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Programs should have clear policies for administering medication to children. Providers should obtain parental consent, ensure proper storage, and follow precise administration procedures. Staff should be trained in medication administration and record-keeping to ensure safety and compliance. These measures help protect children’s health and prevent medication errors.

To ensure the safety of children in child care programs, facilities should adhere to building and physical premises safety standards. This includes identifying and mitigating hazards, securing bodies of water, and managing vehicular traffic. Regular inspections and compliance with fire prevention codes are essential. These measures help create a safe environment, protecting children from potential dangers.

According to the Health Needs and Use of Services Among Children with Development Disabilities article, 1 in 6 children in the U.S. has developmental disabilities or delays, yet only 34.4% of children aged 9-35 months received a developmental screening in 2022. Caregivers should partner with local agencies or health care professionals to screen and document children’s development and behavior upon entering care and annually. These screening tools should be age appropriate and should be used with parental consent and involvement. Developmental screening can identify concerns about a child's development, enabling early intervention services that can enhance outcomes for the child.

Programs should provide each child with a known allergy with a care plan, written and signed by the child’s primary health care provider that includes all known allergens, steps to take to avoid them, and a detailed treatment plan to use in the event of an allergic reaction. Caregivers, teachers, and substitutes should immediately let parents or families know of any suspected allergic reactions and immediately contact emergency medical services whenever they administer epinephrine, even if the child appears to have recovered from the allergic reaction. Caregivers should serve developmentally-appropriate foods and supervise children while eating to avoid choking.

Emergency preparedness means having a plan for emergency situations, including urgent medical needs, threatening incidents, and disasters. Emergencies can both physically and emotionally harm infants and toddlers. Child care programs should create intentional plans to keep infants and toddlers safe and continue to provide essential, responsive care during emergencies.

To ensure the safety of children in childcare programs, facilities should adhere to guidelines for the use and storage of toxic substances. Keep toxic substances away from children and use them as the manufacturer suggests. They should be stored in their original labeled containers and not used when children are present. These measures are essential to prevent accidental poisoning and exposure, ensuring a safe environment for all children.

Ensuring children have access to physical activity and nutritious food helps children to learn healthy habits. Physical activities should be tailored to the age and developmental stage of the children, including opportunities for infants and toddlers to practice motor skills every day. The United States Department of Agriculture’s Child and Adult Care Food Program (CACFP) guidelines aim to provide children in care settings with healthy meals and snacks. These guidelines focus on balanced diets that incorporate fruits, vegetables, whole grains, and lean proteins, while minimizing sugars and unhealthy fats. Following CACFP guidelines fosters healthy eating habits and contributes to overall well-being.

To ensure the safety of children in childcare programs, staff should be trained in pediatric first aid and have current certification in pediatric CPR. This training should be regularly updated and the facility should maintain these records in its personnel file. States and territories will determine the frequence of the training requirement. These measures are essential to ensure that staff can respond effectively to health emergencies, providing a safe environment for all children.

To ensure the safety of children during transportation, child care programs should follow child passenger safety guidelines and driver qualification standards. Drivers should have a valid license for the vehicle type, pass background checks, and receive training in child passenger safety. Children should be secured in appropriate car seats, booster seats, seat belts, or harnesses based on their weight and age, following state and federal laws. Maintain a comfortable interior temperature in vehicles. These measures are key to the prevention of injuries and assurance of safe travel for all children.

To prevent the spread of infectious diseases in child care programs, programs should require children and staff to be up to date on immunizations and enforce rigorous hygiene practices, including handwashing and sanitizing surfaces. If a child shows symptoms of illness, they should be excluded from care until they are no longer contagious. These measures help maintain a healthy environment for all children.

Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. AHT, which includes shaken baby syndrome, is a preventable and severe form of physical child abuse that results in an injury to the brain of a child. It often happens when a parent or caregiver becomes angry or frustrated because of a child’s crying, and is caused by violent shaking and/or blunt impact. Child care providers play an important role in adopting prevention strategies to support themselves, other caregivers, parents, and families.

Effective program management is essential to overseeing and coordinating the various activities of child care programs. Programs should establish and follow written plans and training for handling urgent medical care and threatening incidents, disaster planning, authorized pick-ups, and signing in-and out of the facility. Programs should also have clear records of monitoring reports, valid license, certificate, or registration of facility or family child care home, and should keep confidential files for each child in their program.

Child care regulations require specific staff-child ratios to ensure safe and quality care. Staff must pass comprehensive background checks before working with children unsupervised, and receive initial and ongoing training in child development, health, and safety.

Child maltreatment including physical abuse, sexual abuse, emotional abuse, exploitation, and neglect puts children at risk for behavioral, physical, and mental health problems. To ensure the safety and well-being of children, child care programs should provide education on child maltreatment. Caregivers and teachers are mandated reporters and should be trained to recognize signs of abuse and neglect including shaken baby syndrome and abusive head trauma. Staff should understand reporting procedures and should learn to implement preventive measures. These measures are essential to protect children from harm and ensure a safe and supportive environment for all children.

To reduce the risk of Sudden Unexpected Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS), child care programs should follow safe sleep practices. Infants should be placed on their backs to sleep, on firm sleep surfaces, with nothing in the crib but the baby. These measures are essential to prevent suffocation and other sleep-related infant deaths, ensuring a safe sleep environment for all infants.

Effective supervision of children is crucial for ensuring their safety and well-being. Programs should meet staff ratios during all hours of operation in accordance with state or territory requirements and caregivers and teachers should always supervise all children by sight and sound. By employing these methods, caregivers can create a safe and supportive environment that promotes the well-being of children in their care.