DOCUMENT RESUME ED 414 053 Stepping Stones To Using
DOCUMENT RESUMEED 414 053TITLEINSTITUTIONSPONS AGENCYPUB DATENOTEAVAILABLE FROMPUB TYPEEDRS PRICEDESCRIPTORSIDENTIFIERSPS 026 029Stepping Stones To Using "Caring for Our Children": NationalHealth and Safety Performance Standards for Out-of-HomeChild Care Programs. Protecting Children from Harm.Colorado Univ. Health Sciences Center, Denver.; HealthResources and Services Administration (DHHS/PHS),Washington, DC. Maternal and Child Health Bureau.Health Resources and Services Administration (DHHS/PHS),Rockville, MD. Office for Maternal and Child HealthServices.1997-03-1170p.; Introductory letter contains small, light type.National Maternal and Child Health Clearinghouse, 2070 ChainBridge Road, Suite 450, Vienna, VA 221822536; fax:703-821-2098 (free).GuidesNon-Classroom (055)MF01/PC03 Plus Postage.Accident Prevention; Child Advocacy; *Child Health;*Children; Communicable Diseases; *Day Care Centers; DiseaseControl; Early Childhood Education; Emergency Programs;*Facility Requirements; Family Day Care; injuries; RiskManagement; *Safety; Safety Education; School. Safety;*Standards; Training ObjectivesDay Care Licensing; *Day Care RegulationsABSTRACTDeveloped in support of state licensing and regulatoryagencies as well as state child care, health, and resource and referralagencies, and a variety of other public and private organi4ntions, parents,and advocacy groups, this guide identifies those standards most needed forthe prevention of injury, morbidity, and mortality in child care settings.The first section of the guide, "Building: Safety Policies and Practices,"addresses topics such as facility access, exits, electrical fixtures, heatingand ventilation, fire warning systems, pest control, play areas, watersupply, and environmental hazards. The second section, "Other Safety Policiesand Practices," addresses topics such as sanitation practices, emergencyplans and procedures, first aid, licensing, and illegal drugs. The thirdsection of the guide, "Policies/Practices/Staff Training," addresses topicssuch as staff ratios, orientation, first aid and CPR training, staff health,background check, child abuse recognition, discipline practices,developmentally appropriate practices, medication administration,confidential information, and release authorization. The final section,"Infection Control," addresses topics such as hand washing, diapering, foodsafety, reporting communicable diseases, HIV children and staff, drop-incare, ill child exclusion, immunizations, and universal precautions. Theappendix consists of a glossary of terms, research methodology, andimmunization schedules. **********************************Reproductions supplied by EDRS are the best that can be madefrom the original ***************************************
STEPPING STONESAM National Health and Safety Performance Standardsoa&lie Guidelines for Out-Of-Home Child Care ProgramsPROTECTING CHILDREI /F120)1,.U.S. DEPARTMENT OF EDUCATIONOffice of Educational Research and ImprovementEDUCATIONAL RESOURCES INFORMATIONCENTER (ERIC)XThis document has been reproduced asreceived from the person or organizationoriginating it.Minor changes have been made toimprove reproduction quality.Points of view or opinions stated in thisdocument do not necessarily representofficial OERI position or policy.PERMISSION TO REPRODUCE ANDDISSEMINATE THIS MATERIALHAS BEEN GRANTED BYnON""cam.kU.S. De p rtment of Healthy Human ServicesfirPublic Health ServiceTO THE EDUCATIONAL RESOURCESINFORMATION CENTER (ERIC)Hecdth Resources 8 Services AdministrationMaternal and Child Health Bureau2
DEPARTMENTOFH:EALTH&HUMANSERVICESPublic Health ServiceMammal and Child I kalth BureauHealth Resources andServices AdministrationRockville MD 20857MARI11997Dear Colleague:The Maternal and Child Health Bureau (MCHB)is pleased to sendyou a copy of /Stepping Stones to Using Caring for OurChildren: National Health and Safety Performance StandardsGuidelines for Out-Of-Home Child Care Programs--ProtectingChildren From Harm. This publication was developed from theNational Health and Safety Performance Standards: Guidelinesfor Out-of-Home Child Care Programs to identify thosestandards most needed for the prevention of injury, morbidityand mortality in child care settings.Stepping Stones was developed in support of State licensingand regulatory agencies as well as State child care, health,and resource and referral agencies, and a variety of otherpublic and private organizations, parents, and advocacygroups.Communities can use Stepping Stones to help implementthe "Healthy Child Care America Campaign" with its 10-StepBlueprint for Action.The Campaign promotes a partnership offamilies, child care and health care providers to support thehealthy development of young children in child care andincrease access to preventive health services and safephysical environments.Information can be obtained from theAmerican Academy of Pediatrics, 141 Northwest Point Boulevard,Elk Grove Village, Illinois 60007, phone: (847) 228-5005.TheHealthy Child Care America Blue print for Action is alsoavailable through the National Child Care Information Center'shome page teppincr Stones and the National Health and Safety PerformanceStandards: Guidelines for Out-of-Home Child Care Programs areboth available on the world wide web through the MCHBsupported National Resource Center for Health and Safety inChild Care, located at the University of Colorado, HealthSciences Center, Denver, Colorado (http://nzc.uchsc.edu).BEST COPY AVAILABLE
For questions, please call:National Resource Center for Healthand Safety in Child CareUniversity of Colorado, Health Sciences CenterSchool of Nursing4200 E. Ninth AvenueCampus Box C287Denver, Colorado 80262Phone: 1-800-598-KIDSE-mail: Natl.child.res.ctr.@UCHSC.eduYou may also order copies from the:National Maternal and Child HealthClearinghouse (NMC2070)Chain Bridge Road, Suite 450Vienna, Virginia 22182-2536Fax (703) 821-2098We hope you will find this publication to be a valuableresource in developing policies and regulations, as well as inplanning and providing for the health and safety of childrenin child care settings.Sincerely yours,K7 o-ta , 15'6Audrey H. Nora, M.D., M.P.H.Assistant Surgeon GeneralDirectorEnclosure4
Stepping Stonesto UsingCaring for Our Children(r National Health and Safety\ Performance Standards'for Out-of-Home Child Care)Sponsored byMaternal and Child Health BureauHealth Resources:andServices Administration(Public Health Service'U.S. Department of Health andHuman Services5BEST COPY AVAILABL
Stepping Stones to Using Caring for Our Children was developed by theNational Resource Center for Health and Safety in Child Care, located at theUniversity of Colorado Health Sciences Center School of Nursing andfunded by the Maternal and Child Health Bureau, U.S. Department of Healthand Human Services, Health Resources Services Administration.The National Health and Safety Performance Standards: Guidelines for Outof-Home Child Care (1992), in which' these atandards first appeared, wasinitially developed by the American Public Health Association in cooperationwith the American Academy of Pediatrics through a grant supported by theMaternal and Child Health Bureau.Stepping Stones to Using Caring for Our Children is not copyrighted.Readers are free to duplicate and use all or part of the information containedin this publication in accordance with accepted publishing standards. TheNational Resource Center for Health and Safety in Child Care (NRCHSCC)requests acknowledgment, in print, of any information reproduced in anotherpublication. The publisher also requests acknowledgment that SteppingStones was supported by the Maternal and Child Health Bureau.1997Published byNational Resource Center for HealthSafety in Child CareUniversity of Colorado Health Sciences Center4200 East 9th Avenue, Box C-287Denver, CO 802621-800-598-KIDSInternet: http://nrc.uchsc.eduFor information about additional copies of this publication, please contactthe publisher.6
CONTENTSPrefaceiiiLetter from Dr. StubbsSteering CommitteeviiAcknowledgementsixIntroductionxiHow Stepping Stones is OrganizedxiiBuilding and Premises: Equipment Safety and PracticesBuilding: Safety Policies and PracticesAccess and Exits1Cribs2Drowning Prevention/Swimming and Tubs2Electrical Fixtures and Outlets3Heating, Ventilation and Cooling4Fire Warning Systems4Pest Control4Play Areas/Play Equipment5Water Supply7Sewage8Toilets/Bathrooms8Environmental Hazards8Toxic Substances9Other Safety Policies and PracticesCleaning and Sanitation Practices10Posted Documents11Emergency Plans12Emergency Procedures14First Aid Supplies15Prohibition of Tobacco, Alcohol, Illegal Drugs16Transportation16Facility Licensing/Registration17
Policies/Practices/Staff TrainingPolicy/GeneralChild: Staff Ratios and Group Size17Staff OrientationBloodborne PathogensStaff Training/First Aid and CPRStaff Qualifications and Education19Staff HealthBackground CheckChild Abuse Recognition and Reporting2223Parent AccessParent-Staff CommunicationDiscipline Practices/Corporal PunishmentChildren with Special Health Needs (CSN)Developmentally Appropriate PracticesBirth to 35 Months17202122232424252627273 - 5 YearsDevelopmentally Appropriate Nutrition Practices2828Health ConsultantMedication Administration and Storage30Records/FilesConfidential InformationRelease Authorization31303434Infection ControlHand washingDiapering/Diapering AreasFood Safety/SanitationReportingReportable Communicable Diseases: Policies and PracticesGastrointestinal InfectionMeningococcal DiseaseHib InfectionPertussisTuberculosisSpecial Considerations for HIV Infected Children and StaffDrop-In CareIII Child/ExclusionImmunizations and Preventive Health ServicesUniversal PrecautionsGlossaryAppendix A: Research MethodologyAppendix B: Immunization Schedule3535363738383939404040414243455355
PrefaceIn late 1995, the National Resource Center for Health and Safety in ChildCare was, moved from Georgetown University to the University of ColoradoHealth Sciences Center. With the move, various projects in progress werealso moved. The national comparison matrix project, from which thispublication emerged, is one example.The research methodology which was used to develop the matrix isdescribed by Dr. Richard Fiene on page xi and in Appendix A, page 53. TheUniversity of Colorado project team appreciates and acknowledges themeticulous care taken to decide which standards from "Caring for OurChildren" merited inclusion in this document.The contribution of personnel at the University of Colorado was toincorporate suggestions made during several expert reviews of thedocument content, provide editorial transitions and updates, and organizethe material so it would have logical "stand-alone" usefulness.It is hoped that this volume will serve as a reference for individuals andagencies concerned with regulations governing child care settings andpractices. Published in this format, this subset of standards can be used forcomparing the policies, practices, and regulations with the nationalstandards that have the greatest impact on morbidity and mortality in out-ofhome child care.Marilyn J. Krajicek, Ed.D., R.N., FA.A.N.Project DirectorRuth M. Neil, Ph.D., R.N.Project Coordinator9iii
Dear Colleague:The Maternal and Child Health Bureau (MCHB) is pleased to offer ourlatest contribution to the field of health and safety in child care settings,Stepping Stones to Using Caring for Our Children. Promoting and protectingthe health and safety of young children in child care settings has been aMaternal and Child Health Bureau priority since the early 1980s. TheBureau's efforts in this area include discretionary grants to states and otherinstitutions to improve the health status of young children in out-of-homesettings, to develop statewide systems for health and safety in child caresettings and to develop the National Health and Safety PerformanceStandards Guidelines for Out of Home Child Care Programs. We believethat all of the national health and safety performance standards areimportant to have in place in a quality child care program. We encourage youto continue your use of this publication as the comprehensive resourcedocument it was intended to be.Stepping Stones to Using Caring for Our Children was developed fromthe National Health and Safety Performance Standards to identify thosestandards most needed for the prevention of injury, morbidity and mortalityin child care settings. With the publication of Stepping Stones to UsingCaring for Our Children, the MCHB offers this document primarily in supportof state licensing and regulatory agencies, but also, to state child care,health, and resource and referral agencies, as well as a variety of otherpublic and private organizations, parents, and advocacy groups who needto focus their efforts in order to target limited resources most effectively.Our sincere appreciation goes to all of our colleagues who willingly gavetheir time and expertise to the development of this resource. We hope thislatest offering provides you the support and assistance needed in yourcontinuing support of the health and safety of children in child care settings.Phyllis E. Stubbs-Wynn, MD, MPHChief, Infant and Child Health BranchMaternal and Child Health BureauHealth Resources and Services AdministrationPublic Health ServiceU.S. Department of Health and Human Services10
Stepping Stones to Using Caring for Our ChildrenCarolyn AchesonEditorial ConsultantDenver, COSteering CommitteePauline Koch, M.S.Office of Child Care LicensingWilmington, DEMarilyn J. Krajicek, Ed.D., R.N., F.A.A.N.Project DirectorNational Resource Center for Health andSafety in Child CareSusan S. Aronson, M.D. F.A.A.P.American Academy of PediatricsBryn Mawr, PASue Bredekamp, Ph.D.National Association for the Education ofDenver, COCarol Logan Kuhns, R.N., Ph.D.Former DirectorFormer National Resource Center forHealth and Safety in Child Care,GeorgetownYoung ChildrenWashington, D.C.Beverly R. Buck, M.P.A, J.D.Center for Human Investment PolicyGraduate School of Public Affairs, U.C.D.Washington, D.C.Denver, COJoan LombardiAlbert Chang, M.D., M.P.H.American Public Health AssociationSan Diego, CAAdministration for Children and FamiliesWashington, D.C.Gwen Morgan, M.S.Work/Family Directions, Inc.Boston, MAJane Coury, M.S.N., R.N.Project Officer, Maternal and Child HealthBureauWashington, D.C.Pamela Mangu, M.A.Former Project AssociateNCEMCH, GeorgetownAngela Crowley, M.A.; R.N.,C; C.P.N.P.Yale University School of NursingOrange, CTWashington, D.C.Ruth M. Neil, Ph.D., R.N.Project CoordinatorNational Resource Center for Health andSafety in Child CareKathy DuranIllustrator/Designer, PrintingUniv. of Colorado Health Sciences CenterDenver, CODenver, COKarin Eliott, Ed.M.Former Project AssociateLinda J. RomeroTypesetter, PrintingUniv. of Colorado Health Sciences CenterDenver, CONCEMCH, GeorgetownWashington, D.C.Richard Fiene, Ph.D.Department of PsychologyPennsylvania State UniversityDenise Sofka, M.P.H., R.D.Former Project Officer, Maternal and ChildHealth BureauWashington, D.C.Harrisburg, PAIris-Marie Graville, R.N., M.N.Public Health NurseWhatcom County, WACarolynne H. StevensDivision of LicensingBarbara U. Hamilton, M.A.Resource LibrarianNational Resource Center for Health andSafety in Child CarePhyllis E. Stubbs-Wynn, M.D., M.P.H.Chief, Infant and Child Health BranchMaternal and Child Health BureauRichmond, VAWashington, D.C.Denver, CODiana TaxieraCustomer Service Representative, PrintingUniv. of Colorado Health Sciences CenterDenver, COKay Hollestelle, B.A.Children's FoundationWashington, D.C.Moniquin HugginsVirginia Torrey, B.A.Administrative AssistantNational Resource Center for Health andSafety in Child CareAdministration for Children and FamiliesWashington, D.C.Denver, COBEST COPY AVAILABLEvu
AcknowledgementsThe development of Stepping Stones to Using Caring for Our Children hasoccurred over a three year period during which time more than 256dedicated and caring individuals generously contributed their time andexpertise by participating in the research process and reviewing the contentof this document. From the beginning, the project was supported by theMaternal and Child Health Bureau (MCHB) of the Health Resources andServices Administration (HRSA) which has consistently encouraged andsupported the development of new knowledge and identification of bestpractices to promote and protect the health, safety and development ofchildren in child care settings.A special thank you is extended to Ciro V. Sumaya, M.D., administrator ofHRSA, Audrey H. Nora, M.D., director of MCHB, David Heppel, M.D.,division director for their support and expert counsel. Under the leadership,guidance, and commitment of Phyllis Stubbs-Wynn, M.D., Chief, Infant andChild Health Branch, and her staff including Denise Sofka, MPH, R.D.,initially and later Jane Coury, M.S.N., R.N., the path which led to the"Stepping Stones"document was completed.Many individuals and organizations participated in the development of"Stepping Stones". The Steering Committee representing experts in thefields of child care including health and safety in child care development,provided invaluable guidance and expertise in moving the process along. In1994, the MCHB supported National Resource Center for Health and Safetyin Child Care then located at the National Center for Education in Maternaland Child Health (NCEMCH), Georgetown University, began the projectunder the able leadership of Carol Logan Kuhns, R.N., Ph.D. who was thenProject Director. Dr. Kuhns together with Pamela Mangu, M.A. and KarinEliott, Ed.M. were responsible for the tedious task of overseeing the manysteps necessary in selecting the standards to include in this volume.Dr. Richard Fiene, Ph.D., Department of Psychology, Pennsylvania StateUniversity at Harrisburg, served as consultant throughout the project andexpertly developed the scientific methodology to assign weights to, andselect, the standards.2ix
With a grant from MCHB, the new National Resource Center for Health andSafefOriliChild Care at the University of Colorado Health Sciences Center,School:Of Nursing, took over the process in 1996. Under the skillful directionof Marilyn k':,Krajicek, Ed.D., R.N., F.A.A.N., Project Director, and Ruth M.Neil, Ph.R,::::Project Coordinator, Stepping Stones to Using Caring for OurChildren'Was completed. Special appreciation needs to be given to thefollowing University of Colorado staff, as well: Beverly Buck, CarolynAcheson and; Barbara Hamilton for writing and editing; Diana Taxiera, LindaRomero and kOny:puran for typesetting, graphics and lay-out; and VirginiaTorrey for administrative support.Last but not least, special acknowledgment needs to be given to theAmerican Public Health Association and the American Academy ofPediatrics, who had the vision and foresight to partner with the MCHB whichin turn funded the development of Caring for Our Children-National Healthand Safety Performance Standards: Guidelines for Out-of-Home Child CarePrograms. It is the quality and comprehensiveness of this hallmarkdocument which allowed the development of the "Stepping Stones"to usingthe full "Caring for Our Children".13x
INTRODUCTION"Caring for Our Children", published in 1992, was embraced by the earlychildhood field as a comprehensive set of national standards for health andsafety in child care programs. (Note: this document also was publishedunder an MCHB grant with the title National Health and Safety PerformanceGuidelines for Out-of-Home Child Care Programs.) TheStandardsstrength of the national standards is the comprehensive nature of thematerial. This strength, however, presents somewhat of a challenge to thosewho use the standards for planning regulatory change or doing regulatoryanalysis.To create a planning and regulatory analytical tool from the comprehensivevolume of standards, a project was begun in the summer of 1994 to prioritizethe standards by risk assessment (morbidity and mortality). "Caring for OurChildren" contains 981 standards. The question became: Can that numberof standards be reduced to 150-200 standards that would serve as the mostcritical and logical starting points for state administrators planning policy andregulatory revisions, as well as parents, child care and health personnel whoare most concerned about protecting children in child care settings fromharm.A modified Delphi approach was employed to accomplish the research taskof deciding which standards to include in Stepping Stones to Using Caringfor Our Children. The process included ten important components which aredetailed in Appendix A: Research Methodology.During the research phase of this project, the document being developedwas referred to as the National Comparison Matrix (NCM). The NCM wasreviewed by a selected steering committee with representation from themajor national groups with an interest in health and safety in child care. Aftermany reviews and revisions the final number of standards was reduced to182 and are now published as Stepping Stones to Using Caring for OurChildrenProtecting Children From Harm.Richard Fiene, Ph.D.14xi
How "Stepping Stones" Is OrganizedThe standards in this book have been selected from "Caring for OurChildren", also known as the National Health and Safety PerformanceStandards: Guidelines for Out-of-Home Child Care Programs. The standardswithin the original document are coded and numbered according to thechapter name. The same coding and numbering system has been used inthis volume to assist users to locate and refer to the context(s) of the originalstandards. Users who want to review the rationale and additional informationabout the standards should consult the original full text document of "Caringfor Our Children".Chapter titles and associated codes are:1. Staffing2. Program: Activities for Healthy Development3. Program: Health Protection and Health Promotion4. Nutrition and Food Service5. Facilities, Supplies, Equipment and Transportation6. Infectious Diseases7. Children with Special Needs8. Administration9. Recommendations for Licensing and Community C)(APP)References to specific information in "Caring for Our Children" are identifiedwith the abbreviation CFOC.As is true in the original publication, standards in this book have applicationto three types of out-of-home child care settings. These are:center: a facility that provides care and education for any number ofchildren in a nonresidential setting,large family child-care home: usually offers care and education forseven to twelve children (including preschool children of the caregiver)in the home of the caregiver,small family child-care home: usually offers care and education for oneto six children (including preschool children of the caregiver) in thehome of the caregiver.Symbols denoting the type(s) of facility to which a given standard applies areas follows: If a standard applies only to a center, the symbol A appearsdirectly above the standard If a standard applies to only a large family childcare home, the symbol rr. appears above the standard. If a standard isrelevant to only a small family child-care home, the symbol *appears abovethe standard. If all three symbols appear above the standard, the standardapplies to all three types of facilities.I, 5
BUILDING AND PREMISES:EQUIPMENT SAFETY and PRACTICESBUILDING: SAFETY POLICIES AND PRACTICESAccess and ExitsCSN54The center shall be accessible for children who use wheelchairs and forother children with several motor disabilities, in accordance with Section 504Guidelines (Editor's Note: of the Rehabilitation Act of 1973]. Accessibilityincludes access to buildings, toilets, sinks, drinking fountains, and allclassroom and therapy areas. [Editor's Note: also outside play areas.]Special provisions shall also be made, as needed, for the child with health,vision, or hearing impairment. [Editor's Note: See also the rationale to thissection, CFOC, p. 257, which states, in part, that it is clear that any facilityaccepting children with significant motor disabilities will need to be accessibleto all children served. Small family home caregivers may be limited in theirability to serve such children, but are not precluded from doing so if there is areasonable degree of compliance with this Standard.7.CSN55 4AIn facilities that include children with physical disabilities, all exits and stepsnecessary for evacuation shall have ramps approved by the local buildingauthority.FA22.AEach building or structure, new or old, shall be provided with unobstructedexits to allow occupants to escape to an outside door or fire tower in case offire or other emergency. Each floor above or below ground level used forchild care shall have at least two unobstructed exits that lead to an openarea at ground level that meets safety requirements for an outdoor play area.Entrance and exit routes shall be reviewed and approved by the local fireinspection authority.FA23 .4A40A facility shall have a minimum of two exits, at different sides of the buildingor home, leading to an open space at ground level. If the basement in asmall family child-care home is being used, one exit must be from thebasement.FA25Where exits are not immediately accessible from an open floor area, safeand continuous passageways, aisles, or corridors shall be maintainedleading to every exit and shall be so arranged as to provide access for eachoccupant to at least two exits by separate ways of travel.AFA27Exits shall be clearly visible and the paths of escape shall be so arranged ormarked that the path to safety outside is unmistakable.16
FA26No lock or fastening shall be installed.that prevents free escape from theinterior of any building. All door hardware in areas used by school-agechildren shall be within reach of children. In centers, only panic hardwarethat can be opened by pressure in the direction of travel or single-actionhardware (hardware that allows a door to open either way but keeps it fromswinging back past the center point) shall be permitted on exterior doors.FA14AAll windows above ground level in areas used by children under 5 years ofage shall be constructed, adapted, or adjusted to limit the exit openingaccessible to children to less than 6 inches, or be otherwise protected withguards that do not block outdoor light.CribsFA106Cribs shall be made of wood, metal, or approved plastic and have securelatching devices. They shall have slats spaced no more than 2 3/8 inchesapart, with a mattress fitted so that no more than two fingers can fit betweenthe mattress and the crib side. The minimum height from the top of themattress to the top of the crib rail shall be 36 inches. Drop-side latches shallsecurely hold sides in the raised position and shall not be reachable by thechild in the crib. Cribs shall not be used with the drop side down. There shallbe no corner post extensions (over 1/16 inch) or cut-outs in headboards onthe crib.[Note: See HP93 for resource information on SIDS, CFOC, p. 92.]Drowning Prevention/Swimming and TubsFA263AtoAll water hazards, such as pools, swimming pools, stationary wading pools,ditches, and fish ponds, shall be enclosed with a fence that is at least 5 feethigh and comes within 3-1/2 inches of the ground. Openings in the fenceshall be no greater than 3-1/2 inches. The fence shall be constructed todiscourage climbing. Exit and entrance points shall have self-closing,positive latching gates with locking devices a minimum of 55 inches from theground. The child care building wall shall not constitute one side of the fenceunless there are no openings in the wall.FA264AAbove-ground pools shall have nonclimbable sidewalls that are 4 feet highor shall be enclosed with an approved fence as specified in standard FA263.When the pool is not in use, steps shall be removed from the pool orotherwise protected to ensure that they cannot be accessed.1?2
FA273.4AEach swimming pool more than 6 feet in width, length, or diameter shall beprovided with a ring buoy and rope and/or a throw line and a shepherd'shook. Such equipment shall be of sufficient length to reach the center of thepool from the edge of the pool and shall be safely and conveniently storedfor immediate access.[Editor's Note: See also FA266 Safety Covering, FA 269 Pool Equipment andMaterials, FA281 Pool Water Quality, CFOC, pp. 193-195.]L(10FA276Children shall not be permitted in hot tubs, spas, or saunas.[Editor's Note: Small portable wading pools are prohibited in standard FA278.].Aci0HP109Children shall not be permitted to play without constant supervision in areaswhere there is any body of water, including swimming pools, built-in wadingpools, tubs, pails, sinks, or toilets.[Editor's Note: HP112, CFOC, p. 96, states that At least one of thecaregivers, volunteers, or other adults who are counted in the child:staff ratiofor wading and swimming shall be certified in CPR and basic safety . ."; seealso FA271, CFOC, p.194, which requires that an adult who knows thepump's location be present when children are in the pool.HP111APreschool children and children with special needs shall not be leftunattended in a bathtub or shower.Electrical Fixtures and OutletsFA55AbiPFacilities shall be supplied with electric service. Outlets and fixtures shall beinstalled properly and shall be connected to the source of electric energy ina manner that meets local electrical codes, as certified by an electrical codeinspector.FA56Electrical outlets accessible to children shall be covered with child-resistantcovers or be of the child-proof type. Shock stops (safety plugs) shall beinstalled on all unused outletsjEditor's Note: See also FA59-60 Use ofExtension Cords, CFOC, p. 151.]FA58ANo electrical device
DOCUMENT RESUME. ED 414 053 PS 026 029. TITLE Stepping Stones To Using "Caring for Our Children": National. Health and Safety Performance Standards for Out-of-Home Child Care Programs. Protecting Children from Harm. INSTITUTION Colorado Univ. Health Sciences Center, Denver.; Health. Resource
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