Charting Progress for Babies in Child Care

Promote Health and Safety

Policy Ideas

What policies can states use to move toward this recommendation?

To move toward this recommendation, states may use multiple policy levers, starting from different points. Potential state policies include the following:

Licensing

Collect and analyze data related to deaths, injuries, and illness outbreaks occurring in child care to determine how to better prevent future incidents.
Study how current providers implement state licensing health and safety requirements that are important for infant and toddler care, to identify potential areas for improvement, technical assistance, and additional monitoring.
Review and improve current licensing provisions in areas that are critically important to infant and toddler health and safety, such as caregiver suitability, risks presented by physical hazards (pools, water temperature, animal bites, etc.), feeding, diapering, handwashing, sanitizing toys and play areas, and safe sleep practices. Use the standards articulated by the American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care and Early Education in Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs as a point of reference.
Have written health and safety standards that are specific to the age of children in care and the type of care setting (including center, family child care, and family, friend, and neighbor care), and make them applicable to all individuals who provide care for a fee on a regular basis to at least one unrelated child.
Provide specialized training and technical assistance materials targeted to minimizing the highest areas of risks to infant/toddlers in group care.
Require child care providers seeking state licensure to receive 40 hours of pre-service training that addresses basic health, safety, and child development issues, including those important for infants and toddlers, and ensure there are sufficient resources, supports, and capacity in the state training system to help providers meet these training levels through a variety of different delivery methods.
Require licensed providers to receive 24 hours of continuing training each year that builds on the provider's previous knowledge and experience, including up-to-date training on child development relevant to the age of children cared for. Ensure there are sufficient resources, supports, and capacity in the state training system to help providers meet these training levels.
Require certification in infant CPR, child CPR, and pediatric first aid and safe sleep practices training for all infant and toddler licensed providers and all family, friend, and neighbor caregivers who receive child care subsidies to care for infants and toddlers.
Ensure that required health and safety training for infant/toddler child care providers and caregivers is available in the languages spoken in the state's communities, using appropriate formats and effective literacy levels.
Ensure that there are adequate numbers of state monitors trained to evaluate compliance with health and safety care standards for infants and toddlers and who can provide technical assistance to improve performance in each area of caregiving.
Require all licensed providers caring for babies and toddlers to undergo checks for criminal background, including in federal and state fingerprint records, and in child abuse and neglect and sex offender registries. Provide a system to screen and address the resulting information in a timely and affordable fashion.
Require all licensed providers to be checked for tuberculosis and to provide certification of up-to-date immune status (measles, mumps, rubella, diphtheria, tetanus, polio, varicella, influenza, pneumonia, hepatitis A, and hepatitis B) prior to working with infants and toddlers.
Ensure that the state licensing system has sufficient resources, supports, and capacity to implement and oversee the above recommendations.

Subsidy

Require providers who receive child care subsidies and who care for babies and toddlers to complete 40 hours of pre-service training and 24 hours of ongoing training annually on health and safety issues relevant to infants and toddlers.
Require all license-exempt family, friend, and neighbor caregivers who receive child care subsidies to participate in a free, culturally and linguistically appropriate basic health and safety workshop prior to caring for babies and toddlers.
Require all license-exempt family, friend, and neighbor caregivers who wish to receive child care subsidies to care for babies and toddlers to first register with the state and meet basic health and safety standards, with assistance and verification provided through a home visit.
Ensure that required health and safety training for infant/toddler child care providers and caregivers in the subsidy system is available in the primary languages of communities in the state and uses appropriate formats and literacy levels
Require all providers who receive subsidies and care for babies and toddlers to undergo checks for criminal background, including in federal and state fingerprint records, and in child abuse and neglect and sex offender registries. Provide a system to screen and address the resulting information in a timely and affordable fashion.
Require all providers who receive child care subsidies, including family, friend, and neighbor caregivers, to be screened for tuberculosis and to provide certification of up-to-date immune status (measles, mumps, rubella, diphtheria, tetanus, polio, varicella, influenza, pneumonia, hepatitis A, and hepatitis B) prior to working with infants and toddlers.
Ensure the state training system has sufficient resources, supports, and capacity to help providers meet these requirements.

Quality Enhancement

Provide grants and on-site technical assistance and monitoring to providers to help them conduct reviews of health and safety practices in infant and toddler settings and make improvements to meet the standards articulated by the American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care and Early Education in Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs.
Provide incentives within the state quality rating and improvement system (QRIS) for infant and toddler providers to meet the standards articulated by the American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care and Early Education in Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs, and monitor to ensure compliance.
Review current state training and education content and trainer and educator skills to ensure these offerings address particular areas of concern as informed by current state death and injury data, as well as current research on injury prevention and health promotion, and are delivered in a culturally and linguistically appropriate manner.
Develop capacity of the state professional development system to provide 40 hours of pre-service and 24 hours of ongoing annual health and safety training for all infant and toddler providers throughout the state.
Provide grants to agencies that deliver health and safety training to child care providers and caregivers to review and improve their capacity to provide such training in the primary languages of communities in the state, using appropriate formats and literacy levels.
Offer paid release time and substitutes so that center-based and family child care providers may participate in training during regular work hours.
Create networks of statewide specialists or nurse consultants with expertise in infant and toddler health and safety issues to provide coaching, mentoring, on-site or in-home consultations, technical assistance, and other supports for all infant and toddler providers and caregivers.
Use creative support strategies, such as home visitations, health and safety kits, and voluntary community-based learning opportunities, to provide health and safety information to family, friend, and neighbor caregivers.
Ensure that pre-service and ongoing training programs include basic information on how to care for children with special health needs and coordinate with state IDEA part-C programs to ensure access to any additional training necessary to meet the health and safety needs of infants and toddlers in child care who have disabilities or other special health needs.
Provide grants to child care providers to improve the health and safety of the physical environment in which babies and toddlers receive care.

Related Project Recommendations

Visit page: http://www.clasp.org/babiesinchildcare/recommendations?id=0008