A Guide To Worksite Wellness And Safety In The Child Care .
HTWTW OTALORKERHEALTH A Guide toWorksite Wellnessand Safetyin theChild Care SettingDeveloped byJUNE 2015
Total Worker Health :A Guide to Worksite Wellnessand Safety in the Child Care CenterINTRODUCTIONThis guide uses the Centers for Disease Control and Prevention’s Total Worker Health frameworkwith a focus on the child care setting. It combines assessment, training and education on both thepersonal safety and health promotion aspects of the child care environment and workforce.Safety encompasses the activities that protect employees from occupational injury and illness, such asergonomics and infectious disease prevention. Health promotion encompasses the activities thatmaintain or improve the personal health of a workforce, ranging from health risk assessments towellness programs and immunizations.These two factors, personal health and personal safety, are each essential to a productive worker andto a productive workplace. When effectively combined, they can have an increased impact on overallhealth and productivity.Materials in this guide were originally developed in 2015 by the Northern Kentucky HealthDepartment for use in child care centers in a four-county district. It should be a starting point toallow collaboration between public health or early care partners and child care providers with theultimate goal of improving worksite wellness and safety in child care centers.Total Worker Health : Worksite Wellness and Safety in the Child Care Setting has been compiled andprovided for public use with an acknowledgement or attribution:2015. Total Worker Health : Worksite Wellness and Safety in the Child Care Setting. Northern KentuckyHealth Department.Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 1
EXECUTIVE SUMMARYTotal Worker Health : Staff Wellness and Safety in the Child Care Setting project focuses onpersonal health and safety of child care providers in early care environments.Through the use of a staff wellness and safety pre-assessment tool, goal setting, child care centerstaff training, technical assistance and post-assessment, sustainable change in staff wellness andsafety can be obtained for a productive staff and a productive workplace.This program focuses on the concept of combining employee safety efforts with wellness efforts inearly care environments. Early child care environment professionals are exposed to a wide variety ofjob-specific health and safety risks including: infectious disease, musculoskeletal injuries, falls,environmental hazards and stress. The health of early child care professionals impacts the quality ofcare they are able to provide to children. Many health and safety policies in early child care programsprotect children and adults; however, some wellness and safety issues specific to adult caregivers areoften neglected.The program utilized an environmental assessment on staff wellness and safety developed by theNorthern Kentucky Health Department that combines aspects of the original Nutrition AndPhysical Activity Self Assessment for Child Care assessments and various staff wellness surveys. Theassessment components include wellness, nutrition, physical activity, ergonomics, stressmanagement and preventative measures.This intervention was designed to enhance staff wellness and safety policies, practices, andenvironments in the child care setting by: Obtaining insight into the director’s perception of staff safety and staff wellness and howhe/she views the two within the child care setting.Assessing the current staff wellness and safety environment and practices, and determiningstaff needs and interests through an environmental assessment and staff interest/needssurvey.Providing staff training and onsite consultation related to staff wellness and safety andeducation on best practices to improve the wellness and safety environment.Offering CDC recommended adult vaccinations including a Tdap booster and annualinfluenza vaccinations to child care center staff during the staff training event.Assisting child care centers with development of staff wellness and safety policies andpractices and related environmental characteristics.Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 2
Table of ContentsIntroduction . 1Executive Summary . 2Program Outline . 4Sample Staff Wellness Policy. 6Wellness Policy and Program DevelopmentInitial Environmental Self-Assessment . 12Post-Program Environmental Self-Assessment. 19Staff Safety and Wellness Action Planning Document . 26Employee Wellness Interest Survey . 31Staff Safety/Wellness Training Survey . 36Acknowledgment and Attribution . 37References . 38AppendicesChild Care Ergonomics (St. Elizabeth Healthcare, used with permission) . 39Promoting Health and Safety of Child Care Staff(National Training Institute for Child Care Health Consultants, used with permission)Presentation . 46Teacher’s Guide . 86Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 3
Program OutlinePurpose: To provide public health and child care staff with clear expectations of programWhen to use: At beginning of programPROGRAM DATES: START TO FINISHThis program is unique in that it combines assessment, training and education on both the personalsafety and health promotion aspects of the child care environment and workforce.Safety encompasses the activities that protect employees from occupational injury and illness, such asergonomics or infectious disease prevention.Health promotion encompasses the activities that maintain or improve the personal health of aworkforce, ranging from health risk assessments to wellness programs and immunizations.These two factors, personal health and personal safety, are each essential to a productive worker andto a productive workplace. When effectively combined, they can have an increased impact on overallhealth and productivity.Through this program, there will be opportunity for staff to receive free staff training clock hoursthrough hands-on activities, as well as earning incentives for the center to further support health andsafety efforts.This program, through training and incentives, helps child care center staff learn safe and healthyskills for themselves, and learn how to be healthy role models for the children they see every day.PROGRAM COMPONENTS1. Introductory meeting/interview (DATE)a. At this meeting, child care staff and TWH program staff will go over the program indetail. The child care center will also receive their environmental pre-assessment anda staff wellness interest survey. An audio-recorded interview will be conducted toprovide insight into the director’s perception of staff safety and staff wellness andhow he/she views the two within the child care setting. This interview will takeapproximately 1 hour to complete.i. The director will receive an INCENTIVE for participating.2. Director will ask the staff to complete the staff wellness interest survey, and thedirector will complete the environmental pre-assessment within 2 weeks of receiving,and return it to the TWH program staff contact.a. The staff interest survey will help determine the needs and interests of individualstaff as they pertain to safety and wellness. Results from this survey will help shapefuture staff training opportunities.b. The environmental pre-assessment will look at the child care environment as itrelates to staff wellness and safety. Results from this assessment will help directorsdetermine goals to set and provide a way to help evaluate the program.Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 4
3. Once the TWH program staff receives and reviews the environmental preassessment and staff interest surveys, they will assist the child care center director indetermining goals for the program.a. Directors will complete a goal sheet: Using the report from the interest survey,the director will determine the goals he/she wants to work towards during theprogram.b. Goals for the program will be individual to each center. Goals selected are basedon staff interest, as well as time commitment of the director/staff. Directors shouldselect realistic and achievable goals, so implementation is not overwhelming orstressful.4. Child care center staff training (DATE) will be held for all participating child carecenters. All child care center staff attending will receive five FREE staff training clock hours.Training topics will be partially determined based on feedback from the staff safety/wellnessinterest survey. In general, training topics will include:a. Nutritionb. Physical activityc. Stress managementd. Ergonomics and other safety practicesOther programs/services that might be offered at the staff training includeimmunization and health screenings. Attendees will also receive additional educationalmaterials on health/safety.5. Beyond the child care center staff training, child care center director/staff willcontinue to work towards the goals they set for the program. This again is all up to eachchild carecenter and what their goals are. While the program length is one year from start tofinish, that does not mean for the entire year there has to be wellness/safety programmingoccurring. The TWH program staff will be available for technical assistance andconsultation.6. Mid-program incentive. Child care centers will have the opportunity to earn a midprogram incentive in (DATE). It will be awarded to child care centers that are showingactive progress towards their goals. INCENTIVE can be used for materials that will assistthe center with continuing to work on staff safety and wellness initiatives (i.e. could use topurchase pedometers for a staff step challenge).7. An environmental post-assessment will be delivered to the child care center director(DATE). Upon receipt and review of the post-assessments, the child care center will receive anadditional INCENTIVE for participating in the program. This incentive should go towardsmaterials/supplies to help continued effort to support staff safety and wellness initiatives.8. Child care centers director will participate in “exit interview” (DATE). This interviewwill revisit the questions asked in the introductory interview to see if the director’sperception of staff safety and wellness has changed. This interview will again be recorded.a. At this time, the child care center director will receive an INCENTIVE for participationin the interview.Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 5
SAMPLE Staff Wellness PolicyPurpose: To provide guidance and support related to staff safety and wellness practicesWhen to use: OngoingINTENT STATEMENTWe are committed to the health, safety and well-being of the child care providers in our employ.This Wellness Policy is designed to make healthy nutrition and physical activity choices the easychoices, while being supportive of individual rights to choose.WORKSITE WELLNESS PROGRAMMINGOur goal for the wellness program is to make a positive difference in the lives of our staff and tohelp them enjoy happier, healthier lives. We support staff participating in worksite wellnessactivities. Staff participation in wellness activities is voluntary. We will provide awareness andeducation by including worksite wellness information in new staff orientation, posting flyers on wallsor bulletin boards and sending e-mail correspondence. Components of our wellness program willinclude:Environmental wellness: The positive perception of the environment that one works and lives in. Finding satisfaction and worth in your work Ensuring your work environments and relationships are comfortable Being aware of the natural environment you live in Recognizing opportunities that lead you to new skills and acting on those opportunities Working to ensure the stability and longevity of our natural resourcesEmotional wellness: Possession of a secure self identity and a positive sense of self-regard; also theability to cope with and/or improve unpleasant mood states. Keeping a positive attitude Being sensitive to your feelings and the feelings of others Learning to cope with stress Being realistic about your expectations and time Taking responsibility for your own behavior Dealing with your personal and financial issues realistically Viewing challenges as opportunities rather than obstacles Functioning independently but knowing when you need to ask for helpSpiritual wellness: A positive perception of meaning and purpose in life. Being open to different cultures and religions Giving your time to volunteer or participate in community service activities Spending time defining personal values and ethics, and making decisions that complementthem Participating in spiritual activitiesGuide to Worksite Wellnessand Safety in the Child Care CenterPAGE 6
Participating in activities that protect the environmentCaring about the welfare of others and acting out of that careSocial wellness: A perception of having support available from family, friends, or co-workers in timesof need and a perception of being a valued support provider. Being comfortable with and liking yourself as a person Interacting easily with people of different ages, backgrounds, races, lifestyles Contributing time and energy to the community Communicating your feelings Developing friendships Recognizing a need for fun time in your life Budgeting and balancing your time to include both responsibilities and relaxationIntellectual wellness: The perception of being internally energized by an optimal amount of intellectuallystimulating activity. Learning because you want to, not because you are told to. Doing the work assigned Learning through varied experiences, such as reading, writing, sharing and exploration Observing what is around you Listening Finding applications for material learning in the classroom Staying current with world affairs/news Questioning Exposing yourself to new experiences, such as arts, theaterPhysical wellness: A perception and expectation of physical health. Exercising regularly Eating properly Getting regular physical check-ups Avoiding the use of tobacco or illicit drugsSource: PROCEDURE/PRACTICENutritionAt least 50 percent of pre-packaged foods and beverages for meetings and/or vending should behealthy options.Staff is encouraged to consider healthier alternatives when making available food for others at staffpotluck lunches, special occasions, staff meetings, etc.Staff is encouraged to support the use of locally grown fruits and vegetables, such as providingGuide to Worksite Wellnessand Safety in the Child Care CenterPAGE 7
on-site or neighborhood farmers’ markets, Community Supported Agriculture programs, on-site orcommunity gardening space, etc.Environmental accommodations for food preparation and storage, such as sinks, refrigerators andmicrowave, are made available to support staff in bringing healthy lunches and snacks to work.BreastfeedingWe seek to foster a breastfeeding-friendly environment where breastfeeding is accepted as thepreferred method of infant feeding. We shall provide breastfeeding staff with reasonable break timeand a private, non-restroom place for employees to express breast milk or breastfeed. Staff shall beprovided access to space with an electrical outlet and seating, and nearby access to running water.Staff may use their own cooler packs to store expressed breast milk or may store milk in adesignated refrigerator/freezer. (See Breastfeeding Policy http://www.kentuckycchc.org/policies/ ).Professional DevelopmentStaff will be encouraged to write an annual professional development plan to include two hours ormore in health and wellness education. Training topics may include: staff wellness, managing stress,healthy living, etc.Physical ActivityWe encourage (but do not require) staff to engage in a regular program of exercise and healthimprovement, unless existing health related conditions make such a program inadvisable.Shoes with good shock absorption will help reduce injury.During pregnancy, staff should take extra caution to prevent back problems, swollen feet, varicoseveins and fatigue.In the course of meetings lasting more than 1 hour, staff are encouraged, but not required, toincorporate short stretch breaks for every 60 minutes of meeting time.Staff is encouraged to take short walks or engage in other physical activity during their breaks.Staff is encouraged to participate in work-sponsored physical activity opportunities offered throughworksite wellness programs.ErgonomicsStaff shall maintain good posture by: Using adult-sized furniture when possible Squatting and lifting with the legs to stand Sitting with back to the wall for other firm support Avoiding sitting or standing for long periods Storing items where they are accessible Squatting or kneeling instead of bending forward and down from the waistGuide to Worksite Wellnessand Safety in the Child Care CenterPAGE 8
Staff shall use proper lifting technique by: Giving a firm base of support, with feet shoulder width apart and one foot next to the childyou are lifting and the other slightly back Squatting down by bending at the knees, not the waist; engaging stomach muscles andkeeping the back as straight as possible Having a comfortable hold on the child before beginning to lift Using the legs to lift slowly and smoothlyChild-sized furnishing and inadequate work surfaces can cause back injuries, therefore we will followrecommendations from Caring for Our Children National Health and Safety Performance Standards, whichinclude: Adult-height changing tables Small, stable stepladders, stairs or similar equipment to enable children to climb to thechanging table Adult furniture that eliminates awkward sitting and working positionsWorkplace Interventions to Decrease StressIn an effort to decrease or eliminate stress in the workplace, whenever possible, we shall have: Someone on call so staff members can take a break from direct care A pleasant, comfortable space for breaks Regularly scheduled exercise breaks for staff Regular staff meetings Involvement of staff in program decisions Volunteers during the busiest times of the day A limited number of children for which staff are responsible Staff plan activities only for a specific group of children Assigned toys and materials to a specific room A set arrival and departure times with a fixed schedule An assigned volunteer for each roomPreventative MeasuresWe encourage, but do not require, staff to stay up to date on adult vaccinations recommended bythe Centers for Disease Control and Prevention, including Tdap booster, annual influenzavaccination and pneumococcal polysaccharide vaccine for staff 65 years and over.Because employees are at risk for exposure to toxic materials, employees will be trained on anychemicals present in the workplace. Sanitation materials must be labeled and have a Material SafetyData Sheet on file.Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 9
Staff will: Use cleaning products for their intended purpose and according to manufacturer’sinstructions. Store products in original containers. Look at the ASTM D-4236 or ACMI label on artmaterials. These labels certify that the materials can be used without risk to health hazards. Use solvents such as turpentine and aerosol fixatives only outside or with good ventilation. Review toxicity of all art supplies. Substitute less hazardous products whenever possible. Call in experts to assess and eliminate any lead, asbestos, mold or mildew issues in the childcare environment.APPLICABLEThis policy applies to all current and new staff.COMMUNICATIONStaff and volunteers will receive a written copy of this policy in their orientation packets beforebeginning work at the facility. Staff will receive written notification of any updates.Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 10
REFERENCESAmerican Academy of Pediatrics, American Public Health Association, National Resource Centerfor Health and Safety in Child Care and Early Education (2011). Caring for our Children: NationalHealth and Safety Performance Standards; Guidelines for Early Care and Education Programs. 3rd Edition.http://cfoc.nrckids.org/American Academy of Pediatrics, Pennsylvania Chapter (2002). Model Child Care Health Policies, 4thEd. http://www.ecels-healthychildcarepa.orgKentucky Child Care Health Consultation. http://www.kentuckycchc.org/Kentucky Division of Child Care - 922KAR:129 Child Care Health and Safety ette County Health aspxMCH Library for Child Care Health health-consultants/Northern Kentucky Health Department. hConsultation.aspxVanderbilt University – Health and ork-life/Reviewed by: Director/OwnerCCHC/Health Professional(optional)Staff MemberParentBoard Member(optional)EFFECTIVE DATE/REVIEW DATEThis policy is effective immediately. It will be reviewed yearly by the center director.Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 11
Initial Environmental Self AssessmentPurpose: To provide the child care center director and TWH staff with baseline measures of current practices, policiesand environments related to staff safety and wellnessWhen to use: This is the first step of the program once the initial meeting has been conducted between the child carecenter director and the TWH staff memberDate:Your Name:Child Care Program Name:Email address:Phone #: / Fax #:Results from this survey will be used to plan changes to your center’s environment to make it saferand healthier for children and staff.Survey topics include: staff access to healthy foods for meals and breaks, current worksite wellnessplans, physical activity, ergonomics, workplace stress and preventative measures.Before you begin: Gather staff manuals and other documents that include policies and guidelines about staffwellness and environmental safetyDuring the assessment: Definitions of keywords are marked by asterisks (*). Answer each question as best you can. If none of the answer choices seem quite correct, justpick the closest fit. If the question does not apply, go to the next question.Understanding your results: The answer choices in the left-hand column represent the best practice recommendation in thisarea. To interpret your results, you can compare your responses to these best practicerecommendations. This will show your strengths and the areas in which your program canimprove. “In Progress” means you are currently working on that area. “Potential Priority” means you would be interested in working on that area.Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 12
YESINPROGRESSNOPOTENTIALPRIORITY1. Do you currently have a staff wellness policy?OOOO2. If yes (to question 1), does the policy includeboth staff wellness and staff safetycomponents?OOOO3. Does the worksite have a comprehensive*worksite wellness plan in place?OOOO4. Does the worksite offer staff training in healthareas such as physical activity, nutrition andtobacco cessation?OOOO5. Does the worksite policy prohibit tobacco useanywhere on the property?OOOO6. Are staff encouraged to write their annualprofessional development plan to include atleast two hours in health and wellness educationon topics such as staff wellness, managingstress, healthy living, etc.?OOOO7. Are vending machines located on the propertyor within close walking distance and used bystaff during working hours?OOOOWELLNESS COMPONENT*Comprehensive: Addresses the purpose, nature, duration, resources required, participants involved and expectedresults of the program.Comments:Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 13
NUTRITION COMPONENTYESINPROGRESSNOPOTENTIALPRIORITY8. Does the worksite send healthy eating messagesto employees (delivered via e-mail, payrollstuffers, bulletin boards, etc.)?OOOO9. Are staff encouraged to role model healthyeating behaviors?OOOO10. Does the worksite encourage staff to considerhealthier alternatives when making availablefood for others at staff potluck lunches, specialoccasions, staff meetings, trainings and otherevents?OOOO11. Are environmental accommodations for foodpreparation and storage (i.e., sink, refrigeratorsand microwaves) made available to supportstaff in bringing healthy lunches and snacks towork?OOOO12. Does the worksite offer local fruits andvegetables at the worksite (e.g. farmers’market)?OOOO13. Does the worksite provide on-site gardening?OOOO14. Does the worksite provide an appropriate placeand breaks for breastfeeding/pumping forstaff?OOOO15. Does the worksite provide lactation educationprograms for staff?OOOO16. Are at least 50 percent of pre-packaged foodand beverages for meetings and/or vendinghealthy options?OOOOComments:Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 14
PHYSICAL ACTIVITY COMPONENTYESINPROGRESSNOPOTENTIALPRIORITY17. Are staff encouraged (but not required) toparticipate in a regular program of exercise andhealth improvement (unless existing healthrelated conditions making such a programinadvisable)?OOOO18. In a course of meetings lasting more than 1hour, are staff encouraged (but not required) toincorporate short stretch breaks for every 60minutes of meeting time?OOOO19. Are staff encouraged to be active during breaktime?OOOO20. Are staff encouraged to take short walks orengage in other physical activity opportunitiesoffered through worksite programs?OOOO21. Does the worksite map out on-site trails ornearby walking routes?OOOO22. Does the worksite provide exercise/physicalfitness messages and information to staff?OOOO23. Does the worksite offer incentive-basedprograms to encourage activity (e.g. pedometerwalking campaigns)?OOOOComments:Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 15
YESINPROGRESSNOPOTENTIALPRIORITY24. Are adult-height diaper changing tables used?OOOO25. Are there small, stable stepladders, stairs orsimilar equipment to encourage children toclimb to the changing table?OOOO26. Are adult-size furniture/chairs used thateliminates awkward sitting and workingpositions?OOOOERGONOMICS COMPONENT *27. Are staff trained to use proper posture techniques by:O Squatting and lifting with legs to stand?O When sitting on the floor, having their back against the wall for firm support?O Avoid sitting or standing for a long periods?O Squatting or kneeling instead of bending forward and down from the waist?28. Are staff trained to use proper lifting technique by:O Giving him/herself a firm base of support, with feet shoulder-width apart and one footnext to the child they are lifting and the other slightly back?O Squatting down by bending at the knees, not the waist?O Having a comfortable hold on the child before he/she begins to lift?O Using his/her legs to lift slowly and smoothly?*Ergonomics: Safety measures put in place to prevent injury – i.e. proper lifting techniques when liftingchildren, adults not sitting in child-size chairs, etc.Comments:Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 16
STRESS MANAGEMENT COMPONENTYESNOPOTENTIALPRIORITYIn an effort to decrease or eliminate stress in the workplace, whenever possible,do you have:29. Someone on call so staff can take a break fromdirect care?OOO30. A pleasant, comfortable space for breaks?OOO31. Regularly scheduled exercise breaks for staff?OOO32. Regular staff meetings?OOO33. Involvement of staff in program decisions?OOO34. Volunteers during busiest times of the day?OOO35. A limit to the number of children for whichstaff are responsible?OOO36. Resources staff can utilize to help cope withtheir stress? (i.e. list of qualified counselorstrained in stress management)OOO37. Opportunities for staff to socialize with oneanother during fun activities that are not workrelated? (i.e. – group outings to baseball games,bowling, picnics)OOOComments:Guide to Worksite Wellnessand Safety in the Child Care CenterPAGE 17
PREVENTATIVE MEASURESYESNOPOTENTIALPRIORITY38. Do you encourage (but not require) staff to stayup to date on CDC recommended adultvaccinations, including Tdap booster, annualinfluenza vaccination and
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