TABLE 1

Domains of Health and Safety Quality in ECE

Domains of Health/ Safety in ECESpecific Areas of Health Safety in ECE
ImmunizationStaff
Children
Infection controlHand washing with soap and running water after diapering, before handling food, and when contaminated by body fluids
Children wash hands after toileting and before eating
Routinely cleaned facilities, toys, and equipment
NutritionSafe food storage
Sanitary food preparation
Healthy meals and snacks
Monitoring choking hazards
EnvironmentClean air
Integrated pest control
Smoke-free environments
Oral healthTeeth brushing
Physical activityActive play
Limited screen time
Staff ratios and supervisionSmall group sizes
High staff-to-child ratiosa
Staff qualificationsConsistent caregiving
College degrees in ECE
Child development associate’s credential
Ongoing in-service training
Low turnover rate
Strong background checks
Policies for children with special health care needsMedication administration
Child care health consultation
Care plans completed at the medical home
Emergency proceduresCardiopulmonary resuscitation and first aid training
Written policies
Disaster planning procedures
All staff and children familiar with procedures
Up-to-date parent contact lists
Injury preventionPlay equipment safe, including proper shock-absorbing materials under climbing toys
Safe sleep practices (especially for infants)
Developmentally appropriate toys and equipment
Toxins out of reach
Safe administration of medicines
Child abuse prevention training
Policies on discipline and restraint
Sunscreen and insect repellent use policies
Water play safety
Facility safety (fire and carbon monoxide detectors, etc)
  • Adapted from Stepping Stones20

  • a There are different staff-to-child ratios for small-family homes, large-family homes, and centers. Ratios are also based on the ages of the children. Specific staff-to-child ratios are described in standard (1.1.1.2).21