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Caring for Our Children, National Health and Safety Performance Standards,4th Edition

By American Academy of Pediatrics
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The fourth edition contains guidelines on the development and evaluation of the health and safety of children in early care and education settings.

https://shop.aap.org/caring-for-our-children-national-health-and-safety-performance-standards-4th-edition-paperback/

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  1. Page ix
    Acknowledgments
  2. Page xvii
    Introduction
  3. Page xix
    Guiding Principles
  4. Page xx
    Advice to the User
  5. Page xxiii
    History of Caring for Our Children Standard Language Changes Since the 3rd Edition (Through July 2018)
  6. Page 1
    1. Staffing
    1. Page 3
      Child:Staff Ratio, Group Size, and Minimum Age
      1. Page 3
        Child:Staff Ratio and Group Size
      2. Page 7
        Minimum Age
    2. Page 9
      Recruitment and Background Screening
    3. Page 11
      Pre-service Qualifications
      1. Page 11
        Director’s Qualifications
      2. Page 12
        Caregiver’s/Teacher’s and Other Staff Qualifications
      3. Page 19
        Family Child Care Home Caregiver/Teacher Qualifications
    4. Page 21
      Professional Development/Training
      1. Page 21
        Pre-service Training
      2. Page 23
        Orientation Training
      3. Page 26
        First Aid and CPR Training
      4. Page 28
        Continuing Education/Professional Development
      5. Page 31
        Specialized Training/Education
      6. Page 33
        Educational Leave/Compensation
    5. Page 34
      Substitutes
    6. Page 36
      Consultants
    7. Page 42
      Staff Health
    8. Page 46
      Human Resource Management
      1. Page 46
        Benefits
      2. Page 47
        Evaluation
  7. Page 49
    2. Program Activities for Healthy Development
    1. Page 51
      Program of Developmental Activities
      1. Page 51
        General Program Activities
      2. Page 59
        Program Activities for Infants and Toddlers from Three Months to Less Than Thirty-Six Months
      3. Page 64
        Program Activities for Three- to Five-Year-Olds
      4. Page 66
        Program Activities for School-Age Children
    2. Page 68
      Supervision and Discipline
    3. Page 80
      Parent/Guardian Relationships
      1. Page 80
        General
      2. Page 82
        Regular Communication
      3. Page 84
        Health Information Sharing
    4. Page 85
      Health Education
      1. Page 85
        Health Education for Children
      2. Page 88
        Health Education for Staff
      3. Page 90
        Health Education for Parents/Guardians
  8. Page 93
    3. Health Promotion and Protection
    1. Page 95
      Health Promotion in Child Care
      1. Page 95
        Daily Health Check
      2. Page 96
        Routine Health Supervision
      3. Page 97
        Physical Activity and Limiting Screen Time
      4. Page 102
        Safe Sleep
      5. Page 108
        Oral Health
    2. Page 111
      Hygiene
      1. Page 111
        Diapering and Changing Soiled Clothing
      2. Page 118
        Hand Hygiene
      3. Page 122
        Exposure to Body Fluids
    3. Page 125
      Cleaning, Sanitizing, and Disinfecting
    4. Page 127
      Health Protection in Child Care
      1. Page 127
        Tobacco and Drug Use
      2. Page 128
        Animals
      3. Page 131
        Emergency Procedures
      4. Page 132
        Child Abuse and Neglect
      5. Page 135
        Sun Safety and Insect Repellent
      6. Page 138
        Strangulation
    5. Page 139
      Care Plans and Adaptations
    6. Page 141
      Management of Illness
      1. Page 141
        Inclusion/Exclusion Due to Illness
      2. Page 147
        Caring for Children Who Are Ill
      3. Page 153
        Medications
      4. Page 155
        Reporting Illness and Death
  9. Page 159
    4. Nutrition and Food Service
    1. Page 161
      Introduction
    2. Page 162
      General Requirements
    3. Page 174
      Requirements for Special Groups or Ages of Children
      1. Page 174
        Nutrition for Infants
      2. Page 184
        Nutrition for Toddlers and Preschoolers
      3. Page 186
        Nutrition for School-Age Children
    4. Page 187
      Staffing
    5. Page 188
      Meal Service, Seating, and Supervision
    6. Page 193
      Food Brought From Home
    7. Page 194
      Nutrition Learning Experiences for Children and Nutrition Education for Parents/Guardians
    8. Page 197
      Kitchen and Equipment
    9. Page 200
      Food Safety
    10. Page 206
      Meals from Outside Vendors or Central Kitchens
  10. Page 209
    5. Facilities, Supplies, Equipment, and Environmental Health
    1. Page 211
      Overall Requirements
      1. Page 211
        General Location, Layout, and Construction of the Facility
      2. Page 215
        Space per Child
      3. Page 217
        Openings
      4. Page 219
        Exits
      5. Page 221
        Steps and Stairs
      6. Page 222
        Exterior Areas
    2. Page 224
      Quality of the Outdoor and Indoor Environment
      1. Page 224
        Ventilation, Heating, Cooling, and Hot Water
      2. Page 230
        Lighting
      3. Page 232
        Noise
      4. Page 233
        Electrical Fixtures and Outlets
      5. Page 234
        Fire Warning Systems
      6. Page 235
        Water Supply and Plumbing
      7. Page 239
        Sewage and Garbage
      8. Page 241
        Integrated Pest Management
      9. Page 243
        Prevention and Management of Toxic Substances
    3. Page 253
      General Furnishings and Equipment
      1. Page 253
        General Furnishings and Equipment Requirements
      2. Page 260
        Additional Equipment Requirements for Facilities Serving Children with Special Health Care Needs
    4. Page 261
      Space and Equipment in Designated Areas
      1. Page 261
        Toilet and Handwashing Areas
      2. Page 265
        Diaper Changing Areas
      3. Page 267
        Bathtubs and Showers
      4. Page 268
        Laundry Area
      5. Page 268
        Sleep and Rest Areas
      6. Page 272
        Space for Children Who Are Ill, Injured, or Need Special Therapies
    5. Page 273
      Storage Areas
    6. Page 274
      Supplies
    7. Page 277
      Maintenance
  11. Page 281
    6. Play Areas/Playgrounds and Transportation
    1. Page 283
      Play Area/Playground Size and Location
    2. Page 287
      Play Area/Playground Equipment
      1. Page 287
        General Requirements
      2. Page 291
        Use Zones and Clearance Requirements
      3. Page 292
        Play Area and Playground Surfacing
      4. Page 293
        Specific Play Equipment
      5. Page 296
        Inspection of Play Areas/Playgrounds and Equipment
    3. Page 297
      Water Play Areas (Pools, Etc.)
      1. Page 297
        Access to and Safety Around Bodies of Water
      2. Page 300
        Pool Equipment
      3. Page 300
        Pool Maintenance
      4. Page 302
        Water Quality of Pools
      5. Page 302
        Other Water Play Areas
    4. Page 303
      Toys
      1. Page 303
        Selected Toys
      2. Page 305
        Riding Toys and Helmets
    5. Page 307
      Transportation
      1. Page 307
        Transportation Staff
      2. Page 309
        Transportation Safety
      3. Page 313
        Vehicles
  12. Page 315
    7. Infectious Diseases
    1. Page 317
      How Infections Spread
    2. Page 317
      Immunizations
    3. Page 320
      Respiratory Tract Infections
      1. Page 320
        Group A Streptococcal (GAS) Infections
      2. Page 321
        Haemophilus Influenzae Type B (Hib)
      3. Page 323
        Influenza
      4. Page 324
        Mumps
      5. Page 325
        Neisseria Meningitidis (Meningococcus)
      6. Page 326
        Parvovirus B19
      7. Page 326
        Pertussis
      8. Page 328
        Respiratory Syncytial Virus (RSV)
      9. Page 329
        Streptococcus Pneumoniae
      10. Page 330
        Tuberculosis
      11. Page 331
        Unspecified Respiratory Tract Infection
    4. Page 332
      Enteric (Diarrheal) Infections and Hepatitis A Virus (HAV)
    5. Page 336
      Skin and Mucous Membrane Infections
      1. Page 336
        Conjunctivitis
      2. Page 337
        Enteroviruses
      3. Page 338
        Human Papillomaviruses (Warts)
      4. Page 338
        Impetigo
      5. Page 339
        Lymphadenitis
      6. Page 340
        Measles
      7. Page 340
        Molluscum Contagiosum
      8. Page 341
        Pediculosis Capitis (Head Lice)
      9. Page 342
        Tinea Capitis and Tinea Cruris (Ringworm)
      10. Page 342
        Staphylococcus Aureus Skin Infections Including MRSA
      11. Page 343
        Scabies
      12. Page 344
        Thrush
    6. Page 344
      Bloodborne Infections
      1. Page 344
        Hepatitis B Virus (HBV)
      2. Page 346
        Hepatitis C Virus (HCV)
      3. Page 347
        Human Immunodeficiency Virus (HIV)
    7. Page 349
      Herpes Viruses
      1. Page 349
        Cytomegalovirus (CMV)
      2. Page 350
        Herpes Simplex
      3. Page 351
        Herpes Virus 6 and 7 (Roseola)
      4. Page 351
        Varicella-Zoster (Chickenpox) Virus
    8. Page 353
      Interaction with State or Local Health Departments
    9. Page 353
      Note to Reader on Judicious Use of Antibiotics
  13. Page 355
    8. Children with Special Health Care Needs and Disabilities
    1. Page 357
      Guiding Principles for This Chapter and Introduction
    2. Page 359
      Inclusion of Children with Special Needs in the Child Care Setting
    3. Page 360
      Process Prior to Enrolling at a Facility
    4. Page 361
      Developing a Service Plan for a Child with a Disability or a Child with Special Health Care Needs
    5. Page 365
      Coordination and Documentation
    6. Page 365
      Periodic Reevaluation
    7. Page 366
      Assessment of Facilities for Children with Special Needs
    8. Page 367
      Additional Standards for Providers Caring for Children with Special Health Care Needs
  14. Page 369
    9. Administration
    1. Page 371
      Governance
    2. Page 372
      Policies
      1. Page 372
        Overview
      2. Page 377
        Transitions
      3. Page 379
        Health Policies
      4. Page 393
        Emergency/Security Policies and Plans
      5. Page 402
        Transportation Policies
      6. Page 403
        Play Area Policies
    3. Page 405
      Human Resource Management
    4. Page 407
      Records
      1. Page 407
        Facility Records/Reports
      2. Page 418
        Child Records
      3. Page 424
        Staff Records
  15. Page 427
    10. Licensing and Community Action
    1. Page 429
      Introduction
    2. Page 429
      Regulatory Policy
    3. Page 430
      Licensing Agency
      1. Page 430
        The Regulation Setting Process
      2. Page 431
        Advisory Groups
      3. Page 433
        Licensing Role with Staff Credentials, Child Abuse Prevention, and ADA Compliance
      4. Page 435
        Technical Assistance from the Licensing Agency
      5. Page 439
        Licensing Staff Training
    4. Page 440
      Facility Licensing
      1. Page 440
        Initial Considerations for Licensing
      2. Page 442
        Facility Inspections and Monitoring
      3. Page 443
        Procedures for Complaints, Reporting, and Data Collecting
    5. Page 444
      Health Department Responsibilities and Role
    6. Page 448
      Caregiver/Teacher Support
      1. Page 448
        Caregiver/Teacher Training
      2. Page 449
        Caregiver/Teacher Networking and Collaboration
    7. Page 450
      Public Policy Issues and Resource Development
  16. Page 478
    Appendixes
  17. Page 453
    Appendix A: Signs and Symptoms Chart
  18. Page 458
    Appendix B: Major Occupational Health Hazards
  19. Page 459
    Appendix C: Nutrition Specialist, Registered Dietitian, Licensed Nutritionist, Consultant, and Food Service Staff Qualifications
  20. Page 460
    Appendix D: Gloving
  21. Page 461
    Appendix E: Child Care Staff Health Assessment
  22. Page 467
    Appendix F: Enrollment/Attendance/Symptom Record
  23. Page 468
    Appendix G: Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger
  24. Page 476
    Appendix H: Recommended Immunization Schedule for Adults Aged 19 Years or Older
  25. Page 482
    Appendix I: Recommendations for Preventive Pediatric Health Care
  26. Page 484
    Appendix J: Selecting an Appropriate Sanitizer or Disinfectant
  27. Page 491
    Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
  28. Page 493
    Appendix L: Cleaning Up Body Fluids
  29. Page 494
    Appendix M: Recognizing Child Abuse and Neglect: Signs and Symptoms
  30. Page 498
    Appendix N: Protective Factors Regarding Child Abuse and Neglect
  31. Page 500
    Appendix O: Care Plan for Children With Special Health Needs
  32. Page 506
    Appendix P: Situations that Require Medical Attention Right Away
  33. Page 507
    Appendix Q: Getting Started with MyPlate
  34. Page 508
    Appendix R: Choose MyPlate: 10 Tips to a Great Plate
  35. Page 509
    Appendix S: Physical Activity: How Much Is Needed?
  36. Page 510
    Appendix T: Helping Children in Foster Care Make Successful Transitions Into Child Care
  37. Page 512
    Appendix U: Recommended Safe Minimum Internal Cooking Temperatures
  38. Page 513
    Appendix V: Food Storage Chart
  39. Page 515
    Appendix W: Sample Food Service Cleaning Schedule
  40. Page 516
    Appendix X: Adaptive Equipment for Children with Special Health Care Needs
  41. Page 518
    Appendix Y: Even Plants Can Be Poisonous
  42. Page 520
    Appendix Z: Depth Required for Shock-Absorbing Surfacing Materials for Use Under Play Equipment
  43. Page 522
    Appendix AA: Medication Administration Packet
  44. Page 527
    Appendix BB: Emergency Information Form for Children With Special Needs
  45. Page 529
    Appendix CC: Incident Report Form
  46. Page 530
    Appendix DD: Child Injury Report Form for Indoor and Outdoor Injuries
  47. Page 532
    Appendix EE: America's Playgrounds Safety Report Card
  48. Page 535
    Appendix FF: Child Health Assessment
  49. Page 536
    Appendix GG: Licensing and Public Regulation of Early Childhood Programs
  50. Page 544
    Appendix HH: Use Zones and Clearance Dimensions for Single- and Multi-Axis Swings
  51. Page 547
    Appendix II: Bike and Multi-sport Helmets: Quick-Fit Check
  52. Page 549
    Appendix JJ: Our Child Care Center Supports Breastfeeding
  53. Page 550
    Appendix KK: Authorization for Emergency Medical/Dental Care
  54. Page 551
    Acronyms/Abbreviations
  55. Page 557
    Glossary
  56. Page 575
    Index

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