# Safe Sleep Regulations Hosted by: CDSS Community Care Licensing (https://www.cdss.ca.gov/inforesources/child-care-licensing) Presented by: CDSS Child Care Advocate Program Date: 2023-10 · Length: 39:13 Web page: https://childcare.support/t/cdss-safe-sleep/ NOTE: Presented October 2023. Rules and deadlines may have changed since; check Rules & laws for the current version. ## What it is A Child Care Advocate Program webinar walking through California's infant safe sleep regulations for licensed homes and centers. ## 3 things to know - Infants up to 12 months sleep on their backs, alone in a crib, with nothing but a fitted sheet. [✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=7; ✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=9] - Check every sleeping infant (up to 24 months) every 15 minutes and write down name, date and time. [✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=10; ✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=11] - No swaddling. Sleep sacks only with an approved waiver, which is available to centers, not family child care homes. [✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=10; ✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=12] ## What to do - Keep a LIC 9227 on file for every infant up to 12 months and update it as the infant starts rolling. Tell the parent by the next business day. [presenter said at 00:12:36, not independently confirmed] - Make your own 15-minute sleep log (licensing has no form): child's name, date, time of each check, and staff initials at centers. [presenter said at 00:21:04, not independently confirmed] - Family child care homes: decline parents' requests for sleep sacks or swaddling; licensing cannot give homes a waiver. [presenter said at 00:19:14, not independently confirmed; presenter said at 00:30:38, not independently confirmed] - Check your infant equipment against Consumer Product Safety Commission recalls. [presenter said at 00:34:39, not independently confirmed] ## Welcome - Presented by the Child Care Advocate Program in English, Cantonese, Mandarin and Spanish, during SIDS Awareness Month (October). [presenter said at 00:03:22, not independently confirmed] ## SIDS and SUID - SIDS is the unexplained sudden death of an infant under one, usually during sleep. The presenter cited AAP figures: over 3,500 U.S. babies die suddenly while sleeping each year, and 90% of SIDS cases occur in the first six months. [presenter said at 00:05:46, not independently confirmed; presenter said at 00:06:07, not independently confirmed; presenter said at 00:06:34, not independently confirmed] - Sleep-related deaths do happen in child care. Licensing publishes child care facility fatality data; the presenter said there were 45 deaths in child care facilities from 2018 through 2022. [presenter said at 00:07:05, not independently confirmed] ## Safe sleep regulations and resources - The regulations took effect August 18, 2020. An infant is a child under two, and many rules apply to all infants from 0 to 24 months. [presenter said at 00:07:50, not independently confirmed] - The Safe Sleep FAQs, in several languages, are a good handout for families and staff. [✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=6] ## Infants up to 12 months: back to sleep and the LIC 9227 - Two rules apply only to infants up to 12 months: place them on their backs to sleep, and keep a LIC 9227 Individual Infant Sleeping Plan on file. [presenter said at 00:08:56, not independently confirmed] - Only a written medical exemption from a licensed physician allows another sleep position. Otherwise, return the infant to their back until they can roll both ways consistently. [presenter said at 00:09:16, not independently confirmed; presenter said at 00:09:08, not independently confirmed] - Once you see an infant roll consistently, tell the parent by the next business day and complete Section C; after that, an infant who rolls during a nap may stay that way. [presenter said at 00:12:36, not independently confirmed; presenter said at 00:13:24, not independently confirmed] - Centers also need a needs and services plan for each infant; homes do not. [presenter said at 00:11:07, not independently confirmed] ## The crib and sleep environment - One crib per infant; even twins cannot share. Centers use cribs only; homes may also use a play yard. [presenter said at 00:14:35, not independently confirmed; presenter said at 00:14:45, not independently confirmed] - Firm mattress and fitted sheet only: no blankets, pillows, toys, bumpers, or anything that could cover the head. Remove hats, bibs and hair bows. [presenter said at 00:29:04, not independently confirmed; presenter said at 00:28:06, not independently confirmed] - Nothing may hang on or above the crib, and pacifiers cannot have anything attached. [✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=9] ## Where infants may sleep - Don't force an infant to sleep, stay awake, or stay in the sleep area. [✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=10] - No sleeping in swings, strollers, highchairs, car seats or a provider's arms. Move an infant who falls asleep elsewhere to a crib as soon as possible. [presenter said at 00:27:32, not independently confirmed] - An infant may move to a mat or cot only once they can climb out of the crib on their own. [presenter said at 00:28:26, not independently confirmed] ## Swaddling and sleep sacks - No swaddling, even for newborns or with a parent's permission. [presenter said at 00:19:14, not independently confirmed] - Sleep sacks count as swaddling. Centers may ask their regional office for a waiver or exception; licensing cannot issue waivers to family child care homes, so homes must decline. [presenter said at 00:30:38, not independently confirmed] ## 15-minute sleep checks and logs - Physically check every sleeping infant (0 to 24 months) every 15 minutes, in a crib, play yard, mat or cot, and document it. [presenter said at 00:23:21, not independently confirmed] - Record the child's name, date and time of each check. Staff initials are required at centers and optional (but best practice) in homes. Licensing has no form, so make your own. [presenter said at 00:21:04, not independently confirmed] - Note labored breathing or signs of distress, keep the log off the crib, and never delay emergency care. [presenter said at 00:23:46, not independently confirmed; presenter said at 00:24:09, not independently confirmed; presenter said at 00:24:28, not independently confirmed] ## Rules for child care centers - A separate nap room needs one teacher or aide per 12 sleeping infants. The presenter said half or transparent walls can count toward the overall ratio if constant sight and sound supervision is kept. [presenter said at 00:32:06, not independently confirmed] [applies to: infant nap rooms. The linked one-teacher-per-24 rule (Title 22 §101230) is the general center nap ratio, not infant-specific.] - Provide mats or cots for infants who can climb out of the crib. The 15-minute checks are on top of constant supervision. [presenter said at 00:24:52, not independently confirmed] ## Rules for family child care homes - If an infant sleeps in another room, keep the door open, be able to see the infant without moving the door, and stay close enough to hear them wake. [✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=16] ## Recalled infant equipment - Check the Consumer Product Safety Commission site for recalls. The presenter said rocking and inclined sleepers are not safe for infant sleep. [presenter said at 00:34:39, not independently confirmed] ## Upcoming webinar and contacts - The next quarterly webinar was December 12, 2023, at 6:00 p.m. That date has passed. [✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=18] - Questions: Child Care Advocate Program email or Child Care Assistance line. Resources include PIN 19-02-CCP and PIN 20-24-CCP. [✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=20; ✓ official source: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf#page=21] ## Sources - Official slides (English): https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-Webinar.pdf - Official slides in Chinese (Traditional): https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-zh.pdf - Official slides in Spanish: https://cdss.ca.gov/Portals/9/CCLD/CCP%20Documents/Safe-Sleep-Regulations-es.pdf - Official recording (YouTube): https://youtu.be/gi7ChIMjqjA Independent notes, not an official record of any agency, host or presenter. Check official sources before acting.