Parents can never do too much to make sure that their child, or the child of a friend or relative, will be cared for in a healthy and safe childcare environment. The following guidelines will assist parents in finding quality childcare. The first thing that should be asked, before going any further, is whether the Child Center, Child Care Home, or program has an open door policy allowing caregivers or parent to drop in as needed. If the answer is no, that provider should be crossed off the list.
Licensed child care centers and programs provide an extra layer of safety.
State licensed facilities have to meet certain requirements, including background checks for all staff as they will be in close contact with the children. State health and safety regulations, which vary from state to state, must be also be met. Child care providers are also licensed to serve a certain number of charges depending on the facility size, and the ratio of staff per number of children served. Providers serving infants is also taken into consideration. Licenses should be prominently displayed where they can be checked to ensure that they are up to date. State licensing requirements for all states can be found on the Child Care Aware website.
Health and Safety First
Children are prone to various childhood diseases, viruses, and infections, and staff needs to know what precautions to take to protect the health of all children in their care and themselves. Staff should wear non-latex gloves when changing diapers, administering first aid, or touching an infected child. Check to see if gloves and diapers are disposed of in a separate trash receptacle or special container with a locking lid and labelled "bodily fluids." All trash should be taken out at the end of every day, and gloves should be worn for that also.
Protecting Children from Outside Influences
With non-custodial parents sometimes attempting to kidnap their child, providers should have procedures in place to make sure that no one is allowed to pick a child up except for those listed by parents or caregivers. Doors should be kept locked at all times to help prevent anyone who may want to harm children or staff from gaining entrance into the facility. Staff should have also been trained on what to do in the case of suspected child abuse or neglect as they, like teachers, are required by law to act as reporters.
Well-trained staff are better equipped to provide a safe and healthy environment for children.
Comprehensive training prepares staff for handling a variety of situations. Most states require all staff to have CPR training, including CPR for infants if the child care center or home will be serving babies, first aid training, and training on doing the Heimlich maneuver. Training should have been given by certified trainers like the American Red Cross or First Responders. Parents should ask to see proof and that staff were certified or re-certified within the past year. Staff should also be trained on nutrition, how to prepare and store food, food allergies, and foodborne illnesses, among other things.
Kitchen and Dining Health and Safety
Most accidents, both at home and away from home, are caused by a lack of safety. Emergency rooms across the U.S. report that children are often hurt while in a childcare setting from touching their eyes or mouths after being exposed to toxic chemicals or swallowing cleaning materials, especially in the kitchen and dining area. Make sure childcare staff keep cleaning supplies and other hazardous materials stored in containers with tight-fitting lids, spray bottles are turned off, and everything placed in a locked cabinet well out of the reach of children, and that surfaces are cleaned with a mild disinfectant, rather than a household cleaner.
Tables need to be wiped down with warm soapy water followed up with a secondary wipe down with just hot water. More toxic materials should be kept for cleaning kitchens and bathrooms when the facility is closed. Electric outlets should have safety covers, and stove control knobs should be removed when staff is not preparing meals. Toilets, refrigerators, cabinets, and kitchen drawers should have locks.
Precautions to Prevent Falls and Other Types of Injuries
Safety gates should be placed tightly in front of stairs, kitchen, and laundry doorways, basements, porches, utility areas, or other places that are open. Ensure that basement doors have safety locks that are high enough children cannot reach them and that there are child safety locks on cupboards, refrigerators, washing machines and dryers, oven doors, and microwaves. Also, check to make sure curtain or window blind cords are not looped, so there is no potential for hanging.
Anyone providing childcare should be cognizant of children's ages and take that into consideration when it comes to outdoor play equipment. Monkey bars, swings, and other equipment used for climbing should be low enough to minimize the risk of injury for smaller children. The same goes for tricycles or scooters. And equipment should be locked up when not in use. There should be plenty of space between pieces of equipment, the play area completely enclosed with a locking gate, and no splinters, jagged wires, etc. children could get hurt on. Check to see if slides are covered when not in use to prevent burns on hot days.
Children should be supervised by staff at all times, even when outdoors. If possible, outdoor play areas should have a thick covering of wood chips or soft rubber matting under equipment to soften a fall. (Wood chips or rubber matting is helpful but not required as they can be an expensive purchase, especially for a private childcare home).
Childcare providers should have contingency plans for emergencies.
A fire and evacuation plan, disaster plans for tornadoes or hurricanes, a floor plan, and emergency contact numbers should be posted on a wall or a bulletin board where they can be easily seen by staff. Check with staff to make sure children are taught what to do if there is a fire on-site and if drills are scheduled regularly.
How a childcare provider stores medication is extremely important to protect the health and safety of all the children. Make sure providers follow physician's orders printed on bottles, how they refrigerate medications that must be kept cold if there is a first aid kit on site that includes ipecac and that the first aid kit is up to date. It is paramount for providers to keep medication in a locked cabinet or box and stored out of the reach of children.
Although most parents administer medication at home, providers should separate and store each child's medication in separate zip lock bags with the individual child's name in permanent black marker as an extra precaution. Allergies to medication, food, etc. should be posted where other parents cannot see the names of the children in order to protect the child's information.
Toys can also be hazardous.
Toys made overseas have, at times, been found to contain lead, and even toys manufactured in the U.S. may present a choking danger or other hazards. Parents should ask the providers if they keep a current and updated list of recalled products as a visible reminder of what not to purchase, including infant formula.
For infants, childcare providers should have cribs with a certification safety seal, slats should be no more than two and three-eighths inches apart and mattresses should fit snugly. Ask providers how infants are placed in a crib to sleep, making sure they are placed on their backs without pillows or comforters and they are not put to bed with a bottle of liquid propped in the infant's mouth.
Choosing the childcare provider is only the beginning.
Even after a provider is selected and a child is in attendance, parents need to remain diligent. Be sensitive to any sudden changes in a child's behavior or emotional ups and downs. If children develop a fear of a staff person or going into the childcare center parents should follow up by asking the child questions and by scheduling a meeting with the center or home operator to discuss any concerns. If a child continues to exhibit fear, cries or screams and clings to a parent, and has trouble sleeping or has nightmares, consider finding another childcare home or center. If a provider is licensed, consider calling the state-licensed board.
As a past Early Childhood Education Consultant for twelve years I was assigned the task, at times, of doing health and safety checks at facilities.