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Caring for Our Children, 3rd Edition

National Health and Safety Performance Standards: Guidelines for Early Care and Early Education Programs

By American Academy of Pediatrics, American Public Health Association and National Resource Center for Health and Safety in Child Care and Early Education
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The new 3rd edition contains updated guidelines on the development and evaluation of the health and safety of children in all types of early care and education settings - centers and family child care homes. Features 10 chapters of 650+ standards including a new Preventing Childhood Obesity in Early Care and Education Programs standards: Includes standards in all areas - Expanded discussion of all standards, Easy-to-read 2-column format: Chapters include: Staffing / Program Activities for Health Development / Healthy Promotion and Protection / Nutrition and Food Service / Facilities, Supplies and Equipment / Playgrounds and Transportation / Infectious Diseases / Children with Special Health Care Needs / Administration / Licensing and Community Action.

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  1. Page ix
    Acknowledgements
  2. Page xvii
    Introduction
  3. Page xix
    Guiding Principles
  4. Page xxi
    Advice to the User
  5. Page xxiv
    New and Significant Changes in Caring for Our Children (CFOC) Standards Since the 2nd Edition
  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 10
      Pre-service Qualifications
      1. Page 10
        Director’s Qualifications
      2. Page 12
        Caregiver’s/Teacher’s and Other Staff Qualifications
      3. Page 18
        Family Child Care Home Caregiver/Teacher Qualifications
    4. Page 19
      Professional Development/Training
      1. Page 19
        Pre-service Training
      2. Page 21
        Orientation Training
      3. Page 24
        First Aid and CPR Training
      4. Page 26
        Continuing Education/Professional Development
      5. Page 29
        Specialized Training/Education
      6. Page 31
        Educational Leave/Compensation
    5. Page 32
      Substitutes
    6. Page 33
      Consultants
    7. Page 39
      Staff Health
    8. Page 43
      Human Resource Management
      1. Page 43
        Benefits
      2. Page 43
        Evaluation
  7. Page 47
    2. Program Activities for Healthy Development
    1. Page 49
      Program of Developmental Activities
      1. Page 49
        General Program Activities
      2. Page 57
        Program Activities for Infants and Toddlers from Three Months to Less Than Thirty-Six Months
      3. Page 61
        Program Activities for Three- to Five-Year-Olds
      4. Page 63
        Program Activities for School-Age Children
    2. Page 64
      Supervision and Discipline
    3. Page 77
      Parent/Guardian Relationships
      1. Page 77
        General
      2. Page 78
        Regular Communication
      3. Page 80
        Health Information Sharing
    4. Page 81
      Health Education
      1. Page 81
        Health Education for Children
      2. Page 83
        Health Education for Staff
      3. Page 84
        Health Education for Parents/Guardians
  8. Page 87
    3. Health Promotion and Protection
    1. Page 89
      Health Promotion in Child Care
      1. Page 89
        Daily Health Check
      2. Page 89
        Routine Health Supervision
      3. Page 90
        Physical Activity and Limiting Screen Time
      4. Page 96
        Safe Sleep
      5. Page 101
        Oral Health
    2. Page 104
      Hygiene
      1. Page 104
        Diapering and Changing Soiled Clothing
      2. Page 110
        Hand Hygiene
      3. Page 114
        Exposure to Body Fluids
    3. Page 116
      Cleaning, Sanitizing, and Disinfecting
    4. Page 118
      Health Protection in Child Care
      1. Page 118
        Tobacco and Drug Use
      2. Page 119
        Animals
      3. Page 122
        Emergency Procedures
      4. Page 123
        Child Abuse and Neglect
      5. Page 126
        Sun Safety and Insect Repellent
      6. Page 129
        Strangulation
    5. Page 129
      Care Plans and Adaptations
    6. Page 131
      Management of Illness
      1. Page 131
        Inclusion/Exclusion Due to Illness
      2. Page 137
        Caring for Children Who Are Ill
      3. Page 141
        Medications
      4. Page 144
        Reporting Illness and Death
  9. Page 149
    4. Nutrition and Food Service
    1. Page 151
      Introduction
    2. Page 152
      General Requirements
    3. Page 162
      Requirements for Special Groups or Ages of Children
      1. Page 162
        Nutrition for Infants
      2. Page 174
        Nutrition for Toddlers and Preschoolers
      3. Page 175
        Nutrition for School-Age Children
    4. Page 176
      Staffing
    5. Page 177
      Meal Service, Seating, and Supervision
    6. Page 182
      Food Brought From Home
    7. Page 183
      Nutrition Learning Experiences for Children and Nutrition Education for Parents/Guardians
    8. Page 185
      Kitchen and Equipment
    9. Page 188
      Food Safety
    10. Page 195
      Meals from Outside Vendors or Central Kitchens
  10. Page 197
    5. Facilities, Supplies, Equipment, and Environmental Health
    1. Page 199
      Overall Requirements
      1. Page 199
        General Location, Layout, and Construction of the Facility
      2. Page 203
        Space per Child
      3. Page 204
        Openings
      4. Page 206
        Exits
      5. Page 208
        Steps and Stairs
      6. Page 209
        Exterior Areas
    2. Page 211
      Quality of the Outdoor and Indoor Environment
      1. Page 211
        Ventilation, Heating, Cooling, and Hot Water
      2. Page 217
        Lighting
      3. Page 218
        Noise
      4. Page 219
        Electrical Fixtures and Outlets
      5. Page 221
        Fire Warning Systems
      6. Page 221
        Water Supply and Plumbing
      7. Page 225
        Sewage and Garbage
      8. Page 226
        Integrated Pest Management
      9. Page 228
        Prevention and Management of Toxic Substances
    3. Page 237
      General Furnishings and Equipment
      1. Page 237
        General Furnishings and Equipment Requirements
      2. Page 244
        Additional Equipment Requirements for Facilities Serving Children with Special Health Care Needs
    4. Page 245
      Space and Equipment in Designated Areas
      1. Page 245
        Toilet and Handwashing Areas
      2. Page 248
        Diaper Changing Areas
      3. Page 250
        Bathtubs and Showers
      4. Page 251
        Laundry Area
      5. Page 251
        Sleep and Rest Areas
      6. Page 255
        Space for Children Who Are Ill, Injured, or Need Special Therapies
    5. Page 256
      Storage Areas
    6. Page 257
      Supplies
    7. Page 259
      Maintenance
  11. Page 263
    6. Play Areas/Playgrounds and Transportation
    1. Page 265
      Play Area/Playground Size and Location
    2. Page 269
      Play Area/Playground Equipment
      1. Page 269
        General Requirements
      2. Page 272
        Use Zones and Clearance Requirements
      3. Page 273
        Play Area and Playground Surfacing
      4. Page 274
        Specific Play Equipment
      5. Page 277
        Inspection of Play Areas/Playgrounds and Equipment
    3. Page 278
      Water Play Areas (Pools, Etc.)
      1. Page 278
        Access to and Safety Around Bodies of Water
      2. Page 281
        Pool Equipment
      3. Page 281
        Pool Maintenance
      4. Page 282
        Water Quality of Pools
      5. Page 283
        Other Water Play Areas
    4. Page 283
      Toys
      1. Page 283
        Selected Toys
      2. Page 286
        Riding Toys and Helmets
    5. Page 287
      Transportation
      1. Page 287
        Transportation Staff
      2. Page 289
        Transportation Safety
      3. Page 293
        Vehicles
  12. Page 295
    7. Infectious Diseases
    1. Page 297
      How Infections Spread
    2. Page 297
      Immunizations
    3. Page 300
      Respiratory Tract Infections
      1. Page 300
        Group A Streptococcal (GAS) Infections
      2. Page 301
        Haemophilus Influenzae Type B (HIB)
      3. Page 303
        Influenza
      4. Page 304
        Mumps
      5. Page 305
        Neisseria Meningitidis (Meningococcus)
      6. Page 306
        Parvovirus B19
      7. Page 306
        Pertussis
      8. Page 307
        Respiratory Syncytial Virus (RSV)
      9. Page 308
        Streptococcus Pneumoniae
      10. Page 309
        Tuberculosis
      11. Page 311
        Unspecified Respiratory Tract Infection
    4. Page 311
      Enteric (Diarrheal) Infections and Hepatitis A Virus (HAV)
    5. Page 315
      Skin and Mucous Membrane Infections
      1. Page 315
        Conjunctivitis
      2. Page 316
        Enteroviruses
      3. Page 316
        Human Papillomaviruses (Warts)
      4. Page 317
        Impetigo
      5. Page 317
        Lymphadenitis
      6. Page 318
        Measles
      7. Page 318
        Molluscum Contagiosum
      8. Page 319
        Pediculosis Capitis (Head Lice)
      9. Page 319
        Tinea Capitis and Tinea Cruris (Ringworm)
      10. Page 320
        Staphylococcus Aureus Skin Infections Including MRSA
      11. Page 321
        Scabies
      12. Page 321
        Thrush
    6. Page 321
      Bloodborne Infections
      1. Page 321
        Hepatitis B Virus (HBV)
      2. Page 324
        Hepatitis C Virus (HCV)
      3. Page 324
        Human Immunodeficiency Virus (HIV)
    7. Page 326
      Herpes Viruses
      1. Page 326
        Cytomegalovirus (CMV)
      2. Page 327
        Herpes Simplex
      3. Page 327
        Herpes Virus 6 and 7 (Roseola)
      4. Page 328
        Varicella-Zoster (Chickenpox) Virus
    8. Page 329
      Interaction with State or Local Health Departments
    9. Page 329
      Note to Reader on Judicious Use of Antibiotics
  13. Page 331
    8. Children with Special Health Care Needs and Disabilities
    1. Page 333
      Guiding Principles for This Chapter and Introduction
    2. Page 335
      Inclusion of Children with Special Needs in the Child Care Setting
    3. Page 336
      Process Prior to Enrolling at a Facility
    4. Page 337
      Developing a Service Plan for a Child with a Disability or a Child with Special Health Care Needs
    5. Page 340
      Coordination and Documentation
    6. Page 341
      Periodic Reevaluation
    7. Page 341
      Assessment of Facilities for Children with Special Needs
    8. Page 342
      Additional Standards for Providers Caring for Children with Special Health Care Needs
  14. Page 345
    9. Administration
    1. Page 347
      Governance
    2. Page 348
      Policies
      1. Page 348
        Overview
      2. Page 351
        Transitions
      3. Page 353
        Health Policies
      4. Page 364
        Emergency/Security Policies and Plans
      5. Page 373
        Transportation Policies
      6. Page 374
        Play Area Policies
    3. Page 375
      Human Resource Management
    4. Page 377
      Records
      1. Page 377
        Facility Records/Reports
      2. Page 386
        Child Records
      3. Page 392
        Staff Records
  15. Page 395
    010. Licensing and Community Action
    1. Page 397
      Introduction
    2. Page 397
      Regulatory Policy
    3. Page 398
      Licensing Agency
      1. Page 398
        The Regulation Setting Process
      2. Page 399
        Advisory Groups
      3. Page 400
        Licensing Role with Staff Credentials, Child Abuse Prevention, and ADA Compliance
      4. Page 402
        Technical Assistance from the Licensing Agency
      5. Page 406
        Licensing Staff Training
    4. Page 407
      Facility Licensing
      1. Page 407
        Initial Considerations for Licensing
      2. Page 409
        Facility Inspections and Monitoring
      3. Page 410
        Procedures for Complaints, Reporting, and Data Collecting
    5. Page 411
      Health Department Responsibilities and Role
    6. Page 414
      Caregiver/Teacher Support
      1. Page 414
        Caregiver/Teacher Training
      2. Page 416
        Caregiver/Teacher Networking and Collaboration
    7. Page 416
      Public Policy Issues and Resource Development
  16. Page 419
    Appendices
    1. Page 421
      Appendix A: Signs and Symptoms Chart
    2. Page 426
      Appendix B: Major Occupational Health Hazards
    3. Page 427
      Appendix C: Nutrition Specialist, Registered Dietitian, Licensed Nutritionist, Consultant, and Food Service Staff Qualifications
    4. Page 428
      Appendix D: Gloving
    5. Page 429
      Appendix E: Child Care Staff Health Assessment
    6. Page 430
      Appendix F: Enrollment/Attendance/Symptom Record
    7. Page 431
      Appendix G: Recommended Childhood Immunization Schedule
    8. Page 434
      Appendix H: Recommended Adult Immunization Schedule
    9. Page 439
      Appendix I: Recommendations for Preventive Pediatric Health Care
    10. Page 440
      Appendix J: Selecting an Appropriate Sanitizer or Disinfectant
    11. Page 442
      Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
    12. Page 444
      Appendix L: Cleaning Up Body Fluids
    13. Page 445
      Appendix M: Clues to Child Abuse and Neglect
    14. Page 449
      Appendix N: Protective Factors Regarding Child Abuse and Neglect
    15. Page 451
      Appendix O: Care Plan for Children with Special Health Care Needs
    16. Page 458
      Appendix P: Situations that Require Medical Attention Right Away
    17. Page 459
      Appendix Q: Getting Started with MyPlate
    18. Page 460
      Appendix R: Choose MyPlate: 10 Tips to a Great Plate
    19. Page 461
      Appendix S: Physical Activity: How Much Is Needed?
    20. Page 462
      Appendix T: Foster Care
    21. Page 464
      Appendix U: Recommended Safe Minimum Internal Cooking Temperatures
    22. Page 465
      Appendix V: Food Storage Chart
    23. Page 467
      Appendix W: Sample Food Service Cleaning Schedule
    24. Page 468
      Appendix X: Adaptive Equipment for Children with Special Health Care Needs
    25. Page 470
      Appendix Y: Non-Poisonous and Poisonous Plants
    26. Page 472
      Appendix Z: Depth Required for Shock-Absorbing Surfacing Materials for Use Under Play Equipment
    27. Page 474
      Appendix AA: Medication Administration Packet
    28. Page 479
      Appendix BB: Emergency Information Form for Children with Special Health Care Needs
    29. Page 481
      Appendix CC: Incident Report Form
    30. Page 482
      Appendix DD: Injury Report Form for Indoor and Outdoor Injuries
    31. Page 484
      Appendix EE: America’s Playgrounds Safety Report Card
    32. Page 487
      Appendix FF: Child Health Assessment
    33. Page 488
      Appendix GG: Licensing and Public Regulation of Early Childhood Programs
    34. Page 496
      Appendix HH: Use Zones and Clearance Dimensions for Single-and Multi-Axis Swings
    35. Page 499
      Appendix II: Bicycle Helmets: Quick-Fit Check
    36. Page 501
      Appendix JJ: Our Child Care Center Supports Breastfeeding
    37. Page 502
      Appendix KK: Authorization for Emergency Medical/Dental Care
    38. Page 503
      Appendix LL: Conversion Table CFOC 2nd Edition to 3rd Edition
    39. Page 523
      Appendix MM: Conversion Table CFOC 3rd Edition to 2nd Edition
  17. Page 541
    Acronyms/Abbreviations
  18. Page 575
    Glossary
  19. Page 559
    Index

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