Abdominal pain. See Pain
Abrasions. See Cuts
Abuse. See Child abuse and neglect
Abusive head trauma. See Shaken baby syndrome/abusive head trauma
Accessibility as it relates to ADA
to exits, 208
to facilities, 199
Accessibility to facility records, 379
Accreditation of Program, 380, 384, 393
Activities. See also Developmental activities, Physical activities
expressive, for preschoolers, 62
participation of older children and staff in 180
school-age, 63–64
to support learning of infants and toddlers, 58–59
that are incompatible with eating, 178–179
ADA, See Americans with Disabilities Act (1990) (ADA)
Adaptive equipment, storage for, 244
Administration, 347–393
governance, 347–348
human resource management, 375–377
policies, 348–375
records, 377–393
written delegation of authority in, 347–348
Admission agreement, contents of, between child care 388
Adults
animals that might have contact with, 119–121
number of children fed simultaneously by one, 180
supervision by, of children who are learning to 180
Advocates, qualifications and responsibilities for 16–18
AED. See Automated External Defibrillators (AED)
Age, minimum, to enter child care, 7–9
feeding to infants, 173–174
introduction to infants, 172–173
Age groups, xxii
Age requirements
assistant teachers and, 13
directors and, 10
drivers and, 288
lead teachers and, 12
teacher aides and, 13
volunteers and, 13
Age-specific guidance for meals and snacks, 155
AIDS. See Human immunodeficiency virus (HIV)
Air, fresh, 211–212
Airborne transmission of infections, 297
Air filters, maintenance of, 214
Air pollution, protection from, 94–95
Air quality index (AQI), 94
defined, 95
levels of, 95
Alcohol
beverages of, in family child care homes, 119
policies prohibiting, 363
Allergen triggering materials, removal of, from outdoor areas, 260
Allergies. See also Asthma
exposure to animals, 120
peanut or tree nut, 161
AMBER alerts, 94
Americans with Disabilities Act (1990) (ADA)
children with chronic health conditions and, 360
for children with special health care needs and disabilities, 335, 341
goal of, 9
licensing agency role in communicating importance of compliance with, 402–403
on outdoor play areas, 265
on play equipment and surfaces, 270
reasonable accommodations for persons with disabilities, 40
staff recruitment and, 9
Americans with Disabilities Act Accessibility Guidelines for Buildings and Facilities (ADAAG), 199, 207, 270
Anaphylaxis, 158–161
Animals, 119–122
allergies to, 120
care for, 121–122
caregiver instruction on contact with, 119–120
exposure of immunocompromised children to, 120
that have contact with children and adults, 119–121
humane care for, 121
medical care for, 121
pregnant women's exposure to cat feces, 120–122
prohibited, 121
Annual staff competency evaluation, 44
Antibiotics, judicious use of, 329–330
Anti-scald aerators, 216
Areas used by children for wheeled vehicles, 210
Arsenic, health effects related to, 269
Art and craft materials
proper use of, 231–232
ventilation when using, 213
Asbestos, preventing exposure to, 231
Aspiration hazards, 285
Assistant teachers, qualifications for, 13
Asthma. See also Allergies
air pollution and, 94
dust and dust mites and, 94
tobacco smoke and residue and, 119
winter as problematic, 94
Attendance records, children, 289, 371-373, 378, 381
Attendance records, maintenance of, for staff who care for children, 393
Audits, reports of annual, monthly maintenance checks of play areas and equipment, 375
Authorized persons to pick up child, 371–372
Autism, vaccines and, 299
Automated External Defibrillators (AED), child care 24–25
Babies. See Infants
Background screening, 9–11, 401–402, 408
maintenance of record, 392
process for substitutes, 32
Back injuries, facilities arrangements to minimize, 241
Balloons, 284–285
Ball pits, 276
Barriers/guards for heating equipment and units, 216
Basements
exits, 206
use of, 201
Bathrooms. See also Bathtubs; Showers; Toilets
floors, walls, and ceilings in, 240–241
monitoring of, 65
supplies for, 258–259
ventilation of, 213
ratio and location of, 250–251
safety of, 251
Bedding
cleaning individual, 118
prohibiting sharing of, 136, 251-252, 255
as personal item, 256
concerning safety, 96
storage of, 256
Beds
arrangement of, 252
bunk, 255
futons, 255
safety of, 251-252
for toddlers, 251
types, 251-255
Behavior
around swimming pool, 69
modeling of healthy and safe, 82–83
prohibited, for caregivers/teachers, 75–76
self-stimulatory, 63
sharing of information on, 80–81
during transportation, 291
Below grade areas, use of, 201
Bisphenol A (BPA), 165, 171, 178, 232–233
Biting, handling, 72–73
Blood
cleaning up, Appendix L
exposure to, in diapers or pull-ups, 115
exposure to, in eyes or nose, 115
exposure to, in human milk, 166
exposure to, in oral hygiene, 102
exposure to, in skin openings, 115
preventing exposure to, 114–116
Bloodborne infections, 321–324
hepatitis B virus and, 321–324
hepatitis C virus and, 324
human immunodeficiency virus and, 324–326
staff education on prevention of, 323
transmission of, 297
BMI. See Body mass index (BMI)
Body awareness, 83
Body fluids
exposure to, 114–116
prevention of exposure to, 114–116
training on occupational risk related to handling body fluids, 30–31
Body mass index (BMI), information on, in routine health supervision, 89–90
Body mastery for three-to-five-year olds, 62–63
Bottle feeding
cleaning and sanitizing equipment used for, 172
cow's milk in, 169–170
preparing, feeding, and storing infant formula, 167–169
soy-based formula and soy milk in, 169
techniques for, 170–171
weaning bottles and infant foods, 170–172
Bottle propping, 170, 362, 545
Bottles, temperature in serving, 171–173
Brain development, xix, 14, 67, 83
Breastfeeding. See also Human milk
benefits of, 151
caregivers/teachers encouragement of, 151
duration of, 8
importance of, to infant, 163
preparing, feeding, and storing human milk, 165–166
reasons for choosing not to, 151
Breast milk. See Human milk
Building codes, 199, 201, 207–209, 212–213, 215, 221, 231, 246, 268
Buildings, inspection of, 199
Bunk beds, 255
Burns
from contact with space heaters, 214–215
from hot liquids and foods, 181
response to, 123
CACFP. See Child and Adult Care Food Program (CACFP)
Candles, inaccessibility to, 257
Car safety. See Child passenger safety
Carbon monoxide, 214–215
Carbon monoxide detectors, 230-231
Cardiopulmonary resuscitation (CPR)
child-staff ratio and skills, 4-5
for swimming, 26
training for staff, 24–25
for water play, 26
Care plan for children with special health care needs, 129, 130
Caregivers/teachers. See also Staff
ability of, with HIV infection to care for children, 325–326
access to in-service training, 73
administration of medication, 13
annual staff competency evaluation, 44
assessment and planning of nutrition by, 153
assistant teachers, teacher aides, and volunteers, 13–14
avoiding third-hand smoke exposure, 119, 363
awareness of environmental hazards, 93
awareness of television and computer exposure, 95
background screening and, 10
behavior around swimming pool, 69
on bottle feeding, 170–171
cardiopulmonary resuscitation (CPR) performance of, 13
care for children with food allergies, 160–161
carrying out nutrition plan, 152
child abuse and neglect education, 30
child car seat policy and, 372
child: staff ratio, group size, and minimum age, 3–9
communication between parents/guardians and, 159–160, 172–173
concern about plagiocephaly, 98
consultants, 33–39
continuing education, 31
in centers and large family child care homes, 26, 31
for small family child care home, 28–29
contribution of, to development of measurable objective for children with special health care needs and disabilities, 338–340
cuts and scrapes of, 114
daily health check, 89
defined, xxiii
differentiated roles of, 12
discipline measures, 70–72
educational leave/compensation, 31
emergency protocols of, 122-123, 232
encouragement
of breastfeeding, 151
of physical activity by, 95–96
of self-feeding by older infants and toddlers, 175
enrollment information to, 349–350
establishing support services for parents/guardians, 80
exclusion of children and, 133–134
familiarity with facility policies, plans and procedures, 43
family child care home qualifications, 18–19
feeding infants on cue by consistent, 164–165
first aid and cardiopulmonary resuscitation (CPR) training, 24–25
gender and body awareness and, 83
handling
complaints about, 44–45
of intoxicated parents/guardians, 372
physical aggression, biting, and hitting, 72–73
head count of children during transportation, 6
health education for, 83–84
health of, 39–43
HIV infection in ability to care for children, 325–326
human resource management and, 43–45
immunity for reporting child abuse and neglect, 124
immunization of, 299–300
for influenza, 303
inclusion/exclusion dismissal of children, 131
information on poison control, 229
informing of group A streptococcal (GAS) infections, 301
instruction on contact with animals, 119–120
interactions with infants and toddlers, 57–58
introduction
of age-appropriate solid foods to infants and, 172–173
of new foods, 159
lead teachers, 12–13
licensing agency provision of written agreements for, 403
limiting television screen time, 66–68
mixed director/teacher role, 12
modeling of healthy and safe behavior and health and safety education activities, 82–83
monitoring children's development/obtaining consent for screening, 51–53
mutual responsibility of parents/guardians and, 77–78
need for health insurance, 376
need for help with sound abatement, 219
nicotine withdrawal and, 42
nonuse of tobacco and drug use, 118–119
nutrition
as basic responsibility of, 151
learning experiences for children and, 183–185
provision of meals and snacks, 153
observation of staff, 44
occupational hazards and, 41
oral health education and, 103–104
oral hygiene activities and, 101–102
orientation, 21–22
passenger load and, 293
personal relationships
for infants and toddlers, 57
for three-to-five-year olds, 61
preparation of formula by, 168–169
pre-service qualifications of, 10–11
procedure for changing children's soiled underwear/pull-ups and clothing, 108–110
professional development/training, 19–31
prohibited behaviors, 75–76
protection of children, 347
provision of information on ill children, 140–141
qualifications for, 12–16
qualifications for facilities that care for children who are ill, 138–139
qualifications for preschool-age children, 15
qualifications for school-age children, 15–16
recruitment and background screening, 9–10
replacement of toothbrushes, 102
restriction from food preparation and handling, 188–189
sharing of pacifiers, 100
sleep positions and, 98
socialization during meals and, 179–180
staff improvement plan, 44
stress for, 41–43
substitutes, 32–33
supervision near body of water, 68–69
support of, 414-416
for breastfeeding mothers, 151
time-outs and, 71
toilet learning/training, 60
training of, 415–416
to administer medications, 143–144
monitoring for hand hygiene, 112–113
on preventing shaken baby syndrome/abusive head trauma, 125
in safe sleep practices, 96–97
transitioning within programs and indoor and outdoor learning/play environments, 54–55
on use of soy-based formula and soy milk, 169
verbal interaction, 56–57
written reports on Individualized Family Service Plan (IFSP), 341
Carpeted areas, ventilation of recently installed, 213
Carpets, cleaning and maintenance, 115-116, 219, 239
Carriage requirements, 242
Car seat, limiting infant/toddler time in, 66
Cats' feces, pregnant women's exposure to. See Animals
Ceilings, 240-241
height of, 204
Celiac disease, dietary modifications, 158-159
Centers. See Child care centers
Certificate, record of valid, 384
Certified health education specialist (CHES), as source of assistance, 50
Certified Playground Safety Inspector, 265, 267, 269, 272, 274, 277, 374
Changing tables
maintenance of, 250
requirements for, 249–250
Charcoal grills, 214-215
Chemical air fresheners, 213–214
Chemical air sanitizers, 213–214
Chemical toilets, 245–246
Chemicals
in controlling odors, 234
in lawn care treatments, 228, 276
in pools, 282-283
in toys, 284
in water supply, 222
Chickenpox (varicella)
staff exclusion and, 135
temporary exclusion of children and, 133
transmission of, 137
defined, xxiii
immunity for reporters of, 124
licensing agency provision of prevention materials, 402
licensing agency role in communicating importance of reporting suspected, 402
recognizing and reporting suspected, 123–124
registry for, 408
specialized training in, 30
training of licensing agency personnel about, 407
Child and Adult Care Food Program (CACFP)
age-specific guidance for meals and snacks, 155
meal and snack patterns, 156, 162–163
nutrition learning experiences for children and, 183
nutrition training and, 27
for school-age children, 175–176
for toddlers and preschoolers, 174
use of, 153–154
Child care
agency collaboration to safeguard children in, 410
child deaths in, 6
coordination of public and private resources to ensure families' access to quality, 417
defined, 49
evening and nighttime, 362
importance of immunization in, 297–298
inclusion for children with special health care needs and disabilities, 335–336
minimum age for, 7–9
protecting HIV-infected children and adults in, 324–325
sources of technical assistance to support quality of, 402–406
use of fact sheets on common illnesses associated with, 414
Child care areas
separating office space from, 202
separation of operations from, 202
unrelated business in, 201-202
Child care businesses, adherence to federal law, 9
Child care centers, xxii. See also Family child care homes
adopting use of Standard Precautions, 114–116
Automated External Defibrillators (AED) and, 24–25
contents of admission agreement between parents/guardians and, 388
credentialing of individual, 400–401
development of organizations and networks, 416
dishwashing in, 193–194
frequency of inspections for, 409
hand hygiene in, 110–113
handwashing sinks for diaper changing area in, 248–249
locations of, 199
need for immunization documentation, 297–298
preventing expulsions, suspensions, and other limitations in, 73–75
staff education for, 31
transportation policy for, 373–374
waste receptacles in, and in child care facility toilet rooms, 247
written daily activity plan and statement of principles, 49–50
written human resource management policies for, 375–376
Child Care Development Block Grants, 35
Child care food service manager, employment of, 152
Child care health consultants, 33–36, 89
availability of, to facilitate, 403
in developing model policies, 348
documentation of training visits, 385–386
for facilities that care for children who are ill, 139–140
frequency of visits, 36
review of health policies, 364
staff training on growth assessment, 90
staff training in conducting health check, 89
Child care licensing advisory board, 399–400
Child deaths. See Death
Child development. See Developmental activities
Child exploitation, recognizing and reporting 123-124
Child maltreatment. See Child abuse and neglect
Child passenger safety, 289-293
Child records, 386-392
contents of, 386-392
admission agreement between child care program and parents/guardians, 388
child’s primary care provider’s assessment, 389-390
facility health log for each child, 391-392
medication, 391
health history, 390
pre-admission enrollment information for each child, 387-388
release of, 392
Child restraint, age and size-appropriate vehicle, 289
for children with special health care needs, 4
CPR skills and, 4-5
developmentally appropriate, 65
for facilities
serving children with special health care needs and disabilities, 6
that care for children who are ill, 139
first aid and, 4
for large family child care homes and centers, 4-6
for nap time, 3-4
pediatric first aid and, 5
for small family child care homes, 3-4
supervision
during transportation and, 6
for toddlers, 3-7
Children. See also Children who are ill; Infants; Preschool-age children; Toddlers
access to kitchen, 185-186
adults supervision of, who are learning to feed themselves, 180
agency collaboration to safeguard, in child care, 410
animals that might have contact with, 119-121
area used by, for wheeled vehicles, 210
assisting with hand hygiene, 112
authorized persons to pick-up, 371-372
behavior during transportation, 291
caring for, who require medical procedures, 130-131
collection of data on illness or harm to, in facilities, 411
communication between school and, 64
content and development of plan for care of, who are ill, 354
contents of facility health log for each, 391-392
contents of primary care provider’s assessment, 389-390
documentation of exemptions and exclusion of, who lack immunizations, 356
health and safety education topics for, 81-82
health history of, 390
influenza immunizations for, 303
limiting screen time, 66-68
maintenance of attendance records for staff who care for, 393
methods of supervision of, 64-66
monitoring development, 51-53
number of, fed simultaneously by one adult, 180
nutrition learning experiences of, 183-185
outdoor play for, 93-94
parents/guardians provision of information on health and behavior of, 80-81
participation of older, in mealtime activities, 180
pre-admission enrollment information for each, 387-388
procedure for changing soiled underwear/pull-ups and clothing, 108-110
procedure for parents/guardians notification about exposure of, to infectious diseases, 144
protection from air pollution, 94
ratios of toilets, urinals, and hand sinks to, 246
recognition of health problems in, 26-27
release of record of, 392
separation of infants and toddlers from older, 59
space required per, 203-204
unimmunized, 298-299
vulnerability of, to exposure of contaminated environmental media materials, 200
Children who are Ill . See also Facilities that care for children who are ill
caring for, 137-141
collaborative development of child care requirements and guidelines for, 400
public-private collaboration on care of, 400
space requirements for, 137-138, 255
Children with special health care needs and disabilities, 333-343
Americans with Disabilities Act (1990) (ADA) for, 335, 341
assessment of facilities, 341-342
care plan for, 129-130
child-care ratios for, 6
child-staff ratio for, 3-4
compensation for participation in multidisciplinary assessments for, 405-406
coordination and documentation, 340-341
written reports on IFSPs/IEPs to caregivers/teachers, 341
defined, xxiii
developing service plan for, 337
contracts and reimbursement, 340
designation and role of staff person responsible for coordinating care in child care facility, 338
determination of eligibility for special services, 337-338
development of measurable objectives, 338-340
formulation of action plan, 337
dietary modifications for, 158-159
evacuation of, 206-207
feeding plans and dietary modifications, 158-159
guiding principles for, 333
inclusion of, in child care setting, 335-336
Individualized Education Program (IEP) for, 337-338, 340-341
Individualized Family Service Plan (IFSP) for, 334, 337-338, 341
Individuals with Disabilities Education Act for, 333-335, 338, 340, 342
need for diapering, 110
orthotic and prosthetic devices for, 244
periodic reevaluation, 341
process prior to enrolling at facility, 336
qualifications of caregivers/teachers, 12
resources for parents/guardians of, 405
Section 504 of the Rehabilitation Act (1973) for, 334-335, 341-342
special adaptive equipment for, 244
specialized consultation for facilities serving, 39
staff orientation for, 22-23
standards for providers caring for, 342-343
therapeutic and recreational equipment for, 244
toilet learning/training for, 59-60
Chlorine
in pools, 282-283
washing dishes and, 195
Choking
adult supervision of feeding and, 180
foods that are hazards for, 181
Chromated copper arsenate (CCA)
testing wood fences and playground structures for, 268-269
treatment of pressure-treated wood, 234-235
Classroom Assessment Scoring System (CLASS), 38
Clean Air Act, checking of, 94-95
Cleaning
of crib surfaces, 118
of humidifiers, 261
of individual bedding, 118
of objects intended for mouth, 118
of pacifiers,100
routine schedule for, 116-117
schedule for exterior areas, 260
of toys, 117-118
Cleaning agents, inaccessibility of, 202
Clearance requirements of playground areas, 273
Climbing equipment, prohibited surfaces for placing, 273-274
Closet door latches, 208
Closing facility, 32
Clothing
appropriate for weather, 353
for physical activity, 353,
protective against sun exposure, 93
storage, 256
Coat hooks/cubicles, 256
Cold injury, preventing, 93
Cold weather
outdoor play in, 93
as trigger to asthma, 94
Collaborative development of child care requirements and guidelines for children who are ill, 400
Communicable diseases. See Infectious diseases
Communication
between caregivers/teachers and parents/guardians, 173
between child care and school, 64
disaster planning, training, and, 366-368
documentation of drop-off, pick-up, daily attendance of child, and parent/provider, 372-373
licensing agency role in, importance of compliance with Americans with Disabilities Act, 402
opportunities for, of health and safety education for parents/guardians, 84
parents/guardians conferences, 78-79
from specialists, 81
successful feeding and, 159-160
verbal interaction in, 56-57
of written policies, 349
Community outreach for school-age children, 64
Community participation in development of licensing rules, 398-399
Community resource information, 386
Compensation for participation in multidisciplinary assessments for children with special health care or education needs, 405-406
Complaints
handling, about caregivers/teachers,44-45
parents/guardians procedures, 80
procedure for receiving, 410
Computer time, screen time, limiting, 66-68
Conferences, parents/guardians, 78-79
Confidentiality, written policy for facility records, 378-379
Congenital toxoplasmosis, 122
Conjunctivitis, 315
Construction, during hours of operation, 237
child care health, 33–36
early childhood education, 38
early childhood mental health, 36-38
support for, to provide technical assistance to facilities, 403-405
Consumer Product Safety Improvement Act (CPSIA), 233
for center staff, 26-28
for directors in centers and large family child care homes, 26-27
for licensing staff, 406
payment for, 31
preventing infectious diseases and, 415
promotion of, 414-415
for small family child care home caregivers/teachers, 28-29
staff qualifications and, 12, 21, 44, 84
Contract services, requirements for compliance of, 381
Contracts for children with special health care needs and disabilities, 340
Cooling, 211-217
Cooperation, fostering, in three-to-five-year olds, 62
Coordinated Child Care Health Program Model, 50-51
Copper, testing for levels of, in drinking water, 222-223
Corporal punishment, prohibition of, 75-76
etiquette, 114
medications, 358
Court records in background screening, 10, 401
Cow’s milk, feeding, 169-170
CPR. See Cardiopulmonary resuscitation
Crawl spaces, size and anchoring of, 271
Cribs, 253-254
cleaning surfaces, 118
limiting infant/toddler time in, 66
sleep position in, 96
stackable, 254–255
Crib toys, 285
Criminal record files, 408
Cross-connections, 224
Cross-contamination among children, 180
Cue feeding, 164-165
Cultural beliefs, dietary modifications based on, 159
single service, 258
transition from bottle to, 165, 171
Curriculum, diversity in, 55-56
Cuts, body fluids and, 114
Cutting boards, 193-194
Cytomegalovirus (CMV), 297, 326-327
staff education and policies on, 326
testing of children with, 327
Daily attendance of child, documentation of, and parents/guardians communication, 372-373
Daily health checks
documentation of, 89
Daily roster, use of, during evacuation drills, 371
Data, collection of, on illness or harm to children in facilities, 411
Death. See also Sudden infant death syndrome (SIDS)
child, in child care, 6
documentation of parents/guardians notification of, 383
plan for responding to, of child, 146-147
Deck surfaces, 279-280
Deficiencies, written plan/record to resolve, 384-385
Dehumidifiers, maintenance of, 216-217
Dental Health Consultant, availability of, to facilitate, 404
Dermatitis, diaper, 104-105
Developmental activities, 49-50
communication in native language other than English, 55
coordinated child care health program model, 50-51
diversity in enrollment and curriculum, 55-56
health, nutrition, physical activity, and safety awareness, 50
helping families cope with separation, 53-54
monitoring children’s development/obtaining consent for screening, 51-53
transitioning within programs and indoor and outdoor learning/play environments, 54-55
verbal interaction, 56-57
written daily activity plan and statement of principles, 49
Developmentally appropriate seating and utensils for meals, 177-178
Diabetes, dietary modifications and, 158-159
Diaper changing, gloves for, 109
Diaper changing areas, 248
handwashing sinks for
in centers, 248-249
in homes, 249
use, location, and setup of, 249
Diaper changing tables, 248
maintenance of, 249-250
requirements for, 249-250
Diaper containers, labeling, cleaning, and disposal of, 226
Diaper cream, 104, 106, 249, 358
Diaper dermatitis
diapering practices and, 104
frequency and severity of, 105
Diapers
checking for need to change, 105
containment of soiled, 226
handling cloth, 105
procedure for changing, 106-108
types of, 104-105
Diarrhea. See also Enteric (diarrheal) infections
maintenance of records on incidents of, 314-315
staff exclusion and, 135
temporary exclusion of children and, 132-133
Dietary Guidelines for Americans, 2010, 152, 155
Dietary modifications, 158-159
Directors
continuing education for, in centers and large family child care homes, 26
general qualifications of, 10-11
mixed teacher role, 12
qualifications of, of facilities that care for children who are ill, 138
Disability and Business Technical Assistance Centers (DBTAC), 40
Disasters
planning, training, and communications, 366-368
supply of food and water for, 192-193
Discipline measures, 70-72
Discipline policies, written, 351
Dishes, washing by hand, 194-195
Dishwashing in small and large family child care homes, 194
Disinfecting, routine, 116-117
Dismissal of children, inclusion/exclusion, in management of illness, 131-136
Disposable towels, used for cleaning, 259
Diversity
in enrollment and curriculum, 55-56
technical assistance to facilities to address in community, 406
Documentation of daily health check, 89
Dog-assisted therapy programs, 120
Doors
ability to open toilet room,245
directional swing of indoor, 206
finger-pinch injuries in, 205
latches for closets, 208
Drainage of paved surfaces, 210
Drinking fountains, 224
Drivers, qualifications for, 288-289
Driving records in background screening, 10
Drop-in facility, defined, 407-408
Droplet route, transmission of infection via, 297
Drop-off, 289
documentation of, and parents/guardians communication, 372-373
points for, 209
Drownings
circumstances surrounding, 7
defined, 26
prevention of, 7, 27, 29, 68-69, 210, 251, 267, 275, 278-279, 281, 283
use of CPR with, 26
Drug tests in background screening, 10
Dry bulk foods, storage of, 192
Early care and education programs on breastfeeding, 151
Early childhood education consultants, 38
availability of, to facilitate, 403-404
Early childhood mental health consultant (ECMHC), 36-38
availability of, to facilitate, 403-404
Early Head Start programs, 352
Eastern equine encephalitis, 228
Eating
activities that are incompatible with, 178-179
hand hygiene before, 110
staff modeling of healthy, 82
utensils for, 178
Education. See also Continuing education
nutrition
for children, 183-184
for parents/guardians, 183-185
for staff, 83
oral health, 103-104
for parents/guardians, 185
Education for All Handicapped Children Act (1975), 333
Electrical cords, 181, 220, 240, 252
Electrical devices, location of, near water, 220
Electrical fixtures, outlets maintenance and, 261
Electrical outlets, safety covers and shock protection devices for, 219
Electrical service,
electrical cords, 220
extension cords, 220
ground fault circuit interrupters (GFCIs) for outlets near water, 220
location of electrical devices near water, 220
safety covers and shock protection devices for, 219
Electric fans, 214
Electric outlets, ground fault circuit interrupters (GFCIs) for near water, 220
Elevated play areas, 266-267
Eligibility, determination of, for children with special health care needs and disabilities, 337-338
Emergency and evacuation drills/exercises policy, 370-371
Emergency exits, 207
labeled, 208
Emergency lighting, 218
Emergency Medical Services (EMS)
call for, in anaphylaxis, 161
route to, 292-293
Emergency procedures, 122-123
health protection in child care and, 122-123
Emergency/security policies, 364-373
on actions to be followed when no authorized persona arrives to pick up child, 372
authorized persons to pick up child, 371-372
daily roster during evacuation drills, 371
disaster planning, training, and communication, 366-368
documentation of drop-off, pick-up, daily attendance of child, and parent/provider communication, 372-373
emergency and evacuation drills/exercises, 370-371
review of written plan for urgent care, 365-366
for seasonal and pandemic influenza, 368-370
sign-in/sign-out system, 371
written plan and training for handling urgent medical care or threatening incidents, 364-365
Enclosures
for outdoor play areas, 268
requirements of, 242
English, communication in native language other than, 55
Enrollment
diversity in, 55-56
exchange of information upon, 350
information to parents/guardians and caregivers/teachers, 349-350
Enteric (diarrheal) infections. See also Diarrhea
control of, 311-313
disease surveillance of, 314
hepatitis A virus and, 311-315
staff education and policies on, 313-314
Enteroviruses, 316
Entrapment hazards of play equipment, 272
Environmental audit of site location, 200
Environmental quality of outdoor and indoor, 211-237
Epidemiological studies, 200
Epinephrine, peanut and/or tree nut allergy and need for, 161
Equal Employment Opportunity Act (EEOA) (1972), staff recruitment and, 9
Equipment
cleaning and sanitizing, when used in bottle feeding, 172
exercise, 243
general, 237-244
inspection and maintenance of heating and ventilation, 212-213
installation of play, 270
placement of, 240
recreational, 244
selection of, for three-to-five year olds, 61
special adaptive, 244
storage for adaptive, 244
surfaces of, 239-240
therapeutic, 244
toilet learning/training, 246-247
Erythema Infectiosum, attendance of children with, 306
Etiquette, cough and sneeze, 114
Evacuation drills
record of, 385
use of daily roster during, 371
Evening child care, plans for, 362
Exchange of information
at transitions, 352-353
upon enrollment, 350
criteria for exclusion, 132
conditions that do not require exclusion, 131-132
in facilities for children who are ill,141
of children, 131-134
Exercise equipment, 243
Exits
access to, 208
emergency, 207
possibility of, from windows, 204-205
Expressive activities for preschoolers, 62
Expulsions, preventing, 73-75
Extension cords, 220
Exterior areas, cleaning schedule for, 260
Exterior surfaces, maintenance of, 259
Face-to-name count of children, transportation of children and, 6
Facilities
accessibility of, 199
areas for school-age children, 204
arrangements to minimize back injuries, 241
assessment for children with special health care needs and disabilities, 341-342
basements and below grade areas, 201
bathtubs and showers
ratio and location of, 250-251
safety of, 251
buildings of wood frame construction, 201
collection of data on illness or harm to children in, 411
compliance with fire prevention code, 199
designating role of person responsible for coordinating care in child care, 338
development of list of providers of services to, 405
diaper changing areas, 248
handwashing sinks for
in centers, 248-249
in homes, 249
maintenance of tables, 249-250
requirements for tables, 249-250
use, location, and setup of, 249
electrical service, 219a
electrical cords, 220
extension cords, 220
ground fault circuit interrupters (GFCIs) for outlets near water, 220
location of electrical devices near water, 220
safety covers and shock protection devices for, 219
exits
access to, 208
alternate, and emergency shelter, 206
closet door latches, 208
evacuation of children with special health care needs and children with disabilities, 206-207
labeled emergency, 208
locks, 207-208
path of egress, 207
exterior areas
areas used by children for wheeled vehicles, 210
construction and maintenance of walkways, 209-210
designated walkways, bike routes, and drop-off and pick-up points , 209
drainage of paved surfaces, 210
guardrails and protective barriers, 210-211
location of satellite dishes, 211
walking surfaces, 210
fire warning systems, 221
portable fire extinguishers, 221
floor space beneath low ceiling heights, 204
general furnishings and equipment, 237-244
arrangements to minimize back injuries, 241
availability and use of telephone or wireless communication device, 243
carriage, stroller, gate, enclosure, and play yard requirements, 242
ceilings, 240-241
exercise, 243
floors, 240-241
high chair requirements, 241-242
orthotic and prosthetic devices, 244
placement of equipment and furnishings, 240
product recall monitoring, 238
restrictive infant equipment requirements, 242-243
safety of equipment, materials, and furnishings, 237-238
size of furniture, 238-239
special adaptive, 244
storage for adaptive, 244
surfaces of equipment, furniture, toys, and play materials, 239-240
therapeutic and recreational, 244
walls, 240-241
governing body of, 347
inclusion and exclusion of children from, that serve children who are ill, 141
insurance coverage for, 377
integrated pest management, 226-228
insect breeding hazard, 228
laundry area
location of equipment and water temperature for laundering, 251
service and equipment, 251
layout to reduce risk of child abuse and neglect, 125-126
licensing, 407-411
alternative means of compliance, 408-409
procedure prior to issuing a license, 408-409
quality rating and improvement systems, 408
that care for children who are ill, 140
uniform categories and definitions, 407-408
lighting
emergency, 218
fixtures including halogen lamps, 217-218
high intensity discharge lamps, 218
levels of illumination, 217-218
mercury lamps, 218
multi-vapor lamps, 218
maintenance
cleaning of humidifiers, 261
cleaning schedule for exterior areas, 260
electrical fixtures and outlets, 261
of exterior surfaces, 259
inaccessibility of hazardous equipment, 260
plumbing and gas, 261
removal of allergen triggering materials from outdoor areas, 260
removal of hazards from outdoor areas, 259-260
storage area ventilation and, 260
structure, 261
monitoring of, 409-410
multiple use of rooms, 202-203
noise, levels of, 218-219
notification of, about infectious disease or other problems by parents, 145
office space, 202
on-site sewage systems, 225
containment of garbage, 225
containment of soiled diapers, 226
labeling, cleaning, and disposal of waste and diaper containers, 226
removal of garbage, 225
storage and disposal of infectious and toxic wastes, 226
openings
directional swing of indoor doors, 206
finger-pinch protection devices, 205-206
possibility of exit from windows, 204-205
safety guards for glass windows/doors, 205
screens for ventilation, 205
weather-tightness and water-tightness, 204
plan for responding to death of child, 146-147
prevention and management of toxic substances, 228-229
carbon monoxide detectors, 230-231
chemicals used to control odors, 234
construction and remodeling during hours of operation ,237
exposure to asbestos or other friable materials, 231
informing staff regarding presence of toxic substances, 229-230
plastic containers and toys, 232-234
prohibition of poisonous plants, 234
proper use of art and craft materials, 231-232
radon concentrations, 230
shoes in infant play areas, 236-237
testing for lead, 235-236
treatment of chromated copper arsenate (CCA) pressure-treated wood, 234-235
use and storage of toxic substances, 228
use of play dough and other manipulative art of sensory materials, 232
use of poison center, 229
process prior to enrolling at, for children with special health care needs and disabilities, 336
program requirements for, that care for children who are ill, 138
in promoting active opportunities for physical activity, 90-93
provision of training to, by health agencies, 415-416
quality of outdoor and indoor environment, 211-237
ventilation, heating, cooling, and hot water, 211-217
record of valid license, certificate or registration of, 384
records of
access to, 379
availability of records to licensing agency, 380
maintenance of, 378
proper installation and maintenance of equipment of, 375
written policy on confidentiality of, 378-379
requirements for, to report to health department, 413-414
Safe Sleep Policy at, 100-101
safe sleep practices for, 96-99
scheduled rest periods and sleep arrangements, 100-101
separation of operations from child care areas, 202
sleep and rest areas
bunk beds, 255
cribs, 253-254
equipment and supplies, 251-253
futons, 255
stackable cribs, 254-255
space for children who are ill, injured, or need special therapies
for ill children, 255
for therapy services, 255-256
space per child, 203-204
steps and stairs, 208-209
balusters, 208
guards at stairway access opening, 209
handrails, 208-209
landings, 209
storage areas
coat hooks/cubicles, 256
firearms, 257
of flammable materials, 256-257
inaccessibility to matches, candles, and lighters, 257
of plastic bags, 257
of play and teaching equipment and supplies, 256
for soiled and clean linens, 256
storage and labeling of personal articles, 256
structurally sound, 201
supplies
for bathrooms and handwashing sinks, 258-259
first aid and emergency, 257-258
microfiber cloths, rags, and disposable towels and mops used for cleaning, 259
single service cups, 258
support for consultants to provide technical assistance to facilities, 403-405
technical assistance to, to address diversity in community, 406
toilet and handwashing areas
ability to open toilet room doors, 245
chemical toilets, 245-246
cleaning and disinfection, 247
general requirements for, 245
handwashing sinks, 247-248
learning/training equipment, 246-247
location of toilets and privacy issues, 245
mop sinks, 248
preventing entry to toilet rooms by infants and toddlers, 245
prohibited uses of handwashing sinks, 248
ratios of toilets, urinals, and hand sinks to children, 246
waste receptacles in child care facility and in child care facility toilet rooms, 247
toothbrushes and toothpaste in, 102-103
types of, xxii
unrelated business in child care area, 201-202
unscheduled access to rest areas, 101
water supply and plumbing*, 221
cross-connections, 224
drinking fountains, 224
emergency safe drinking water and bottled water, 223
handwashing sink using portable water supply, 224
installation of pipes and plumbing fixtures, 224
testing for lead and copper levels in drinking water, 222-223
testing of drinking water not from public system, 222
water handling and treatment equipment, 223-224
water supply, 221-222
water test results, 223
window size, 204-205
Facilities serving children with disabilities, specialized consultation for, 39
Facilities that care for children who are ill. See also Children who are Ill
child care health consultants for, 139-140
child-staff ratios for, 139
Facility health log, contents of, for each child, 391-392
Facility records/reports, 377-386
Fact sheets, use of, on common illnesses associated with child care, 414
Families
coordination of public and private resources to ensure, access to quality child care, 417
helping cope with separation, 53-54
information sharing on health of, 358
meal service, benefits of meal service style, 179
Family and Medical Leave Act (1993) (FMLA), parental leave and, 8
alcoholic beverages in, 118-119
caregivers/teachers qualifications, 18-19
child-staff ratios, 3
continuing education for directors of, 31
defined, 407
support networks for, 19
Family Educational Rights and Privacy Act (FERPA), 38
care plan for children with special health care needs, 129-130
confidentiality of, 130-131
Fans, electric, 214
Feeding infants on cue by consistent caregivers/teachers, 164-165
Fever
defined, 141
temporary exclusion of children and, 132
Finger-pinch protection devices, 205-206
Fire, response to, 123
Firearms, 257
policy prohibiting, 363-364
Fire extinguishers
portable, 221
use of, 123
Fireplaces, 215-216
inserts in, 215-216
Fire prevention code, compliance with, 199
Fire protection devices, availability of reports on inspections of, 385
Fire warning systems, 221
portable fire extinguishers, 221
Firearms, 257
policy prohibiting, 363-364
Fireplaces, 215-216
inserts in, 215-216
First aid
child-staff ratio and, 4
emergency supplies and, 257-258
topics covered in training, 25
training for staff in, 24-25
Flammable materials, storage of, 256-257
Floors, 240-241
Flu. See Influenza
Fluoride toothpaste, regular tooth brushing with, 101
Fluoride varnish, reduction in decay rates and, 102
Food allergies
care for children with, 160-161
dietary modifications and, 29-30, 158-159
Food and nutrition service policies and plans, 361
Food areas and equipment, cleaning, 193
Food avoidance, successful, 160-161
Food-borne illness. See also Infectious diseases
food brought from home and, 182
outbreaks of, 361
restriction of staff from food preparation and handling, 188-189
Food brought from home
nutritional quality of, 183
selection and preparation of, 182
Food poisoning, food brought from home and, 182
Food preparation area, 185-186
Foods
burns from hot liquids and, 181
categories of, 155-156
experience with familiar and new, 181
feeding age-appropriate solid, to infants, 173-174
introduction of age-appropriate solid to infants, 172-173
introduction of new, 159-160
maintaining safe temperatures, 187
nutritional quality of, when brought from home, 183
prohibited uses of, 182
selection and preparation of, brought from home, 182
storage of dry bulk, 192
supply of, for disaster, 192-193
that are choking hazards, 181
training of staff with responsibilities for handling, 29-30
cleaning food areas and equipment, 193
compliance with Food and Drug Administration, U. S. (FDA) sanitation standards, state and local, 188
cutting boards, 193
dishwashing
in centers, 193-194
in small and large family child care homes, 194
leftovers, 191
precautions for safe food supply, 189-191
preparation for and storage of food in refrigerator, 191-192
staff restricted from food preparation and handling, 188-189
storage
of dry bulk foods, 192
of foods not requiring refrigeration, 192
supply of food and water for disasters, 192-193
during transport, 195
washing dishes by hand, 194-195
Food sensitivity, problems of, 159
Food service. See Nutrition and Food Service
Food service facilities, holding of food prepared at off-site, 195
Food Stamp Programs, soy-based formula and soy milk, 169
Formula
concentrated, 168
elements, 168
powdered, 168
preparation, 167-169
soy-based, 169
storage, 168
Fountains, drinking, 224
Friable materials, preventing exposure to, 231
Frostbite, 94
Fruit, whole as more nutritious than juice, 157-158
Fruit juice, 157-158
Funding, adequacy of staff and, for regulatory enforcement, 397
Furnishings
arrangements to minimize back injuries, 241
availability and use of telephone or wireless communication device, 243
carriage, stroller, gate, enclosure, and play yard requirements, 242
ceilings, 240-241
exercise, 243
floors, 240-241
general, 237-244
high chair requirements, 241-242
orthotic and prosthetic devices, 244
placement of, 240
product recall monitoring, 238
requirements for safety of equipment, materials, and furnishing, 237-238
restrictive infant equipment requirements, 242-243
safety of equipment, materials, and furnishings, 237-238
size of furniture, 238-239
special adaptive, 244
storage for adaptive, 244
surfaces of equipment, furniture, toys, and play materials, 239-240
therapeutic and recreational, 244
walls, 240-241
Furniture, size of, 238-239
Futons, 255
containment of, 225
removal of, 225
Gas grills, 214-215
Gas heaters, 214-215
Gas maintenance, 261
Gas stoves, portable, 214-215
Gastrointestinal (GI) tract disease
diaper hygiene and, 104
notification of parents/guardians, 145
Gate requirements, 242
Gender awareness, 83
Generators, 214-215
Glass windows/doors, safety guards for, 205
Gloves
body fluids exposure and, 114
for changing children's soiled underwear/pull-ups and clothing, 108-109
for diaper changing, 107
hypoallergenic latex, 116
preventing transmission of infectious diseases, 114-116
G-max scale, 274
Governance, 347-348
written delegation of administrative authority, 347-348
Governing body of facility, 347
Ground fault circuit interrupters (GFCIs), 219
for outlets near water, 220
Group A streptococcal (GAS) infections
exclusion for, 300-301
informing caregivers/teachers of, 301
Group size
defined, 4-5
floor space and, 203
recommended, and child-staff ratio for, 3
for small family child care homes, 3-4
Growth charts, basis for, 89-90
Guardians. See Parents/guardians
Guardrails
for elevated play areas, 266-267
protective barriers and, 210-211
Guards
at doors, 205
at heaters, 216
at stairway access openings, 209
at windows, 204-205
splash, 187
Guideline, xxi
Haemophilus influenzae type B (HIB)
immunization for, 301–303
informing parents/guardians of, 302
notification of parents/guardians, 145
staff exclusion and, 135
Halogen lamps, light fixtures including, 217-218
Hand hygiene, 110–113
after applying insect repellent, 127
assisting children with, 112
hand sanitizers, 113
handwashing procedure, 111–112
situations that require, 110–111
training and monitoring for, 112–113
washing, 194–195
Handrails, 208–209
Hand sinks, ratios of, to children, 246
Handwashing procedure in child care centers, 111–112
Handwashing sinks, 247–248
for diaper changing areas in centers, 248–249
for diaper changing areas in homes, 249
portable water supply for, 224
prohibited uses of, 248
separate from food zones, 187
supplies for, 258–259
Harm, collection of data on, or illness to children in facilities, 411
Hazardous equipment, inaccessibility of, 260
Hazards, removal of, from outdoor areas, 259–260
Head count, caregivers/teachers’ of children during transportation, 6
Head-impact injuries, 274
Head injury criterion (HIC) scale, 274
attendance of children with, 319
spread of, from sharing helmets, 286
staff exclusion and, 135
temporary exclusion of children and, 131-133
Head Start Act, section 645A of, 352
Health, nutrition, physical activity, and safety awareness, 50
Health advocates, qualifications and responsibilities for, 16–18
Health agencies, provision of training to facilities by, 415-416
Health care for animals, 121
Health department
requirements for facilities to report to, 413-414
responsibilities and role of, 411–414
written plans for role of, 413
written policy reporting notifiable diseases, 355
Health education
for caregivers/teachers, 83–84
for parents/guardians, 84–85
staff modeling of healthy and safe behavior and activities, 82–83
topics for children, 81–82
Health history, 390
Health information sharing, parents/guardians provision of information on their child’s health and behavior, 80–81
Health insurance, caregivers/teachers need for, 376
Health Insurance Portability and Accountability Act (1996) (HIPAA)
care plan for children with special health care needs, 130
confidentiality of, 131
Health limitations of staff, 41
Health policies, 353–364
child care health consultant’s review of, 364
content and development of plan for care of children and staff who are ill, 354
documentation of exemptions and exclusion of children who lack immunizations, 356
food and nutrition service, and plans, 361
identification of child’s medical home and parental consent for information exchange, 356–357
infant feeding, 361–362
information sharing
on family health, 358
on therapies and treatments needed, 357–358
oral, 362–363
plans for evening and nighttime child care, 362
policies and practices that promote physical activity, 353–364
prohibiting
firearms, 363–364
smoking, tobacco, alcohol, illegal drugs, and toxic substances, 363
for reporting notifiable diseases to health department, 355
sanitation, and procedures, 360–361
on use of medications, 358–360
written, for obtaining preventive health service information, 355–356
Health protection in child care
animals and, 119–122
care for children who have been abused/neglected, 125
child abuse and neglect, 123–126
daily health check, 89
emergency procedures and, 122–123
facility layout to reduce risk of child abuse and neglect, 125–126
fire extinguishers, 123
for children who have been abused/neglected, 125
insect repellent and protection from vector-borne diseases, 127–128
preventing and identifying shaken baby syndrome/abusive head trauma, 125
response to fire and burns, 123
routine health supervision and, 89–90
sun safety including sunscreen, 126–127
tobacco and drug use, 118–119
to reduce risk of child abuse and neglect, 125–126
Heat-induced illness, preventing, 93
Heating, 211–217
Heating, ventilation, air conditioning (HVAC) systems, 211–217
inspection and maintenance, 212–213
Helmets, 286–287
Hepatitis A virus (HAV) infections
control of, 311–313
disease surveillance of, 314
staff education and policies on, 313–314
staff exclusion and, 135
temporary exclusion of children and, 133
Hepatitis B virus (HBV) infections
disease recognition and control of, 321–322
handling injuries to carrier, 323–324
observation and follow-up of child who is, 322–323
risk of transmission in feeding human milk to another mother’s child, 167
Hepatitis C virus (HCV) infections
control measures with, 324
risk of transmission in feeding human milk to another mother’s child, 167
Herpes simplex virus (HSV)
disease recognition and control of, 327
Herpes virus 6 and 7 (roseola), 327–328
Herpes viruses, 326
cytomegalovirus (CMV), 326–327
herpes simplex, 327
herpes virus 6 and 7, 327–328
varicella-zoster (chickenpox), 328–329
High chair
limiting infant/toddler time in, 66
requirements for, 241–242
washing, rinsing, and sanitizing trays, 178
High intensity discharge lamps, 218
Hip dysplasia, swaddling and, 99
History, health, 390
Hitting, handling, 72–73
HIV. See Human immunodeficiency virus (HIV) infection
Home room for school-age children, 5
Homes
handwashing sinks for diaper changing areas in, 249
nutritional quality of food when brought from, 183
selection and preparation of food brought from, 182
Hospitalizations from food allergy, 160
Hours of operation
construction and, 237
remodeling during, 237
Humane care for animals, 121
Human immunodeficiency virus (HIV) infection, 324–326
attendance of children with, 324
risk of transmission in feeding human milk to another mother’s child, 167
staff education about preventing transmission of, 325
Human milk. See also Breastfeeding
as developmentally appropriate for infants, 151
feeding to another mother’s child, 167
iron-fortified infant formula as alternative to, 163
preparing, feeding, and storing, 165–166
Human papillomaviruses (warts), 316
Human resource management, 375–377
benefits, 43
written
for centers and large family child care homes, 375–376
for small family child care homes, 376–377
Human temperatures, thermometers for taking, 135–136
Humidifiers
cleaning of, 261
maintenance of, 216–217
Hygiene
checking for need to change diapers, 105
cough and sneeze etiquette, 114
diaper changing procedure, 106–108
exposure to body fluids, 114–116
hand, 110–113
handling cloth diapers, 105
procedure for changing children’s soiled underwear/pull-ups and clothing, 108–110
type of diapers worn, 104–105
Hyperthermia, 99, 291-292, 373
Hypoallergenic latex gloves, 114
Illegal drugs, policies prohibiting, 363
Illness. See also Food-borne illness; Infectious diseases
collaborative development of child care requirements for children with, 400
collection of data on, or harm to children in facilities, 411
content and development of plan for children and staff who have, 354
documentation of parents/guardians notification of, 383
records of, 381–382
reporting, 144–147
review and accessibility of reports on, 383–384
use of fact sheets on common, associated with child care, 414
Immunity for reporters of child abuse and neglect, 124
autism and, 299
of caregivers/teachers, 299–300
documentation, 297–298
of exemptions and exclusion of children who lack, 356
against Haemophilus influenzae type B (HIB), 301–303
importance of, in child care, 297–298
against infectious diseases, 297–300
against influenza, 303
against measles-mumps-rubella, 304, 318
parent/guardian concerns over safety of, 298–299
PCV7, 308
PCV13, 308
against Streptococcus pneumoniae, 308–309
Impetigo, 317
temporary exclusion of children and, 133
Inborn errors of metabolism, dietary modifications and, 159
Inclusion, planning for, 335–336
Inclusion/exclusion dismissal of children, 131–135
Individualized Education Programs (IEPs)
children with chronic health conditions and, 360
for children with special health care needs and disabilities, 337, 338, 340, 341
compensation for participation in multidisciplinary assessments for children with special health care or education needs and, 405-406
written reports on Individualized Family Service Plan (IFSP), 341
Individualized Family Service Plan (IFSP)
children with chronic health conditions and, 360
for children with special health care needs and disabilities, 334, 337, 338, 341
compensation for participation in multidisciplinary assessments for children with special health care or education needs and, 405-406
Individuals with Disabilities Education Act (IDEA) (1991) (PL 102-119)
for children with special health care needs and disabilities, 333–335, 338, 340, 342
compensation for participation in multidisciplinary assessments for children with special health care or education needs and, 405-406
Part B Section 619 of, 334–335
Indoor learning/play environments, transitioning within programs, 54–55
Indoor play areas
inspection of, 277
size and requirements of, 265–266
Indoor temperature, 212
Infant equipment requirements, restrictive, 242–243
Infant feeding policy, 361–362
Infant foods, temperature in serving, 171–173
Infant formula
preparing, feeding, and storing, 167–169
as supplement for breastfed infant, 151
Infant play areas, shoes in, 236–237
brain development of, 14
caregivers/teachers qualifications for, 14–16
child safety seats for, 290
child-staff ratio for, 3-5
encouraging self-feeding by older, 175
enrollment in child care settings, 7–8
feeding age-appropriate solid foods to, 173–174
guardrails and protective barriers for, 210
housing of child care units for, 201
human milk as developmentally appropriate for, 151
importance of low child-staff ratios for, 3
interactions with caregivers/teachers, 57–58
limiting time in crib, high chair, car seat, etc., 66
nutrition for, 162–174
cleaning and sanitizing equipment used for bottle feeding, 172
feeding age-appropriate solid foods to, 173–174
feeding cow's milk, 169–170
feeding human milk to another mother's child, 167
feeding on cue by consistent caregivers/teachers, 164–165
general plan for feeding, 162–164
introduction of age-appropriate solid foods to, 172–173
preparing, feeding and storing formula, 167–169
preparing, feeding and storing human milk, 165–166
techniques for bottle feeding, 170–171
use of soy-based formula and soy milk, 169
warming bottles and foods, 171–172
personal caregivers/teachers relationships for, 57
preventing entry to toilet rooms by, 245
risk of sudden infant death syndrome (SIDS), 32, 33, 35
safe sleep procedures for, 96
separation of, from older children, 59
space and activity to support learning of, 58–59
tummy time of, 91
Infectious diseases, 297–330. See also Food-borne illness
bloodborne infections
hepatitis B virus, 321–324
hepatitis C virus, 324
human immunodeficiency virus (HIV), 324–326
daily health check and, 89
enteric (diarrheal) infections and hepatitis A, 311–315
exposure of children to, 144
gloves in preventing, 115
health check in reducing transmission of, 89
herpes viruses
cytomegalovirus (CMV), 326–327
herpes simplex, 327
herpes virus 6 and 7, 327–328
varicella-zoster (chickenpox), 328–329
immunizations against, 297–300
of caregivers/teachers, 299–300
documentation, 297–300
unimmunized children, 298–299
interactions with state or local health departments, 329
judicious use of antibiotics, 329–330
as major concern of parents/guardians and staff, 354
measures with Hepatitis C virus (HCV) and control, 324
notification of facility about, or other problems by parents/guardians, 145
for parents/guardians notification about exposure of children to, 144
in preventing transmission of infectious diseases, 114
prevention
with sanitation policies, 360
of transmission by handwashing, 247
procedure for parents/guardians notification about exposure of children to, 144
requiring parents/guardians notification, 145
respiratory tract infections
group A streptococcal infections, 300–301
Haemophilus influenzae type B, 301–303
influenza, 303–304
mumps, 304–305
Neisseria meningitides, 305–306
parvovirus B19, 306
pertussis, 306–307
respiratory syncytial virus, 307–308
Streptococcus pneumoniae, 308–309
tuberculosis, 309–311
unspecified, 311
sick leave in minimizing, 376
skin and mucous membrane infections
conjunctivitis, 315
enteroviruses, 316
human papillomaviruses, 316
impetigo, 317
lymphadenitis, 317–318
measles, 318
molluscum contagiosum, 318–319
Pediculosis capitis (head lice), 319
scabies, 321
Staphylococcus aureus skin infections including MRSA, 320–321
thrush, 321
tinea capitis and tinea cruris, 319–320
spread of, 297
transmission of, 136-137
written policy for reporting, to the health department, 355
Influenza, 303–304
control of, 303
prevention education, 303–304
written plan for seasonal and pandemic, 368–370
Information
community resource, 386
exchange of
at transition, 352–353
upon enrollment, 350
obtaining health check from parents/guardians, 89
parental consent for exchange of, 356–357
pre-admission enrollment, for each child, 387–388
sharing, on family health, 358
sharing, on therapies and treatments needed, 357–358
written policy for obtaining preventive health service, 355–356
Informing staff regarding presence of toxic substances, 229–230
Ingestion of substances that do not provide nutrition, 161–162
Injuries
documentation of parents/guardians notification of, 383
head-impact, 274
records of, 382
review and accessibility of reports on, 383–384
Insect breeding hazard, 228
Insect repellent, 127–128
Inspections
electrical, 219
frequency, 409
of equipment, 186
of facility, 409
of food, 188-189
of heating systems, 212
of pools, 281
of records, 384
playground safety, 269, 277, 374
unannounced, 3
water quality, 223
Installation of play equipment, 270
Insurance
caregivers/teachers need for health, 376
facility coverage, 377
vehicle, 377
Integrated pest management, 226–228
insect breeding hazard, 228
Interferon-gamma release assay (IGRA) blood test, 310
Introduction of age-appropriate solid foods. See Age-appropriate solid foods
Introduction of new foods, 159, 173, 181, 183
Invasive infections, notification of parents/guardians, 145
Iron-fortified infant formula as alternative to human milk, 163
Juice. See Fruit juice.
Kerosene heaters, 214–215
Kitchen and equipment
design of food service equipment, 186
food preparation area, 185–186
food preparation sinks, 187
handwashing sink separate from food zones, 187
maintaining safe food temperatures, 187
maintenance of food service surfaces and equipment, 186–187
microwave ovens, 188
ventilation over cooking surfaces, 187–188
Lactose intolerance. See Soy-based formula and soy milk
Landings, 209
Language development, fostering, in three-to-five-year olds, 62
Large family child care homes, xxii
child-staff ratio for, 4–6
continuing education for directors and caregivers/teachers in, 26
defined, 407
dishwashing in, 194
food service staff at, 176
frequency of inspections for, 409
locks in, 207
transportation policy for, 373–374
written daily activity plan and statement of principles, 49–50
written human resource management policies for, 375–376
Latchkey children, 416
Latex, ongoing exposures to, 116
Latex gloves, hypoallergenic, 116
Laundry area
location of equipment and water temperature for laundering, 251
service and equipment, 251
Laundry equipment, location of, 251
Laundry service and equipment, 251
Lawn care treatments, chemicals used in, 228
Lead
effects of toxicity, 161
in paint, 162, 237–238, 259, 260
and poison center as a resource, 229
in tableware and feeding utensils, 178
test results for, 378, 380, 384
testing for, 235–236
testing for levels of, in drinking water, 222–223
Lead teachers, qualifications of, 12–13
Learning, space and activity to support in infants and toddlers, 58–59
Learning experiences for children, 183–185
Learning/play environments, transitioning within programs and indoor and outdoor, 54–55
Leftovers, 191
Lice. See Head lice
Licenses
licensing agency procedures prior to issuing, 408
record of valid, 384
Licensing agency, 398–407
availability of records to, 380
collaborative development of child care requirements and guidelines for children who are ill, 400
community participation in development of rules, 398–399
licensing staff training, 406–407
operation permits, 398
procedures prior to issuing a license, 408
provision of child abuse prevention materials, 402
public-private collaboration on care of children who are ill, 400
rational basis of regulations, 398
role in communicating importance of compliance with Americans with Disabilities Act, 402
role with staff credentials, child abuse prevention, and Americans with Disabilities Act, 399–400, 400–402
technical assistance from, 402-406
training of personnel, about child abuse, 407
Licensing and community action, 397–418
caregivers/teachers support, 414-416
facility licensing, 407–411
health department responsibilities and role, 411–415
licensing agency, 398–407
public policy issues, 397–418
regulatory policy, 397
Licensing inspectors
education, experience and training of, 406–407
performance monitoring of, 406-407
Licensing of facilities that care for children who are ill, 140
Licensing rules, community participation in development of, 398–399
Licensing staff training, 406–407
Lighters, inaccessibility to, 257
Lighting, 217–218
emergency, 218
fixtures including, 217–218
high intensity discharge lamps, 218
levels of illumination, 217–218
mercury lamps, 218
multi-vapor lamps, 218
natural, 217
Limiting time
in equipment (cribs, high chairs, etc), 66
screen, 66-68
Linens, storage for soiled and clean, 256
Local health department
interaction with, concerning infectious diseases, 329
role of, 411–414
Lock down drills, record of, 385
Locks, 207–208
Lost child, 364
Lyme disease, 128
Lymphadenitis, 317–318
Maintenance
of air filters, 214
of changing tables, 250
cleaning of humidifiers, 261
cleaning schedule for exterior areas, 260
of dehumidifiers, 216–217
electrical fixtures and outlets, 261
of exterior surfaces, 259
gas, 261
of humidifiers, 216–217
inaccessibility of hazardous equipment, 260
plumbing, 261
plumbing and gas, 261
removal of allergen triggering materials from outdoor areas, 260
removal of hazards from outdoor areas, 259–260
storage area ventilation and, 260
structure, 261
Management of illness
inclusion/exclusion due to illness, 131–136
infectious disease outbreak control, 136
sharing of personal articles prohibited, 136
staff exclusion for, 135
thermometers for taking human temperatures, 135–136
Manipulative art or sensory materials, use of, 232
Matches, inaccessibility to, 257
Material Safety Data Sheets (MSDS), 213–214, 228
Maternal and Child Health programs, nutrition training and, 27
McKinney-Vento Homeless Assistance Act, 356
Meal and snack patterns, 156–157
for infants, 361-362
for school-age children, 175–176
for toddlers and preschoolers, 174–175
Meals, socialization during, 179–180
Meal service, seating, and supervision, 177–182
activities that are incompatible with eating, 178–179
adult supervision of children who are learning to feed themselves, 180
developmentally appropriate seating and utensils for meals, 177–178
experience with familiar and new foods, 181
foods that are choking hazards, 181
hot liquids and foods, 181
numbers of children fed simultaneously by one adult, 180
participation of older children and staff in mealtime activities, 180
prohibited uses of food, 182
socialization during meals, 179–180
tableware and feeding utensils, 178
Meals from outside vendors or central kitchens
approved off-site food services, 195
food safety during transport, 195
holding of food prepared at off-site food service facilities, 195
Mealtime activities, participation of older children and staff in, 180
Measles, 318
immunization against, 304, 318
notification of parents/guardians, 145
staff exclusion and, 135
temporary exclusion of children and, 133
Measles-mumps-rubella (MMR) vaccine, 304, 318
Measurable objectives, development of, for children with special health care needs and disabilities, 338–340
Media, limiting, 66–68
Medical care
authorization form, Appendix KK
coordinating, 356-357
for children with special health care needs, 336-337
for frostbite, 94
for hypothermia, 94
when to seek, Appendix P
written plan and training for handling urgent, or threatening incidents, 364–365
Medical home, identification of, 356–357
Medical procedures, caring for children who require, 130–131
Medications
administration, 141–142
labeling, storage, and disposal, 143
non-prescription, over-the-counter (OTC), 141-142
parents/guardians notification on use of, 357–358
policy on use of, 358–360
standing orders, 142
toxicity of, 228
training of caregivers/teachers to administer, 143–144
Medications record, 359–360
contents of, 391
Meningococcal infections
informing public health authorities of, 305–306
recommended control measures for invasive, 305
staff exclusion and, 135
Mental health, See Consultants
Menus, written, 159–160
Mercury lamps, 218
Methicillin-resistant Staphylococcus aureus (MRSA), 320–321
Microfiber cloths, used for cleaning, 259
Microwave ovens, 188
Milk. See also Human milk
allergy to, 153, 159, 161, 169
cow’s, 169-170
dry, 189
skim, 189-190
soy, 169
Mini-blinds, 235-236
Minimum age to enter child care, 7–9
Mixed age groups, 4, 27, 29, 59
Mixed director/teacher role, 12
Modeling, opportunities for, of health and safety education for parents/guardians, 84
Model work standards, development of, 376
Molluscum contagiosum, 318–319
Mops for cleaning, 259
Mop sinks, 248
Mosquito-borne viruses, 228
Mouth
cleaning and sanitizing objects intended for, 118
temporary exclusion of children and sores of, 133
Multidisciplinary assessment, compensation for participation in, for children with special health care or education needs, 405-406
Multiple use of rooms, 202–203
Multi-vapor lamps, 218
Mumps, 304–305
temporary exclusion of children and, 133
Nap time
Nasal bulb syringes, use of, 114–116
Nasal secretions, procedure for, 114–116
Native language, communication in, other than English, 55
Natural lighting, 217
Neisseria meningitides, 305–306
notification of parents/guardians, 145
Nicotine withdrawal, caregivers/teachers stress related to, 42
Nighttime child care, plans for, 362
Noise, levels of, 218–219
Nondiscriminatory policy, 350–351
Nurse, substitute, 32
Nutrition
assessment and planning of, for individual children, 153
food handling staff, 29–30, 176-177
for infants, 162–174
cleaning and sanitizing equipment used for bottle feeding, 172
feeding age-appropriate solid foods to, 173–174
feeding cow’s milk, 169–170
feeding human milk to another mother’s child, 167
feeding on cue by consistent caregivers/teachers, 164–165
general plan for feeding, 162–164
introduction of age-appropriate solid foods to, 172–173
preparing, feeding
and storing formula, 167–169
and storing human milk, 165–166
soy-based formula and soy milk for, 169
techniques for bottle feeding, 170–171
warming bottles and foods, 171–172
need for written plan in, 152–153
Nutrition and Food Service, 151–195
approved off-site, 195
assessment and planning of nutrition for individual children, 153
availability of drinking water, 157
care for children with food allergies, 160–161
categories of foods, 155–156
education for parents/guardians, 185
feeding plans and dietary modifications, 158–159
food brought from home
nutritional quality of, 183
selection and preparation of, 182
food safety
cleaning food areas and equipment, 193
compliance with Food and Drug Administration, U. S. (FDA) sanitation standards, state and local, 188
cutting boards, 193
dishwashing in centers, 193–194
dishwashing in small and large family child care homes, 194
leftovers, 191
precautions for safe food supply, 189–191
preparation for and storage of food in refrigerator, 191–192
staff restricted from food preparation and handling, 188–189
storage of dry bulk foods, 192
storage of foods not requiring refrigeration, 192
supply of food and water for disasters, 192–193
washing dishes by hand, 194–195
fruit juice, 157–158
ingestion of substances that do not provide nutrition, 161–162
kitchen and equipment
design of food service equipment, 186
food preparation area, 185–186
food preparation sinks, 187
handwashing sink separate from food zones, 187
maintaining safe food temperatures, 187
maintenance of food service surfaces and equipment, 186–187
microwave ovens, 188
ventilation over cooking surfaces, 187–188
learning experiences for children, 183–185
meal and snack patterns, 156–157
meal service, seating, and supervision, 177–182
activities that are incompatible with eating, 178–179
adult supervision of children who are learning to feed themselves, 180
developmentally appropriate seating and utensils for meals, 177–178
experience with familiar and new foods, 181
foods that are choking hazards, 181
hot liquids and foods, 181
numbers of children fed simultaneously by one adult, 180
participation of older children and staff in mealtime activities, 180
prohibited uses of food, 182
socialization during meals, 179–180
tableware and feeding utensils, 178
meals from outside vendors or central kitchens
approved off-site food services, 195
food safety during transport, 195
holding of food prepared at off-site food service facilities, 195
need for written nutrition plan, 152–153
staffing, 176–177
food service staff by type of facility and food service, 176
use of nutritionist/registered dietitian, 176–177
use of USDA-CACFP guidelines, 153–154
vegetarian/vegan diets, 162
written menus and introduction of new foods, 159–160
Nutritionist/registered dietitian
approval of dietary modifications, 159
availability of, to facilitate, 403
employment of, 152
use of, 176–177
Nutrition service, records of, 386
over consumption of fruit juices and, 158
prevention of, 18, 20, 22,33–34, 50, 81–84, 90-91, 100, 151–152, 157–158, 164, 177, 182, 185, 362, 552
risk of, 66-67, 158, 163, 170, 179, 182
screening for, 389
Observation of caregivers/teachers, 44
Occupational hazards, caregivers/teachers and, 41
Occupational risk, training on, related to handling body fluids, 30–31
Occupational Safety and Health Administration (OSHA), 40
Odors
chemicals used to control, 234
ventilation to control, 213–215
Office space, separating from child care areas, 202
Oil heaters, 214–215
On-site inspections, statutory authorization of, 409–410
On-site sewage systems, 225
containment of garbage, 225
containment of soiled diapers, 226
labeling, cleaning, and disposal of waste and diaper containers, 226
removal of garbage, 225
storage and disposal of infectious and toxic wastes, 226
Open-door policy, 380
Operation permits, 398
Oral health
education for, 103–104
policy, 362
routine hygiene activities, 101–102
toothbrushes and toothpaste, 102–103
Oral hygiene, caregivers/teachers in promoting, 170
Orientation
for care of children with special health care needs, 22–23
initial, of all staff, 21–22
of substitutes, 32–33
topics, 23–24
Orthotic devices, 244
Outdoor play areas, 93–94
elevated, 266–267
enclosures for, 268
inspection of, 277
location near bodies of water, 267
protection from air pollution, 94–95
removal of hazards from, 259–260
on rooftops, 266
shading of, 267–268
size and requirements of, 265
transitioning within programs, 54–55
visibility of, 267
Outdoor playground as exit, 206
Outlets maintenance, electrical fixtures and, 261
Pacifiers
cleaning, 100
as strangulation hazard, 129
sudden infant death syndrome (SIDS) and, 98, 100
bone, 320
chest, 316
eye, 132
first aid for, 25
from bite, 382
health check and, 89
medication, 360
oral, 327
Paints
lead in, 162, 236–239, 259–260
volatile organic compounds (VOC), 237, 239
Pandemic flu/influenza. See Influenza
Paneled areas, ventilation of recently, 213
Parental leave, unpaid and paid, 8
availability of documents to, 380–381
caregivers/teachers handling of intoxicated, 372
caregivers/teachers weaning of infants from, 100
communication between caregivers/teachers and, 159–160, 173
complaint procedures for, 80
concern about plagiocephaly, 98
concerns over safety of vaccines, 298–299
conferences with, 78–79
consent for information exchange, 356–357
contents of admission agreement between child care program and, 388
defined, xxiii
documentation of drop-off, pick-up, daily attendance of child, and communication, 372–373
documentation of notification of injury, illness, or death in program, 383
education plan of, 84–85
enrollment information to, 349–350
health education for, 84–85
helping cope with separation, 53–54
infectious diseases that require notification, 145
informing, of Haemophilus influenzae type B (HIB) exposure, 302
licensing agency provision of written agreements for, 403
list of excludable and reportable conditions for, 145–146
monitoring children's development/obtaining consent for screening, 51–53
mutual responsibility of staff and, 77–78
notification about infectious diseases or other problems, 145
notification of use of insect repellent, 128
notification on use of medication, 357–358
nutrition as basic responsibility of, 151
nutrition education for, 185
nutrition learning experiences for children and, 183–185
obtaining health information from, 89
procedure for notification about exposure of children to infectious disease, 144
provision of information on their child's health and behavior, 80–81
resources for, of children with special health care needs and disabilities, 405
seeking input, 79–80
staff's notification about varicella-zoster (chickenpox) virus and, 328–329
support services for, 80
unimmunized children and, 298–299
visits of, 78
Parvovirus B19
attendance of children with, 306
notification of parents/guardians, 145
Passenger vans, 293–294
Path of egress, 207
Paved surface, drainage of, 210
Payment for continuing education, 31
PCV7 vaccine, 308
PCV13 vaccine, 308
Peanut allergy, need for epinephrine and, 161
Pediatric first aid, child-staff ratio and, 5
Pediculosis capitis (head lice), 319
Performance monitoring of licensing inspectors, 406-407
Personal articles, storage and labeling of, 256
Pertussis, 306–307
exclusion for, 307
notification of parents/guardians, 145
prophylactic treatment for, 306–307
staff exclusion and, 135
temporary exclusion of children and, 133
Pest management, integrated, 226–228
Pets. See Animals
pregnant women's exposure to cat feces, 120, 122
Phthalates, 233
Physical abuse. See Child abuse and neglect
active opportunities for, 90–93
barriers to, 353
caregivers/teachers encouragement of, 95–96
policies and practices that promote physical activity, 353–364
time spent on, 90-91
weight management and, 151
Physical activity consultant, availability of, to facilitate, 404
Physical aggression, handling, 72–73
Physical restraint, using, 76–77
Physical therapy
equipment, 244, Appendix X
space for, 255-256
Pica, 161
Pick-up, 289
Pick-up child
authorized persons for, 371–372
documentation of, and parents/guardians communication, 372–373
Pick-up points, 209
Picky eater, 152
Pillows, 252
Pink eye. See Conjunctivitis
Pipes, installation of, 224
Plagiocephaly, concern about, 98
Planned program of daily activities, written description of, 49–50
Plants
prohibition of poisonous, 234
safe, 234, Appendix Y
Plastic bags, storage of, 257
Plastic containers, 232–234
Play and teaching equipment, storage of, 256
Play area and playground surfacing
inspection of, 277–278
prohibited surfaces for placing climbing equipment, 273–274
Play areas/playgrounds
clearance requirements of, 273
elevated, 266–267
enclosures for outdoor, 268
inspection of, 277–278
inspection of indoor and outdoor, 277
location of, near bodies of water, 267
policies on, 374–375
records of proper installation and maintenance of facility equipment, 375
reports of annual audits/monthly maintenance checks of equipment, 375
use and maintenance of, 374–375
on use and maintenance of, 374–375
reports of annual audits/monthly maintenance checks of, 375
rooftops as, 266
shading of, 267–268
shoes in infant, 236–237
size and location of, 265
size and requirements of indoor, 265–266
soil in, 200
visibility of, 267
water, 278–283
Play dough, use of, 232
Play equipment
Americans with Disabilities Act requirements for, 270
arrangement of, 272
ball pits, 276
connecting and linking devices, 270–271
crawl spaces in, 271
design of, 270
enclosure of moving parts on, 271
entrapment hazards of, 272
installation of, 270
location of moving, 272–273
material defects and edges on, 271–272
requirements for, 269–270
sandboxes, 274
sensory table materials, 275–276
trampolines, 276
use zone for fixed, 272
water play tables, 275
Play materials, surfaces of, 239–240
Play yard requirements, 242
Plumbing
installation of fixtures, 224
maintenance of, 261
Poison center, use of, 229
Poisonous plants, prohibition of, 234
Policies, 348–375
content of, 348
enrollment information to parents/guardians and caregivers/teachers, 349–350
exchange of information upon enrollment, 350
food and nutrition service, 361
health, 353–364
infant feeding, 361–362
nondiscriminatory, 350–351
oral health, 362–363
play area, 374–375
review and communication of written, 349
sanitation, 360–361
transportation, 373–374
written discipline, 351
Polybrominated diphenyl ether (PBDE), 239
Polyvinyl chloride (PVC), 232–233
Pooling, 59
Pools. See Swimming pools
Pool toys, 283–285
Portable electric space heaters, 215
Portable fire extinguishers, 221
Portable gas stoves, 214–215
Portable wading pools, 283
Portable water supply, handwashing sink using, 224
Pre-admission enrollment information for each child, 387–388
Pregnant women, exposure to cats' feces, 120, 122
appropriate amount of physical activity for, 92
body mastery for, 62–63
caregivers/teachers qualifications for, 15
expressive activities for, 62
fostering cooperation of, 62
fostering language development of, 62
guardrails and protective barriers for, 210
housing of child care units for, 201
nutrition for
meal and snack patterns for, 174–175
serving size for, 174–175
outdoor play of, 91
personal caregivers/teacher relationships for, 61
selection of equipment for, 61
short structured activities for, 91
supervision for, 3
toilet facilities for, 65–66
toilet height for, 246
Pre-service qualifications
caregivers/teachers, 12–19
director's, 10–11
mixed director/teachers, 12
Pre-service training, 19–21
Prevention and management of toxic substances, 228–229
carbon monoxide detectors, 214, 230
chemicals used to control odors, 234
construction and remodeling during hours of operation, 237
exposure to asbestos or other friable materials, 231
informing staff regarding presence of toxic substances, 229–230
plastic containers and toys, 232–234
prohibition of poisonous plants, 234
proper use of art and craft materials, 231–232
radon concentrations, 230
shoes in infant play areas, 236–237
testing for lead, 235–236
treatment of chromated copper arsenate (CCA) pressure-treated wood, 234–235
use and storage of toxic substances, 228
use of play dough and other manipulative art of sensory materials, 232
use of poison center, 229
Prevention of obesity. See Obesity
Preventive health services
provision of routine, 90
written policy for obtaining information, 355–356
Primary care provider, defined, xxiii
Privacy. See also Health Insurance Portability and Accountability Act (1996) (HIPAA)
toilet location and, 245
Private residence, use of, as child care facility, 199
Product recall monitoring, 238
Professional development/training, pre-service training, 19–21
Program consultant, availability of, to facilitate, 403
Prohibited animals, 121
Prohibited surfaces for placing climbing equipment, 273–274
Projectile toys, 285
Prophylactic treatment for pertussis, 306–307
Propping bottle. See Bottle propping
Prosthetic devices, 244
Public health authorities, informing
of hepatitis B virus cases, 323
of invasive Haemophilus influenzae type B (HIB) cases, 302–303
of invasive Streptococcus pneumoniae, 309
of meningococcal infections, 305–306
of pertussis cases, 306
Public policy issues and resource development, 416-417
Public-private collaboration on children who are ill, 400
Pull-ups, changing soiled, 108–110
Punishment. See Corporal punishment
Quality, sources of technical assistance to support, of child care, 402–406
Quality improvement, management principles of, 347
Quality rating and improvement systems (QRIS), 408
Radon concentrations, 230
Rags, used for cleaning, 259
Raisins, 181
Rash
staff exclusion and, 135
temporary exclusion of children and, 133
Ratios. See Child-staff ratios
Rational basis of regulations, 398
Reading, 67
Reasonableness as legal standard, 340
Recalls. See Product recall monitoring
Recipes, provision of, in nutrition education for parents/guardians, 185
Records, 377–393. See also Staff records
access to facility, 379
availability of
documents to parents/guardians, 380–381
on inspections of fire protection devices, 385
to licensing agency, 380
child, 386–392
community resource information, 386
documentation of child care health consultation/training visits, 385–386
documentation of parents/guardians notification of injury, illness, and death in program, 383
evacuation and shelter-in-place drill, 385
facility, 377–386
facility records/reports, 377–386
of illness, 381–382
of injury, 382
maintenance and display of inspection, 384
maintenance of, on incidents of diarrhea, 314–315
of nutrition service, 386
requirements for compliance of contract services, 381
review and accessibility of injury and illness, 383–384
staff, 392–393
training, 393
of valid license, certificate, or registration of facility, 384
written plan/record to resolve deficiencies, 384–385
written policy of confidentiality, 378–379
Recreational equipment, 244
References, checking in background screening, 10
Refrigeration, storage of foods not requiring, 192
Refrigerator, preparation for and storage of food in, 191–192
Registration of facility, record of valid, 384
Regulations, xxi
rational basis of, 398
Regulatory agency, provision of caregivers/teachers and consumer training and support services, 414–416
Regulatory enforcement, state statute support of, 397
Regulatory policy
adequacy of staff and funding for enforcement, 397
regulation of all out-of-home child care, 397
state statute support of enforcement, 397
Rehabilitation Act (1973), Section 504 of, accessibility of facilities and, 199
Reimbursement for children with special health care needs and disabilities, 340
Relationships, developing, for school-age children, 64
Religious beliefs, dietary modifications based on, 159
Remodeling, during hours of operation, 237
Reports, facility, 377–386
Resource and referral agencies, development of, 416-417
Respiratory illness, staff exclusion and, 135
Respiratory syncytial virus (RSV), 307–308
attendance of children with, 307–308
Respiratory tract infections (RTIs)
attendance of children with, 311
group A streptococcal infections, 300–301
Haemophilus influenzae type B, 301–303
influenza, 303–304
mumps, 304–305
Neisseria meningitides, 305–306
parvovirus B19, 306
pertussis, 306–307
respiratory syncytial virus, 307–308
Streptococcus pneumoniae, 308–309
tuberculosis, 309–311
unspecified, 311
Rest areas, unscheduled access to, 101
Rest periods, scheduled, 100–101
Retaining wall in creating elevated play areas, 266–267
Rifampin treatment of children exposed to child with Haemophilus influenzae type B (HIB) disease, 302
Ringworm, attendance of children with, 319–320
Rooftops as play areas, 266
Roseola, 327–328
Routine health supervision, 89–90
Rubella
staff exclusion and, 135
temporary exclusion of children and, 133
Safe sleep practices. See Sleep
Safety
strangulation hazards, 129
sun, 126–127
Safety covers
for electrical outlets, 219
for swimming pools, 279
Safety guards for glass windows/doors, 205
Safety straps for diaper changing table, 106-109
Salmonella, See Exclusion for illness; food safety; animals
St. Louis encephalitis, 228
Sand
as a surfacing material, 274
type used in sandboxes, 274
Sandboxes, 274
Sanitation
of objects intended for mouth, 118
policies and procedures, 360–361
routine, 116–117
toys, 117–118
Satellite dish, location of, 211
Scabies, 321
attendance of children with, 321
staff exclusion and, 135
temporary exclusion of children and, 133
School, communication between child and, 64
School-age activities
space for, 63–64
supervised, 63
School-age child care facility, 407
School-age children
areas for, 204
bike routes for, 287
caregivers/teachers qualifications for, 15–16
community outreach for, 64
developing relationships, 64
fostering collaboration to establish programs for, 416
guardrails and protective barriers for, 210
home room for, 5
housing of child care units for, 201
limiting screen time for, 95
meal and snack patterns for, 175–176
planning activities for, 64
in small family child care homes, 3
supervision of, 64–66
use of toilet facilities of, 65–66
Scrapes, body fluids and, 114
Screening, obtaining consent for, 51–53
Screens for ventilation openings, 205
Screen time
caregivers/teachers awareness of, 95
limiting, 66–68
for school-age children, 95
Section 504 of the Rehabilitation Act (1973) for children with special health care needs and disabilities, 335, 341, 342
Self-feeding, encouraging by older infants and toddlers, 175
Self-stimulatory behaviors, ignoring, 63
Sensors or remote monitors for swimming pools, 279
Sensory table materials, 275–276
Separation, helping families cope with, 53–54
Separation of operations from child care areas, 202
Service plan, developing, for children with special health care needs and disabilities, 337–340
Services, planning for child's transition to new, 351–352
Sewage systems, on-site, 225
Sex offender registries, 401, 408
in background screening, 10
Sexual abuse. See Child abuse and neglect
Shading of play areas, 267–268
Shaken baby syndrome/abusive head trauma
preventing and identifying, 125
prevention of, 18
Shelter-in-place, 368
Shelter-in-place drills
evacuation and records of, 385
records of, 385
Shigella. See Exclusion for illness
Shingles, staff exclusion and, 135
Shock protection devices for electrical outlets, 219
Shoes in infant play areas, 236–237
ratio and location of, 250–251
safety of, 251
Sick leave, 43
in minimizing infectious diseases, 377
SIDS. See Sudden infant death syndrome (SIDS)
Sign-in/sign-out system, 371
Single service cups, 258
Sippy cups. See Cups
Site location, environmental audit of, 200
Skin and mucous membrane infections, 315
conjunctivitis, 315
enteroviruses, 316
human papillomaviruses, 316
impetigo, 317
lymphadenitis, 317–318
measles, 318
molluscum contagiosum, 318–319
notification of parents/guardians, 145
Pediculosis capitis (head lice), 319
scabies, 321
staff exclusion and, 135
Staphylococcus aureus skin infections including MRSA, 320–321
thrush, 321
tinea capitis and tinea cruris, 319–320
Sleep, 96–99
pacifier use and, 99–100
safe practices and SIDS/suffocation risk reduction, 96
supervision during, 3
swaddling and, 99
Sleep and rest areas
bunk beds, 255
cribs, 253–254
equipment and supplies, 251–253
futons, 255
stackable cribs, 254–255
Sleeping equipment and supplies, 251–253
Small family child care homes, xxii
child-staff ratio for, 3–4
continuing education for caregivers/teachers of, 31
defined, 407–408
dishwashing in, 194
food service staff at, 176
frequency of inspections for, 409
locks in, 207
mixed use of rooms, 202
school-age children in, 3
transportation policy for, 373–374
written daily activity plan and statement of principles, 49–50
written human resource management policies for, 376–377
Smoke alarms, 221
Smoke detection systems, 221
Smoking, policies prohibiting, 363
Sneezing etiquette, 114. See also Cough and sneeze
Socialization during meals, 179–180
Social policies, efforts to strengthen, 8
Social Security Act (1935), social policies and, 8
Social security trace in background screening, 10
Soil in play areas, 200
Solid foods, introduction of age-appropriate, 172–173
Sound abatement, caregivers/teachers need for help with, 219
Soy-based formulas, use of, 169
Soy milk, use of, 169
for children with special health care needs, 255-256
for play areas per child, 265
for school-age activity, 63–64
per child, 203
to support learning of infants and toddlers, 58–59
Space for children who are ill, injured, or need special therapies
space for ill children, 255
space for therapy services, 255–256
Space heaters, portable electric, 215
Special adaptive equipment, 244
Special health care needs, recognition of health problems in, 26–27
Specialists, communication from, 81
Special Supplemental Nutrition Programs for Women, Infants, and Children (WIC)
nutrition training and, 27
soy-based formula and soy milk, 169
Square footage. See Space
Stackable cribs, 254–255
Staff. See also Caregivers/teachers
adequacy of, and funding for regulatory enforcement, 397
competence and training of transportation, 287–288
content and development of plan for care of, who are ill, 354
designating role of person responsible for coordinating care in child care facility, 338
education of
policies on cytomegalovirus (CMV) and, 326
preventing transmission of HIV infection, 325
on prevention of bloodborne diseases, 323
exclusion for illness, 135
food service, by type of facility and food service, 176
health appraisals of, 408
health limitations of, 41
health of
daily check, 40–41
pre-employment and ongoing adult health appraisals, including immunization, 39–40
informing, regarding presence of toxic substances, 229–230
maintenance of attendance records for, who care for children, 392
notification of parents/guardians about varicella-zoster (chickenpox) virus, 328–329
nutritionist/registered dietitian as member of, 176–177
participation in mealtime activities, 180
recruitment of, 9
restriction from food preparation and handling, 188–189
Staff-child ratios. See Child-staff ratios
Staff records, 392–393
maintenance and content of, 392–393
maintenance of attendance, who care for children, 393
training, 393
Stairway access openings, guards at, 209
Standard (defined), xxi
adopting use of, 114-116
bodily fluids, preventing exposure to, 114-116
infectious disease, preventing spread of, 322-326
toothbrushing and, 102
Standing orders guidance, 142
Staphylococcus aureus skin infections including MRSA, 320–321
State child abuse registries in background screening, 10
State early childhood advisory council, 399–400
State health department
interaction with, concerning infectious diseases, 329
role of, 411–414
State law, whistle-blower protection under, 410
State statute support of regulatory enforcement, 397
Stationary activity centers, 242
Statutory authorization of on-site inspections, 409–410
Steps and stairs, 208–209
Storage areas
coat hooks/cubicles, 256
firearms, 257
of flammable materials, 256–257
inaccessibility to matches, candles, and lighters, 257
maintenance and ventilation, 260
of plastic bags, 257
of play and teaching equipment and supplies, 256
for soiled and clean linens, 256
storage and labeling of personal articles, 256
Storage for adaptive equipment, 244
Stoves, wood/corn pellet, 215–216a>
Strangulation hazards, 129
Strep throat, staff exclusion and, 135
Streptococcal pharyngitis, temporary exclusion of children and, 133
Streptococcus pneumoniae, 308–309
informing public health authorities of invasive, 309
Stress for caregivers/teachers, 41–43
Strings on children's clothing as strangulation hazard, 129
Stroller requirements, 242
Structurally sound facility, 201
Structure maintenance, 261
Substances, ingestion of, not providing nutrition, 161–162
Substitutes
age of, 32
employment of, 32
illness of, 41
orientation of, 32–33
Sudden infant death syndrome (SIDS)
accusation of child abuse and neglect and, 147
in child care, 18
deaths in child care facilities attributable to, 97
reducing risk of, 96-98
Suffocation, 96-99
Sun safety, 126–127
Sunny weather, outdoor play in, 93
Sunscreen, 126–127
Supervision
methods of, 64–66
near bodies of water, 68–69
for preschoolers, 3
for school-age activity, 63
during sleep, 3
for swimming, wading, and water play, 7
for toddlers, 3
touch, 7
Supervision during transportation, child-staff ratio and, 6
Supplies
for bathrooms and handwashing sinks, 258–259
first aid and emergency, 257–258
microfiber cloths, rags, and disposable towels and mops used for cleaning, 259
single service cups, 258
Support networks for, family child care, 19
Support services for parents/guardians, 80
Suspensions, 73–75
Swaddling, 99
Swimming
cardiopulmonary resuscitation (CPR) training for, 26
supervision for, 7
accessibility to aboveground, 279
behavior around, 69
deck surface, 279–280
drain covers, 280
electrical safety for areas, 282
equipment, 281
hot tubs, spas, and saunas in areas around, 283
maintenance, 281–282
safety covers for, 279
safety rules, 280
supervision of pool pump, 280
water quality of, 282–283
water temperature, 282
Swings, clearance space for, 273
Syrup of ipecac, 258
Tableware and feeding utensils, 178
Tamper-resistant electrical outlets, 219
Teacher aides
assistant teachers and, 13
qualifications for, 13
Technical assistance
to facilities to address diversity in community, 406
from licensing agency, 402–406
Telephone, availability and use of, 243
Television, limiting time, 66-68
Temperature
indoor, 212
interior of vehicles, 291–292
for laundering, 251
of bottles and infant foods, 171–172
of foods, 187
of swimming pool water, 282
thermometers for taking human, 135–136
wind chill, 93
Temporary Assistance for Needy Families (TANF), 35
Termination of child attending facility. See Expulsions
Therapeutic equipment, 244
Therapy services, space for, 255–256
Thermometers
for taking human temperatures, 135–136
type and placement of room, 214
Threatening incidents, written plan and training for handling urgent medical care or, 364–365
Three-to-five year olds. See Preschool-age children
Thrush (candidiasis), 321
Ticks
protecting children from, 128
removal of, 128
Tinea capitis and tinea cruris (ringworm), 319–320
Title V, 35
Tobacco
drug use and, 118–119
policies prohibiting, 363
appropriate amount of physical activity for, 92
caregivers/teachers qualifications for, 12–15
child-staff ratio for, 3-4
cleaning of individual bedding for, 118
encouraging self-feeding by older, 175
housing of child care units for, 201
guardrails and protective barriers for, 210
importance of low child-staff ratios for, 3
interactions with caregivers/teachers, 57–58
limiting time in crib, high chair, car seat, etc., 66
nutrition for
encouraging self-feeding by older, 175
meal and snack patterns for, 174–175
serving size for, 174–175
outdoor play of, 90–91
personal caregivers/teachers relationships for, 57
preventing entry to toilet rooms by, 245
sensory table materials and, 275
separation of, from older children, 59
short structured activities for, 91
space and activity to support learning of, 58–59
supervision for, 3
swimming pools risk for, 68–69
toilet height for, 246
toilet learning/training, 59–60
Toilet and handwashing areas
ability to open toilet room doors, 245
chemical toilets, 245–246
cleaning and disinfection, 247
general requirements for, 245
handwashing sinks, 247–248
learning/training equipment, 246–247
location of toilets and privacy issues, 245
mop sinks, 248
preventing entry to toilet rooms by infants and toddlers, 245
prohibited uses of handwashing sinks, 248
ratios of toilets, urinals, and hand sinks to children, 246
waste receptacles in child care facility and in child care facility toilet rooms, 247
Toilet learning/training equipment, 246–247
Toilet rooms
ability to open, 245
ability to open door of, 245
preventing entry to, by infants and toddlers, 245
chemical, 245–246
cleaning and disinfecting, 247
location of, 245
ratios of, to children, 246
use of, 65–66
Toilet training, changing children's soiled underwear/pull-ups and clothing and, 108–110
Tongue thrust, dietary modifications and, 159
Tooth brushing, 101
Toothpaste, 101
Touch supervision, 7
Towels
for cleaning, 259
for handwashing, 111
storage as personal article, 256
Toxic substances
informing staff regarding presence of, 229–230
policies prohibiting, 363
prevention and management of, 228–229
carbon monoxide detectors, 230-231
chemicals used to control odors, 234
construction and remodeling during hours of operation, 237
exposure to asbestos or other friable materials, 231
informing staff regarding presence of toxic substances, 229–230
plastic containers and toys, 232–234
prohibition of poisonous plants, 234
proper use of art and craft materials, 231–232
radon concentrations, 230
shoes in infant play areas, 236–237
testing for lead, 235–236
treatment of chromated copper arsenate (CCA) pressure-treated wood, 234–235
use and storage of toxic substances, 228
use of play dough and other manipulative art of sensory materials, 232
use of poison center, 229
use and storage of, 228–229
Toxoplasmosis, 274
congenital, 122
Toys
cleaning and sanitizing, 117–118
crib, 285
inaccessibility of, or objects to children under three years of age, 284–285
projectile, 285
riding, with wheels and wheeled equipment, 286
sleep policy regarding, 96
surfaces of, 239–240
Training
of caregivers/teachers, 414–416
on administering medications, 143–144
on care of children with special health care needs, 22
on emergency/disaster planning and response, 366–368
on first aid and CPR, 24
on food handling, 29–30
on health topics, 83-84
on safe sleep practices, 96–97
pre-service, 19-21
documentation of child care health consultation, 385–386
of licensing personnel about child abuse, 407
licensing staff, 406–407
record of, 393
Training time and professional development leave, 31
Transition plan, format for, 352
Transitions, 351–353
exchange of information at, 352–353
format for, 352
planning for child's, to new services, 351–352
Transportation
child behavior during, 291
distractions while driving, 292
food safety during, 195
interior temperature of vehicles, 291–292
passenger vans, 293
policies, 373–374
for centers, 373
for large family child care homes, 373
for small family child care homes, 373
qualifications for drivers, 288–289
route to emergency medical services, 292–293
Transportation safety
child passenger safety, 289–291
drop-off and pick-up, 289
Transportation staff, competence and training of, 287–288
Trash. See Garbage
Trauma, abusive head, preventing and identifying, 125
Tree nut allergy, need for epinephrine and, 161
Tremolite, 274
Tuberculin skin test (TST), 310
Tuberculosis, 309–311
attendance of children with latent infection or active disease, 310–311
measures for detection, control, and reporting of, 309–310
notification of parents/guardians, 145
staff exclusion and, 135
temporary exclusion of children and, 133
Tummy time for infants, 91
Twenty-four hour care. See Evening care
Underwear, changing soiled, 108-110
Uniform categories and definitions, 407–408
Unimmunized children, 298–299
Universal precautions. See Standard precautions, 114–116
Unrelated business in child care area, 201–202
Unscheduled access, to rest areas, 101
Unspecified respiratory tract infection, 311
attendance of children with, 311
Upper respiratory infections, exposure to cold air and, 94
Urgent care, review of written plan for, 365–366
Urinals, ratios of, to children, 246
Use zone for fixed play equipment, 272
Utensils, tableware and feeding, 178
Vaccines. See Immunizations
Varicella-zoster (chickenpox) virus, 328–329
notification of parents/guardians, 145
staff and parents/guardians notification about, 328–329
Vector-borne diseases, protection from, 127–128
Vegetarian/vegan diets, 162
Vehicles
interior temperature of, 291–292
passenger vans, 293–294
Ventilation, 211–217
to control odors, 213–214
over cooking surfaces, 187–188
of recently carpeted or paneled areas, 213
screens for openings, 205
storage area and, 260
when using art materials, 213
Verbal interaction, 56–57
Video watching, limiting, 66-68
Visibility of outdoor play area, 267
Visits, parents/guardians, 78
Volatile organic compounds (VOC), paints, 237
Volunteer records, maintenance and content of, 392–393
Volunteers
age of, 32
assistant teachers and, 13
illness of, 41
qualifications for, 13
Vomiting
staff exclusion and, 135
temporary exclusion of children and, 133
Wading, supervision for, 7
Wading pools, portable, 283
Walking surfaces, 210
Walkways
construction and maintenance of, 209–210
designated, 209
Walls, 240–241
Warm weather, outdoor play in, 93
Waste containers, labeling, cleaning, and disposal of, 226
Waste receptacles in child care facility and in child care facility toilet rooms, 247
Wastes, storage and disposal of infectious and toxic, 226
Water
access to safety around bodies of, 278–279
availability of drinking, 157
bodies of location of play areas near, 268
bottled, 223
in containers, 283
emergency safe drinking, 223
handling and treatment equipment, 223–224
handwashing sink using portable supply, 224
heating devices and temperature allowed, 216
location of electrical devices near, 220
location of play areas near bodies of, 267
supervision near bodies of, 68–69
supply of, for disaster, 192–193
testing for lead and copper levels in drinking, 222–223
testing of drinking, not from public system, 222
Water play
cardiopulmonary resuscitation (CPR) training for, 26
supervision for, 7
Water play areas
access to and safety around bodies of water, 278–279
hot tubs, spas, and saunas, 283
portable wading pools, 283
Water play tables, 275
Water-related injuries, circumstances surrounding, 7
Water supply, 221–222
Water temperature for laundering, location of laundry equipment and, 251
Water test results, 223
Water-tightness of opening, 204
Weather Radio All Hazards (NWR), provision of weather information, 94
Weather-tightness of opening, 204
Weight management, physical activity and, 151
Western equine encephalitis, 228
West Nile virus, 228
Wheeled vehicles, areas used by children for, 210
Wheels and wheeled equipment, riding toys with, 286
Whistle-blower protection, under state law, 410
Whooping cough, 298, 300, 306-307. See also Pertussis
Wind chill advisory, 93
Wind chill temperature, 93
Windows
covering cords as strangulation hazard, 129
possibility of exit from, 204–205
Wireless communication device, availability and use of, 243
Wood/corn pellet stoves, 215–216
Wood frame construction, buildings of, 201
Written daily activity plan and statement of principles, 49
Written discipline policies, 351
Written plan and training for handling urgent medical care or threatening incidents, 364–365
Zoning, 384
