Attachment B 105cmr430.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

430.002: Authority

430.003: Citation

430.010: Scope

430.020: Definitions

430.090: Employment Background Information

430.091: Staff Orientation

430.093: Prevention of Abuse and Neglect

430.100: Camp Counselor and Junior Counselor Requirements

430.101: Required Ratio of Supervisory Staff or Counselors to Campers

430.102: Camp Director Requirements

430.103: Supervision of Specialized Activities

430.150: Health Records

430.151: Physical Examinations by Physician and Certificate of Immunization

430.152: Required Immunizations

430.153: Physical Examinations or Immunizations Excepted

430.154: Injury Reports

430.155: Medical Log

430.156: Availability of Health Records and Logs

430.157: Communicable Disease Reporting

430.158: Reporting of Outbreak of Disease

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

460.165: Tobacco 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 and 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 Emergency (Residential and Day Camps)

430.211: Special Contingency Plans for Day Camps

430.212: Emergency Procedures - Primitive, Travel and Trip Camps

430.213: Emergency Communication System Required

430.214: Storage of Hazardous Materials

430.215: Fire Prevention

430.216: Smoke Detectors Required

430.217: Requirements for Tents

430.250: Vehicles 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

430.303: Testing of Private Water Supplies

430.304: Common Drinking Cup Prohibited

430.320: Compliance with 105 CMR 590.000: State Sanitary Code Article X - Minimum Sanitation

Standards for Food Establishments, Required

Section: continued

430.321: Special Provisions for Primitive, Travel and Trip Camps

430.330: Nutritious Meals to be Served

430.331: Minimum Daily Food Requirements for Camps Providing Three Meals

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: Location and Maintenance of Toilet 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 Special Needs Campers

430.379: Handwash Basins for Special Needs Campers

430.380: Shower Facilities for Special Needs Campers

430.400: Rodent and Insect Control - Residential and Day Camps

430.401: Weed Control - Residential and Day Camps

430.432: Bathing Beaches

430.450: Site Location

430.451: Certificate of Occupancy Required

430.452: Screening Required

430.453: Lighting Required

430.454: Maintenance of Floors

430.455: Egresses Required

430.456: Egress to be Free of Obstructions

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: Original License

430.632: Board of Health Shall Grant, Suspend or Revoke License

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

430.752: Failure to Comply with Provisions of 105 CMR 430.000

430.800: Board of Health May Grant Variance

430.801: Variance to be in Writing

430.830: Severability

430.001: Purpose

The purpose of 105 CMR 430.000 is to insure minimum housing, health, safety and sanitary protection for children in the care of recreational camps operating in the Commonwealth.

430.002: Authority

105 CMR 430.000 is adopted under authority of M.G.L. c. 111, §§ 3 and 127A.

430.003: Citation

105 CMR 430.000 shall be known, and may be cited as 105 CMR 430.000: Minimum Sanitation and Safety Standards for Recreational Camps for Children (State Sanitary Code, Chapter IV).

430.010: Scope

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

105 CMR 430.000.

(B) During the period of its use as a part of a recreational camp for children, the minimum standards offitness for human habitation required in 105 CMR 410.000: Minimum Standards of Fitness for Human Habitation (State Sanitary Code, Chapter II), shall not be applicable to any structure which is required to conform to the minimum sanitationand safetystandards contained in 105 CMR 430.000.

430.020: Definitions

Bathing Beach means a natural or artificial flowing or impounded pond, lake, stream, river or other body of fresh or salt water at the location where it is used for bathing and swimming purposes together with equipment and appurtenances, if any, and the land areas used in connection therewith.

Board of Health means the appropriate and legally designated health authority of a city, town, or other legally constituted governmental unit, having the usual powers and duties of the board of health of a city or town, and includes any authorized agent or representative of said board of health. 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 ofprogramoperations, supportive services, business affairs, health matters, food, staff supervision and transportation.

Camper means a child who attends a recreational camp for children.

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.

Child and Children mean an individual or individuals who is or are less than 18 years of age.

Counselor means an individual who has a supervisory role with and who may have exclusive responsibility for campers.

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 five days during a two week period; and

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

430.020: continued

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 foodunless such containers and cans have been cleaned or prepared for recycling.

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

Health Supervisor means that person on the staff of a recreational camp for children who is responsible for the day to day operation of the health program or component.

Junior Counselor means anindividualwhoassistscounselors in the performance of their duties, but who is not exclusively responsible for them without the presence of a counselor or instructor.

Medical Specialty Camp means a camp, which has one of its defined purposes to provide programs for campers with specific medical/health needs.

A Mildly Disabled Camper means a camper who canfunctiononhis or her own in providing total self care but needs assistance in other camp activities.

Operator means an owner of a recreational camp for children and shall include any individual

(1) who alone or jointly or severally 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.

The camp director shall also be responsible as if he were the operator.

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 are not usually 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.

Recreational Camp for Children means any day, primitive or outpost, residential, sports, travel or trip camp conducted wholly or in part for recreation or recreational instruction which:

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

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

(3) operates for any period of time between June 1 and September 30 of any year or not more than 14 consecutive days during any other time of the year.

(4) Recreational Camp for Children shall also mean any program which promotes or advertises itself as a camp, even if it does not meet the criteria listed above.

Provided that it is notpromoted oradvertised as a camp, none of the following shall be deemed to be a recreational camp for children:

(a) a child care program licensed by the Office of Child Care Services in accordance with M.G.L. c. 28A § 10;

(b) single purposeclasses, 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;

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

(d) a classroom based instructionalprogramprovided that no specialized or high risk activities (See 105 CMR 430.103) are conducted as part of the program;

(e) a summer school program accredited by a recognized educational accreditation agency, where the accreditation includes standards forspecialized and highrisk activities, if the program involves such activities (See 105 CMR 430.130), and the summer program meets those accreditation standards.

430.020: continued

ResidentialCamp means a program which operates on a permanent site for four or more consecutive overnights and meets the definition of a recreational camp for children.

Rubbish means combustible and noncombustible waste materials, except garbage, and includes but is not limited to such material as paper, rags, cartons, boxes, wood, excelsior, rubber, leather, tree branches, yard trimmings, grass clippings, tin cans, metals, mineral matter, glass, crockery, dust and the residue from the burning of wood, coal, coke, and other combustible materials.

A Severely Disabled Camper means a camper who needs assistance in self-care and camp activities.

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 programwhichoperates for two or more hours per day with a primary focus on one or more sports activities and meets the definition of a day or residential camp for children.

Staff means any person employed by a recreational camp for children 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 his/her work is to be performed; and

(2) is paid directly by the camp operator. This does not include any person at the camp performing emergency services when under the supervision of the camp operator or his/her designee.

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

Swimming and Diving Areas means and includes thoseaquatic facilitiesandoperationsgenerally known as swimming pools, wading pools, diving tanks, beaches, rivers, lakes, other natural bodies or water and similar areas and facilities.

Swimming Pool means and includes every 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, together with equipment, land, decks and appurtenances used in connection with the pool.

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 programwhichprovides care for not less than a 72-hour period, moves campers under their own power or by a transportation mode permitting individualguidance ofa 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.

430.090: Background Information

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

430.090: continued

(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. Inmaking this determination, the operator shall consider at a minimum that 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 staffperson including, but not limited to, previous employers or school administrators. Returning staff persons may use references on record with the camp from the preceding year to satisfy the requirements of 105 CMR 430.090(C)(2). However, if there is a gap in employment with the camp for at least one camp season, 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, self-reporting of any felony conviction and 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 Massachusetts Criminal History Systems Board for all prospective staff.

(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, orotherlocal authority with access to relevant information, a criminal record check or its recognized equivalent.

(d) If there is no interruption in the staffperson’s employment by the camp/organization from the time of the initial background check, no new criminal or sex offender history is required for each camping season. This applies only to permanent employees of the same camp/organization. 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) Inaccordancewith M.G.L. c. 6, § 172G, operators shall obtain a CORI/Juvenile Report from the Massachusetts Criminal History Systems Board.

(E) The operatorshall 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 determinationwith regard to allbackground information required pursuant to 105 CMR 430.090(C) and (D).

430.091: Staff Orientation

The operator shall provide orientation for allstaff and volunteers. The operator shall describe, in writing, the camp’s plan for orientation that shall include at a minimum, but not be limited to, the camp’s philosophy, organization, policies and procedures. The operator shall not assign any person to be responsible for a group of childrennor utilize any staff or volunteer to supervise others until such person has received the minimum orientation described in 105 CMR 430.090.

430.093: Prevention of Abuse and Neglect

(A) The operator shall have procedures in place which protect campers from abuse and neglect while in the camp’s care and custody.

NON-TEXT PAGE

430.093: continued

(B) The operator shall develop and follow written procedures for reporting of any suspected incidents of child abuse and 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 Social Services or to the camp director.

(2) The camp director shall immediately report suspected abuse or neglect to the Massachusetts Department of Social Services.

(3) The camp director shallnotify the board of health if a 51A report alleging abuse or neglect of a child while in the care of the recreational camp for children or during a program related activity is filed. The 51A report itself shall not be forwarded to the Board of Health.

(C) The operator shall cooperate in all official investigations of abuse and neglect alleged to have occurred at the camp, 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 that an allegedly abusive or neglectful staff person does not work directly with campers until the Massachusetts DepartmentofSocialServices investigationiscompleted.

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 participant in structured group camping and/or at least four weeks experience in a supervisory role with children; or

(2) have satisfactorily completed a camp counselor orientation program prior to the arrival of campers.

(B) Each junior counselor in a recreational camp for children shall have satisfactorily completed 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 special needs camps:

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

(b) junior counselors shall have attained 16 years of age;

(2) In a day camp

(a) counselors shall have attained 16 years of age;

(b) junior counselors shall have attained 15 years of age.

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

(D) For the purpose of105 CMR 430.000, age shall be determined at the start of the camp season.

430.101: Required Ratio of Supervisory Staff or Counselors to Campers

Each recreational camp for children shall have the following minimum ratio:

(A) Residential and Day Camps. Residential and day camps shall have at least one supervisory staff person for every ten campers over the age of six. There shall be one supervisory staff person for every five campers age six or under. Junior counselors may be included in meeting up to one half of the camper/staffratio within each unit, living or general activity group, but only if they have received training and supervision to verify their ability to handle camper groups independently.

(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.

(C) Special Needs Camps. Each camp serving special needs campers shall have at least:

(1) one counselor for every four mildly disabled campers needing occasional assistance in activities;

430.101: continued

(2) one counselor for every two severely disabled campers needing frequent or constant assistance in activities.

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 at least 25 years of age and who meets at least one of the following:

(1) Have successfully completed a course in camping administration such as those offered by national professional camping associations, national agencies or their equivalent, or

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

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

(1) Have successfully completed a course in camping administration such as those offered by national professional camping associations, national agencies, or their equivalent, or

(2) Have at least two seasons previous experience 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 accompany the campers who shall:

(1) Be at least 21 years old; 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 administrationof the camp at any given time. In the event of the absence of the director for more than 12 consecutive hours, 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 of Specialized Activities

Each recreational camp for childrenwhichconducts specialized or high risk activities, either on or off-site, including, but not limited to, horseback riding, hiking, scuba diving, rock climbing, firearms, canoeing and aquatic events shall conduct such activities only under the supervision of a counselor who has evidence of appropriate training, certification and experience in each activity under his or her supervision. Said counselor shall be present duringperiods ofsuchactivity. The operator shall make adequate provisions to assure any special training necessary for camp personnelto protect the safety and health of disabled campers.

(A) Aquatics. Aquaticsactivities, including those events associated with swimming, boating, canoeing, watercraft and water skiing, shall if conducted at the camp, be directly supervised by an aquatics director who holds the following current certifications:

(1) A current AmericanRed Cross Lifeguard Training Certificate, Royal Bronze Medallion, Boy Scouts of America Lifeguard Certificate, or National YMCALifeguard Certificate or an equivalent certification;

(2) A current American Red Cross CPR Certificate for the Professional Rescuer or American Heart Association Health Care Provider CPR Certificate; and

(3) A current American Red Cross Standard First Aid Certificate, or Community First Aid and Safety Certificate (which certification maybe evidenced by a notation on the back of any American Red Cross Lifeguard Training Certificate), or an equivalent certification.

(4) When an aquatics director supervises two or more aquatics staff members, 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.

430.103: continued

(B) Swimming. In addition to the aquatics director, swimming supervision shall include one counselor for every ten campers in the water or on the beach to supervise swimming. For every 25 campers, or portion thereof, there shall be at least one counselor who shall hold the certifications required in 105 CMR 430.103(A)(1), (2) and (3). If swimming activities occur away from the camp, the camp shall provide supervision as required in105CMR430.103 without the need to provide an aquatics director.

(C) Watercraft.

(1) All watercraft activities carried out on flat water shall be supervised by a minimum of one counselor for every ten campers in watercraft. Each counselor shallhold certificationas required in 105CMR430.103(A)(1) through(3), or American Red Cross certification in Small Craft Safety and Basic Water Rescue.

(2) All watercraft activities carried out on white water, hazardous salt water, or hazardous fresh water shall be supervised by a minimum of one counselor to every ten campers in watercraft.

However, regardless of the number of campers, there shall be a minimum of two counselors, each in separate watercraft, supervising the activity. In addition to the certification and training required by 105 CMR 430.103(C)(1), each counselor shall have evidence of previous training and experience with this type of water activity totaling at least six hours on the water.

(3) Campers shall possess at least an American Red Cross Level 4 or higher Program Certificate or its equivalent before being allowed to participate in white water, hazardous salt water or hazardous fresh water boating activities. 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.

(4) All staff and participants in water craft activities shall wear U.S. Coast Guard approved personal floatation devices appropriate to the activity.

(D) Scuba Diving. Scuba diving activities shall be supervised byindividualswho are currently certified by a national or regional scuba training programsuch 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.

(E) Firearms. Firearm activities shall be supervised by an individual who possesses a current National Rifle Association Instructor’s card or its equivalent. A ratio of one counselor for every ten campers on the range shall be maintained at all times. This ratio may include the instructor.

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

(G) 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.

430.150: Health Records

(A) Each recreationalcamp for childrenshall maintain a health record for each camper and for each staff person who is younger than 18 years old, that shall include at least the following:

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

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

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

(4) 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;

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

(6) 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;

(7) Copies of injury reports, if any, required by 105 CMR 430.154;

430.150: continued

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

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

(B) Each recreational camp for children shall maintain for each staff person who is 18 years of age or older, a health record that shall include at least the following:

(1) The staff member’s name and home address;

(2) The name, address and phone number of an individual, if any, to be contacted in the case of emergency;

(3) The name, address and phone numbers of the staff member’s health care provider or health maintenance organization, if any;

(4) Copies of injury reports, if any, required by 105 CMR 430.154;

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

(6) 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 full time 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 health history;

(2) A report of a physical examination conducted during the preceding 24 months; and

(3) A certificate of immunization.

(B) Every camper and full time 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 bya licensed healthcare provider, however, in the case of a staff member 18 years of age or older, the staff member’s signature shall be sufficient.

(2) A certificate of immunization.

(C) No person known to be suffering fromtuberculosis ina 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 into contact with any camper at such camp.

430.152: Required Immunizations

Written documentation of immunization shall be required for all campers and staff as follows:

(A) For Campers and Staff under 18 Years Old:

(1) Measles, Mumps and Rubella (MMR) Vaccine: A minimum of one dose of MMR vaccine(s) must be administered at or after 12 months of age. A second dose of live measles-containing vaccine given at least four weeks after the first, is required for all campers and staff, who will be entering grades K-12 or college in the school year immediately following the camp session (or in case of an ungraded classroomorthe camper/staff does not attend school/college, campers or staff five years of age or older). Laboratory evidence of immunity is acceptable.

(2) Polio Vaccine: A minimum of three doses of either inactivated polio vaccine (IPV) or oral polio vaccine (OPV) are required. If a mixed (IVP/OPV) schedule was used, four doses are required;

(3) Diptheria and Tetanus Toxoids and Pertussis Vaccine: A minimum of four doses of DTaP/DTP/DT or at least three doses of Td is required. Where a camper or staff person is seven or more years of age and requires additional immunizations to satisfy 105 CMR 430.152(A)(3), Td is to be substituted for DTaP, DTP or DT vaccine. Effective January 1, 2004, a booster dose of Td is required for all campers and staff who willbe enteringgrades seven through ten (or in the case of an ungraded classroom or the camper or staff does not

430.152: continued attend school, campers or staff 12 through 15 years of age) if it has been more than five years since the last dose of DTaP/DTP/DT. For allcampers and staffwho will be entering grades 11 and 12 (or in the case of an ungraded classroom or the camper or staff does not attend school, campers or staff16 through 17 years of age) a booster of Td is required if it has been more than tenyears since the last dose of DTaP/DTP/DT/Td.

(4) Hepatitis B: For all children born on or after January 1, 1992, three doses of Hepatitis B vaccine are required. Laboratory evidence of immunity is acceptable.

(B) For Camper and Staff 18 Years of Age or Older:

(1) Measles Vaccine: Unless born before 1957, two doses of live measles-containing vaccine administered at/or after 12 months of age (at least four weeks apart) are required Laboratory evidence of immunity is acceptable.

(2) Mumps Vaccine: Unless born before 1957, at least one dose of mumps vaccine administered at/or after 12 months of age is required. Laboratory evidence of immunity is acceptable.

(3) Rubella Vaccine: Unless born before 1957, at least one dose of rubella vaccine administered at/or after 12 months of age is required. Laboratory evidence of immunity is acceptable.

(4) Diphtheria and Tetanus Toxoids: At least three doses of DTaP/DTP/DT/Td are required.

A booster dose of tetanus/diphtheria, adult type toxoid (Td) is required if more than ten years have elapsed since the last dose of DTaP/DTP/DT/Td vaccine.

430.153: Physical Examinations or Immunizations Excepted

(A) Religious Exceptions. 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, to the effect that the individual is in good health and stating the 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 that he or she has examined the individual and that in the physician's opinion the physical condition of the individual is such that his or her health would be endangered by such immunization.

430.154: Injury Reports

A report shall be completed on a form prescribed by the Massachusetts Department of Public Health for each fatality or serious injury as a result of which a camper or staff person is sent home, is brought to the hospital or physician's office and where a positive diagnosis is made. Such injuries shall include but shall not necessarily be limited to those where suturing or resuscitation is required, bones are broken, or the child is admitted to the hospital. A copy of each injury report shall be sent to the Massachusetts Department of Public Health within seven days of the occurrence of the injury.

430.155: Medical Log

Eachrecreationalcamp for childrenshall maintain a medical log which shall contain a record ofall camper and staff health complaints and treatment. The medical log shall list the date, name of patient, complaint and treatment. The medical log shall be a bound book with pre-numbered pages in sequential order and lined pages. No lines shall be skipped and all entries shall be in ink.

430.156: Availability of Health Records and Logs

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

All medical records and logs shall be made available upon request to authorized representatives of the Massachusetts Department of Public Healthand ofthe local board of health which licenses the camp. The Department of Public Health and the local board of health shall maintain the confidentiality of information relating to individual campers and staff.

430.157: Communicable Disease Reporting

The operator of a recreational camp for children shall be responsible for insuring that each case of any such communicable disease occurring in a camp is immediately reported to the local board of health. The report shall be made by the operator. 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 shall be maintained.

430.158: Reporting of Outbreak of Disease

The operator of a recreational camp for children shall be responsible for insuring that each suspected case of food poisoning or any unusual prevalence ofanyillness in which fever, rash, diarrhea, sore throat, vomiting, or jaundice is a prominent symptom is reported immediately to the local board of health and to the Massachusetts Department of Public Health, verbally or by telegram or telephone.

This report shall be made by the camp physician, or if there is no physician in attendance, by the camp nurse, or if there is no nurse in attendance, by the camp director or by the camp operator.

430.159: Health Care Staff to be Provided

The operator of each recreational camp for children shall provide:

(A) A designated Massachusetts licensed physician, nurse practitioner or physician assistant with pediatric training as the camp’s 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; and

(6) Develop and sign written orders to be followed by the on-site camp health supervisor in the administration of his/her health related duties.

(B) A written camp medical policy, approved by the local board of health and by the camp health care consultant. Such policy shall include, but not be limited to, daily health supervision, infection control, handling of health emergencies and accidents, available ambulance services, provision for medical, nursing and first aid services, the name of the designated on-site camp health supervisor, the name address and phone number of the camp health care consultant required by 105 CMR 430.159(A) and the name of the health supervisor required by 105 CMR 430.159(E), if applicable.

(1) Each full time staff member shall receive a copy of the policy and shall be trained in the program’s infection control procedures and implementation of the policy during staff orientation.

(2) Prior to admitting a child to the camp, the parents shall be provided 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 policy shall be furnished to parents upon their request.

(C) A health supervisor, who is at least 18 years of age and is present at the camp at all times. The health supervisor shall be a Massachusetts licensed physician, physician assistant, nurse practitioner, registered nurse, licensed practical nurse, or other person specially trained in first aid. First aid training shall mean at least current certification in American Red Cross Standard First Aid, or its equivalent and

CPR.

Primitive, Travel, and Trip Camps shall have at least one individual in addition to the health supervisor accompanying the campers, who is adequately trained to render first aid. Said individual shall possess at least current certification in Red Cross Standard First Aid, or its equivalent.

(D) In residentialcamps in which the total number of campers and staff is less than150 and inallday camps, the health supervisor may have additional non-health related duties, but shall at all times be available at the camp to render emergency first aid.

430.159: continued

(E) In camps operated for children who are physically and/or mentallyhandicapped,medicalspecialty camps, residential camps for children where the total number of campers and staff is 150 or greater and at any other camp when so advised by the health care consultant described in 105 CMR 430.159(A), the health supervisor shall be;

(1) A nurse registered to practice in the Commonwealth;

(2) A physician licensed to practice in the Commonwealth;

(3) A nurse practitioner or physician assistant licensed to practice in the Commonwealth; or

(4) A Massachusetts licensed practical nurse.

430.160: Storage and Administration of Medication

(A) Medication prescribed for campers shall be kept in original containers bearingthe pharmacylabel, which shows the date of filling, the pharmacy name and address, the filling pharmacist’s initials, the serial number of the prescription, the name of the patient, the name of the prescribing practitioner, the name of the prescribed medication, directions for use and cautionary statements, if any, contained in such prescription or required by law, and if tablets or capsules, the number in the container. All over the counter medications for campers shall be kept in the original containers containing the original label, which shall include the directions for use.

(B) All medication prescribed for campers shall be kept in a locked storage cabinet used exclusively for medication, which is kept locked except whenopened to obtain medication. The cabinet shall be substantially constructed and anchored securely to asolid surface. Medications requiring refrigeration shall be stored at temperatures of38° to 42°F in a locked box, used exclusively for medications, and physically affixed to the refrigerator.

(C) Medication shall only be administered by the health supervisor or by a licensed health care professional authorized to administer prescription medications. If the health supervisor is not a licensed health care professional authorized to administer prescription medications, the administration of medications shall be under the professional oversight of the health care consultant. The health care consultant shall acknowledge inwritinga list ofall medications administered at the camp. Medication prescribed for campers brought from home shall only be administered if it is from the original container, and there is written permission from the parent/guardian.

(D) When no longer needed, medications shallbe returned to a parent or guardian whenever possible.

If the medication cannot be returned, it shall be destroyed as follows:

(1) Destruction of prescription medication shall be accomplished by the health care consultant, witnessed by a second person and recorded in a log maintained by the camp for this purpose. Said log shall include the name of the camper, the name of the medication, the quantity of the medication destroyed, and the date and method of destruction. The health care consultant and the witness shall sign each entry in the medication destruction log.

(2) The medication log shall be maintained for at least three years following the date of the last entry.

430.161: Emergency/Medical Facilities and Equipment

(A) The operator of each residential camp and each day camp shall provide a single facility identified as an infirmary or first aid facility. Such facility in a residential camp shall have an exterior light remaining lit all night which is visible from a distance.

(B) In every residential camp, space shall be designated for isolation of a child ill with a communicable disease or suspected of such illness or otherwise in need of quiet and rest, at a location suitably separated from the regular living and sleeping quarters so as to insure both quiet to the patient and safety to other persons. The space shall be suitably equipped and not utilized for any other purpose.

An isolated child shall be provided with adequate adult supervision.

2/18/00 105 CMR - 1726.1

430.161: continued

(C) First aid supplies shall be readily available to the staffwherever the healthcare consultant deems necessary. Said determination shall be part of the writtenorders required by105 CMR 430.159(A).

First aid kits shall contain emergency first aid supplies to meet the needs of the campers and staff, including but not limited to non-perfumed soap, sterile gauze squares, compresses, adhesive tape, bandage scissors, triangular and rolled bandages, a mask with a one way valve, tweezers, a cold pack and barrier protection gloves, preferably of non-latex composition.

430.162: Personal Hygiene and Laundry

The operator shall provide adequate facilities and time in order that the campers and staff are encouraged to carry out good personal hygiene practices. Furthermore, he shall cause the personal laundry of each person in a residential camp who is in attendance for more than 14 consecutive days to be washed at least once every 14 days.

430.163: Protection From The Sun

The operator shall at all times encourage campers and staff to reduce exposure to ultraviolet exposure from the sun. Such measures shall include, but need not be limited to, encouraging the use of wide brim hats, long sleeve shirts, long pants, screens with a solar protection factor of 15 or greater and lip balm.

2/18/00 105 CMR - 1726.2

430.165: Tobacco Use

Tobacco use, ifany, shall be restricted to designated areas not accessible to campers. An operator may designate a tobacco use area, but only if non-tobacco use areas are of sufficient size and capacity to accommodate non-users and is in compliance with local ordinance(s) regarding tobacco use.

430.190: General Program Requirements

(A) The operator of each recreational camp for children shall provide a program of activities and physical environment which shall meet the generally recognized needs of the campers and shall in no respect be in conflict with their best interests nor a hazard to their health and safety.

(B) The operator shall release campers only to the camper’s parent or an individual designated in writing by the camper’s parent unless alternative arrangements are approved in writing by the board of health.

(C) The operator shall print on any promotional literature orbrochures the following, “This camp must comply with regulations of the Massachusetts Department of Public Health and be licensed by the local board of health.”

(D) The operator shall inform parents 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.

430.191: Requirements for Discipline

(A) Discipline and guidance shall be consistent and based upon an understanding of the individual needs and development of a child. The operator shall direct discipline to the goal of maximizing the growth and development of the children and for protecting the group and individuals within it.

(B) Prohibitions.

(1) Corporal punishment, including spanking, is prohibited;

(2) No camper shall be subjected to cruel or severe punishment, humiliation, or verbal abuse;

(3) No camper shall be denied food or shelter as a form of punishment;

(4) No child shall be punished for soiling, wetting or not using the toilet.

(C) The operator shall describe in writing, the camp’s procedures for disciplining campers. The written plan shall also include the prohibitions of 105 CMR 430.191(B)(1) through (4).

430.201: Riflery Program Requirements

If riflery is a camp activity it shall be conducted with the following precautions:

(A) Firearms shall be kept in good condition and stored in a locked cabinet when not in use.

Ammunition shall also be stored in a locked facility in a location separate from the firearms.

(B) Shooting ranges shall be located well away from other activity areas and shall be constructed in accordance with standards of the National Rifle Association.

(C) Single shot rifles shall be used and persons shall stay behind the firing line at all times except when ordered by the range instructor to retrieve targets.

430.202: Archery Program Requirements

If archery is a camp activity it shall be conducted with the following precautions:

8/15/03 105 CMR - 1727

430.202: continued

(A) Archery equipment shall be kept in good condition and stored under lock and key when not in use.

(B) The archery range shall be located in an area well away from other program activities, clearly marked to warn passersby away from the…