Texas childcare rule 746.3819

Food allergy emergency plan required; caregivers must be aware of each child individual allergies.

Med-High severity #14 most-cited rule in Texas 875 cited findings

Source: TX HHSC public inspection records · last reviewed 5/12/2026

By the numbers

875
Lifetime citations of 746.3819 in Texas
765
Distinct facilities cited for this rule
#14
Most-cited rule rank in Texas
Med-High
Severity tier

What inspectors look for

  • Caregiver provided child food containing known allergen
  • Food allergy emergency plan not signed by parent and physician
  • Allergy posting not current in food preparation area
  • Substitute caregiver unaware of childs allergy
  • Allergic reaction occurred without documented plan

Real inspector narratives (from TX HHSC records)

The operation does not have a completed food allergy plan for a child in care.
During the monitoring visit, one child did not have a food allergy emergency plan available for review during the monitoring visit.
Three children with food allergies were missing the action plans and the medication.
A child with a diagnosed food allergy did not have a parent signature on their food allergy emergency plan. Note: This was corrected at the inspection when the mom signed the FARE form at pick up.
The operation did not ensure compliance with the allergy action plan signed by the parent and medical professional. The parent did not provide the prescribed medication to the operation. The operation is unable to implement the emergency plan without the medication on site, putting the child at risk in the event of exposure to the allergen.

How to stay compliant with 746.3819

Use the evidence list above as a daily-walk-through checklist. Most 746.3819 citations come from documentation gaps that surface during routine inspection — not surprise findings. Build the habit of capturing evidence (signed forms, dated logs, training records) and most of these go away.

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Frequently asked questions

What does Texas childcare rule 746.3819 require?

Food allergy emergency plan required; caregivers must be aware of each child individual allergies.

What evidence do TX HHSC inspectors look for under 746.3819?

Inspectors typically check for: Caregiver provided child food containing known allergen; Food allergy emergency plan not signed by parent and physician; Allergy posting not current in food preparation area; Substitute caregiver unaware of childs allergy; Allergic reaction occurred without documented plan.

How often is 746.3819 cited in Texas?

746.3819 is the #14 most-cited rule in Texas, with 875 lifetime citations across TX HHSC inspections — at least 765 distinct facilities have been cited for this rule.

What is the severity of 746.3819 citations?

Med-High severity. Medium-high citations are common drivers of inspection follow-ups and corrective-action plans.

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