(1) You must notify your DLR licensor if you or any adults having access to children in your care, have been exposed to someone with tuberculosis or when a health care provider recommends testing.

(2) Retesting for license renewals is not required unless the above conditions apply.

(3) Staff with a reportable communicable disease or a notifiable disease condition in an infectious stage, as defined by the department of health in chapter 246-101 WAC, must not be on duty until they have a physician's approval for returning to work.

(4) Each facility that cares for medically fragile children must have an infection control program supervised by a nurse licensed by the department of health. Staffed residential homes licensed for five or fewer children who are medically fragile may use other methods to develop infection control procedures, such as in-home nursing services, upon approval by the department.

(5) You must promote personal hygiene to help prevent the spread of germs.

(6) You must have written policies and procedures about the control of infections. These must include, but are not limited to, the following areas:

(a) Isolation of sick children;

(b) Germ control procedures;

(c) Hygiene, including hand washing, using the toilet, diapering, and laundering;

(d) Prevention of the transmission of communicable diseases including management and reporting;

(e) First aid;

(f) Care of minor illnesses;

(g) Actions to be taken for medical emergencies;

(h) Infant care procedures when infants are under care; and

(i) General health practices.

(7) If you are licensed to care for thirteen or more persons at once, you must arrange to have one of the following people help you develop and periodically review your medication management and your medical policies and procedures:

(a) An advisory physician;

(b) A physician's assistant; or

(c) A registered nurse.