California Infant Safe Sleep Rules for Family Child Care Homes (Title 22 § 102425)

(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

(1) All cribs or play yards shall meet the United States Consumer Product Safety Commission safety standards.

(2) Placement of cribs or play yards shall not hinder entrance or exit to and from the space where infants are sleeping.

(3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

(4) Mattresses shall be made specifically for the size crib or play yard in which they are placed.

(5) Fitted sheets shall be replaced when wet or soiled.

(6) Each infant's bedding shall be used for him/her only. Bedding that touches the infant's skin shall be cleaned at least weekly or before use by another infant.

(7) Soiled bedding shall be placed in a closed container and made inaccessible to infants until washed.

(b) Cribs or play yards shall be free from all loose articles and objects.

(1) Pacifiers shall be allowed in the crib or play yard if the following provisions are in place:

(A) There shall not be anything attached to the pacifier.

(B) The pacifier shall be specific to the infant it is being given to.

(2) Bumper pads shall not be used.

(3) There shall be no objects hanging above or attached to the side of the crib.

(c) An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

(1) This plan shall be signed and dated by the infant's authorized representative.

(2) The Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be maintained in the infant's file and shall be available to the Department for review.

(d) The provider shall place infants up to 12 months of age on their backs for sleeping.

(1) This requirement shall not apply if the infant has a written medical exemption from a licensed physician that allows for an alternative sleep position. The exemption shall be attached to the Individual Infant Sleeping Plan [LIC 9227 (3/20)] and contain the following criteria:

(A) Instructions on how the infant shall be placed to sleep, including sleep position.

(B) Duration the exemption is to be in place.

(C) The licensed physician's contact information.

(D) Signature of the licensed physician and date of signature.

(2) Upon expiration of the medical exemption, the provider shall follow all requirements set forth in Subsection (d).

(3) The medical exemption shall be included in the infant's file and be maintained as specified in Section 102421.

(4) An infant with an Individual Infant Sleeping Plan [LIC 9227 (3/20)] that has Section C of the form completed and signed by an authorized representative shall be placed on their back when first laid down to sleep. In the event the infant changes position, the infant may remain in the alternative position.

(A) Upon the provider's observation that the infant is capable of rolling from their back to their stomach and stomach to their back, the provider shall fill out Section D of the Individual Infant Sleeping Plan [LIC 9227 (3/20)], notify the authorized representative, and obtain the authorized representative's signature on the Individual Infant Sleeping Plan no later than the next business day following observation.

(e) No infant shall be forced to sleep, to stay awake, or to stay in the designated sleeping area.

(1) The provider is not prohibited from scheduling sleep times for infants over 12 months old.

(f) An infant shall not be swaddled while in care.

(g) An infant's head shall not be covered while sleeping.

(h) Car seats shall only be used for transportation purposes and shall not be used for sleeping.

(i) If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.

(j) The provider shall supervise infants while they are sleeping and adhere to the following requirements:

(1) The provider shall physically check on sleeping infants every 15 minutes.

(2) The provider shall document the following:

(A) Labored breathing.

(B) Signs of distress, which includes but is not limited to flushed skin color, increase in body temperature, and restlessness.

(C) Infants up to 12 months of age who are sleeping in a position other than on their back.

1. If the infant's Individual Infant Sleeping Plan [LIC 9227 (3/20)] does not have Section C completed, the provider shall return the infant to their back for sleeping.

(D) Documentation shall be maintained in the infant's file and be available to the Department for review. Documentation shall include the following:

a. Date.

b. Infant's name.

c. Time of each 15-minute check.

(3) If the provider observes labored breathing or signs of distress as specified in Subsection (j)(2)(B), the provider shall do the following:

(A) Immediately notify the infant's authorized representative.

(B) Obtain specific instruction from the infant's authorized representative regarding action to be taken and make prompt arrangements to obtain medical treatment if necessary.

(C) There shall be no delay in obtaining emergency medical treatment for the infant if the infant's condition requires immediate attention.

(4) The provider shall be near enough to the sleeping infant to be able to hear them wake up.

(5) If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times.

(A) The provider shall be able to visually observe the infant without moving the door.

(6) The provider shall be on the same floor as the sleeping infant.

(7) A digital video and audio monitoring device may be used in the home but shall not be used in place of the requirements enumerated in Subsection (j).