# Nebraska child care, camp and ratio rules

Source: https://backpr.com/resources/states/nebraska. Last updated: 2026-10-19.

Checked October 2026 against Nebraska's official rules and federal sources. General information, not legal advice; confirm with the agency.

### Child care licensing
Child care for four or more children at a time generally needs a DHHS license under the Child Care Licensing Act (Neb. Rev. Stat. §§ 71-1908 to 71-1923). Rules exist for Family Child Care Homes I and II, child care centers (13 or more children), school-age-only centers (13 or more children in kindergarten or above) and preschools (391 NAC chapters 1-5).

After-school and recreation programs: Exempt programs include services offered only to school-age children during summer and other long school breaks, programs run or contracted by a public school district under State Department of Education rules, recreation camps (Neb. Rev. Stat. § 71-3101), and recreation programs run by a city, county or other local government. Care averaging less than two hours a week and care only for children 13 and older are also exempt (391 NAC 3-001.02 and 4-001.02). Exempt programs may still choose to be licensed.

Licensing agency: Nebraska Department of Health and Human Services (DHHS), Division of Public Health, Licensure Unit (Child Care Licensing) (https://dhhs.ne.gov/licensure/Pages/Child-Care-Licensing.aspx)

### Staff-to-child ratios in licensed centers
| Ages | Children per staff member | Largest group |
| --- | --- | --- |
| 3 years | 1:10 | Not set |
| 4 years | 1:12 | Not set |
| 5 years | 1:12 | Not set |
| School-age (kindergarten and up) | 1:15 | Not set |

Rule: 391 NAC 3-006.15C (child care centers); 391 NAC 4-006.14C (school-age-only centers). Nebraska uses a '4 and 5 years' band (1:12). A child counts as school-age (1:15) once in kindergarten, so a 5-year-old in kindergarten is 1:15. Ratios are measured center-wide, and the rules set no maximum group size. Two staff must be on the premises unless there are 12 or fewer children (or 15 or fewer when all are school-age). Center rules effective February 20, 2013.

Sources: 391 NAC 3-006 Standards of Operation and Care (Cornell LII copy of the Nebraska Administrative Code) (https://www.law.cornell.edu/regulations/nebraska/391-Neb-Admin-Code-ch-3-SS-006); 391 NAC 3-001 Scope and exemptions (Cornell LII) (https://www.law.cornell.edu/regulations/nebraska/391-Neb-Admin-Code-ch-3-SS-001); 391 NAC 4-006 School-age-only centers (Cornell LII) (https://www.law.cornell.edu/regulations/nebraska/391-Neb-Admin-Code-ch-4-SS-006); ChildCare.gov Nebraska licensing resources (links to DHHS pages) (https://childcare.gov/state-resources/nebraska/understanding-and-finding-child-care-resources)

### Summer camps
Recreation camps need an annual DHHS permit to operate under 178 NAC 1, Rules and Regulations Relating to Recreation Camps. The rules mainly cover the campsite, buildings, water, plumbing, sewage, food, swimming pools, safety, first aid and health records. Recreation camps are exempt from child care licensing. A summer-only program for school-age children is also exempt from child care licensing.

Sources: 178 NAC 1, Recreation Camps (Cornell LII) (https://www.law.cornell.edu/regulations/nebraska/health-and-human-services-system/title-178/chapter-1); 178 NAC 1-012 Health of campers and staff (Cornell LII) (https://www.law.cornell.edu/regulations/nebraska/178-Neb-Admin-Code-ch-1-SS-012); 391 NAC 3-001 exemptions (Cornell LII) (https://www.law.cornell.edu/regulations/nebraska/391-Neb-Admin-Code-ch-3-SS-001)

### Background checks
Under the center rules, the licensee, every staff member and volunteer aged 19 or older (and household members if the center is in a home) need a criminal history check before employment, through the Nebraska State Patrol or local law enforcement. Everyone must also clear the Nebraska child abuse/neglect central register (age 13 and older), the adult protective services registry (18 and older) and the State Patrol sex offender registry before caring for children (391 NAC 3-006.03). The recreation camp rules contain no background check requirement.

Sources: 391 NAC 3-006.03 (Cornell LII) (https://www.law.cornell.edu/regulations/nebraska/391-Neb-Admin-Code-ch-3-SS-006)

### Giving medication
Staff may give prescription or over-the-counter medication only with prior written permission and written instructions from a parent, following the 'Five Rights' (right drug, child, dose, route and time). A prescriber's written statement is needed for as-needed prescriptions or unusual routes. All medication is kept locked in its original container labeled for the child, and the time and amount of each dose is recorded. Errors must be reported to the parent (391 NAC 3-006.27).

Sources: 391 NAC 3-006.27 Medications (Cornell LII) (https://www.law.cornell.edu/regulations/nebraska/391-Neb-Admin-Code-ch-3-SS-006)

### Reporting child abuse
Nebraska requires any person who suspects child abuse or neglect to report it, not only listed professionals. Reports go to law enforcement or the DHHS hotline. Center directors must immediately report, or make sure a report is filed, with the Child Abuse-Neglect Hotline and/or local law enforcement (391 NAC 3-006.02). Hotline: 1-800-652-1999 (https://www.education.ne.gov/wp-content/uploads/2019/08/LB281Posters-Break-the-Silence.pdf).

Sources: Child Welfare Information Gateway, Mandatory Reporting of Child Abuse and Neglect (current through May 2023) (https://www.childwelfare.gov/resources/mandatory-reporting-child-abuse-and-neglect/); Nebraska Department of Education hotline poster (https://www.education.ne.gov/wp-content/uploads/2019/08/LB281Posters-Break-the-Silence.pdf); 391 NAC 3-006.02 (Cornell LII) (https://www.law.cornell.edu/regulations/nebraska/391-Neb-Admin-Code-ch-3-SS-006)