Caring for our children : national health and safety performance standards : guidelines for out-of-home child care.

Chapter 1 – Staffing ................................................................................................................................ 1 1.1 Child:Staff Ratio and Group Size ............................................................................................... 3 1.2 Licensure/Certification of Qualified Individuals ..................................................................... 6 1.3 Preservice Qualifications and Special Training........................................................................ 7 1.4 Training .........................................................................................................................................17 1.5 Substitutes ...................................................................................................................................30 1.6 Health Consultants .....................................................................................................................32 1.7 Staff Health ..................................................................................................................................36 1.8 Staff Benefits ................................................................................................................................40 1.9 Performance Evaluation.............................................................................................................41 Chapter 2 - Program: Activities for Healthy Development ...............................................45 2.1 Program of Developmental Activities.....................................................................................47 2.2 Supervision ..................................................................................................................................58 2.3 Transportation .............................................................................................................................60 2.4 Discipline......................................................................................................................................64 2.5 Parent Relationships ...................................................................................................................66 2.6 Health Education .........................................................................................................................74 Chapter 3 – Health Promotion and Protection in Child Care..........................................83 3.1 Health Promotion in Child Care ............................................................................................. 85 3.2 Hygiene......................................................................................................................................... 91 3.3 Sanitation, Disinfection, and Maintenance...........................................................................104 3.4 Health Protection in Child Care............................................................................................ 111 3.5 Special Medical Conditions in Young Children...................................................................118 3.6 Management of Illness ..............................................................................................................123 Chapter 4 – Nutrition and Food Service ...................................................................................147 4.1 Introduction...............................................................................................................................149 4.2 General Requirements.............................................................................................................149 4.3 Requirements for Special Groups or Ages Of Children..................................................155 4.4 Staffing.........................................................................................................................................163 4.5 Meal Service, Seating, and Supervision.................................................................................165 4.6 Food Brought From Home .....................................................................................................169 4.7 Kitchen and Equipment............................................................................................................170 4.8 Food Safety ................................................................................................................................173 4.9 Maintenance ...............................................................................................................................178 4.10 Meals From Outside Vendors or Central Kitchens ........................................................181 4.11 Nutrition Learning Experiences and Education ...............................................................182 Chapter 5 – Facilities, Supplies, Equipment, and Transportation.................................187 5.1 Overall Space and Equipment Requirements......................................................................189 5.2 Space and Equipment in Designated Areas .........................................................................235 5.3 Active Play Indoor and Outdoor Areas ..............................................................................253 5.4 Swimming, Wading, and Water..............................................................................................264 5.5 Interior and Exterior Walkways, Steps, and Stairs............................................................271 5.6 Maintenance for Safety.............................................................................................................272 5.7 Transportation ...........................................................................................................................274 TABLE OF CONTENTS Table of Contents Caring for Our Children: National Health and Safety Performance Standards Table of Contents iv Chapter 6 – Infectious Diseases .....................................................................................................283 6.1 Respiratory Tract Infections ...................................................................................................285 6.2 Herpes Viruses ..........................................................................................................................293 6.3 Enteric (Diarrheal) and Hepatitis A Virus (HAV) Infections ...........................................296 6.4 Bloodborne Infections..............................................................................................................300 6.5 Skin Infections ............................................................................................................................305 Chapter 7 – Children Who are Eligible for Services Under IDEA................................313 7.1 Guiding Principles for this Chapter and Introduction ......................................................315 7.2 Inclusion of Children With Special Needs in the Child Care Setting ...........................317 7.3 Process Prior to Enrolling at a Facility .................................................................................318 7.4 Developing a Service Plan for a Child With Special Needs ............................................319 7.5 Coordination and Documentation........................................................................................323 7.6 Periodic Reevaluation...............................................................................................................324 7.7 Assessment of Facilities for Children With Special Needs .............................................325 Chapter 8 – Administration.............................................................................................................331 8.1 Identifiable Governing Body/Accountable Individual.........................................................333 8.2 Management and Health Policies and Statement of Services..........................................334 8.3 Program of Activities................................................................................................................355 8.4 Personnel Policies .....................................................................................................................357 8.5 Written Statement of Services ..............................................................................................358 8.6 Special Needs Plan ....................................................................................................................359 8.7 Records ......................................................................................................................................359 8.8 Posting Documents...................................................................................................................376 8.9 Contracts ...................................................................................................................................378 8.10 Drop-in Care ...........................................................................................................................378 Chapter 9 – Licensing and Community Action......................................................................381 9.1 The Regulatory Agency ...........................................................................................................383 9.2 Health Department Responsibility........................................................................................392 9.3 Training .......................................................................................................................................400 9.4 Program Development.............................................................................................................401 9.5 Regulatory Coordination ........................................................................................................402 9.6 Public Policy Issues and Resource Development...............................................................403 Appendices ..............................................................................................................................................407 A – Guiding Principles for the Standards.................................................................................409 B – Major Occupational Health Hazards.................................................................................410 C – Nutrition Specialist and Child Care Food Service Staff Qualifications .....................411 D – Gloving ....................................................................................................................................412 E – Child Care Staff Health Assessment .................................................................................413 F – Enrollment/Attendance/Symptom Record.......................................................................414 G – Recommended Childhood Immunization Schedule.......................................................415 H – Recommendations for Preventive Pediatric Health Care ............................................416 I – Selecting an Appropriate Sanitizer.....................................................................................417 J – Cleaning Up Body Fluids ......................................................................................................419 K – Clues to Child Abuse and Neglect....................................................................................420 L – Risk Factors for Abuse and/or Neglect............................................................................421 M – Special Care Plan for a Child With Asthma ....................................................................422 N – Situations that Require Medical Attention Right Away ................................................424 O – Food Guide Pyramid.............................................................................................................425 Caring for Our Children: Table of Contents National Health and Safety Performance Standards v Table of Contents P – Child Care Infant Meal Pattern ..........................................................................................426 Q – Meal Pattern Requirements for Children Ages 1 through 12 Years ..........................427 R – Food Storage Chart ..............................................................................................................428 S – Sample Food Service Cleaning Schedule..........................................................................430 T – Adaptive Equipment for Children With Special Needs ................................................431 U – Poisonous Plants and Safe Plants........................................................................................434 V – Depth Required for Tested Shock-absorbing Surfacing Materials for Use Under Play Equipment....................................................................................................................435 W – Permission for Medical Condition Treatment.................................................................436 X – Emergency Information Form for Children With Special Needs...............................437 Y – Incident Report Form...........................................................................................................439 Z – Child Health Assessment.....................................................................................................440 AA – Licensing and Public Regulation of Early Childhood Programs - NAEYC Position ................................................................................................................................441 BB – Contact Information .............................................................................................................449 CC– Conversion Table – Standard Numbers From 1st Edition to 2nd Edition ...............459 DD– Conversion Table – Standard Numbers From 2nd Edition to 1st Edition ...............468 Glossary ....................................................................................................................................................479 Index...........................................................................................................................................................495