Health and Safety Requirements

Lead Agencies must certify that there are in effect health and safety standards and training requirements applicable to providers serving children receiving CCDF services whether they are licensed or license-exempt. These health and safety requirements must

  • be appropriate to the provider setting and age of the children served,
  • include specific topics and training on those topics, and
  • be subject to monitoring and enforcement procedures.

Lead Agencies also must specify how they enforce these requirements. The only exception to this requirement is for providers who are caring for their own relatives since Lead Agencies have the option of exempting relative providers from some or all CCDF health and safety requirements.

The CCDF final rule requires Lead Agencies to certify that there are health and safety requirements for licensed and license-exempt providers receiving CCDF in the following areas:

  1. Prevention and control of infectious diseases (including immunization)
  2. Prevention of sudden infant death syndrome and use of safe sleep practices
  3. Administration of medication, consistent with standards for parental consent
  4. Prevention and response to emergencies due to food and allergic reactions
  5. Building and physical premises safety, including identification of and protection from hazards, bodies of water, and vehicular traffic
  6. Prevention of shaken baby syndrome, abusive head trauma, and child maltreatment
  7. Emergency preparedness and response planning for emergencies resulting from a natural disaster or a man-caused event (such as violence at a child care facility), within the meaning of those terms under section 602(a)(1) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act [42 U.S.C. 5195a(a)(1)] The planning at the child care provider level must include procedures for evacuation, relocation, shelter-in-place and lockdown, as well as training and drills for staff and volunteers, communications and reunification with families, continuity of operations, and accommodations for infants and toddlers, children with disabilities and children with chronic medical conditions.
  8. Handling and storage of hazardous materials and the appropriate disposal of biocontaminants
  9. Appropriate precautions in transporting children (if applicable)
  10. Pediatric first-aid and pediatric cardiopulmonary resuscitation (CPR)
  11. Recognition and reporting of child abuse and neglect. Note: The description must include a certification that child care providers within the state comply with the child abuse reporting requirements of section 106(b)(2)(B)(i) of the Child Abuse Prevention and treatment Act (42 U.S.C. 5106a(b)(2)(B)(i)).

As an important reminder, the final rule requires that child development also be addressed, including the major domains (cognitive, social, emotional, physical development and approaches to learning). [2]

In addition, there are optional topic areas: [3]

  • Nutrition, including age-appropriate feeding
  • Access to physical activity
  • Caring for children with special needs
  • Other Lead Agency – areas determined subject necessary to promote child development or to protect children’s health and safety

States must have both preservice (or during an orientation period) and ongoing minimum health and safety training requirements (appropriate to the provider setting) for providers serving CCDF children in the topic areas listed above. Preservice or orientation training must be completed within 3 months of caring for children. Preservice and orientation training do not have to be all done before working unsupervised with children, but the Lead Agency must identify those health and safety trainings that are required before caring for children unsupervised. [4]

ACF expects that these trainings will be part of a broader systematic approach and progression of professional development within each state that will result in opportunities for child care providers to accumulate knowledge, competencies, and credits toward eventual completion of professional certification or higher education. The law requires states to implement a progression of professional development that is based on current research and best practices and aimed toward improving the quality and stability of the child care workforce. [5]

The law does not specify a required number of training or education hours, but states must report the minimum number of annual training hours required for CCDF providers in their CCDF Plans. Though the law does not require a specific number of preservice and ongoing training hours for CCDF health and safety training, a reasonable benchmark is 30 hours of preservice or orientation training (16 hours of which should be in child development programming and 14 of which should be in health and safety) and between 24 and 30 hours of ongoing training annually (these numbers are based on recommendations in Caring for Our Children: National Health and Safety Performance Standards, Guidelines for Early Care and Education Programs). ACF strongly encourages states to look at all training—including ongoing annual training—as a meaningful opportunity to help child care staff progress professionally and pursue credentials and higher education. [6]


[1] CCDBG Act of 2014 658E(c)(2)(I); Child Care and Development Fund, 45 C.F.R. § 98.41 (2016).

[2] Child Care and Development Fund, 45 C.F.R. § 98.44(b)(1)(iii) (2016).

[3] CCDBG Act of 2014 658E(c)(2)(I)(ii); Child Care and Development Fund, 45 C.F.R. § 98.41(xii)(A–D) (2016).

[4] Office of Child Care. (2016). Child Care and Development Fund final rule frequently asked questions. U.S. Department of Health and Human Services, Administration for Children and Families.

[5] CCDBG Act of 2014 658E(c)(2)(G)(ii)(I); Child Care and Development Fund, 45 C.F.R. § 98.44 (2016).

[6] CCDBG Act of 2014 658E(c)(2)(I)(i)(XI); Child Care and Development Fund, 45 C.F.R. § 98.44(b) (2016).