Maryland daycare regulations

Centers must be licensed

COMAR 13A.16.02.01 Effective January 2020 Centers View rule COMAR 13A.16.02.01

Anyone who operates a child care center must hold a license (or, for qualifying religious programs, a letter of compliance). The license can't be transferred, must be posted where parents can see it, and must be surrendered if the center closes or the license is suspended, revoked or not renewed. No employee, substitute or volunteer may be assigned to a group or have access to children until they have passed the child abuse and neglect clearance and a federal or State criminal background check, and no one may be alone with children until all checks are cleared.

Opening a center

COMAR 13A.16.02.02 Effective November 2023 Centers View rule COMAR 13A.16.02.02

Before opening, complete an MSDE licensing orientation, file a notice of intent before applying for building permits, and submit the application at least 60 days before the planned opening date. Background check applications are required for the applicant (if they will have frequent contact with children), the director, every employee, substitute and volunteer, and every adult living on the premises.

Continuing license and annual paperwork

COMAR 13A.16.02.03 Effective January 2020 Centers View rule COMAR 13A.16.02.03

After the initial license, the operator applies for a continuing license, which needs a passed local fire inspection. Every 12 months the operator sends proof of staff continued training, and every 24 months new notarized permission forms for abuse and neglect record checks. Keep proof of the most recent fire inspection at the center.

Family and large family child care homes

Md. Code, Educ. § 9.5-301 Family child care View rule Md. Code, Educ. § 9.5-301

Family child care is care in a residence for children under 13 (or developmentally disabled persons under 21) for which the provider is paid. A family child care home serves up to 8 children and a large family child care home 9 to 12. The law's definition of an unregistered (unlawful) home leaves out providers who are related to every child in care, are a friend of each child's parents, do not provide care on a regular basis, or received the children through a licensed placement agency. Since October 1, 2025 (Ch. 375 of 2025), condominium, homeowners' association and cooperative housing documents may not prohibit or restrict a family or large family child care home or limit it to fewer children than MSDE authorizes (a cooperative may still pass on increased insurance costs, charge a common-element fee of up to $50 a year and require advance notice), and local governments may not limit such a home to fewer children than MSDE authorizes.

Registering a family child care home

COMAR 13A.15.02.02 Effective November 2023 Family child care View rule COMAR 13A.15.02.02

Applicants complete MSDE's family child care orientation, submit a medical evaluation for themselves and every resident (done within 12 months), get federal and State fingerprint checks for themselves, every resident 18 or older, their substitute and any employee or volunteer 18 or older, and give notarized permission for abuse and neglect record checks. They also show fire, health and zoning compliance, the required training and lead-safe compliance, and, if renting, written permission from the landlord.

Registering a large family child care home

COMAR 13A.18.02.02 Effective November 2023 Family child care View rule COMAR 13A.18.02.02

Large family home applicants complete a separate orientation and submit background checks for themselves, every employee, substitute and volunteer, and every adult resident; medical evaluations; evidence of zoning and building code compliance; a written plan of operation; and an emergency and disaster plan.

Center ratios and group sizes

COMAR 13A.16.08.03 Effective January 2020 Centers View rule COMAR 13A.16.08.03

Centers must keep these staff-to-child ratios and maximum group sizes: infants (under 18 months) 1:3, group of 6; toddlers (18–24 months) 1:3, group of 9; 2-year-olds 1:6, group of 12; 3- and 4-year-olds 1:10, group of 20; 5 years and older 1:15, group of 30. Mixed groups have their own staffing tables: for example, a group with 3 or more infants is capped at 6 with 2 staff, and a mixed preschool group may not exceed 20 and may include no more than six 2-year-olds once it has 13 or more children. During a school day in an MSDE-approved educational program (nursery school), 3- and 4-year-olds may be 1:12 in a class of up to 24.

SafePass tip: SafePass shows a live count for each room: children checked in against staff clocked in, and directors get an alert when a room goes over ratio. Set each room's ratio and group size to Maryland's numbers (for example 1:3 with a group of 6 for infants, 1:6 with 12 for 2-year-olds, 1:10 with 20 for 3- and 4-year-olds), because SafePass's built-in defaults are not Maryland's.

When group sizes may vary

COMAR 13A.16.08.04 Effective October 2008 Centers View rule COMAR 13A.16.08.04

Groups may be larger during outdoor play and special activities such as field trips and assemblies, but the ratios must still be kept. Groups of only school-age children may be any size under a plan approved by the licensing office, again only if ratios are kept.

Ratios at rest time (centers)

COMAR 13A.16.08.08 Effective October 2008 Centers View rule COMAR 13A.16.08.08

For children under 2, the full ratio applies during rest and every assigned staff member stays with the group. For children 2 and older, the ratio applies until all children are resting quietly; then at least one teacher or aide stays in the room and the others may step out but must stay on the premises and within hearing range.

Family child care home capacity

COMAR 13A.15.04.03 Family child care View rule COMAR 13A.15.04.03

A family child care home may care for no more than 8 children at a time, of whom no more than 4 may be under age 2, and only up to the capacity on its certificate. More than 2 children under 2 requires the licensing office's approval, extra infant-toddler training, and an approved 'additional adult' present whenever more than 2 under-2s are in care. The provider's own children (and other residents) under 6 count, and visiting children under 8 may count. A home that also runs an approved nursery-school program is limited to 8 children with no more than 2 under age 2.

SafePass tip: SafePass Kiosk check-ins give a running count of who is in care right now, by child and age. Remember to also count your own children under 6, who usually aren't checked in.

Large family child care home ratios

COMAR 13A.18.08.03 Effective June 2013 Family child care View rule COMAR 13A.18.08.03

Large family homes (up to 12 children) follow their own tables: 2-year-olds 1:6; 3- and 4-year-olds 1:10; 5 and older 1:12; infants and toddlers 1:3 (infant groups up to 6, toddler groups up to 9). A mixed group with 1 or 2 children under 2 needs 1 staff member for up to 8 children and 2 for up to 12; with 3 or 4 under-2s it needs 2 staff for up to 8 and 3 for up to 12. A mixed group of children 3 and older is 1:10.

SafePass tip: SafePass shows a live count for each room: children checked in against staff clocked in, and directors get an alert when a room goes over ratio. Set each room's ratio and group size to Maryland's numbers (for example 1:3 with a group of 6 for infants, 1:6 with 12 for 2-year-olds, 1:10 for 3- and 4-year-olds), because SafePass's built-in defaults are not Maryland's.

Statutory limits for family homes

Md. Code, Educ. § 9.5-305 Family child care View rule Md. Code, Educ. § 9.5-305

State law caps a family child care home at 8 children with no more than 4 under age 2 and at least 1 adult for every 2 children under age 2, and a large family home at 12 children. The provider's own children under 2 count as children served. The Department may lower a home's capacity if the standard limits aren't suitable for that home.

Attendance, hours and minimum age (centers)

COMAR 13A.16.04.02 Effective October 2008 Centers View rule COMAR 13A.16.04.02

Every child present at one time counts for capacity, group size and ratio. A center may not enroll a child for more than 14 hours in a 24-hour period without advance approval, may not admit an infant younger than 6 weeks, and may enroll only age groups the licensing office has approved for the facility.

Center capacity

COMAR 13A.16.04.01 Effective October 2008 Centers View rule COMAR 13A.16.04.01

The licensing office sets each center's capacity from its floor space (at least 35 square feet per child, 13A.16.05.03), outdoor space, staffing, equipment, ages served, toilets and local codes. The center may never have more children in care at one time than its approved capacity.

Center directors

COMAR 13A.16.06.05 Effective January 2020 Centers View rule COMAR 13A.16.06.05

A director must be at least 21, have a high school diploma or equivalent, and have 90 clock hours (6 semester hours) of approved preservice training or a CDA credential, plus 9 hours on communicating with staff and parents, 3 semester hours of administrative training, 3 hours of ADA training, basic health and safety training within 90 days, and MSDE regulation training within 6 months of hire. The director must be on site at least half of the center's weekly operating hours and complete 12 hours of continued training a year (at least 6 in core of knowledge). Preschool directors also need experience and, for larger centers, college credit or a degree (13A.16.06.06).

SafePass tip: SafePass staff profiles store certifications with expiration dates, so credential documents are in one place for the licensor.

Child care teachers in preschool centers

COMAR 13A.16.06.09 Effective July 2015 Centers View rule COMAR 13A.16.06.09

A preschool teacher must be 19 or older (see the note above about 18-year-olds), have a high school diploma or equivalent, 90 clock hours or 6 semester hours of approved preservice training (or a CDA), 3 hours of ADA training, 9 hours on communicating with staff and parents, basic health and safety training within 90 days, and a year of supervised experience or college. Teachers of infants and toddlers need 3 semester hours of infant-toddler training and breastfeeding-support training. Teachers complete 12 hours of continued training a year.

Probationary teachers

COMAR 13A.16.06.09-1 Effective November 2023 Centers View rule COMAR 13A.16.06.09-1

A first-time teacher with an associate or bachelor's degree may teach children 3 and older for up to 6 months while finishing training: with a degree in early childhood or a related field they must be enrolled in the 90-hour preservice course; with an unrelated degree they must already have 45 of the 90 hours. Health and safety training must be done within 90 days, and ADA and the rest of preservice within 6 months, or the person must be removed from teaching. Chapter 361 of 2026 extends this to rooms of 2-year-olds; COMAR has not yet been updated.

Aides

COMAR 13A.16.06.12 Effective January 2020 Centers View rule COMAR 13A.16.06.12

Aides must be at least 16, work under the direct supervision of the staff person in charge of the group, complete basic health and safety training within 90 days, and complete 6 hours of continued training a year. An aide hired since 2009 without 90 hours of early childhood training must complete an MSDE-guided orientation on supervision, professionalism and working with parents within 6 months.

Substitutes

COMAR 13A.16.06.13 Effective July 2015 Centers View rule COMAR 13A.16.06.13

Substitutes must be 18 or older (substitute aides 16). Centers must bring in substitutes whenever needed to keep ratios. If a substitute is needed for more than 2 weeks in a row, they must meet the qualifications of the absent staff member unless the center shows it tried and failed to find one, or gets permission for family or medical leave.

Family child care providers

COMAR 13A.15.06.01 Effective October 2008 Family child care View rule COMAR 13A.15.06.01

A family child care provider must be at least 18. Before registration they need current first aid and CPR, either 24 hours of approved training across the six core of knowledge areas or an equivalent (90-hour course, CDA, or an early childhood degree), emergency and disaster planning training, breastfeeding-support, 3 hours of ADA and medication administration training, and basic health and safety training within 90 days (13A.15.06.02).

Large family home teachers and directors

COMAR 13A.18.06.06 Effective January 2020 Family child care View rule COMAR 13A.18.06.06

In a large family home, a family child care teacher must be 19 or older with a high school diploma, 90 hours of preservice training (or a CDA or NAFCC accreditation), 9 hours on communication, 3 hours of ADA and basic health and safety training. The director (the provider unless someone else is designated) must be 21, meet preservice and administrative training rules, have infant-toddler training and a year of experience, and be present at least half the operating hours (13A.18.06.05).

Who can't work in a center

COMAR 13A.16.06.03 Effective April 2022 Centers View rule COMAR 13A.16.06.03

A center may not employ anyone with a conviction, probation before judgment, not-criminally-responsible finding or pending charge for crimes involving a child, animal cruelty, domestic violence, weapons, sex offenses, violent felonies, kidnapping, abuse of a child or adult, confinement of an unattended child, drug distribution within 5 years, perjury, pornography, reckless endangerment, murder, spousal abuse or arson. For other offenses or an indicated abuse/neglect finding, the licensing office assesses suitability case by case. A person found unsuitable can ask for reassessment once every 12 months and can appeal to the Office of Administrative Hearings.

Not alone with children until cleared

COMAR 13A.16.07.06 Effective January 2020 Centers View rule COMAR 13A.16.07.06

Until an employee or staff member has passed federal and State criminal background checks and the abuse and neglect records review, they may not be alone with an unrelated child. Cleared staff must accompany children whenever another adult is present, with narrow exceptions (parents, authorized service providers, school employees), and stay within sight and sound of any contractor whose checks are not on file.

Report new hires and departures in 5 working days

COMAR 13A.16.03.06 Effective January 2020 Centers View rule COMAR 13A.16.03.06

Within 5 working days of hiring, tell the licensing office the person's name, date of birth, hire date and assignment, with proof of the criminal background check and notarized permission to check abuse and neglect records; send proof of qualifications within 15 working days. Report departures within 5 working days. A new adult (18+) living on the premises must also be reported and fingerprinted within 5 working days.

Family home substitutes, additional adults and volunteers

COMAR 13A.15.06.03 Effective January 2020 Family child care View rule COMAR 13A.15.06.03

Every family child care provider must designate at least one MSDE-approved substitute who is 18 or older, has a medical evaluation from the past 12 months, abuse and neglect clearance and federal and State fingerprint checks. Additional adults (13A.15.06.04) need the same plus first aid/CPR for under-2s and SIDS training. Volunteers need fingerprint checks and must be accompanied around unrelated children (13A.15.06.05).

SafePass tip: SafePass stores each staff member's background check date in their profile so you can show the licensor when each person was cleared.

Annual continued training (centers)

COMAR 13A.16.06.09 Effective July 2015 Centers View rule COMAR 13A.16.06.09

Directors and child care teachers complete at least 12 clock hours of approved training per year of employment (at least 6 core of knowledge, at most 6 elective), documented on a professional development plan. Assistant teachers and aides complete 6 hours (13A.16.06.11–.12). The director documents that every staff member finishes the health and safety training MSDE requires each calendar year.

SafePass tip: SafePass keeps staff training records with dates in each staff profile and tracks certification expiration dates, with reminders 30 days out.

Family child care training

COMAR 13A.15.06.02 Effective January 2020 Family child care View rule COMAR 13A.15.06.02

Family providers keep current first aid and CPR for every age group they serve, complete 18 hours of approved training in the first year, then 12 hours every year (at least 6 core of knowledge), plus the annual health and safety training, documented on a professional development plan. Caring for more than 2 children under 2 requires 45 clock hours (3 semester hours) of infant-toddler training, and caring for any child under 24 months requires SIDS training within the past 5 years.

Medication administration training

COMAR 13A.16.11.04 Effective February 2024 CentersFamily child care View rule COMAR 13A.16.11.04

Whenever children are present, at least one employee who has completed MSDE-approved medication administration training must be on site, and only trained employees may give medication, unless the center uses a nurse or certified medication technician or a delegating nurse. Family providers must also complete approved medication administration training (13A.15.06.02, 13A.15.11.04G).

Sick children

COMAR 13A.16.11.01 Effective October 2008 Centers View rule COMAR 13A.16.11.01

Staff must watch for signs of acute illness, notify the parent, and isolate the child within sight and hearing of an adult. A child with symptoms of acute illness may not be admitted or stay in care (except at centers approved for ill children). After 3 or more days absent for illness, a child needs a written note from the parent or physician to return.

SafePass tip: SafePass can run an optional health check at check-in (temperature and symptoms) and notifies directors and parents when a child doesn't pass.

Handwashing and diapering

COMAR 13A.16.11.03 Effective January 2020 Centers View rule COMAR 13A.16.11.03

Post an MSDE-approved handwashing procedure at every handwashing sink. Staff, volunteers and children wash hands after toileting or diapering, before preparing food or eating, and after outdoor play or handling animals. Diapering follows a written procedure approved by the licensing office.

Alcohol, tobacco, cannabis and vaping

COMAR 13A.16.11.05 Effective February 2024 CentersFamily child care View rule COMAR 13A.16.11.05

No one may drink alcohol, use cannabis or be under the influence while at the center during operating hours, on off-site activities or during transport. No smoking or vaping in any indoor or outdoor area approved for child care while children are or will be present, and alcohol, tobacco, cannabis (including edibles) and vaping products must be kept out of children's reach. Family homes follow the same rule, and must tell prospective parents if a resident smokes or vapes (13A.15.11.05).

Staff health evaluations

COMAR 13A.16.06.04 Effective January 2020 Centers View rule COMAR 13A.16.06.04

Every staff member and on-site support staff needs a medical evaluation, done within 6 months before starting, confirming they are free of communicable tuberculosis if indicated and able to do the job. It transfers between centers if less than 24 months old and must be updated every 5 years. Staff with a serious communicable disease may not work during the exclusion period.

Safe use of furnishings and equipment

COMAR 13A.16.10.03 Effective October 2008 Centers View rule COMAR 13A.16.10.03

Furnishings, activity materials and equipment, indoors and out, must be used safely and appropriately by staff and children and, where applicable, according to the manufacturer's instructions and recommendations. Maryland has no separate furniture-anchoring rule, so this regulation and 13A.16.05.01 (building kept free from health and safety hazards) are what an inspector would cite for a tip-over hazard. Anchoring tall shelves, dressers and TVs, as their manufacturers instruct, is the practical way to comply.

Hazardous items, outlets, firearms and window cords

COMAR 13A.16.10.04 Effective February 2024 Centers View rule COMAR 13A.16.10.04

Store all potentially harmful items where children can't reach them; keep cleaning agents and poisons apart from food, labeled; use only EPA-approved pesticides, applied when children aren't in care. Plug or cap child-accessible outlets as the fire code requires. No firearms on center premises (except small centers in a residence, where they must be unloaded, partly disassembled and locked with ammunition locked separately). Window coverings installed since October 1, 2010 must be cordless, and older ones may not have accessible cords, beads or strings.

Hot water and drinking water

COMAR 13A.16.05.07 Effective October 2008 Centers View rule COMAR 13A.16.05.07

Hot water may not exceed 120°F. Provide at least one drinking water source for every 40 children that 2-year-olds and older can use without help and that isn't in a toilet room or handwashing sink. Centers must notify parents in writing within 10 business days if their water supplier reports contamination (13A.16.03.06G).

Lead-safe environment

COMAR 13A.16.05.05 Effective January 2020 Centers View rule COMAR 13A.16.05.05

Lead paint may not be used anywhere in the facility. In a building built before 1978 that isn't certified lead-free, there may be no chipping, peeling or deteriorated paint in child care areas, and a lead dust test is required when deterioration is found or renovation disturbs painted surfaces. Rental properties built before 1978 must submit a current lead risk reduction certificate.

Outdoor play area and pools

COMAR 13A.16.05.12 Effective January 2020 Centers View rule COMAR 13A.16.05.12

Centers need an outdoor activity area with adequate play space; centers that filed a notice of intent since 2009 need at least 75 square feet of usable play space for half the approved capacity (or for each child if capacity is 20 or fewer). Equipment must be safe and in good repair. Any pool on the premises must be inaccessible, with a fence at least 4 feet high, a self-closing, self-latching locked gate and an alarm.

Family home hazards

COMAR 13A.15.10.02 Effective February 2024 Family child care View rule COMAR 13A.15.10.02

Family homes must keep knives, sharp tools, firearms, matches, alcohol, tobacco, cannabis, cannabis edibles and vaping products stored and out of children's reach. Children may not use climbing equipment with a fall height of 7 feet or more or use a trampoline (which must be made inaccessible), and may not use above-ground or inflatable/fill-and-drain pools (13A.15.10.03–.04).

Center emergency and disaster plan and drills

COMAR 13A.16.10.01 Effective March 2011 Centers View rule COMAR 13A.16.10.01

At least one employee completes MSDE-approved emergency preparedness training and writes the center's plan, covering evacuation and route, relocation to a safe site, shelter in place, notifying parents, and children with special needs, plus contacts for the local emergency operations center, staff assignments and the local Emergency Alert System station. Practice fire evacuation monthly and other emergencies twice a year, update the plan yearly, post escape-route floor plans in every room, and take attendance records out during every drill or evacuation to account for each child. Keep a written record of drill dates and times (13A.16.03.03B(4)).

SafePass tip: During an evacuation, SafePass's checked-in list shows exactly who is in attendance, and parent messaging can reach every family at once. SafePass does not keep drill logs, so record drill dates and times separately.

Family home emergency plan and drills

COMAR 13A.15.10.01 Effective January 2020 Family child care View rule COMAR 13A.15.10.01

Family providers write and maintain the same kind of plan, practice fire evacuation monthly and other emergencies twice a year (and four times a year with children present if offering overnight care), update it yearly, post the escape route floor plan, train substitutes and additional adults on it, teach children to call 9-1-1, and take attendance records and emergency cards out during drills.

First aid and CPR on site

COMAR 13A.16.10.02 Effective January 2020 Centers View rule COMAR 13A.16.10.02

At all times, including off-site, at least one teacher or the director with current first aid and CPR certification appropriate to every age group served must be present. Centers approved for more than 20 children need certified staff in attendance at a ratio of at least 1 per 20 children present, and every vehicle transporting children needs a certified adult. (A 2025 law lets MSDE set this ratio; a proposal to change the school-age rules is pending.)

SafePass tip: SafePass tracks each staff member's first aid and CPR expiration dates, reminds them 30 days out and alerts directors when one lapses.

Giving and storing medication

COMAR 13A.16.11.04A–G Effective February 2024 CentersFamily child care View rule COMAR 13A.16.11.04A–G

No medication, prescription or over-the-counter, may be given unless the center has the parent's signed and dated MSDE authorization form and a licensed health practitioner has approved the medication and dose. A prescription medication must already have been given at least once at home, and must carry the pharmacy label. Parent-supplied diaper cream, sunscreen and insect repellent need no practitioner approval but must be noted. Record every dose in the child's record, store medicines out of children's reach, labeled with the child's name, dose and expiration date, and give medicine only through trained staff. Family homes follow the same rules (13A.15.11.04).

SafePass tip: SafePass collects the parent's signed medication request; staff approve it and log each dose with time, amount and staff name, and the parent gets a notification. You still need the licensed health practitioner's approval on MSDE's form.

Self-administration and medical cannabis

COMAR 13A.16.11.04H–I Effective February 2024 CentersFamily child care View rule COMAR 13A.16.11.04H–I

A child may carry and use their own medication only with a written physician's order, a written parent request, and a written self-administration procedure, which the operator can revoke. Medical cannabis given by a caregiver to a qualifying patient follows Maryland Cannabis Administration rules (COMAR 10.62), and smoked or vaped cannabis is prohibited.

Immunization, health and lead records (centers)

COMAR 13A.16.03.04 Effective January 2020 Centers View rule COMAR 13A.16.03.04

Before admission, get an immunization record showing age-appropriate vaccines under Maryland Department of Health guidelines (or at least one dose of each with the rest scheduled, a medical contraindication, or a religious objection with a signed health statement), a physician's medical evaluation (within 2 months for babies under 9 months, 3 months for 9–24 months, 12 months for 2 and older), and lead test documentation (children born since 2015 are tested at 12 and 24 months). School-age children in a program at their own school are exempt from the immunization record rule.

SafePass tip: SafePass lets parents upload vaccine records; staff verify them, the dashboard lists overdue and due-soon doses, and parents get reminders 30 and 7 days before a recorded due date.

Temporary admission while records are pending

COMAR 13A.16.03.02 Effective January 2020 Centers View rule COMAR 13A.16.03.02

A child who is homeless, or whose parent can't produce the required health records, may be admitted temporarily if the parent shows an appointment, no later than 20 calendar days out, to get the evaluation, immunizations or records. If the parent doesn't bring the records within 3 business days after the appointment, the child must be excluded.

Family home admission records

COMAR 13A.15.03.02 Effective January 2020 Family child care View rule COMAR 13A.15.03.02

Family providers also need age-appropriate immunization evidence on an MSDE-approved form before admitting a child, with the same temporary-admission option when the parent is getting the records.

Meals, drinks and menus

COMAR 13A.16.12.01 Effective January 2020 CentersFamily child care View rule COMAR 13A.16.12.01

Food and drinks the center provides must meet CACFP guidelines; the center supplies all beverages and milk with every meal unless the parent provides them. No drinks with added sweeteners or caffeine (except formula or prescribed drinks). Children 2 and older get 1% or nonfat milk unless a health care provider or parent asks otherwise. Serve meals or snacks at least every 3 hours, post a weekly menu, and keep a dated record of food actually served for 4 weeks. Family homes follow parallel rules (13A.15.12.01).

SafePass tip: SafePass weekly menus and meal logs show parents what was served and how much their child ate.

Infant feeding

COMAR 13A.16.12.06 Effective October 2008 Centers View rule COMAR 13A.16.12.06

Follow each infant's and toddler's written feeding schedule and update it at least every 3 months. Hold babies for bottle feeding unless they are developmentally able and insist on holding the bottle while seated. Label and refrigerate bottles and infant food, warm milk right before feeding, and don't serve foods that are a high choking risk. Keep daily records of what each infant and toddler ate and drank for 4 weeks, available to parents (13A.16.03.04K).

SafePass tip: SafePass daily activity logs record bottles and meals for each child, and parents see them the same day.

Modified diets

COMAR 13A.16.12.02 Effective October 2008 Centers View rule COMAR 13A.16.12.02

A child on a medically modified diet needs a written prescription signed by the child's health practitioner within the past 6 months; a cultural or religious diet needs dated written instructions from the parent.

Back to sleep, no swaddling or weighted items

COMAR 13A.16.10.05 Effective April 2024 Centers View rule COMAR 13A.16.10.05

Unless a physician or other licensed health care provider directs otherwise in writing, a child who can't roll over is put to sleep on their back, and a baby under 12 months who can roll over is put down on their back but may then choose their position. No restricting device of any kind, including swaddling, without a written medical order, and no weighted blankets, sleepers or swaddles for children under 12 months.

Cribs and rest furnishings (centers)

COMAR 13A.16.09.04 Effective April 2024 Centers View rule COMAR 13A.16.09.04

Each child under 12 months needs a CPSC-compliant crib (not stackable) with a snug mattress, waterproof cover and tight fitted sheet on a firm, flat, non-inclined surface; no pillows, quilts, comforters or bumpers. Cribs must have a long side open and be spaced at least 3 feet apart side to side (18 inches end to end) unless separated by a solid barrier. A baby who falls asleep anywhere else must be moved to a crib right away. Children 12 months to 5 years present more than 4 hours need a cot or mat.

15-minute checks in family homes

COMAR 13A.15.08.01 Effective January 2020 Family child care View rule COMAR 13A.15.08.01

In a family home, a resting child under 2 must be within sight and sound of the provider and checked at least every 15 minutes to make sure they are safe, breathing normally and not in distress; a video and sound monitor may meet the sight-and-sound part. Children 2 and older are also checked every 15 minutes, and doors to the room must stay open. Large family homes must observe resting children at least every 15 minutes too (13A.18.08.08).

SafePass tip: SafePass nap logs record when each child went down and woke up, and parents see them. SafePass does not keep 15-minute sleep-check logs, so keep those on paper or in another system.

Family home cribs and bedding

COMAR 13A.15.05.06 Effective April 2024 Family child care View rule COMAR 13A.15.05.06

Each child under 12 months needs a CPSC-compliant crib, portable crib or playpen with a firm, flat, non-inclined sleep surface and no soft bedding or bumpers, and a baby who falls asleep elsewhere must be moved to it immediately. Older children need their own bed, cot, mat or sleeping bag with clean linens.

No physical discipline; written policy

COMAR 13A.16.07.03 Effective January 2020 CentersFamily child care View rule COMAR 13A.16.07.03

Discipline must suit the child's age, maturity and physical condition. Staff may not spank, hit, shake or use any physical discipline, force a child to eat or drink, punish a child for not eating, or withhold food as punishment. Centers write a discipline policy, give it to parents (and prospective parents) and the licensing office, and make sure everyone follows it. Family homes follow the same prohibitions (13A.15.07.04).

Reporting abuse and neglect

COMAR 13A.16.07.02 Effective January 2020 CentersFamily child care View rule COMAR 13A.16.07.02

Any operator, employee, substitute or volunteer who suspects abuse must report directly to the local department of social services or law enforcement (neglect to the local department), and the center may not require reports to go through the director. Post the CPS and police numbers near every phone and train staff to watch for signs of abuse daily.

Child records and the emergency form

COMAR 13A.16.03.04 Effective January 2020 Centers View rule COMAR 13A.16.03.04

Keep each child's records on MSDE-provided or approved forms, accessible to staff, during enrollment and for 2 years after. The emergency form lists the parent's contact details, who may pick the child up daily and in an emergency, the child's physician, and special health instructions; it is signed by the parent, updated at least yearly, and taken on off-site activities. Also keep records of illness exclusions, reportable injuries, medication, special diets and field trip permissions.

SafePass tip: SafePass registration packets collect guardians, emergency contacts, authorized pickups, physician and allergy information, with a parent signature.

Staff records and posted staffing pattern

COMAR 13A.16.03.05 Effective January 2020 Centers View rule COMAR 13A.16.03.05

Keep a current list of everyone who works at the center, and post a staffing pattern showing the number and ages of children, the ratio across the daily schedule and each staff member's assignment. Keep each person's training, experience, age verification, medical evaluation and the date they received orientation for 2 years after they leave, but destroy criminal background check results as soon as they leave.

SafePass tip: SafePass staff profiles keep training and certification records with dates, and the time clock records who worked each day.

Injury and incident notifications

COMAR 13A.16.03.06 Effective January 2020 Centers View rule COMAR 13A.16.03.06

Notify the licensing office within 24 hours if a child dies at the center or of a contagious disease, or is injured at the center or on a field trip and needs treatment by a medical professional or hospitalization. Tell parents immediately about serious injuries and the same day about any other injury or accident. Notify the office immediately if an employee or resident is under investigation for a crime or child abuse.

SafePass tip: SafePass incident reports record what happened, the action taken and first aid, notify the parent, and capture the parent's e-signature.

Program records and Infants and Toddlers notice

COMAR 13A.16.03.03 Effective March 2025 CentersFamily child care View rule COMAR 13A.16.03.03

Keep enrollment and attendance records for 2 years, the discipline policy, 4 weeks of food served, and drill dates and times. Since March 17, 2025, centers must also document that at least once each calendar year the parent of every child under 3 got information about the Maryland Infants and Toddlers Program and the local lead agency's contact; email or text counts. Family homes have the same requirement (13A.15.03.03H).

SafePass tip: SafePass messaging gives you a dated record of the annual Infants and Toddlers Program notice sent to each family.

Daily attendance verified by parents (centers)

COMAR 13A.16.03.03 Effective March 2025 Centers View rule COMAR 13A.16.03.03

Centers keep attendance by group showing the dates each child attended, with each parent's verification of that child's recorded daily attendance, for at least 2 years. They must also have procedures so the whereabouts of every child in attendance is known at all times.

SafePass tip: The SafePass Kiosk records each check-in and check-out with a timestamp and who dropped off or picked up, and attendance exports as PDF. Ask your licensing specialist whether parent check-in at the kiosk counts as the parent's verification before you retire paper sheets.

Daily attendance verified by parents (family homes)

COMAR 13A.15.03.03 Effective March 2025 Family child care View rule COMAR 13A.15.03.03

Family providers keep a written record of each child's daily attendance verified by the child's parent, plus a record of each day a substitute provided care, and keep them 2 years.

SafePass tip: SafePass Kiosk check-in/out creates the daily drop-off and pick-up record for every child.

Release only to authorized, verified adults

COMAR 13A.16.07.05 Effective October 2008 CentersFamily child care View rule COMAR 13A.16.07.05

Staff may release a child only to the parent or to someone the parent has directed, after verifying their identity. If no one authorized is available, or if Child Protective Services asks, the child may be released to CPS. Family homes follow the same rule (13A.15.07.06).

SafePass tip: At check-out, SafePass shows staff the child's guardians and authorized pickups, with photos, and records who picked the child up.

Children travelling to school alone

COMAR 13A.16.08.01 Effective January 2020 Centers View rule COMAR 13A.16.08.01

A child may go to or from school or a school bus stop without an adult only if the child is in first grade or higher and the parent and operator agree in writing that the child can travel safely.

Car seats and vehicles

COMAR 13A.16.10.06 Effective October 2008 CentersFamily child care View rule COMAR 13A.16.10.06

Unless riding a licensed school bus or contract motor coach, each child is buckled into a car seat or seat belt appropriate to age and weight under Maryland law, and every vehicle must meet State and federal safety requirements. Family homes follow the same seat rule (13A.15.10.05).

A second adult in the vehicle

COMAR 13A.16.08.06 Effective January 2020 Centers View rule COMAR 13A.16.08.06

When the center transports children, a second background-cleared adult besides the driver must be in the vehicle if more than 8 preschoolers ride together, or if the driver isn't a center employee or an authorized parent. A first aid/CPR-certified adult must be on board (13A.16.10.02C). Off-site activity transport by a contractor or school district also needs a second adult.

SafePass tip: SafePass doesn't keep vehicle or transport logs; use the attendance list to count children on and off the vehicle and keep a separate trip record.

Announced and unannounced inspections

COMAR 13A.16.17.02 Effective January 2020 CentersFamily child care View rule COMAR 13A.16.17.02

The licensing office inspects each center on an announced basis before issuing an initial or continuing license and unannounced at least once every 12 months, and may visit without notice at any time during operating hours. Operators must allow access to every area and make all required records available for inspection and copying. A finding can be contested by requesting a review by the regional or central office. Family homes are inspected on the same schedule (13A.15.13.01). From May 1, 2026, annual inspections also cover child records, first aid/CPR, medication administration and child security.

SafePass tip: SafePass keeps attendance, incident, medication and staff records with dates and times, and exports reports as PDF to hand to an inspector.

Warnings and intermediate sanctions

COMAR 13A.16.17.04 Effective January 2020 Centers View rule COMAR 13A.16.17.04

For a violation that isn't an immediate threat, the office may issue a written warning citing the regulation and a correction deadline (13A.16.17.03). If children's health or safety is at risk, it may restrict enrollment, reduce the number of children, require training, increase monitoring, or require a correction agreement and parent notification. Since December 25, 2023 it may also impose these as emergency sanctions, including barring a staff member under investigation from being alone with children (13A.16.17.04-1).

Suspension and revocation

COMAR 13A.16.17.05 Effective January 2020 Centers View rule COMAR 13A.16.17.05

The office may suspend a license for up to 60 days with 20 days' written notice, or immediately in an emergency, and may revoke it for threatening violations, false information, interfering with inspectors, using a prohibited person, breaking child security rules, or violating a sanction (13A.16.17.06–.07). Parents are notified of suspensions and revocations.

Penalties for unlicensed care

COMAR 13A.16.17.08 Effective January 2020 Centers View rule COMAR 13A.16.17.08

Operating a center without a license is a misdemeanor punishable by a fine of up to $1,500 for a first offense and $2,500 after that. Civil penalties are up to $1,000 per violation, each day counting separately, with a cap of $5,000 per civil action.

Requesting a hearing

COMAR 13A.16.18.03 Effective January 2020 Centers View rule COMAR 13A.16.18.03

A center may request a hearing before the Office of Administrative Hearings to contest a license denial, suspension, revocation, reduced capacity or age limits, a civil penalty, or a decision barring an employee. Request it in writing within 20 days of the notice; a timely request stays most non-emergency actions. For emergency actions, request within 30 days; the hearing is held within 7 days and decided within 7 days after, but the request does not stop the emergency action.

Decision and court appeal

COMAR 13A.16.18.08 Effective April 2010 CentersFamily child care View rule COMAR 13A.16.18.08

The administrative law judge's decision is the Department's final decision, with findings of fact and conclusions of law. A party may appeal to the circuit court within 30 days of the notice of decision. Family homes have the same process (13A.15.14).

Review of inspection findings (family homes)

COMAR 13A.15.13.01 Effective March 2011 Family child care View rule COMAR 13A.15.13.01

A family provider who disagrees with a noncompliance finding may ask for a review by the regional office or MSDE's central office. Restrictions on capacity, ages or hours can be appealed by requesting a hearing within 20 calendar days (30 days for an emergency reduction) (13A.15.04.04C).