, 3/1/2024)

Section: continued

430.320: Food Service - Compliance with 105 CMR 590.000: State Sanitary Code, Chapter X -

Minimum Sanitation Standards for Food Establishments, Required 430.321: Special Provisions for Primitive, Travel and Trip Camps 430.330: Nutritious Meals to Be Served 430.331: Minimum Daily Food Requirements for Residential, Travel, or Trip Camps 430.332: Minimum Daily Food Requirements for Day Camps 430.333: Therapeutic Diets 430.334: Feeding 430.335: Meals Provided from Home 430.350: Facilities for Solid Waste Storage 430.355: Final Disposal of Solid Wastes 430.360: Sewage Disposal 430.370: Toilet Facilities Required 430.371: Urinals May Be Substituted 430.372: Hygiene Supplies at Toilet and Handwashing Facilities 430.373: Handwashing Facilities 430.374: Bathing Facilities 430.375: Ventilation Required 430.376: Hot Water Temperatures 430.377: Maintenance of Sanitary Facilities 430.378: Toilet Facilities for Campers with Special Needs 430.379: Handwash Facilities for Campers with Special Needs 430.380: Shower Facilities for Campers with Special Needs 430.400: Rodent and Insect Control - Residential and Day Camps 430.401: Weed Control - Residential and Day Camps 430.430: Swimming Pools - Compliance with 105 CMR 435.000: Minimum Standards for Swimming

Pools (State Sanitary Code, Chapter V), Required 430.432: Bathing Beaches - Compliance with 105 CMR 445.000: Minimum Standards for Bathing

Beaches (State Sanitary Code, Chapter VII), Required 430.450: Site Location 430.451: Certificate of Inspection Required 430.452: Screening Required 430.453: Lighting Required 430.454: Structural and Interior Maintenance 430.456: Egresses 430.457: Shelters for Day Camps 430.458: Shelters for Residential Camps 430.459: Non-ambulatory Campers 430.470: Separate Beds to Be Furnished 430.471: Sleeping Prohibited in Food Areas 430.472: All Bedding and Towels to Be Cleaned 430.631: Application for a License 430.632: Board of Health Shall Grant, Suspend or Revoke License; Annual Notification 430.633: Posting of License 430.650: Inspections Required 430.651: Inspection Report Forms 430.700: Orders to Correct Violations 430.701: Violation Which May Endanger or Materially Impair the Health, Safety or Well-Being of the

Public 430.702: Contents of Order 430.703: Service of Orders 430.730: Request for Hearing 430.731: Hearing to Be Held 430.732: Decision of Board of Health 430.733: Public Record 430.734: Appeal of the Board of Health Decision 430.735: Compliance 430.750: Operation without License 430.751: Failure to Comply with Order of the Board of Health

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Section: continued

430.752: Failure to Comply with Provisions of 105 CMR 430.000 430.800: Board of Health May Grant Variance 430.830: Severability

430.001: Purpose

The purpose of 105 CMR 430.000 is to provide minimum standards for housing, health, safety and sanitary conditions for minors attending recreational camps for children in the Commonwealth.

430.010: Scope

(A) No person, corporation, trust, authority, government agency, political subdivision or any other entity shall operate a recreational camp for children in the Commonwealth which does not comply with the requirements of 105 CMR 430.000.

(B) Child care programs licensed by the Department of Early Education and Care (EEC) in accordance with M.G.L. c. 15D operating in their EEC licensed space as a summer camp shall not be required to comply with 105 CMR 430.000, provided no specialized high risk activities are offered unless approved in writing by the Department and conducted in accordance with the requirements in 105 CMR 430.000 related to such activity.

(C) Provided it is not promoted or advertised as a camp, none of the following shall be required to comply with 105 CMR 430.000:

(1) single purpose classes, workshops, clinics or programs sponsored by municipal recreation departments, or neighborhood playgrounds designed to serve primary play interests and needs of children, as well as affording limited recreation opportunities for all people of a residential neighborhood, whether supervised or unsupervised, located on municipal on non-municipal property, whether registration is required or participation is on a drop-in basis as provided in M.G.L. c. 111, § 127A;

(2) a program operated solely on a drop-in basis;

(3) a classroom-based instructional program provided no specialized high risk activities (see

105 CMR 430.103) are conducted as part of the program; and

(4) a summer school program accredited by a recognized educational accreditation agency, where the accreditation includes standards for specialized high risk activities, if the program involves such activities (see 105 CMR 430.103), and the summer program meets those accreditation standards.

430.020: Definitions

Age means the age of a person on the day a camp session begins.

Aquatic Activity means any recreational activity occurring in water at a bathing beach, swimming pool, lake, pond, river, ocean, or other natural bodies of water including, but not limited to, swimming, diving, water-skiing, wakeboarding, windsurfing, sailing, and the use of paddle sport watercrafts or motor-powered boats.

Aquatics Director means a trained water safety professional with current certifications as a lifeguard who has responsibility for supervising aquatic activities. The aquatics director shall be at least 21 years old and have experience in a management or supervisory position at a similar aquatics area of at least six weeks duration.

Bathing Beach means the land where access to the bathing water is provided pursuant to 105 CMR 445.000: Minimum Standards for Bathing Beaches (State Sanitary Code, Chapter VII). For the purposes of 105 CMR 430.000, Bathing Beaches shall not include swimming pools, wading pools and other artificial bodies of water.

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430.020: continued

Board of Health means a municipal board of health, a municipal health department, a regional health district, or any other legally constituted city, town, or county governmental unit within the Commonwealth serving as a public health agency, as established under M.G.L c. 41, § 1, or M.G.L. c. 111, §§ 26, 26A, 27A, or 27B, or its authorized agent or representative under M.G.L. c. 111, § 30. Board of Health shall also mean an inspectional services department in a city or town where the inspectional services department is responsible for the enforcement of 105 CMR 430.000. In any case in which a camp extends into the geographic jurisdiction of two or more boards, those boards may coordinate activities in effecting compliance with 105 CMR 430.000.

Camp Director means an individual who has primary and direct responsibility for the day to day operation and supervision of a recreational camp for children including oversight of program operations, supportive services, business affairs, health matters, food, staff supervision and transportation.

Camper means a child who attends a recreational camp for children, including Counselors-in- Training.

Certificate of Immunization shall mean either:

(1) any form or letter signed and dated by a physician or designee, or

(2) a dated report from the Massachusetts Immunization Information System;

provided that either document specifies the month and year of administration and the type/name of the vaccines(s) administered to the camper or staff person, or alternative evidence of immunity.

Child and Children means individuals who are younger than 18 years old.

Counselor means an individual who supervises campers and who may have exclusive responsibility for campers.

Counselor-in-Training means a camper who is training to become a counselor.

CPR Certificate means a current certification in cardiopulmonary resuscitation (CPR) applicable to the age groups at the camp issued by one of the following training programs that incorporate a hands-on practical test:

(1) the American Red Cross CPR Certificate for the Professional Rescuer;

(2) American Heart Association CPR Certificate for Health Care Provider;

(3) National Safety Council CPR Training;

(4) Health and Safety Institute Basic Life Support; or

(5) any equivalent CPR training recognized in writing by the Department.

Day Camp means a program which:

(1) operates on a site for more than two hours but less than 24 hours a day;

(2) operates for at least four days during a 14 consecutive day period in a city or town; and

(3) meets the definition of a recreational camp for children.

Department means the Massachusetts Department of Public Health.

Direct Supervision means oversight of an individual authorized under 105 CMR 430.159(F) in a medical specialty camp by a licensed healthcare provider listed in 105 CMR 430.159(E) who is present on the camp property and readily available to furnish assistance and direction throughout the course of administration of medications.

First Aid Certificate means a current certification in first aid applicable to the age groups at the camp issued by one of the following training programs:

(1) American Red Cross Standard First Aid Certificate;

(2) National Safety Council Standard First Aid;

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(3) Health and Safety Institute Basic First Aid; or

(4) An equivalent certification recognized in writing by the Department.

Garbage means the animal, vegetable or other organic waste resulting from the handling, preparing, cooking, consumption or cultivation of food, and containers and cans which have contained food unless such containers and cans have been cleaned or prepared for recycling.

Habitation means a portion inside a building, tent, or other structure which is used for living, sleeping, cooking, or consumption of food.

Health Care Consultant means a Massachusetts licensed physician, certified nurse practitioner, or physician assistant.

Health Care Supervisor means a person on the staff of a recreational camp for children who is 18 years of age or older and who is responsible for the day to day operation of the health program or component. The Health Care Supervisor shall be a Massachusetts licensed physician, physician assistant, nurse, or other person specially trained in accordance with 105 CMR 430.160 and has a current CPR and First Aid certificate.

Junior Counselor means an individual who assists counselors in the performance of their duties, but who does not have exclusive responsibility for supervising campers.

Lifeguard means a trained water safety professional who is at least 16 years old and holds the following current certifications:

(1) One of the following lifeguard training programs:

(a) An American Red Cross Lifeguard Training Certificate; or

(b) Lifesaving Society of Canada National Lifeguard Service; or

(c) Boy Scouts of America Lifeguard Certificate; or

(d) National YMCA Lifeguard Certificate; or

(e) Ellis and Associates International Lifeguard Training Program; or

(f) An equivalent certification, approved in writing by the Department, that contains all of the minimum requirements of one or more of the foregoing certification courses; and

(2) A CPR Certificate; and

(3) First Aid Certificate.

Medical Specialty Camp means a camp with a primary purpose to provide programs for campers with special medical or health needs.

Mild Disability means a condition in which a person can function on his or her own in providing total self-care but needs assistance in other camp activities.

Operator means any person who:

(1) alone or jointly with others owns a recreational camp for children; or

(2) has care, charge or control of a recreational camp for children as agent or lessee of the owner or as an independent contractor; or

(3) is the camp director.

Person or Entity means an individual or his or her estate upon his or her death, or a corporation, a government agency, a partnership, a trust, an association, or an organized group of persons, whether incorporated or not, or any receiver, trustee, or other liquidating agent of any of the foregoing while acting in such capacity.

Primitive or Outpost Camp means a portion of the permanent camp premises or other site at which the basic needs for camp operation such as places of abode, water supply systems and permanent toilet and cooking facilities may not be provided.

Qualified Dietitian means a person who is eligible for registration by the American Dietetic Association or has at least a baccalaureate degree in food and nutrition, dietetics, or food service management.

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Recreational Camp for Children means:

(1) any day, primitive or outpost, residential, sports, travel or trip camp conducted wholly or in part for recreation or recreational instruction which:

(a) operates for profit or philanthropic or charitable purposes, whether or not a fee is charged; and

(b) serves five or more children who are not members of the family or personal guests of the operator; and

(c) operates for any period of time between June 1st and September 30th of any year or fewer than 15 business days during any other time of the year; or

(2) any person, entity, or program that promotes or advertises itself as a camp, even if it does not meet the criteria listed above.

Residential Camp means a program which:

(1) meets the definition of a recreational camp for children;

(2) operates on a permanent site for three or more consecutive overnights; and

(3) operates for at least four days during a 14 consecutive calendar day period in a city or town.

Rubbish means waste materials including, but not limited to, such material as paper, rags, cartons, boxes, wood, rubber, leather, tin cans, metals, machine or machine parts, mineral matter, glass, plastic bags and containers, crockery, dust and the residue from the burning of wood, coal, coke, and other combustible materials. Rubbish does not include garbage, yard waste, recyclable material, or bulk items.

Severe Disability means a condition in which a person needs assistance in self-care and camp activities.

Specialized High Risk Activities means those activities posing an inherent risk of serious injury or death due to the nature of the activity regardless of reasonable precautions and supervision.

Such activities present an increased risk to health and safety beyond the routine risk of exercising and being active in various weather conditions. Specialized high risk activities shall include, but not limited to, horseback riding, hiking, scuba diving, rock climbing, firearms, archery, challenge courses, climbing walls, and aquatic activities as defined in 105 CMR 430.020.

Sports means athletic activities including, but not limited to, football, soccer, dance, baseball, gymnastics, swimming, horseback riding, tennis, skating and basketball.

Sports Camp means a program which:

(1) meets the definition of a recreational camp for children;

(2) has a primary focus on one or more sports activities;

(3) operates on a site for more than two hours but less than 24 hours a day; and

(4) operates for at least four days during a 14 consecutive calendar day period in a city or town.

Staff means any person employed by a recreational camp for children, not including a volunteer, who:

(1) is or may be present at any time at the camp when campers are present and is in the service of the camp under any contract of hire, express or implied, oral or written, where the camp operator has the power or right to control and direct the person in the material details of how their work is to be performed; and

(2) is paid directly by the camp operator. This does not include any person at the camp performing contracted services (e.g., delivery person, maintenance staff, bus driver, or third party vendors) while under the supervision of the camp operator or their designee.

Stairway means any group of stairs having three or more risers.

Swimming and Diving Areas means aquatic facilities and operations generally known as swimming pools, wading pools, diving tanks, beaches, rivers, lakes, other natural bodies of water and similar areas and facilities.

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Swimming Pool means a public or semi-public artificial pool of water having a depth of two feet or more at any point and used for swimming or bathing, located indoors or outdoors, and permitted as a swimming pool by the Board of Health in accordance with 105 CMR 435.000:

Minimum Standards for Swimming Pools (State Sanitary Code, Chapter V).

Tent means any structure of which 25% or more of the roof or walls or both are constructed of canvas, or covered or protected by any fabric material.

Travel Camp means a program which provides care for not less than a 72-hour period, uses motorized transportation to move campers as a group from one site to another and meets the definition of a recreational camp for children.

Trip Camp means a program which provides care for not less than a 72-hour period, moves campers under their own power or by a transportation mode permitting individual guidance of a vessel, vehicle or animal from one site to another and meets the definition of a recreational camp for children. Trip Camp includes, for example, a program which leads campers by bicycle, canoe or horseback from one site to another.

Volunteer means any person who performs services in an unpaid capacity at a recreational camp for children.

430.050: License Required

No recreational camp for children shall operate without a license from the Board of Health.

Any person or program that promotes or advertises itself as a camp, even if it does not meet the criteria of a Recreational Camp for Children as defined within 105 CMR 430.020, must be licensed as a recreational camp for children prior to operating.

430.090: Background Information

(A) The operator shall develop and follow written procedures for the review of the background of each staff person and volunteer.

(B) Each staff person and volunteer shall have a background free of conduct that bears adversely upon his or her ability to provide for the safety and well-being of the campers. The operator shall determine whether each staff person’s and volunteer’s conduct, criminal or otherwise, shall disqualify that person from employment or service at the camp. In making this determination, the operator shall consider at a minimum information required under 105 CMR 430.090(C) and (D).

(C) At a minimum the operator shall require for each camping season the following with regard to each staff person:

(1) Prior work history, including name, address and phone number of a contact person at each place of employment for the previous five years, and

(2) Three positive reference checks from individuals not related to the staff person including, but not limited to, previous employers or school administrators. Returning staff persons may use prior references on record with the camp provided if there is a gap in employment with the camp for one or more camp seasons, new references shall be required.

(3) Inquiry by the operator into each staff person’s prior criminal history. Such inquiry shall include, at a minimum, a criminal history inquiry as indicated:

(a) The operator shall obtain a sex offender registry information check from the Massachusetts Sex Offenders Registry Board for all prospective staff. International staff entering the country pursuant to a visa and who have not previously been in the United States are exempt.

(b) In accordance with M.G.L. c. 6, § 172G, operators shall obtain a CORI/Juvenile Report from the Department of Criminal Justice Information Services for all prospective staff.

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430.090: continued

(c) For prospective staff whose permanent residence is not Massachusetts (out of state and international), the operator, where practicable, shall also obtain from the applicant’s state criminal information system, local chief of police, or other local authority with access to relevant information, a criminal record check or its nationally recognized equivalent (e.g., biometric data).

(d) If there is no interruption in the staff person’s employment by the camp or organization operating the camp from the time of the initial background check, a new criminal or sex offender history is required at a minimum every three years. This applies only to permanent employees of the same camp or organization operating the camp. Any break in employment service requires a new criminal history and sex offender inquiry for the staff person.

(D) At a minimum, the operator shall require for each camping season the following with regard to each volunteer:

(1) Prior work or volunteer history, including name, address and phone number of a contact person at each place of employment or volunteer service for the previous five years.

(2) A sex offender registry information check from the Massachusetts Sex Offenders Registry Board.

(3) In accordance with M.G.L. c. 6, § 172G, operators shall obtain a CORI/Juvenile Report from the Department of Criminal Justice Information Services.

(E) The operator shall maintain written documentation verifying the background and character of each staff person and volunteer for three years, or as required by M.G.L. c. 149, § 52C, if applicable.

(F) No person shall be employed or allowed to volunteer at a recreational camp for children until such time as the operator is in receipt of, reviews and makes a determination with regard to all background information required pursuant to 105 CMR 430.090(C) and (D).

430.091: Orientation and Training

(A) The operator shall provide orientation and training for all counselors, junior counselors, and other applicable camp staff and volunteers. The operator shall describe, in writing, the camp's plan for orientation including at a minimum the camp's organization, policies and procedures.

Training shall include anynecessary training specific to overseeing certain camp activities or any specialized training to meet the needs of campers with unique physical or behavioral needs, as applicable. The operator shall provide each staff member and volunteer a copy of the health care policy and shall train staff and volunteers in the program's infection control procedures and implementation of the policy during orientation.

(B) As part of the orientation, all counselors, junior counselors, and other staff and volunteers shall complete one annual online head injury safety training program, such as the Centers for Disease Control and Prevention's "Heads-Up" training, National Federation of State High School Associations Concussion in Sports, or an equivalent training approved in writing by the Department.

(C) The operator shall not assign any person to be responsible for a group of children nor utilize any staff or volunteer to supervise others until such person has received the minimum orientation described in 105 CMR 430.091.

(D) The operator shall maintain documentation of specific training components and attendance records for such trainings in accordance with 105 CMR 430.145.

430.093: Prevention of Abuse and Neglect

(A) The operator shall have written policies and procedures in place to protect campers from both abuse and neglect (as defined in 110 CMR 2.00: Glossary) while in the camp’s care and custody.

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430.093: continued

(B) The operator shall develop and follow written procedures for reporting of any suspected incidents of child abuse or neglect in accordance with procedures described in M.G.L. c. 119, § 51A. The procedures shall include:

(1) All staff shall immediately report any suspected child abuse or neglect. The report shall be made either to the Massachusetts Department of Children and Families or its successor, or to the camp director.

(2) The camp director shall immediately report suspected abuse or neglect to the Massachusetts Department of Children and Families, or its successor.

(3) The camp director shall notify in writing the Department and the Board of Health if a report is filed pursuant to M.G.L. c. 119, § 51A alleging abuse or neglect of a child while in the care of the recreational camp for children or during a program-related activity. The report filed pursuant to M.G.L. c. 119, § 51A itself shall not be forwarded to the Department or Board of Health.

(C) The operator shall cooperate in all official investigations of abuse or neglect, including identifying parents of campers currently or previously enrolled in the camp who may have been in contact with the subject of the investigation.

(D) The operator shall ensure an allegedly abusive or neglectful staff person shall not have any unsupervised contact with campers until the Massachusetts Department of Children and Families investigation is completed.

430.100: Camp Counselor and Junior Counselor Requirements

(A) Each counselor in a recreational camp for children shall:

(1) have at least four weeks experience as a junior counselor, have participated in structured group camping, or have at least four weeks experience in a supervisory role with children;

and

(2) have satisfactorily completed a camp counselor orientation and training program as specified in 105 CMR 430.091 prior to the arrival of campers.

(B) Each junior counselor in a recreational camp for children shall have satisfactorilycompleted a junior counselor orientation program prior to the arrival of campers.

(C) The age of counselors shall be as follows:

(1) in residential, primitive, sports, travel, trip and medical specialty camps:

(a) counselors shall be 18 years of age or older or have graduated from high school;

(b) junior counselors shall be 16 years of age or older;

(2) in a day camp

(a) counselors shall be 16 years of age or older;

(b) junior counselors shall be 15 years of age or older.

(3) All counselors and junior counselors shall be at least three years older than the campers whom they supervise.

430.101: Required Ratio of Counselors to Campers

Each recreational camp for children shall have the following minimum ratio of counselors to campers:

(A) Residential and Day Camps. Residential, day, and sports camps shall have at least one counselor for every ten campers seven years of age or older and one counselor for every five campers younger than seven years old. To meet these required ratios, counselors shall be within the line of sight or close proximity to campers at all times. Junior counselors may be included in meeting up to 50% of the camper to staff ratio within each unit, living or general activity group, but shall always be under the direct supervision of a counselor. Each residential or day camp serving campers with mild or severe disabilities shall have a staffing plan in place to ensure adequate staffing to supervise children with disabilities.

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430.101: continued

(B) Primitive, Travel and Trip Camps. Each primitive, travel and trip camp shall have at least one counselor for every ten campers, with a minimum of two counselors, one of which shall be at least 21 years old. Each primitive, travel or trip camp serving campers with mild or severe disabilities shall have a staffing plan in place to ensure adequate staffing to supervise children with disabilities.

430.102: Camp Director Requirements

Each recreational camp for children shall have at the camp at all times a director who meets the following:

(A) Residential Camp. Each residential camp shall have a director who is 25 years of age or older and who meets at least one of the following:

(1) Successful completion of a course in camping administration such as those offered by national professional camping associations, national agencies or their equivalent, or

(2) At least two seasons of previous experience working as part of an administrative staff of a recreational camp for children.

(B) Day Camp. Each day camp shall have a director who is 21 years of age or older and who meets at least one of the following:

(1) Successful completion of a course in camping administration such as those offered by national professional camping associations, national agencies, or their equivalent, or

(2) At least two seasons of previous experience working as part of the administrative staff of a recreational camp for children.

(C) Primitive, Travel and Trip Camps. Each primitive, travel and trip camp shall have a director who shall:

(1) Be 25 years of age or older; and

(2) Possess demonstrated proof of experience supervising a recreational camp for children in similar camping activities.

(D) The operator shall inform all staff on duty as to who is responsible for administration of the camp at any given time. In the event of the absence of the director, the director or operator shall appoint a designee who shall be at the camp at all times. The designee shall meet the qualifications as required by 105 CMR 430.102(A), (B) or (C).

430.103: Supervision and Operation of Specialized High Risk Activities

Each recreational camp for children which conducts specialized high risk activities, either on or off-site, including, but not limited to, horseback riding, hiking, scuba diving, rock climbing, firearms, archery, challenge courses, climbing walls, watercraft and aquatic activities, shall conduct such activities only under the supervision of a counselor who has evidence of appropriate training, certification and experience in each activity under their supervision. Said counselor shall be present during periods of specialized high risk activity. All camps that provide on-site aquatics activities shall have an aquatics director. If 50 or more campers are in the water or near the water, the aquatics director must be present to directly supervise the activities and may be one of the on-duty lifeguards. The operator shall make adequate provisions to assure any special training necessary for camp personnel to protect the safety and health of campers with disabilities. Any recreational camp for children that operates specialized high risk activities outside of Massachusetts shall comply with all state and local laws or regulations for such activities in the state or local jurisdiction where the activity is held and ensure that facilities hold any required licenses or permits for the specialized high risk activity where they operate.

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430.103: continued

(A) Swimming. Swimming shall be supervised by one counselor for every ten campers in the water or near the water. For every 25 campers swimming, or portion thereof, there shall also be at least one lifeguard. If swimming activities occur at a location separate from the camp, the camp shall provide supervision by lifeguards as required in 105 CMR 430.103 but is not required to provide an aquatics director. Supervision of swimming, if not provided by camp staff, may be allowed through a contractual agreement between the camp and the owner or operator of the swimming venue to supply dedicated lifeguards at the required ratio of one lifeguard for each 25 campers in or near the water.

(B) Watercraft.

(1) All watercraft activities shall be supervised by a minimum of one counselor for every ten campers in watercraft. For every 25 campers participating in watercraft activity, or portion thereof, one counselor shall be a lifeguard. Each counselor operating or supervising watercraft activities shall have documented in-person participatory training specific to the watercraft activities being overseen.

(2) Each counselor operating or supervising paddle sport watercraft activities shall hold a lifeguard certification or hold certifications in American Red Cross Basic Water Rescue and either American Red Cross Small Craft Safety or the American Canoe Association Paddle Sports course, or an equivalent certification recognized in writing by the Department that demonstrates water rescue procedures specific to the type of water and activities conducted.

(3) Each counselor operating or supervising sailing or motor-powered watercraft activities shall:

(a) obtain a Boater Safety Education Certificate issued by the Commonwealth of Massachusetts or an equivalent recognized in writing by the Department; and

(b) comply with all Federal and Massachusetts Boating Laws including M.G.L. c. 90B, 323 CMR 2.00: Use of Vessels, and 323 CMR 4.00: The Operation of Personal

Watercraft.

(4) All paddle sport watercraft activities carried out on white water regardless of the number of campers, shall have a minimum of two counselors, each in separate watercraft, supervising the activity. All white water activities must be carried out on water determined to be no more difficult than Class III as defined by the International Scale of River Difficulty. No trips shall be taken on unclassified white water. In addition to the certification and training required by 105 CMR 430.103(B)(2), each counselor shall have evidence of previous training and experience with this type of water activity totaling at least six hours on the water. Sailing and motor-powered watercraft activities shall not be conducted in hazardous salt or freshwater conditions.

(5) Campers shall possess at least an American Red Cross Level 4 or higher Program Certificate, or an equivalent recognized by the Department, in swimming proficiency before being allowed to participate in white water paddle sport watercraft activities.

(6) The operator of each recreational camp conducting watercraft activities shall develop a written boating safety plan, in consultation with the Aquatics Director. Such plan shall include procedures for emergencies on the water and unexpected hazardous water conditions.

(C) Scuba Diving. Scuba diving activities shall be supervised by individuals who are currently certified by a national or regional scuba training program such as the YMCA, National Association of Scuba Diving Schools, Professional Association of Diving Instructors, National association of Underwater Instructors, Scuba Schools International, or equivalent program recognized by the Department. All diving activities shall be conducted in accordance with the provisions of M.G.L. c. 90B, § 13A.

(D) Firearms. All firearm activities shall be directly supervised by an individual who possesses a current National Rifle Association Instructor's certification and maintains compliance with M.G.L. c. 140, § 129B - Firearm identification cards; M.G.L. c. 140, § 129C(m) - Exemption for instruction, or M.G.L. c. 140, § 131 - Licenses to carry firearms, as applicable. A ratio of one counselor for every ten campers on the range shall be maintained at all times. This ratio may include the instructor.

(E) Archery. A ratio of one counselor for every ten campers shall be maintained on the archery range at all times.

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430.103: continued

(F) Horseback Riding. All riding instructors used by a recreational camp for children whether staff of the camp or of another facility used by the camp, shall be licensed in accordance with M.G.L. c. 128, § 2A.

(G) Challenge Course or Climbing Wall. Camps that either operate or use challenge courses or climbing walls shall:

(1) Obtain documentation that any challenge course or climbing wall located in Massachusetts is licensed and maintained pursuant to 520 CMR 5.00: Amusement Devices;

(2) Comply with the following requirements of American Camp Association Accreditation

Process Guide:

(a) at least an annual inspection by qualified personnel to ensure the integrity of the hardware, material and equipment for each element of the challenge course, climbing wall or other apparatus; and

(b) a written report of such inspection(s) including recommendations concerning the safety of the challenge course or climbing wall and appropriate remedial actions needed to correct any deficiencies noted in the report; and

(3) Maintain a ratio of one counselor for every ten campers at all times.

430.140: Medical Waste

Any medical waste, as defined in 105 CMR 480.000: Minimum Requirements for the

Management of Medical or Biological Waste (State Sanitary Code, Chapter VIII), shall be maintained and disposed of in accordance with the requirements of 105 CMR 480.000.

430.145: Maintenance of Records

(A) Camp operators shall maintain all records relating to campers, staff and volunteers for a minimum of three years.

(B) Operators shall be responsible for destruction of records in a manner that protects the privacy of all campers, staff, and volunteers. Criminal Offender Record Information (CORI) must be destroyed in accordance with 803 CMR 2.15: Destruction of CORI and CORI

Acknowledgment Forms.

430.150: Health Records

Each recreational camp for children shall maintain a health record for each camper and for each staff person who is younger than 18 years old. Camps shall maintain written authorization for emergency medical care for all adult staff and volunteers. The health record shall be readily available at all times in electronic or hard copy form that is secure from unauthorized access and shall include at least the following:

(A) The camper’s or staff member’s name and home address;

(B) The name, address and telephone number of the camper’s or staff member’s parent(s) or guardian(s);

(C) A written authorization for emergency medical care signed by a parent or guardian;

(D) The travel location(s) and telephone number(s) of the camper’s or staff member’s parent(s) or guardian(s) if the parent(s) or guardian(s) will be traveling during the camping season;

(E) The name, address and telephone numbers of the camper’s or staff member’s family health care provider or health maintenance organization, if any;

(F) If the camper or staff member brings a prescribed medication from home, a written authorization to administer the medication signed by a parent or guardian;

(G) Copies of injury and incident reports, if any, required by 105 CMR 430.154;

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430.150: continued

(H) A certificate of immunization indicating compliance with 105 CMR 430.152; and

(I) In addition, in each residential, sports, travel and trip camp: the health history and report of physical examination required by 105 CMR 430.151.

430.151: Physical Examinations by Physician and Certificate of Immunization

(A) Every camper and staff person shall prior to attending or after receiving a conditional offer of employment from a residential, travel, sports, or trip camp, furnish to the camp the following, prepared and signed by a licensed health care provider:

(1) A current medical history which lists allergies, required medications, and any health conditions or impairments which may affect the individual’s activities while attending the camp;

(2) A report of a physical examination conducted during the preceding 18 months; and

(3) A certificate of immunization.

(B) Every camper and staff person shall prior to attending or after receiving a conditional offer of employment from a day camp, furnish to the camp:

(1) A current medical history which lists allergies, required medications, and any health conditions or impairments which may affect the individual’s activities while attending the camp. The medical history shall be signed by a parent or guardian, or by a licensed health care provider, however, in the case of a staff member 18 years of age or older, the staff member’s signature shall be sufficient; and

(2) A certificate of immunization.

(C) No person known to be suffering from tuberculosis in a communicable form, or having evidence of symptoms thereof, shall be allowed to work or attend a recreational camp for children in any capacity which might bring him or her into contact with any camper at such camp. Screening and testing for tuberculosis shall be in accordance with guidance issued by the Department.

430.152: Required Immunizations

Written documentation of immunization in accordance with the most current Department immunization schedules developed pursuant to recommendations of the Centers for Disease Control and Prevention shall be required for all campers and staff.

430.153: Physical Examination or Immunization Exemptions

(A) Religious Exemption. If a camper or staff member has religious objections to physical examinations or immunizations, the camper or staff member shall submit a written statement, signed by a parent or legal guardian of the camper or staff member if a minor, stating that the individual is in good health and stating the general reason for such objections.

(B) Immunization Contraindicated. Any immunization specified in 105 CMR 430.152 shall not be required if the health history required by 105 CMR 430.151 includes a certification by a physician certifying they have examined the individual and in the physician's opinion the physical condition of the individual is such that their health would be endangered by such immunization.

(C) Exclusion. In situations when one or more cases of a vaccine-preventable or any other communicable disease are present in a camp, all susceptible children, including those with medical or religious exemptions, are subject to exclusion as described in 105 CMR 300.000:

Reportable Diseases, Surveillance, and Isolation and Quarantine Requirements.

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430.154: Injury and Incident Reports

(A) A report shall be completed on a form available from the Department for each fatality or serious injury or incident that results in a camper, staff person, or volunteer being sent home or brought to the hospital or treated by a health care provider, and where a positive diagnosis is made. A copy of each injury or incident report shall be sent to the Department, as well as the Board of Health, as soon as possible but no later than seven calendar days after the occurrence of the injury or incident. Such injuries or incidents shall include, but not be limited to:

(1) cuts or lacerations for which suturing is required;

(2) when resuscitation or other life saving measures are required;

(3) fracture or dislocation;

(4) concussion; or

(5) administration of an epinephrine auto-injector; or

(6) those resulting from errors in the administration of medications including diabetes care.

(B) Any operator of a camp that has a challenge course or climbing wall operating at the camp and is subject to licensure pursuant to 520 CMR 5.00: Amusement Devices shall comply with the reporting requirements in 520 CMR 5.00 for each fatality or serious injury, as defined in 520 CMR 5.00, related to the challenge course or climbing wall.

(C) The health care provider who meets the requirements of 105 CMR 430.159(E) or the camp director shall comply with all applicable reporting requirements of M.G.L. c. 94C as well as 105 CMR 700.000: Implementation of M.G.L. c. 94C, including reporting any administration of prescription medication in a manner inconsistent with the individual's prescription or in violation of 105 CMR 700.000 to the Department, as well as the Board of Health, within seven calendar days of the incident. Any incident resulting in the administration of glucagon shall be considered a serious injury and must be included in the injury or incident report.

430.155: Medical Log

Each recreational camp for children shall maintain a medical log which shall contain a record of all camper and staff health complaints and treatments. The medical log shall list the date and time, name of patient, complaint, and treatment for each incident, and shall include information on all medication administration errors, whether or not resulting in injury. The medical log shall be maintained in a readily available format and shall be signed by an authorized staff person.

430.156: Availability of Health Records and Logs

(A) All health records and medical logs shall be readily available to the health care supervisor, camp nurse or camp doctor or other health personnel.

(B) All health records and medical logs shall be made available upon request to authorized representatives of the Department and of the Board of Health which licenses the camp. The Department and the Board of Health shall maintain the confidentiality of information relating to individual campers and staff.

430.157: Communicable Disease Reporting and Parental Education Requirements

(A) The operator of a recreational camp for children, in consultation with the camp’s health care consultant, shall immediately report each case of communicable disease listed as reportable under 105 CMR 300.000: Reportable Diseases, Surveillance and Isolation and Quarantine

Requirements occurring in a camp to the Board of Health and the Department. Such report shall include the name and home address of any individual in the camp known to have or suspected of having such disease. Until action on such case has been taken by the camp health care consultant, strict isolation of affected individuals shall be maintained.

(B) The operator of a recreational camp for children, in consultation with the camp’s health care consultant, shall be responsible for ensuring each suspected case of food poisoning or any unusual prevalence of any illness in which fever, rash, diarrhea, sore throat, vomiting, or jaundice is a prominent symptom is reported immediately to the Board of Health and to the Department, by email or telephone. This report shall be made by the health care consultant, health care supervisor, or the camp director or operator.

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430.157: continued

(C) Information regarding meningococcal disease and immunization shall be provided annually to the parent or legal guardian of each camper in accordance with M.G.L. c. 111, § 219.

(D) Prior to admitting a child to the camp, the camp operator shall provide to parents and guardians a copy of the policy pertaining to the care of mildly ill campers, administration of medication and the procedures for providing emergency health care. A complete copy of the health care policy shall be furnished to parents and guardians upon their request.

(E) The operator shall inform parents in writing at the time application forms are provided that they may request copies of background check, health care, and discipline policies as well as procedures for filing grievances.

430.159: Health Care Staff to be Provided

The operator of each recreational camp for children shall provide:

(A) A designated camp health care consultant. The consultant shall:

(1) Assist in the development of the camp's health care policy as described in 105 CMR 430.159(B);

(2) Review and approve the policy initially and at least annually thereafter;

(3) Approve any changes in the policy;

(4) Review and approve the first aid training of staff;

(5) Be available for consultation at all times;

(6) Develop and sign written orders, including for prescription medication administration, to be followed by the on-site camp health care supervisor in the administration of his or her health related duties; and

(7) Provide trainings as required by 105 CMR 430.160 to the health care supervisor(s) and other camp staff.

(B) A written camp health care policy, approved by the Board of Health and by the camp health care consultant. Such policy shall include, but not be limited to:

(1) Daily health supervision;

(2) Infection control;

(3) Medication storage and administration, including self-administration when appropriate, pursuant to the requirements of 105 CMR 430.160;

(4) Procedures for using insect repellant and conducting tick checks;

(5) Promoting allergy awareness;

(6) Handling health emergencies and accidents, including parental/guardian notifications;

(7) Available ambulance services;

(8) Provision for medical, nursing and first aid services;

(9) The name of the designated on-site camp health care supervisor;

(10) The name, address, and phone number of the camp health care consultant required by 105 CMR 430.159(A); and

(11) The name of the health care supervisor(s) required by 105 CMR 430.159(E), if applicable.

(C) At least one health care supervisor, or more as determined by the camp operator based on camp size and ability to provide for the needs of the camp must be present at the camp at all times.