(1) Licensees must provide appropriate-sized separate beds that are in good condition for all children and youth in care, with a:

(a) Mattress;

(b) Bed frame, unless the bed frame is not appropriate because of the child's or youth's preference or medical or cultural needs; and

(c) Clean bedding.

(2) Licensees must:

(a) Not allow children or youth to use loft-style beds or upper bunks if it is not safe for them because of their developmental capabilities or if they are pregnant;

(b) Provide waterproof mattress covers or moisture-resistant mattresses if needed; and

(c) Cover children's and youth's pillows with waterproof material or provide washable pillows.

(3) Licensees may provide mats for napping but not as a substitute for beds overnight.

(4) Licensees licensed to care for infants:

(a) Must:

(i) Provide infants with safe cribs that comply with chapter 70.111 RCW, Infant Crib Safety Act, including:

(A) A maximum of 2 and 3/8 inches between vertical slats of the crib;

(B) Cribs, infant beds, bassinets, and playpens made of wood, metal, or approved plastic, with secure latching devices; and

(C) Clean, firm, snug-fitting mattresses covered with waterproof material that can easily be disinfected;

(ii) Place infants on their backs for sleeping, unless advised differently by the infant's licensed health care provider;

(iii) Not have loose blankets, pillows, crib bumpers, or stuffed toys with sleeping infants;

(iv) Not use wedges and positioners with sleeping infants unless advised differently by the infant's licensed health care provider; and

(v) Comply with any plans made in compliance with WAC 110-145-3060 regarding baby boards or moss bags;

(b) May swaddle infants:

(i) Under two months old, unless directed otherwise by a licensed health care provider; and

(ii) Over two months old only when advised by a licensed health care provider; and

(c) When swaddling infants, licensees must:

(i) Be trained on proper swaddling techniques for infants;

(ii) Use one lightweight blanket;

(iii) Keep the blanket loose around the infant's hips and legs to avoid hip dysplasia; and

(iv) Not dress swaddled infants in a manner that allows them to overheat.

(5) Licensees, prior to using weighted blankets, must:

(a) Evaluate if there are safety concerns for a child's or youth's use of a weighted blanket;

(b) Only use weighted blankets under the following conditions:

(i) If the child is three years old or older;

(ii) With an order from a licensed health care provider or occupational therapist;

(iii) When they do not:

(A) Exceed 10 percent of the child's or youth's body weight;

(B) Contain metal beads; and

(C) Hinder children's or youth's movement;

(iv) When they are not homemade;

(c) Not place weighted blankets over children's or youth's heads or above the middle of their chests; and

(d) Not use weighted blankets as restraints.

(6) If children or youth are admitted with a weighted blanket without an order from a licensed health care provider or occupational therapist, licensees:

(a) Must obtain an order from a licensed health care provider or occupational therapist within 14 calendar days to continue using the weighted blanket;

(b) May allow children or youth to use their weighted blanket as outlined in subsection (5)(a) through (c) of this section until they have received the order from the licensed health care provider or occupational therapist; and

(c) Must discontinue the use of the weighted blanket if they do not receive the order within 14 calendar days.