TABLE OF CONTENTS

Title i

Copyright Information ii

Acknowledgments vii

Introduction xiii

Advice to Users xvii


Chapter 1 - Staffing 1

1.1 Child:Staff Ratio and Group Size 3

1.2 Licensure/Certification of Qualified Individuals 6

1.3 Preservice Qualifications and Special Training 7

1.4 Training 17

1.5 Substitutes 30

1.6 Health Consultants 32

1.7 Staff Health 36

1.8 Staff Benefits 40

1.9 Performance Evaluation 41


Chapter 2 - Program: Activities for Healthy Development 45

2.1 Program of Developmental Activities 47

2.2 Supervision 58

2.3 Transportation 60

2.4 Discipline 64

2.5 Parent Relationships 66

2.6 Health Education 74


Chapter 3 - Health Promotion and Protection in Child Care 83

3.1 Health Promotion in Child Care 85

3.2 Hygiene 91

3.3 Sanitation, Disinfection, and Maintenance 104

3.4 Health Protection in Child Care 111

3.5 Special Medical Conditions in Young Children 118

3.6 Management of Illness 123


Chapter 4 - Nutrition and Food Service 147

4.1 Introduction 149

4.2 General Requirements 149

4.3 Requirements for Special Groups or Ages Of Children 155

4.4 Staffing 163

4.5 Meal Service, Seating, and Supervision 165

4.6 Food Brought From Home 169

4.7 Kitchen and Equipment 170

4.8 Food Safety 173

4.9 Maintenance 178

4.10 Meals From Outside Vendors or Central Kitchens 181

4.11 Nutrition Learning Experiences and Education 182


Chapter 5 - Facilities, Supplies, Equipment, and Transportation 187

5.1 Overall Space and Equipment Requirements 189

5.2 Space and Equipment in Designated Areas 235

5.3 Active Play Indoor and Outdoor Areas 253

5.4 Swimming, Wading, and Water 264

5.5 Interior and Exterior Walkways, Steps, and Stairs 271

5.6 Maintenance for Safety 272

5.7 Transportation 274


Chapter 6 - Infectious Diseases 283

6.1 Respiratory Tract Infections 285

6.2 Herpes Viruses 293

6.3 Enteric (Diarrheal) and Hepatitis A Virus (HAV) Infections 296

6.4 Bloodborne Infections 300

6.5 Skin Infections 305


Chapter 7 - Children Who are Eligible for Services Under IDEA 313

7.1 Guiding Principles for this Chapter and Introduction 315

7.2 Inclusion of Children With Special Needs in the Child Care Setting 317

7.3 Process Prior to Enrolling at a Facility 318

7.4 Developing a Service Plan for a Child With Special Needs 319

7.5 Coordination and Documentation 323

7.6 Periodic Reevaluation 324

7.7 Assessment of Facilities for Children With Special Needs 325


Chapter 8 - Administration 331

8.1 Identifiable Governing Body/Accountable Individual 333

8.2 Management and Health Policies and Statement of Services 334

8.3 Program of Activities 355

8.4 Personnel Policies 357

8.5 Written Statement of Services 358

8.6 Special Needs Plan 359

8.7 Records 359

8.8 Posting Documents 376

8.9 Contracts 378

8.10 Drop-in Care 378


Chapter 9 - Licensing and Community Action 381

9.1 The Regulatory Agency 383

9.2 Health Department Responsibility 392

9.3 Training 400

9.4 Program Development 401

9.5 Regulatory Coordination 402

9.6 Public Policy Issues and Resource Development 403


Appendices 407
A - Guiding Principles for the Standards 409

B - Major Occupational Health Hazards 410

C - Nutrition Specialist and Child Care Food Service Staff Qualifications 411

D - Gloving 412

E - Child Care Staff Health Assessment 413

F - Enrollment/Attendance/Symptom Record 414

G - Recommended Childhood Immunization Schedule 415

H - Recommendations for Preventive Pediatric Health Care 416

I - Selecting an Appropriate Sanitizer 417

J - Cleaning Up Body Fluids 419

K - Clues to Child Abuse and Neglect 420

L - Risk Factors for Abuse and/or Neglect 421

M - Special Care Plan for a Child With Asthma 422

N - Situations that Require Medical Attention Right Away 424

O - Food Guide Pyramid 425

P - Child Care Infant Meal Pattern 426

Q - Meal Pattern Requirements for Children Ages 1 through 12 Years 427

R - Food Storage Chart 428

S - Sample Food Service Cleaning Schedule 430

T - Adaptive Equipment for Children With Special Needs 431

U - Poisonous Plants and Safe Plants 434

V - Depth Required for Tested Shock-absorbing Surfacing Materials for Use Under Play Equipment 435

W - Permission for Medical Condition Treatment 436

X - Emergency Information Form for Children With Special Needs 437

Y - Incident Report Form 439

Z - Child Health Assessment 440

AA - Licensing and Public Regulation of Early Childhood Programs - NAEYC Position 441

BB - Contact Information 449

CC - Conversion Table - Standard Numbers From 1st Edition to 2nd Edition 459

DD - Conversion Table - Standard Numbers From 2nd Edition to 1st Edition 468


Glossary 479

Index 495