Effective Date: 11/10/16, 07/01/17
Reference: 45 CFR Subpart D, §98.41 Health and safety requirements, CCDF State Plan Section 5.1.6
The Child Care Development Block Grant (CCDBG) Act of 2014 added a new provision specifying that States and Territories must:
- Establish health and safety requirements for providers serving children receiving Child Care Development Fund (CCDF) assistance relating to matters included in the topics listed below, and
- Have pre-service or orientation training requirements, appropriate to the provider setting, that address these health and safety topics. (658E(c)(2)(I)(i))
The Health and Safety Requirements outlined below are applicable to all child care providers receiving CCDF regardless of licensing status (licensed or license-exempt).
Child Care provider approval for participation in the Child Care Assistance Program shall be contingent upon evidence of compliance with health and safety standards that are made applicable by the policies outlined in the CCAP Policy manual. The Illinois CCAP health and safety standards have been developed in accordance with the Child Care Development Block Grant Act of 2014 and define what all child care providers and volunteers in all types of settings need to know and be able to do to provide quality care in a healthy, safe environment. Ensuring the health and safety for all children in care is a necessary foundation for all programs. The health and safety standards for the Child Care Assistance Program outline the minimum requirements for a healthy and safe environment. While most of the health and safety standards will apply to all programs, some are specific to particular program settings. The Department of Human Services identified license-exempt child care providers must agree to a formal annual inspection of health and safety compliance with the Child Care Assistance Program (CCAP) Health and Safety Standards. Compliance with these requirements does not exempt a child care provider from complying with stricter health and safety standards under state law, local ordinance, or other applicable laws.
I. Such requirements shall relate to matters including health and safety topics consisting of:
- Prevention and control of infectious diseases (including immunizations)
Each child care provider should have written policies for managing child and provider illness in child care. This includes hand washing, cleaning, sanitizing, and disinfecting surfaces that could possibly pose a risk to children or staff, following standard precautions for exposure to blood, carefully disposing of material that might contain germs or bacteria, and excluding ill people from the group when necessary.
- Prevention of sudden infant death syndrome and use of safe sleeping practices
Child care provider must ensure that safe sleep practices for all children are followed. All infants must be placed on their backs to sleep. When infants can easily roll over after being placed on their backs to sleep, they should be allowed to adopt their own position; however, caregivers must always place infants on their backs to sleep. Infants who fall asleep in other locations such as a swing or car seat must be moved immediately. Documentation: A parent must provide a documented medical reason signed by a physician if an infant is to be placed to sleep in a position other than his or her back.
- Administration of medication, consistent with standards for parental consent
When medication must be administered to child(ren) while in the child care setting, the child care provider will administer medication only if the parent or legal guardian has provided written consent. Written consent must include Instructions for the dose, time, and how the medication is to be given, and the number of days the medication will be given. Medication means any substance or preparation which is used to prevent or treat a wound, injury, infection, infirmity, or disease. This includes medication that is over the counter, non-prescription, or prescription.
- Prevention and response to emergencies due to food and allergic reactions
When children with food allergies attend a child care setting, the child care provider shall have on record a care plan prepared by the child's doctor, to include:
- Written instructions regarding the food(s) to which the child is allergic and steps that need to be taken to avoid that food;
- A detailed treatment plan to be implemented in the event of an allergic reaction, including the names, doses, and methods of administration of any medications that the child should receive in the event of a reaction. The plan should include specific symptoms that would indicate the need to administer one or more medications; Confidentiality should be maintained in compliance with any laws or regulations.
- Building and physical premises safety, including identification of and protection from hazards that can cause bodily injury such as electrical hazards, bodies of water, and vehicular traffic
During the hours when children are in care child care providers must ensure adequate supervision in a safe environment. Child care providers should be aware of environmental hazards when selecting an area to play indoors as well as outdoors. Children should be observed closely when playing. If an activity occurs outdoors, play areas should be secure and away from heavy traffic areas.
- Prevention of shaken baby syndrome and abusive head trauma and child maltreatment
Child care providers and staff (if applicable) who are in direct contact with children, must receive training on preventing shaken baby syndrome/abusive head trauma, recognition of potential signs and symptoms of shaken baby syndrome/abusive head trauma, strategies for coping with a crying, fussing or distraught child, and the development and vulnerabilities of the brain in infancy and early childhood. Child maltreatment either as an incident or discipline or otherwise, and recognition of the warning signs of abuse and neglect.
- 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)
Child care providers must be able to plan for, recognize and handle emergencies and hazards. Emergency preparedness includes the setting's response to shelter-in-place emergencies that addresses violence, shootings and bombings in addition to natural disasters. From the date care is provided a timely method of communication must be established and agreed upon (phone, email, text, etc.) between the parent/guardian and the child care provider. Emergency contact information must be posted and accessible to relevant staff (if applicable). The child care provider must maintain a written record on each child that includes the name(s) of the child's parent(s); the telephone number(s) and/or alternate agreed upon method of communication at which the parent(s) can be reached during the hours the child is in care; an emergency contact in the event the parent(s) cannot be reached; and the number of hours each child is served. Providers must ensure that records are maintained and disposed of in a manner that protects privacy and confidentiality.
- Handling and storage of hazardous materials and the appropriate disposal of bio-contaminants
Child care settings must have appropriate procedures for handling and storage or medicines, cleaning supplies, hazardous substances and materials, and firearms and other weapons. Child care staff must demonstrate competency in handling and disposal of blood and bodily fluids. No handguns or weapons are allowed on the premises (except in the possession of peace officers or other adults who must possess a handgun as a condition of employment and who reside in the home). Firearms in home must be disassembled, without ammunition, and stored in locked cabinet. Ammunition must be kept in locked storage separate from the disassembled firearms. Providers must notify parents of the presence of firearms in the setting.
- Appropriate Precautions in transporting children (if applicable)
Child care providers must ensure the safety of children in all activities of child care. Proper restraint systems and the correct use of them are critically important during travel to/from the child care setting as well as a part of the activities of the setting. The child care provider must ensure that children are never left unattended in a vehicle. Smoking is prohibited in vehicles used to transport children. Only insured, licensed, well-maintained vehicles will be used to transport children. Drivers will be legally-licensed and shall not be under the influence of any chemical substance that may alter their ability to drive safely. Drivers will meet staff qualifications including the applicable background check.
- Pediatric First Aid and Cardiopulmonary Resuscitation (CPR) Certification
All child care providers must have current certification in pediatric rescue breathing and first aid treatment from a certified instructor. The provider or center staff member must maintain current training in first aid and CPR; The provider and center staff member shall provide a copy of the front and back of the current card issued by the agency or instructor as proof of completion.
- Promotion of child growth, development and learning
Caregivers must ensure the child care setting supports children's health, well-being, and development across domains; including social-emotional, language and cognitive and physical.
II. The Department of Human Services has established training requirements related to health and safety as well as a series of other topics for all CCAP providers. The DHS website will be updated with specifics regarding training requirements and opportunities for completion as soon as the information becomes available. Providers will need to consult the website for new information and postings.