Start Right Table of Contents

1. Emergency Preparedness 1.1: Emergency preparedness plan/policy

Example template1.2: Emergency drills

Example drill record sheet1.3: Staff training in emergency drills

Example staff training log2.1: Emergency radio, batteries, telephone2.2: Emergency plan reviewed and updated

Example emergency plan review log2.3: Parent education on emergency preparedness

http://health.mo.gov/emergencies/readyin3/index.phpwww.cdc.govhttp://www.preparemetrokc.org

3.1: Shelter in PlaceExample shelter in place maintenance logSupply list

3.2: Emergency backpacksSuggested supplies

3.3: Grab and Go binderSuggested list of information for binder

3.4: Trained in emergency preparedness/ready in 3Staff training logDHSS online training: http://health.mo.gov/safety/childcare/training.php

2. Indoor Safety 1.1: Play equipment1.2: Facility ventilation1.3: Window barriers2.1: Product Safety

Consumer Product Safety Commission: www.cpsc.gov2.2: Parent education indoor safety

www.safekids.orgwww.kidshealth.orgwww.cdc.gov

2.3: Poison Prevention for childrenChild’s training certificate

3.1: Medication Administration trainingStaff training log

3.2: Asthma management trainingStaff training log

3.3: Medication Administration & Poison Prevention Policy

Example Medication Administration PolicyMedication Administration packet:http://cfoc.nrckids.org/WebFiles/AppedicesUpload/AppendixAA.pdfExample Poison Prevention PolicyList of non-poisonous and poisonous plants:http://cfoc.nrckids.org/WebFiles/AppedicesUpload/AppendixY.pdf

3. Outdoor Safety 1.1: Outdoor equipment1.2: Children training for equipment use

Children training certificate1.3: Sunscreen use

Example sunscreen authorization form2.1: Playground safety

Playground inspection sheet2.2: Parent education on carseat safety

www.safekids.orgwww.kidshealth.org

2.3: Bike helmetsBike helmet fact sheet:http://cfoc.nrckids.org/WebFiles/AppedicesUpload/AppendixII.pdf

3.1: Outdoor safety staff trainingStaff training sheet

3.2: Simple Shelter3.3: Outdoor safety policy

Example outdoor safety policy

4. Safe Sleep 1.1: Placed on back to sleep1.2: No sharing crib, bed, bedding1.3: Facility uses firm tight-fitting mattress2.1: Infants observed at all times2.2: Parent education on safe sleep

www.safekids.orghttp://www.healthychildcare.org/sids.html

2.3: Designated sleep areas are labeled Example label

3.1: Safe Sleep policyExample policy

3.2: Safe Sleep trainingStaff training sheet

3.3: Soft/loose bedding and blanket-free cribs

5. Communicable Disease 1.1: Immunization record on file1.2: Tracking system for immunizations1.3: Communicable disease policy

Example communicable disease policy2.1: Trained in immunizations and or record keeping

Staff training log2.2: Parent education on communicable diseases

www.cdc.govhttp://www.healthychildren.org/english/safety-prevention/immunizations/Pages/default.aspx

2.3: Hand-washing classesChildren training certificate

2.4: Flu vaccinationDeclination letter

3.1: 100% compliant initial immunization audit3.2: Trained in communicable disease

Staff training sheetDHSS online training: http://health.mo.gov/safety/childcare/index.php

3.3: Tdap vaccinationDeclination letter

3.4: Surveillance siteSurveillance form

6. Physical Activity 1.1: Daily schedule of activities1.2: Appropriate play

Reference sheet with example age-appropriate activitieshttp://www.healthykidshealthyfuture.org/content/dam/hkhf/filebox/khchildcareguide.pdf

1.3: Outdoor play2.1: Structured play2.2: Supervised infant play2.3: Physical activity training

Staff training sheet3.1: Physical activity policy (reference Model policies for creating a healthy nutrition & physical activity environment in child care settings) http://health.mo.gov/living/wellness/nutrition/eatsmartguidelines/pdf/Model_Policies.pdf

Example 1 physical activity policy Example 2 physical activity policy

3.2: Screen time3.3: Daily physical activity

7. Nutrition 1.1: Drinking water1.2: Nutritional requirements

Copy of diet plan: http://health.mo.gov/safety/childcare/pdf/I-TBCC-12.pdf1.3: Milk and meals

Weekly menu: http://health.mo.gov/safety/childcare/pdf/BCC-9.pdf2.1: Staff eats with children2.2: Parent education on breastfeeding

www.womenshealth.govhttp://www.healthychildren.org/english/ages-stages/baby/breastfeeding/Pages/default.aspx

2.3: Trained in nutritionStaff training log

3.1: Nutrition policy (reference Model policies for creating a healthy nutrition & physical activity environment in child care settings) http://health.mo.gov/living/wellness/nutrition/eatsmartguidelines/pdf/Model_Policies.pdf

Example nutrition policy3.2: Fresh fruits & vegetables

Weekly menu: http://health.mo.gov/safety/childcare/pdf/BCC-9.pdf

3.3: BeveragesWeekly menu: http://health.mo.gov/safety/childcare/pdf/BCC-9.pdf

8. General Safety 1.1: Read/reviewed licensing rules: http://health.mo.gov/safety/childcare/lawsregs.php1.2: CPR/First Aid (1:20)1.3: Background checks2.1: CPR/First Aid (all staff)2.2: Parent education on CPR/First Aid

www.heart.org2.3: Children Health Promotion

Children training certificatewww.independencemo.org/health/MatChildHealth.aspx

2.4: Trained in facility safetyStaff training log

3.1: Call system for absent children3.2: Smoke-free campus

Example policyTips for implementation

3.3: Critical violation environmental healthSanitation report

Emergency Preparedness

1.1: Facility has an emergency preparedness plan/policy

The plan will be visually checked off during a site visit An example plan is provided if the center does not have a plan developed Example plan can be found on the MO DHSS website label Emergency

Plan Template http://health.mo.gov/safety/childcare/forms.php 1.2: Holds emergency drills monthly and quarterly

The drills will be checked using the drill record sheet included in this book Emergency drills include but not limited to: fire, tornado, and earthquake Fire drills will be conducted monthly and disaster drills every three months

1.3: All staff trained upon hire in facility emergency operations

The trainings will be checked using the training log. Included in this book are example logs if the center does not have one developed

Training for staff should include but not limited to: fire, tornado, earthquake, and basic “what to do in an emergency”

The training is only required one time: upon hire2.1: Has an emergency radio, batteries, and telephone at each site

The emergency radio, batteries, and telephone will be visually checked off during a site visit and checked to be in working condition

2.2: Emergency preparedness plan is reviewed and updated annually by director or designee

The plan review will be checked off using the “emergency plan review log” provided in this book during a site visit

The purpose of reviewing the plan is to make any updates, changes, and to keep current on procedures

2.3: Parent education on emergency preparedness is displayed at pick-up/drop-off area

The educational materials will be visually checked off during a site visit Educational brochures and fliers are available through the Independence

Health Department, Center for Disease Control, Missouri Department of Health and Senior Services, Independence Emergency Management

3.1: Each site has created and maintained a (24 hr.) shelter in place kit

The shelter in place kit will be visually checked and the maintenance log will be checked during site visits

A list of supplies needed for the kit and maintenance log are included in this book

The kit needs to be contained in a plastic durable container The kit should be checked annually for expired supplies and to replace or

add supplies3.2: Emergency backpack kit is in each classroom

The backpacks will be visually checked during site visit A list of suggestions for the backpacks are included in this resource book

3.3: Grab & Go binder The binder will be visually checked during site visit A list of suggestions for what to include in the binder is included in this

resource book

3.4: Trained one time in “Ready in 3” The trainings will be checked using the training log. Included in this book are example logs if the center does not have one

developed

[Insert Child Care Facility] Emergency Drill Record

Date of Drill _______________ Time of Drill _______________ Type of Drill_______________________________

Brief Description of Drill:

Rooms Participating in Drill:

Lessons Learned & Future Changes:

Facility Director Signature:_________________________________ Date:______________________

*record staff in attendance on the staff training sheet

Staff Member Training Log

Staff Member Name: ____________________________________Date Hired: ______________

Does this staff member work with infants? YES NO

Training Topic:____________________________________ Training Date: ________________

Instructor Name: ______________________

Training Topic:____________________________________ Training Date: ________________

Instructor Name: ______________________

Training Topic:____________________________________ Training Date: ________________

Instructor Name: ______________________

Training Topic:____________________________________ Training Date: ________________

Instructor Name: ______________________

Training Topic:____________________________________ Training Date: ________________

Instructor Name: ______________________

Emergency Plan Review Log

Date Changes Made (list sections for reference) Reviewed By

Shelter In Place: Maintenance Log

Date Supplies Needed Supplies Added Supplies Replaced No Action needed

Checked By

Notes about supplies: Supplies can be expensive. To “grow” your stock of appropriate supplies:

Review the lists and decide which supplies are priorities at your site. Develop a supply rotation system that allows you to use perishable supplies in

your normal operations before the expiration date. For example, buy canned food that is normally on your menu, and plan to replace and serve it every 6 months.

Team up with another program to buy supplies in bulk. Request a small disaster supply fee from families or specific donations. Seek specific donations from the community.

1-Day Supplies per 50 people

SURVIVAL

Water

32 oz per person and child (2 plastic water bottles) - Required 1 gallon of water per adult – (recommended) 1/2 gallons of water per child – (recommended) any tools needed to open water containers cups to dispense water

Stored: _____________________________

Food

Emergency Food: Is easy to serve

Does not require cooling or heating Has a long shelf life Is stored protected from heat, cold, and pests

Our emergency food is part of our regular menu rotation. Food for 1 extra day is always on site. (Familiar food can be a comfort during a disaster.) It is rotated _____________________ (how often) by ____________________ (whom).

We have a separate supply of emergency food. Expiration dates are checked _____________________ (how often) by ____________________ (whom).

We include food for those with food allergies or on special diets.

We include age-appropriate food, such as formula and pureed food for infants (when enrolled).

Supplies kept with food include:

Plastic dishes and utensils Manual can opener Bottles for infants

Stored: ________________________________

General

flashlight w/ extra set of batteries per every 2 staff person blanket (fleece, wool, &/or “__________”) per person (5) extra blankets (10) plastic sanitation bags privacy shelter (10) rolls toilet paper (25) sanitary napkins (10) plastic garbage bags (10) rolls paper towels (250) soap towelettes packets or baby wipes (5) bars of soap (recommended) (2) 5 gal plastic buckets for

sanitation/emergency toilets (recommended) (10) 12-hour light sticks battery-operated lanterns w/ extra batteries - recommended battery powered or handcrank radio (NOAA Weather Radio, if possible) multipurpose tool first aid kit medications (1) small bottle bleach plastic sheeting duct tape (25) dust masks

Stored: ________________________________

Special Equipment/Other

Medical supplies for children with special health care needs: ____________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Stored: ________________________________

Backpack Kit Supply List Be sure the back packs are located somewhere you can grab it on the way

out the door every time your class leaves the classroom!

□ Backpack, labeled for easy identification

□ Emergency forms for students (& staff)

□ “Rescue” medications with authorization forms

□ First aid kit

□ Flashlight(s) & batteries

□ Whistle

□ Bottle of water with small paper cups &/or (infant) bottles

□ Tarp or ground cover

□ (2) Mylar blankets

□ Tissues, toilet paper, &/or wipes

□ Age-appropriate snacks (including infant formula)

□ Diapers (& plastic bags for disposal) for infants, toddlers, & children with special needs

□ Age-appropriate time passers (books, crayons, paper, etc…)

What is a “Grab & Go” bag?

A Grab & Go bag contains essential items for an emergency. It includes things that you may need in the first hour or so following an emergency/disaster. A Grab & Go bag contains only a small portion of your disaster supplies, but is a key part of your preparedness and response. A Grab & Go bag should be easy to transport. A backpack (daypack) usually makes the best carrier.

What should our Grab & Go bag contain?

A Grab & Go bag should include current emergency contact information, a first aid kit, “rescue” medications* with paperwork, and a flashlight. Tarps and/or blankets are also helpful for all ages. Include other items appropriate to the age(s) of children served. (Just make sure that you can easily carry your Grab & Go bag!) Should the Grab & Go bag have enough formula and diapers for all infants? No. Remember that this bag is designed to meet immediate needs for a limited time. Make sure that you have additional supplies in your 24 hour disaster supply kit. How many Grab & Go bags do we need?

A Grab & Go bag should be assembled for each class in your child care center or for each child care area of your home.

Where should we keep our Grab & Go bags?

Your Grab & Go bag should accompany your class everywhere. In the classroom, the best place to keep it is on a hook by the door that you usually use to exit (and that you are most likely to evacuate through). When you leave the classroom, always take it along. Your Grab & Go bag should be with you on the playground, field trips, fire drills, or any other planned or unplanned classroom departure. Some programs have installed hooks on their playgrounds to hang their Grab & Go bags when they are outside. The Grab & Go bag should be out of children’s reach at all times. (Again, don’t make it too heavy – no one should be tempted to set it on the ground where it would be easily accessible to children.)

We’ll have to update our Grab & Go bag from time to time, won’t we?

Absolutely, Make sure you have a system in place for keeping emergency contact information current. Check expiration dates of food, water, batteries, and any medication, and replenish those items regularly. Keep first aid supplies fully stocked.

*Rescue medications include EpiPens®, asthma inhalers, or any other medications that a specific child may need to keep him/her alive.

**Information provided by Missouri Department Health and Senior Services and Seattle & King County Public Health Department

Grab and Go Binder

The grab and Go binder should be located in the facility and the designated person in charge should have access to the binder for emergency purposes. The binder should include but not limited to the following items:

Emergency contact information for each child Medical information for each child (rescue medications, allergy information, list of

medications, etc) Release information for each child Basic information on each child (name, age, parents/guardian)

This binder should be kept current and updated throughout the year and reviewed annually by director or designee.

Indoor Safety

1.1: Play equipment and materials are cleaned daily & in good working condition

This will be visually checked during site visit A log is provided in this book and it will be checked during site visit

1.2: Facility is dry, well-ventilated, free of drafts and temperature controlled

This will be visually checked during site visit1.3: Barriers to prevent children from falling into or through windows are in place

This will be visually checked during site visit2.1: Facility is on a listserve for product safety and recall notifications

Print outs of recalls will be visually checked Recalls should be posted at pick-up/drop-off area To sign up to receive recall information visit: Consumer Product Safety

Commission www.cpsc.gov2.2: Parent education on indoor safety is displayed at pick-up/drop-off area

This will visually checked during site visit Safety information can be obtained online at Center for Disease Control

and Prevention, Missouri Department of Health and Senior Services, and Safe Kids USA or you can contact the Independence Health Department

2.3: Poison prevention education is provided for preschool age children annually Training log will be checked

3.1: Director or designee are trained in medication administration and in turn train staff

Director and staff will need to complete training every three years after initial training

The training log will be checked for staff training

3.2: Director or designee are trained in asthma management and in turn train staff

Director and staff will need to complete training every three years after initial training

The training log will be checked for staff training3.3: Has a written policy on medication administration and poison prevention

Policies will be checked and reviewed during site visit Example policies on both medication administration and poison prevention

are provided in this book if the site does not have a policy developed Included in the book are forms that can be used for medications

(permission form, receiving medications, medication log, incident report, check list for giving medication). These can be used if site does not have forms developed

An informational list of poisonous and non-poisonous plants is also included in this book

Independence Start Right Childcare ProgramWritten Policy on Use of Medications

Administering medication requires skill, knowledge and careful attention to detail. Parents/guardians and prescribing health professionals must give a caregiver/ teacher written authorization to administer medication to the child. Caregivers/teachers must be diligent in their adherence to the medication administration policy and procedures to prevent any inadvertent medication errors, which may be harmful to the child

Consent Forms:The use of written parental/guardian consent forms for each prescription and OTC medication to be administered at the child care facility. The consent form should include:

The child’s name

The name of the medication

The date(s) and times the medication is to be given

The dose or amount of medication to be given

How the medication is to be administered

The period of time the consent form is valid, which may not exceed the length of time the medication is prescribed for, the expiration date of the medication or one year, whichever is less.

The use of the prescribing health professional’s authorization forms for each prescription and OTC medication to be administered at the child care facility.

Medication:The circumstances under which the facility will agree to administer medication. This may include the administration of:

Topical medications such as non-medicated diaper creams, insect repellants, and sun screens

OTC medicines for fever including acetaminophen and ibuprofen

Long-term medications that are administered daily for children with chronic health conditions that are managed with medications

Controlled substances, such as psychotropic medications

Emergency medications for children with health conditions that may become life-threatening such as asthma, diabetes, and severe allergies

One-time medications to prevent conditions such as febrile seizures.

The circumstances under which the facility will not administer medication, this should include:

No authorization from parent/guardian and/or prescribing health professional

Prohibition of administering OTC cough and cold medication

Not administering a new medication for the first time to a child while he or she is in child care

If the instructions are unclear or the supplies needed to measure doses or administer the medication are not available or not in good working condition

The medication has expired

If a staff person or his/her backup who has been trained to give that particular medication is not present (in the case of training for medications that require specific skills to administer properly, such as inhalers, injections, or feeding tubes/ports).

Accepting Medication:The process of accepting medication from parents/ guardians, this should include:

Verifying the consent form

Verifying the medication matches what is on the consent form

Accepting authorization for prescription medications from the child’s prescribing health professional only if the medications are in their original container and have the child’s name, the name of the medication, the dose and directions for giving the medication, the expiration date of the medication, and a list of warnings and possible side effects

Accepting authorization for OTC medications from the child’s prescribing health professional only if the authorization indicates the purpose of the medication and time intervals of administration, and if the medications are in their original

container and include the child’s name, the name of the medication, dose and directions for use, an expiration date for the medication, and a list of warnings and possible side effects

Verifying that a valid Care Plan accompanies all long-term medications (i.e., medications that are to be given routinely or available routinely for chronic conditions such as asthma, allergies, and seizures)

Verifying any special storage requirements and any precautions to take while the child is on the prescription or OTC medication

Handling of Medication:The proper handling and storage of medications, including:

Emergency medications – totally inaccessible to children but readily available to supervising caregivers/teachers trained to give them

Medications that require refrigeration

Controlled substances

Expired medications

A policy to insure confidentiality

Storing and preparing distribution in a quiet area completely out of access to children

Keeping all medication at all times totally inaccessible to children (e.g., locked storage)

Whether to require even short-term medications to be kept at the facility overnight

Administering Medications:The procedures to follow when administering medications, these should include:

Assigning administration only to an adequately trained, designated staff

Checking the written consent form

Adhering to the “six rights” of safe medication administration (child, medication, time/date, dose, route, and documentation)

Documenting and reporting any medication errors

Documenting and reporting and adverse effects of the medication

Documenting and reporting whether the child vomited or spit up the medication.

The procedures to follow when returning medication to the family, including:

An accurate account of controlled substances being administered and the amount being returned to the family

When disposing of unused medication, the remainder of a medication, including controlled substances

Disposal: A medication administration record should be maintained on an ongoing basis by

designated staff and should include the following

Specific, signed parental/guardian consent for the caregiver/teacher to administer medication including documentation of receiving controlled substances and verification of the amount received

Specific, signed authorization from the child’s prescribing health professional, prescribing the medication, including medical need, medication, dosage, and length of time to give medication

Information about the medication including warnings and possible side effects

Written documentation of administration of medication and any side effects

Medication errors log

When the policy applies:This policy is applicable at all times.

Communication plan for staff and parents:• ________________________ will cover policies, plans, and procedures with all new staff (paid and volunteer) during orientation training. They will sign that they have read, understand, and agree to abide by the content of the policies.

• During enrollment this policy will be reviewed by ________________________ with the parents. Parents will sign that they have read, understand, and agree to abide by the content of the policies.

• A copy of all policies will be available during all hours of operation to staff and parents in the policy handbook located _____________________________.

• Parents may receive a copy of the policy at anytime upon request. A summary of this policy will be included in the parent handbook.

• Parents and staff will receive written notification of any updates.

Reviewed by: _________________________________Director/Owner

_________________________________Health Professional (physician, nurse, health department, EMS, Health consultant)

_________________________________Staff member

_________________________________ Other (parent, advisory committee, police, CPS)

Effective Date and Review Date:This policy is effective _____/_____/_____ and will be reviewed annually by ____/_____/_____ or sooner if needed. Parents and staff will be notified of any upcoming policy review.

Standard 9.2.3.9: (Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Settings. Third Edition, 2011)

Independence Start Right Childcare ProgramPoison Control Policy: Storage and use of hazardous materials

Reason this policy is important: Children are naturally curious and are unaware about what substances may be harmful to their health. Adult caregivers are responsible for safeguarding children from harmful items including medications, plants, chemicals, and animal waste.

Procedure and Practices, including responsible person(s):• Poisonous plants will not be permitted in the childcare program. Staff must identify plants and determine “safe” prior to bringing to the facility. (see poison plant list) If the plant is not on the poisonous plant list, please contact the poison control center (1-800-222-1222) for guidance.

• Outdoor plants will be labeled and whenever possible removed if poisonous.

• The Poison Control Center phone number will be posted on the list of emergency numbers by the telephone. Poison emergencies or requests for poison information will be made by contacting the Poison Control Center Hotline at 1-800-222-1222 first – unless the person who has been poisoned is unconscious, not breathing, having trouble breathing or is having convulsions. If any of these conditions are present, CALL 9-1-1 FIRST.

• Chemicals, medications, pesticides, paints, cleaning agents and other potentially harmful substances will be stored in locked areas that are inaccessible to children.

• Toxic substances will be stored away from food and food preparation areas.

• All chemical products and medications shall be stored in their original containers with original labels intact.

• Kitchen staff will be trained in and follow Integrated Pest Management practices for prevention of pests.

• If additional pest control is necessary, only a licensed exterminator will apply pesticides. Pesticides must be EPA approved with natural pesticides that are non-toxic to humans given first consideration.

• Pesticides and other potentially toxic chemicals will not be applied while children are present. Application shall be in a manner that prevents skin contact

and other exposure and minimizes odors. A staff member will observe the application of the chemicals and verify that they are applied according to instructions on the label or otherwise directed by a regulatory authority.

• _______________________ (staff title/name) will notify parents and staff before using pesticides and/or herbicides.

• Following use of pesticides, herbicides or other potentially toxic chemicals the treated area shall be ventilated for the period recommended on the product label, the State Chemist Office, or by a nationally certified poison control center before being reoccupied.

• Children will not have access to animal waste. Staff will do all cleanup of animal waste after hours.

• All staff purses and personal belongings will be securely stored to prevent access by children. Purses and other personal belongings may contain items unsafe for children including medications, lighters, pocketknives, and etcetera.

• Sanitizing solutions will be mixed fresh daily prior to arrival of children. Sanitizers will be in a marked spray bottle available for staff use, out of reach of children.

• Syrup of Ipecac will not be kept on premises.

When the policy applies:This policy is applicable at all times.

Communication plan for staff and parents:• ________________________ will cover policies, plans, and procedures with all new staff (paid and volunteer) during orientation training. They will sign that they have read, understand, and agree to abide by the content of the policies.

• During enrollment this policy will be reviewed by ______________________________ with the parents. Parents will sign that they have read, understand, and agree to abide by the content of the policies.

• A copy of all policies will be available during all hours of operation to staff and parents in the policy handbook located _____________________________.

• Parents may receive a copy of the policy at anytime upon request. A summary of this policy will be included in the parent handbook.

• Parents and staff will receive written notification of any updates.

Reviewed by: _________________________________Director/Owner

_________________________________Health Professional (physician, nurse, health department, EMS, Health consultant)

_________________________________Staff member

_________________________________ Other (parent, advisory committee, police, CPS)

Effective Date and Review Date:This policy is effective _____/_____/_____ and will be reviewed annually by ____/_____/_____ or sooner if needed. Parents and staff will be notified of any upcoming policy review.

*This format is adapted from Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Settings. Third Edition, 2011

Outdoor Safety

1.1: Outdoor equipment is safe and in good condition

This will be visually checked during site visit1.2: Children will be taught annually on safe equipment use

Training for children log will be checked An example log is provided in this book if site does not have one

developed1.3: Sunscreen used on children while outside (exemption: note from parent)

Should be included in outdoor policy

Parents would be required to supply sunblock and signed permission letter stating usage (considered same as OTC medication)

Parents can sign an exemption form

2.1: Site does a daily visual playground safety inspection

Playground inspection log will be checked during site visit

Example logs/checklist are provided in this book if site does not have one developed

2.2: Provides parent information in the pick-up/drop-off area on local car seat checks and never leave children unattended

This will be visually checked during site visit

Never leave children unattended is referring to information on not leaving children in cars unattended or the “not even for a minute” campaign

Informational materials can be found at Safe Kids USA, Center for Disease Control and Prevention, Missouri Department of Health and Senior Services, and the Independence Health Department

2.3: Safety approved bike helmets are used in conjunction with appropriate riding toys

This will be visually checked during site visit

A fact sheet on proper helmet fit is included in this book

Approved bike helmets is defined as any age appropriate child’s helmet that meets federal safety standard set by Consumer Product Safety Commission (CPSC). The helmet should have a label stating it meets the CPSC standards

Appropriate riding toys is defined as bicycles, tricycles, scooters, etc (anything riding or wheeled)

All children one year and over should wear a helmet when using riding or wheeled toys. Under one year should not be on a riding or wheeled toy

When done with riding/wheeled toy, the child should remove helmet before playing on the playground. Helmets could pose a strangulation hazard

3.1: Director or designee is trained in outdoor safety and in turn trains staff

The training log will be checked for staff training

Director and staff will need to complete training every three years after initial training

3.2: Has a simple shelter for sun protection in outdoor play area

This will be visually checked during site visit

Simple shelter is defined as a tent with sides up, awning, or other simple shelter from the sun can be available

3.3: Has a written policy on outdoor safety

Written policy will be checked during site visit

An example policy is provided in this book for site if it does not have a policy developed

Sunscreen Authorization Form

(Sunscreen Brought from Home)

Child’s Name: Date of Birth & Age:

(do not apply on infants 6 months and younger without written permission from health care provider)

Name of Sunscreen & SPF: Active Ingredients:

Start Date: Stop Date:

Times to be applied: Possible Side Effects:

Special Instructions: ______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Reason for medication: Protection from sunAmount to be given: Cover exposed areas of skinRoute: TopicalStorage: Room temperature

_________________________________ ______________________

Parent/Guardian Signature Date

_______________________________________

Daytime Phone Number

Independence Child Safe Program

Visual Playground Safety Inspection Log

Safety Checklist Completed Staff Name Comments

Missing parts

Broken parts

Protrusion of nuts and/or bolts

Chipping/peeling paint or rust

Sharp edges, splinters, rough surfaces

Debris (i.e. glass)

Animal excrement and other foreign material

Standing water, ice, snow

Fencing secure

Gates closed and locked

Other

Visible cracks

Stability of play equipment

Wear and deterioration

Independence Start Right Childcare ProgramPolicy on Use and Maintenance of Play Areas

Properly laid out outdoor play spaces, age-appropriate, properly designed and maintained equipment, installation of energy-absorbing surfaces, and adequate supervision of the play space by caregivers/teachers/parents/ guardians help to reduce both the potential and the severity of injury. Active play areas are associated with the most frequent and the most severe injuries in child care.

Safety: Outdoor equipment for gross motor play is age-appropriate Sunscreen and repellant is used on children when outside (parent note with

permission and parent will provide sunscreen and repellant A simple shelter is provided for sun protection in outdoor play area Bike helmets are used on appropriate riding equipment

Supervision: Children will be supervised at all times outdoor play Children will be accounted for before and after outdoor play No child will be allowed to play in or around a vehicle

Training: Staff training will be trained in outdoor safety upon hire and review policy

annually or upon any changes Children will be taught annually and as new children are enrolled in playground

safety and correct use of equipment

Inspections: Recommended inspections of the facility and equipment, as follows:

o Inventory, once at the time of purchase, and updated when changes to equipment are made in the playground

o Monthly inspections to check for U.S. Consumer Product Safety Commission (CPSC) recalled or hazard warnings on equipment, broken equipment or equipment in poor repair that requires immediate attention

o Daily safety check of the grounds for safety hazards

Outdoor play areas and equipment should be inspected daily for the following

Missing or broken parts Protrusion of nuts and bolts

Rust and chipping or peeling paint Sharp edges, splinters, and rough surfaces Stability of handholds Visible cracks Stability of non-anchored large play equipment (e.g.,

playhouses) Wear and deterioration

All loose-fill surfacing material, particularly sand, should be inspected daily for:

Debris (such as glass) Animal excrement, and other foreign material Depth and compaction of surface Standing water, ice, or snow

When the policy applies:This policy is applicable at all times.

Communication plan for staff and parents:• ________________________ will cover policies, plans, and procedures with all new staff (paid and volunteer) during orientation training. They will sign that they have read, understand, and agree to abide by the content of the policies.

• During enrollment this policy will be reviewed by ________________________ with the parents. Parents will sign that they have read, understand, and agree to abide by the content of the policies.

• A copy of all policies will be available during all hours of operation to staff and parents in the policy handbook located _____________________________.

• Parents may receive a copy of the policy at anytime upon request. A summary of this policy will be included in the parent handbook.

• Parents and staff will receive written notification of any updates.

Reviewed by: _________________________________Director/Owner

_________________________________Health Professional (physician, nurse, health department, EMS, Health consultant)

_________________________________Staff member

_________________________________ Other (parent, advisory committee, police, CPS)

Effective Date and Review Date:This policy is effective _____/_____/_____ and will be reviewed annually by ____/_____/_____ or sooner if needed. Parents and staff will be notified of any upcoming policy review.

STANDARD 9.2.6.1: (Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Settings. Third Edition, 2011)

Safe Sleep

1.1: Child is place on back to sleep in under 12 months

This will be visually checked during site visit Must show medical exemption letter if not on back

1.2: No child shall share a crib, bedding, or bed with another child

This will be visually checked during site visit1.3: Facility uses firm, tight-fitting mattress in safety-approved cribs

This will be visually checked during site visit2.1: Infants should be directly observed by sight and sound at all times

This will be visually checked during site visit2.2: Education materials on Safe Sleep are provided to parents at pick-up/drop-off area

This will visually checked during site visit Safe sleep information can be obtained online at Center for Disease

Control and Prevention, Missouri Department of Health and Senior Services, and Safe Kids USA or you can contact the Independence Health Department

2.3: Designated sleep areas are labeled with child’s name

This will be visually checked during site visit An example label is provided in this book if the site does not have one

developed3.1: Has a written safe sleep policy in place

The policy will be checked and reviewed during site visit An example policy on Safe Sleep is provided in this book if the site does

not have a policy developed3.2: Director or designee is trained on current safe sleep practices and policies, in turn

will train staff

Director and staff will need to complete training every three years after initial training

The training log will be checked for staff training

3.3: Soft or loose bedding should be kept away from sleeping infants and out of safe sleep environments.

This will visually checked at site visit

Should be included in safe sleep policy

These include, but are not limited to: bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, etc

Also, blankets/items should not be hung on the sides of cribs

Independence Start Right Childcare ProgramSafe Sleep Example Policy

Providing infants with a safe place to grow and learn is very important. For this reason, ___________ has created a policy on safe sleep practices for infants up to 1-year-old. We follow the recommendations of the Missouri Department of Health and Senior Services, the American Academy of Pediatrics (AAP), Caring for Our Children: National Health and Safety Performance Standards, and the Consumer Product Safety Commission to provide a safe sleep environment and reduce the risk of sudden infant death syndrome (SIDS). The staff, substitute staff, and volunteers at _______________ follow the safe sleep policy.

Sleep Position: Add State requirements if not listed Infants will be placed flat on their backs to sleep every time unless there is a

physician, practitioner or clinician signed sleep position medical waiver up to date on file. In the case of a waiver, a waiver notice will be posted at the infant’s crib without identifying medical information. The full waiver will be kept in the infant’s file.

Infants will not be placed on their side for sleep. Devices such as wedges or infant positioners will not be used since such devices

are not proven to reduce the risk of SIDS. Infants who use pacifiers will be offered their pacifier when they are placed to

sleep, and it will not be put back in should the pacifier fall out once they fall asleep.

Pacifiers will be cleaned between each use, checked for tears, and will not be coated in any sweet or other solution.

Parents are asked to provide replacement pacifiers on a regular basis. While infants will always be placed on their backs to sleep, when an infant can

easily turn over from back to front and front to back, they can remain in whatever position they prefer to sleep.

Sleep Environment: Add State requirements if not listed Our program will use Consumer Product Safety Commission guidelines for

safety-approved cribs and firm mattresses. Crib slats will be less than 2 3/8” apart Infants will not be left in bed with drop side down Playpen weave will be less than ¼” Consumer Product Safety Commission safety-approved cradles and bassinets

may also be used for sleeping if the infant meets the weight and height requirements.

Infants should not nap or sleep in a car safety seat, bean bag chair, bouncy seat, infant seat, jumping chair, play pen or play yard, highchair, chair, futon, or any other type of furniture/equipment that is not a safety-approved crib

Only one infant will be placed to sleep in each crib. Siblings, including twins and triplets, will be placed in separate cribs.

The crib will have a firm tight fitting mattress covered by a fitted sheet and will be free from loose bedding, toys, and other soft objects (i.e., pillows, quilts, comforters, sheepskins, stuffed toys, etc.)

To avoid overheating, the temperature of the rooms where infants sleep will be checked and will be kept at a level that is comfortable for a lightly clothed adult.

Sleep clothing, such as sleepers, sleep sacks, and wearable blankets, may be used as alternatives to blankets.

Bibs and pacifiers will not be tied around an infant’s neck or clipped on to an infant’s clothing during sleep.

Smoking will not be allowed in or near _______________ If an infant arrives at the facility asleep in a car safety seat, the parent/guardian

or caregiver/teacher should immediately remove the sleeping infant from this seat and place them in the supine position in a safe sleep environment (i.e., the infant’s assigned crib);

If an infant falls asleep in any place that is not a safe sleep environment, staff should immediately move the infant and place them in the supine position in their crib;

Soft or loose bedding should be kept away from sleeping infants and out of safe sleep environments. These include, but are not limited to: bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, etc. Also, blankets/items should not be hung on the sides of cribs.

Toys, including mobiles and other types of play equipment that are designed to be attached to any part of the crib should be kept away from sleeping infants and out of safe sleep environments

Supervision: Add State requirements if not listed Infants will spend limited time in car seats, swings, and bouncer/infant seats

when they are awake. When caregivers/teachers place infants in their crib for sleep, they should check

to ensure that the temperature in the room is comfortable for a lightly clothed adult, check the infants to ensure that they are comfortably clothed (not overheated or sweaty), and that bibs, necklaces, and garments with ties or hoods are removed (clothing sacks or other clothing designed for sleep can be used in lieu of blankets);

Infants should be directly observed by sight and sound at all times, including when they are going to sleep, are sleeping, or are in the process of waking up;

Bedding should be changed between children, and if mats are used, they should be cleaned between uses.

The lighting in the room must allow the caregiver/teacher to see each infant’s face, to view the color of the infant’s skin, and to check on the infant’s breathing and placement of the pacifier (if used).

A caregiver/teacher trained in safe sleep practices and approved to care for infants should be present in each room at all times where there is an infant. This caregiver/teacher should remain alert and should actively supervise sleeping infants in an ongoing manner. Also, the caregiver/teacher should check to ensure that the infant’s head remains uncovered and re-adjust clothing as needed.

Training: Add State requirements if not listed All staff, substitute staff, and volunteers at _______________will be trained on

safe sleep policies and practices every three years. Safe sleep practices will be reviewed with all staff, substitute staff, and volunteers

each year. In addition, training specific to these policies will be given before any individual is allowed to care for infants.

Documentation that staff, substitutes, and volunteers have read and understand these policies will be kept in each individuals file.

When The Policy Applies:This policy applies to all staff, substitute staff, parents, and volunteers when they place an infant to sleep at _________________________

Communication Plan for Staff and Parents:Parents will review this policy when they enroll their child at __________________and a copy will be provided in the parent handbook. Parents are asked to follow this same policy when the infant is at home. These policies will be posted in prominent places. Information regarding safe sleep practices, safe sleep environments, reducing the risk of SIDS in child care as well as other program health and safety practices will be shared if any changes are made. A copy will also be provided in the staff handbook.

Any individual who has questions may ask:Program Contact: Health Professional Contact: (if applicable)

Child’s Name _________________________ DOB: ____/_____/____

Signed by: _________________________________Director/Owner

_________________________________Health Professional/Consultant (if appropriate)

_________________________________Staff Member

_________________________________Parent

Date:Effective Date and Review:

This policy is effective _____/_____/_____ and will be reviewed annually by ____/_____/_____ or sooner if needed. Parents and staff will be notified of any upcoming policy review.

Communicable Disease

1.1: All Children have an immunization record on file

This will be visually checked off during a site visit

1.2: Each site should have a tracking system for child immunizations

This will be visually checked off during a site visit (audits)

1.3: Has a written policy on communicable disease management and procedures

The policy will be visually checked off during a site visit

Policy follows the guidelines and recommendations from Independence Health Department and Missouri Department of Health and Senior Services

An example policy is provided in this book

2.1: Director or designee are trained in immunizations and record keeping annually

The Health Department will hold a training at least once a year

2.2: Parent education on communicable diseases are displayed at pick-up/drop-off area

This will visually checked during site visit

Safety information can be obtained online at Center for Disease Control and Prevention, Missouri Department of Health and Senior Services, or you can contact the Independence Health Department

2.3: Hand-washing classes are provided to staff and children annually

Training log will be checked

The Independence Health Department provides a class for preschool age children

2.4: All staff have Flu vaccination (exemption: physician letter, sign declination)

Staff vaccination records will be checked

Example declination is provided in this book if center does not have one developed

3.1: Site is 100% compliant on IHD immunization initial audit

The Health Department will need to see sites copy of last audit

The IHD will send out an email before immunization audits with any changes/updates to immunizations

To help prepare for audits, sites should review records monthly or quarterly

3.2: Director or designee are trained in communicable disease annually and in turn will train staff upon hire

The training log will be checked for staff training

3.3: All staff that work with infants have Tdap vaccination (exemption: physician letter, signed declaration)

Staff vaccination records will be checked

Example declination is provided in this book if center does not have one developed

3.4: Site is a participating surveillance site

The Health Department will have record of participating sites

Participating sites is defined as sites that turn in disease report weekly

An example surveillance form is provided in this book

Independence Start Right Childcare ProgramCommunicable Disease Example Policy

___________________ daycare follows the guidelines and recommendations from Missouri Department of Health and Senior Services and the Independence Health Department with regards to disease control, hence there may be times when we are forced to send an ill child home, or not accept an ill child into the program.   Once the child is removed from the program, they will NOT be allowed to return until they meet the recommendations for that specific disease. ______________ daycare will follow the exclusion and re-entry guidelines listed in Prevention and Control of Communicable Diseases manual from the Department of Health and Senior Services. _______________ will follow the following guidelines.

Each child shall be observed for contagious diseases and for other signs of illness on arrival and throughout the day.

Each child’s parent(s) shall be notified immediately when any contagious disease occurs in the facility.

Unusual behavior shall be monitored closely and parent(s) shall be contacted if the behavior continues or if other symptoms develop. These behaviors include, but shall not be limited to:

1. Is cranky or less active than usual;2. Cries more than usual;3. Feels general discomfort or seems unwell; or4. Has loss of appetite.

The parent(s) or his/her designee shall be contacted when signs of illness are observed. Unless determined otherwise by the parent(s) or provider, a child with no more than one (1) of the following symptoms may remain in care:

o A child with a temperature of up to one hundred degrees Fahrenheit (100°F) by mouth or ninety-nine degrees Fahrenheit (99°F) under the arm;

o After an illness has been evaluated by a physician, medication has been prescribed and any period of contagion has passed as determined by a licensed physician;

o When it has been determined that a child has a common cold unless the director and the parent(s) agree that isolation precautions should be taken;

o When a child has vomited once with no further vomiting episodes, other symptoms, or both; or

o When a child has experienced loose stools only one (1) time with no further problems or symptoms.

If children exhibit any of the following symptoms, they must be sent home:

o Diarrhea—more than one (1) abnormally loose stool. If a child has one (1) loose stool, s/he shall be observed for additional loose stools or other symptoms;

o Severe coughing—if the child gets red or blue in the face or makes high-pitched croupy or whooping sounds after coughing;

o Difficult or rapid breathing (especially important in infants under six (6) months);

o Yellowish skin or eyes;o Pinkeye—tears, redness of eyelid lining, irritation, followed by swelling or

discharge of pus;o Unusual spots or rashes;o Sore throat or trouble swallowing;o An infected skin patch(es)—crusty, bright yellow, dry or gummy areas of

the skin;o Unusually dark, tea-colored urine;o Grey or white stool;o Fever over one hundred degreeso Fahrenheit (100°F) by mouth or ninety-nine degrees Fahrenheit (99°F)

under the arm;o Headache and stiff neck;o Vomiting more than once; ando Severe itching of the body or scalp, or scratching of the scalp. These may

be symptoms of lice or scabies. Parental contact and the decision made shall be recorded and filed in the child's

record. The ill child shall be kept isolated from the other children until the parent(s)

arrives. The caregiver shall be in close proximity to the child until the parent(s) arrives.

Close proximity means that a caregiver is close enough to hear any sounds a child might make that would indicate a need for assistance

Reporting: Policy complies with the state’s reporting requirements for children who are ill. All notifiable diseases should be reported to the Independence Health

Department at 816-325-7204 ________________ daycare will work with the Independence Health Department

on reporting, fact sheets, parent letter’s, etc

Training: All staff, substitute staff, and volunteers at _______________will be trained on

communicable disease management and practices. Practices will be reviewed with all staff, substitute staff, and volunteers each

year.

Documentation that staff, substitutes, and volunteers have read and understand these policies will be kept in each individuals file.

When The Policy Applies:This policy applies to all staff, substitute staff, parents, and volunteers at all times.

Communication Plan for Staff and Parents:Parents will review this policy when they enroll their child at __________________and a copy will be provided in the parent handbook. A copy will also be provided in the staff handbook.

Any individual who has questions may ask:Program Contact: Health Professional Contact: (if applicable)

Child’s Name _________________________ DOB: ____/_____/____

Signed by: _________________________________Director/Owner

_________________________________Health Professional/Consultant (if appropriate)

_________________________________Staff Member

_________________________________Parent

Date:Effective Date and Review:

This policy is effective _____/_____/_____ and will be reviewed annually by ____/_____/_____ or sooner if needed. Parents and staff will be notified of any upcoming policy review.

Declination of Influenza Vaccination

My employer and the Centers for Disease Control and Prevention (CDC), have recommended that I receive influenza vaccination in order to protect myself and the children I care for.

I acknowledge that I am aware of the following facts: Influenza is a serious respiratory disease that kills an average of 23,607 persons and

hospitalizes more than 200,000 persons in the United States each year. Influenza vaccination is recommended for me and all other childcare providers to

prevent influenza disease and its complications, including death. If I contract influenza, I will shed the virus for 24–48 hours before influenza symptoms

appear. My shedding the virus can spread influenza infection to children in this facility. If I become infected with influenza, even when my symptoms are mild, I can spread

severe illness to others. I understand that the strains of virus that cause influenza infection change almost every

year, which is why a different influenza vaccine is recommended each year. I cannot get influenza disease from the influenza vaccine. The consequences of my refusing to be vaccinated could endanger my health and the

health of those with whom I have contact, includingo children in this settingo my coworkerso my familyo my community

Despite these facts, I am choosing to decline influenza vaccination right now.I understand that I may change my mind at any time and accept influenza vaccination, if the vaccine is available.

Signature: ___________________________________Date: ___________________Name (print): _______________________________ Employer: ___________________

I decline vaccination for the following reason(s). Please check all that apply:__ I believe I will get the flu if I get the shot__ I don’t like needles__ I never get the flu__ My philosophical or religious beliefs prohibit vaccination__ I am concerned about side effects__ Other:___________________________________________________

Have you received information about influenza vaccine? (Please circle): Y N

If yes, please indicate where you received that information:________________________________________________________________________

Declination of Tdap (Tetanus, Diphtheria, and Pertussis)

My employer and the Centers for Disease Control and Prevention (CDC), have recommended that I receive the Tdap vaccination in order to protect myself and the children I care for.

I acknowledge that I am aware of the following facts: Tdap vaccination is recommended for me and all other childcare providers to

prevent pertussis and its complications, including death. If I contract pertussis, I can infect the children I care for by coughing or sneezing

while in close contact with others, who then breathe in the pertussis bacteria. Many infants who get pertussis are infected by parents, older siblings, or other

caregivers who might not even know they have the disease. The consequences of my refusing to be vaccinated could endanger my health

and the health of those with whom I have contact, includingo children in this settingo my coworkerso my familyo my community

Despite these facts, I am choosing to decline the Tdap vaccination right now.I understand that I may change my mind at any time and accept the Tdap vaccination, if the vaccine is available.

Signature: ___________________________________Date: ___________________

Name (print): _______________________________ Employer: ___________________

I decline vaccination for the following reason(s). Please check all that apply:__ I don’t like needles__ My philosophical or religious beliefs prohibit vaccination__ I am concerned about side effects__ Other:___________________________________________________

Have you received information about the Tdap vaccine? (Please circle): Y N

If yes, please indicate where you received that information:_____________________________________________________________________

Physical Activity

1.1: Daily Schedule of activities for all ages of children

Written document of daily activities will be checked during site visit1.2: Provides developmentally appropriate play experiences for all ages of children per day

Should be included into the daily activity document Included in this book is a reference sheet of age-appropriate activities

1.3: A total of at least one hour of outdoor play per day for children in attendance a full day

Should be included in written document of daily schedule, schedule will be checked during site visit

Outdoor play will be based on weather conditions Does not have to be one hour at one time but throughout the entire day child

should have one hour of outdoor play2.1: Have structured play for a minimum of 30 minutes a day

Should be included in written document of daily activities Structured play is considered “teacher-led” activities Structured play lesson plans will be checked during site visit

2.2: Provide supervised opportunities for infants (newborn-12 months) to practice new skills (tummy time, rolling over, sitting up, crawling) per day

Should be included in written document of daily activities for infants2.3: Director or designee is trained in physical activity every three years and in turn will train facility staff upon hire

The training log will be checked for staff training Director and staff will need to complete training every three years after initial

training Health department holds trainings yearly and/or can receive training from

another entity but will need to provide training certificate 3.1: Has a physical activity policy in place

Written policy will be checked during site visit

Example policies are provided in this book for site if it does not have a policy developed

Policy minimum requirements include model policies: 1, 2, 3, 6, 8,11 from “Model Policies for Creating a Healthy Nutrition and Physical Activity Environment in Child Care Settings” (included in this book) on page 31

3.2: No screen time for children under two and no more than one hour (daily) for children over two years old.

Should be included in physical activity policy Will review daily schedule for screen time

3.3: Has two hours of physical activity daily (1 hour structured, 1 hour free play), including outside play per day

Will review written document of daily activities Provide lesson plan for structured play activities

Socializing Healthy Habits in Young Children: Physical Activity

"Structured" Physical Activity and Movement Ideas (Birth to Age 5)

INFANTS

To encourage infants' reaching, holding, picking up, turning, and shaking objects:

o Provide safe, attractive, and age-appropriate toys such as hand, wrist, and ankle rattles, soft blocks, soft balls, floor mirrors, pop-up toys, mobiles, empty containers to put things in and to take out.

o Move attractive objects slowly back and forth in front of infants' faces; use an exaggerated face and voice to capture infants' attention and encourage them to reach for and grab the objects.

o Put safe, attractive objects in places that infants can get to by themselves, such as on low shelves and in small baskets.

o Play social games such as peek-a-boo and pat-a-cake.

To encourage infants' pushing up, rolling, sitting up, crawling, pulling up, standing up, and walking:

o Place infants in different positions: Hold them upright in your arms and support their heads so they can look around; place infants on a blanket on their backs, sides, and stomachs; sit infants at different angles in baby seats and bouncers. Be sure to change infants' positions often so that they use different muscles and see the world from many perspectives.

o Use a soft puppet to touch and label infants' body parts.

Kick Kick Kick: Lay babies on a soft surface, on their backs, and sit across from them. Hold a stuffed toy or some other soft object near babies’ feet and with your voice and facial expressions, encourage them to "kick kick kick" the object. Make sure that babies have the chance to use both of their feet. Also, use a toy that makes noise when kicked. This helps babies understand that their actions can cause things to happen.

Sitting and Reaching: Sit facing a sitting baby and hide an enticing toy behind your back. Using your right or left hand, pull the toy out from behind your back and encourage the baby to twist and reach for the toy. Repeat the activity and alternate hands so that the infant has to reach in both directions. Variations: with babies sitting up, encourage them to drop objects into short cans or baskets and to reach in and pull the objects out; with babies sitting up on a plastic sheet, help them learn about eye-hand coordination by pouring water or sand from one cup into another.

What’s Up There?: Place age-appropriate, safe toys on ottomans, coffee tables, or low benches and encourage babies to crawl over, pull themselves up, stand, and explore. Variations: Using safely secured

toy shelves, regularly rotate toys and encourage babies to explore what is on the shelves. With a soft stuffed toy, like a rabbit or frog, begin a game of chase, encouraging the baby to crawl after the toy. Bring the toy to eventually rest in a location (on a shelf, chair, or low table) that requires babies to pull up so they can retrieve it.

Other Ideas: Socializing Healthy Habits in Young Children: Physical Activity

TODDLERS

My Body: To help toddlers learn their body part names, engage them in simple games of "Head, Shoulders, Knees, and Toes". Start by having toddlers touch just 2 body parts (head, stomach) and as they become comfortable, add another body part (head, stomach, knees). Let children take turns and decide which body parts to touch.

Beanbag Drop: Set up stations of empty containers (paper lunch sacks or large coffee cans) and other containers holding items to drop into the empty ones. Encourage toddlers to stand and drop the items into the containers and then reach in and pull the items out. Variations: Painting with water outside (paint brushes and buckets of water); holding items up high and dropping them in / holding items down low and dropping them in.

Follow-the-Leader: Engage toddlers in simple games of follow-the-leader. For instance, have toddlers walk, jump, and tiptoe behind you. As toddlers acquire more traveling skills, add them into the activity, such as hopping and walking on their "tip toes". Variations: Add "standing still" activities: walk several steps, stop, and reach for the sky or touch the ground in front of you. Provide toddlers with musical instruments, such as wrist bells or shakers, and have a parade. Sing simple songs while walking or clap hands. Play "let's see, I'll be...." a tree moving in the wind, a kangaroo jumping, a squirrel scampering, a choo-choo train.

Balancing Act: Provide a chair for each child to hold onto. Encourage children to stand on one foot, using the chair for balance if they need it; try the other foot. Variations: Hold onto the chair with two hands, hold on with one hand, without hands.

Musical Chairs: Provide a chair for each child, with enough room for children to walk around their own chair without running into the other children. Play music and have children slowly walk around their own chair. Stop the music and tell children to sit down.

Dress-Up Relay: Gather enough hats and sunglasses for all children to have one of each; place hats and sunglasses in small piles (one for each child), spread out so that children can easily get to their own pile without running into another child. Identify a "starting point" across from the hats and sunglasses, such as a line of masking tape along the floor with cross marks for each child to stand on. When you say "go" or ring a bell, children run to their own pile, put the hat and sunglasses on, and run back to their spot. Recognize all children's abilities and participation and avoid competition. Variations: Use different articles of clothing (large t-shirts, baggy shorts).

Other Ideas: Socializing Healthy Habits in Young Children: Physical Activity

PRESCHOOLERS

Personal Space: Introduce the concept of personal space: the space immediately within the child's reach. Have children sit on carpet squares and draw an imaginary line around their bodies.

General Space: Introduce the concept of general space: all of the space in the learning environment that is not being occupied by another child. Have children stand in their personal space and point to all of the areas of the room that are not being occupied by other children. Have children hold a "hula-hoop" around their waist and move through the general space without interfering with another child's personal space.

Stretching and Curling Activities

Terrific Tunnels and Bridges: Have children sit in their personal space. Ask children to identify the objects that use bridges and tunnels. Have children move their bodies into shapes that resemble bridges and tunnels. Allow children to pair-up, with one child the vehicle and the other the bridge or tunnel. Encourage children to take turns.

Stand, Stretch, and Smile: Have children stand in their personal space and reach in all directions. Encourage children to stretch and push on the boundaries of their personal space. Variation: have children sit in their personal space and pretend to be a baby chick, hatching out of a shell.

I can stretch and/or curl my body like: With children sitting in a group, ask them to identify all of the ways that they can stretch and curl. Record their responses on chart paper to display and use for future stretching and curling activities.

Balance Activities

Body Balancing: Have children sit in their personal space. Encourage them to balance their bodies in different ways. For example, have them lie on their back and roll over onto their stomach; balance on one foot and move quickly to the other foot; stand and turn around twice and stay balanced. Variations: have children stretch and balance their bodies to look like objects in the room (a table, a chair, a rug)

Statuettes: Have children stand in their personal space. Introduce the ideas of statues and use your own body to show them what a statue might look like. Tell children that when you say "move", they can move through general space. When you call out "statues freeze", they will stop and freeze into a statue in their personal space. Variations: Call out different instructions such as "tall statues freeze", "happy statues freeze", "sleepy statues freeze".

Balancing Act: Create enough large squares (5 foot sides) on the floor with masking tape for each child to have his/her own side of the square (4 children per square). Have children stand on corners and practice walking to the opposite corner with a bean bag on his/her head.

I can use my body to make different shapes: With children sitting in a group, ask them to identify all of the ways that they can move their bodies to create different shapes (such as letters of the alphabet).

Record their responses on chart paper to display and use for future stretching and curling activities. Socializing Healthy Habits in Young Children: Physical Activity

Traveling Activities

"Walk my Way": Children are spread out in the classroom general space. Encourage children to slowly walk through general space, taking care not to run into anyone else, and: clap hands high up, clap in front of body, walk with hands very close to ground, taking giant steps, taking tiny steps, walk on heels. Variations: create pairs or small groups of children and have them play "follow the leader" and mimic the way their partner/leader is walking; take turns being the leader. This activity can also be done outside, with different kinds of traveling (running slowly, hopping, galloping, etc) that require more space.

"Dancing Ribbons": Children are standing in their personal space. Provide children with 2, 3-foot long pieces of colorful ½ inch ribbon, one ribbon for each hand. In personal space, have children move ribbon in different shapes (big circles around your head, wiggle ribbon along floor like a snake, spin around while holding ribbon, make letters in the air with ribbons. Variations: Play different kinds of music, such a popular or classical, and have children move their ribbons to the music. Have children take turns giving directions to the group. Incorporate the "freeze" concept: tell children that when the music stops playing, they need to freeze their bodies and ribbons.

I can move throughout general space by: With children sitting in a group, ask them to identify all of the ways that they can move throughout general space. Record their responses on chart paper to display and use for future stretching and curling activities.

Preschool Ideas adapted from:

National Association for Sport and Physical Education. (1993). Let's Move / Let's Play: Developmentally Appropriate Movement and Classroom Activities for Preschool Children.

Materials Compiled by:

Sara Gable, Ph.D.

University Outreach and Extension

Department of Human Development and Family Studies

University of Missouri, Columbia

306 Gentry Hall

Columbia, MO 65211

gables@missouri.edu

Independence Start Right Childcare ProgramSample Policy on Physical Activity

Birth through 11 months old:Following the American Academy of Pediatrics recommendations and to encourage

1. Optimal motor development, this program will plan engaging activities for Tummy Time with all infants at least 2-3 times per day while the child is awake. Our staff will respond promptly to cues for frustration, boredom or fatigue.

2. To promote lifelong physical activity, this program will provide planned daily physical activity that is safe, engaging and appropriate for each infant to safely support their physical development and health.

3. All infants and children will be provided outdoor time daily. Children will go outside when the temperatures are above ____º F (including wind chill factor) and below ___ºF.

4. To support infant development, swings, bouncy chairs and other confining equipment (except high chairs and strollers) will be used minimally in the infant classroom.

Children ages one year and older:

We at (name of center) are committed to our children’s health. We recognize the importance of staff as positive role models for children as they learn to live healthy lives. Therefore, we will:

1. Role-model positive behaviors by being physically active with the children, both indoors and outdoors.

2. Encourage all children to try new physical activities and respond positively when they do.

3. Share our own positive experiences with physical activity and facilitate conversations with the children about their experiences.

4. Provide at least 120 minutes of fun, engaging active playtime daily in our lesson plans.

5. Provide structured-play (teacher-led) and free-play daily for children.

6. Make safe equipment accessible in the classroom at all times (e.g. soft balls, push-pull toys, low carpeted blocks to climb on, etc.).

7. Not use physical activity as punishment.

8. Re-direct children to safe physical activities and/or involve them in discussions about what to do when safety issues or other concerns (e.g. mud, arguments over play equipment, etc.) arise.

9. All children will be provided at least two times or more a day of outdoor time. Children will go outside when the temperatures are above ___º F (including wind chill factor) and below ___ºF.

10.Screen time will not be permitted for children under two years old and no more than one hour daily for children two years and older.

When the policy applies:This policy is applicable at all times.

Communication plan for staff and parents:• ________________________ will cover policies, plans, and procedures with all new staff (paid and volunteer) during orientation training. They will sign that they have read, understand, and agree to abide by the content of the policies.

• During enrollment this policy will be reviewed by ________________________ with the parents. Parents will sign that they have read, understand, and agree to abide by the content of the policies.

• A copy of all policies will be available during all hours of operation to staff and parents in the policy handbook located _____________________________.

• Parents may receive a copy of the policy at any time upon request. A summary of this policy will be included in the parent handbook.

• Parents and staff will receive written notification of any updates.

Reviewed by: _________________________________Director/Owner

_________________________________Health Professional (physician, nurse, health department, EMS, Health consultant)

_________________________________Staff member

_________________________________ Other (parent, advisory committee, police, CPS)

Effective Date and Review Date:This policy is effective _____/_____/_____ and will be reviewed annually by ____/_____/_____ or sooner if needed. Parents and staff will be notified of any upcoming policy review.

Independence Start Right Childcare ProgramSample Policy on Physical Activity

Purpose: To provide clear guidance on physical activity in the childcare facility for staff and parents.

Scope: Childcare center

Background: When children are physically active on a daily basis, not only are they more effective learners, but they are less likely to be overweight or obese. Overweight and obese children have an increased risk of being overweight or obese as adults and are at high risk for developing immediate health problems such as type 2 diabetes, heart disease, high blood pressure, asthma, and sleep apnea. Children who are physically active early in life and stay active throughout childhood enjoy many positive benefits to their physical health, building strength, flexibility, endurance and developing and maintaining healthy bones. In addition, being physically active supports emotional health, reducing feelings of anxiety and depression, while promoting psychological well-being. It is important to provide a positive environment for physical activity by giving children of all ages daily opportunities to be physically active, surrounded by positive and responsive adult role models. (Nemours; Best Practices for Physical Activity: For Organizations Serving Children and Youth, A Guide To Help Children Grow Up Healthy)

Active Play & Inactive Time: (__insert facility name_) will provide for each child in our care:

At least 120 minutes of active playtime each day (for children enrolled full day) Children will participate in structured physical activities (teacher-led) two or more

times a day Children will participate in outdoor active play two or more times a day (weather

permitting) Television or videos are rarely or never shown in the facility

Play Environment: ( __insert facility name__) will provide for each child in our care: A wide variety of portable play equipment available for children to use at the

same time

Supporting Physical Activity: (__insert facility name__) will provide for each staff member in our facility:

Receive training on physical activity (not including playground safety) at least twice per year

Approved by:

_________________________ ___________________Director of (insert facility name) Date

Nutrition

1.1: Drinking water shall be available for children at all times

Will visually be checked during site visit

1.2: Site shall provide nourishing foods appropriate for child’s nutritional requirements as specified by his/her parent(s) written diet plan

Will visually check children’s diet plan filled out by parent Copy of diet plan included in this book

1.3: One serving of milk shall be served with each meal

Should be included in weekly menu Serving considered as ½ cup ages 1-2, ¾ cup ages 3-5, and 1 cup ages 6-12

2.1: Staff shall eat meals with children and be served the same foods

Will be visually checked during a site visit Staff should sit with children during meal time and eat the same foods served

to children

2.2: Provide education materials on breastfeeding and support for breastfeeding mothers to parents in the pick-up/drop-off area

This will visually checked during site visit Breastfeeding information can be obtained online at U.S. Department of

Health and Senior Services-Women’s Health (www.womenshealth.gov) or you can contact the Independence Health Department

2.3: Director or designee is trained in nutrition every three years and in turn will train facility staff upon hire

The training log will be checked for staff training Director and staff will need to complete training every three years after initial

training Health department holds trainings yearly and/or can receive training from

another entity but will need to provide training certificate

3.1: Site shall have a nutrition policy in place

Written policy will be checked during site visit An example policy is provided in this book for site if it does not have a policy

developed Policy minimum requirements include model policies: 1,2,3,7,8,10,11,13,17

from “Model Policies for Creating a Healthy Nutrition and Physical Activity Environment in Child Care Settings” (included in this book) on page 8

Policy should also include “no fried foods”, fresh fruits and vegetables at every meal

3.2: Site shall serve fresh fruits and vegetables at every meal

Should be included in weekly menu and nutrition policy Provide copy of weekly menu Will also be visually checked during a site visit

3.3: Facility shall provide only 100% fruit juice (limited amounts), water, or milk beverages

Should be included in weekly menu and nutrition policy Provide copy of weekly menu Will also be visually checked during a site visit Limited fruit juice is defined as no more than ½ cup or 4 oz per day

Independence Start Right Childcare ProgramSample Policy on Nutrition

Purpose: To provide clear guidance on nutrition in the childcare facility for staff and parents.

Scope: Childcare facility

Background: Overweight and obese children have an increased risk of being overweight or obese as adults and are at high risk for developing immediate health problems such as type 2 diabetes, heart disease, high blood pressure, asthma, and sleep apnea. Children who are given healthy food options during early childhood are more likely to continue healthy eating habits when they are older. You and your program play an important part in introducing your children to healthy food, by both providing nutritious food and teaching children how to make healthy food choices. By sharing information with families, you can work with them as partners to support healthy children. (Nemours; Best Practices for Healthy Eating: A Guide To Help Children Grow Up Healthy)

Beverages: (__insert facility name_) will provide for each child in our care: Drinking water is available at all times for self-serve, both indoors and outdoors 100% juice is offered no more than three times a week Only skim or 1% milk is served to children age 2 or older

Mealtime Environment: (__insert facility name_) will provide for each child in our care: Staff members allow children to decide how much to eat. Children are never

forced to eat or to try new foods Staff members encourage children to try new or less favorite food but never force

them to try new foods or to eat something they do not like Staff members join children at the table for meals and snacks Staff members consume the same food and drinks as children. Staff members

do not consume other foods or drinks in front of the children The center displays pictures or posters that support healthy eating

Nutrition Education: (__insert facility name__) will provide for each staff member in our facility:

Staff members receive training on nutrition (other than food safety and food program guidelines) at least twice per year

Approved by:

_________________________ ___________________Director of (insert facility name) Date

General Safety

1.1: All staff has read and reviewed a copy of the Licensing Rules for Group Day Care Homes & Child Day Care Centers in Missouri upon hire and as updated

Should be included in hiring orientation Written document with staff signature stating employee has read and

reviewed document

1.2: At least one caregiver per 20 children shall have current CPR & First Aid certification

Will check CPR/First Aid certification Copy of employees certification on file at site

1.3: Childcare provider shall have on file criminal background check on all staff

Should be included in hiring process A copy of background check is located in each personal staff file

2.1: All staff has CPR & First Aid certification

Will check CPR/First Aid certification Copy of employees certification on file at site

2.2: Parent education on CPR/First Aid is displayed at pick-up/drop-off area

This will visually checked during site visit CPR/First Aid information can be obtained online at Center for Disease

Control and Prevention, Missouri Department of Health and Senior Services, and American Heart Association, Safe Kids USA, or you can contact the Independence Health Department

2.3: Children at the facility participate in at least one IHD health promotion class per year

Will check the children’s training log sheet The Independence Health Department (IHD) provides five health promotion

classes for children free of charge.

Five classes offered include: poison prevention, handwashing, oral health, organ wise guys (physical activity), My Plate (nutrition)

Contact 325-7185 to schedule a class

2.4: Director or designee are trained in emergency facility safety recommendations (intruder safety)

Director will need to complete training every three years after initial training and train staff upon hire in procedures

The training log will be checked for staff training Can contact Independence Health Department on training resources

3.1: Facility has a call system in place for absent children

Written document stating procedures for when child has not shown up to daycare

Needs to include procedures for parents to call in when child not attending and for staff if child has not shown up and no parent phone call

3.2: Facility has a smoke-free indoor and outdoor campus policy in place

Policy will be checked off during site visit Example policy provided in this book Tips for successful implementation are included in this book

3.3: Has not had a critical violation from environmental public health division

Will review most current copy of sanitation inspection Critical violation is defined as a violation that relates directly to factors which

lead to foodborne illnesses and communicable disease prevention Copy of an inspection form included

Independence Start Right Childcare ProgramSample Policy on Smoke-free campus (outdoor)

I. PURPOSE

The purpose of this policy is to provide for and promote the health, safety and welfare for all persons who enter [Company]’s property.

Each year, approximately 440,000 people in the United States die prematurely of diseases caused by tobacco. The Surgeon General concluded that there is no risk-free level of tobacco smoke, including secondhand smoke and smoke residue.

Medical studies have shown that any exposure to tobacco smoke causes immediate damage to the body that can lead to serious illness or death. Evidence has also shown that the use of smokeless tobacco products, such as chewing tobacco, snuff and snus, also cause adverse health effects and can result in oral cancer, increased risk of heart attack, other cardiovascular disease and addiction.

Restricting tobacco use throughout a campus reduces these risks and promotes the health and well-being of members of the entire campus community. Because campuses are often highly visible within a community, adopting a strong tobacco-free policy educates the public, local government and organizations about the advisability of such a policy, and encourages them to adopt similar measures. A campus-wide policy can also help reduce youth initiation to tobacco use, through positive modeling behavior.

In addition to promoting public health, a campus-wide tobacco-free policy can be economically beneficial as well, especially if supported by an effective cessation policy. Benefits include reduced employee health care costs and absenteeism, increased employee productivity, as well as cost savings in areas such as grounds maintenance.

Therefore, this policy is designed to include all products that contain tobacco or that deliver nicotine in a manner that is not approved by the FDA for the treatment of nicotine addiction. Because there is no safe tobacco product, the only logical action is to promote a campus that is completely tobacco-free.

II. DEFINITIONS

For purposes of this policy, the terms set forth below shall have the following meanings:

“Tobacco product” means any product containing tobacco in any form. “Unapproved nicotine delivery product” means any product containing or

delivering nicotine intended or expected for human consumption that has not been approved or otherwise certified for sale by the United States Food and Drug Administration (FDA) as a tobacco use cessation product. This listing can be found at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm198176.htm

III. TOBACCO-FREE CAMPUS POLICY

The use and visual possession of tobacco and unapproved nicotine delivery products are prohibited on all property under the control of [Company] at all times, including, but not limited to:

Grounds Adjacent sidewalks Parking lots Buildings Company vehicles whether or not that vehicle is on [Company] property Private vehicles parked on [Company] property

This policy applies to all persons on [Company]’s campus, regardless of their purpose for being there.

[Job Title] will establish a procedure for informing parents, staff, visitors, contractors, etc. of the ban on the use and visual possession of tobacco products, unapproved nicotine delivery products and associated paraphernalia in, or on the grounds of [Company].

IV. EMPLOYEE TOBACCO-FREE WORKDAY POLICY

Employees are prohibited from using tobacco products and unapproved nicotine delivery products during their working hours, including breaks, whether on or off campus. Clothing worn during an employee’s shift must be free from the odor of tobacco.

V. POLICY EFFECTIVE DATE

This policy is effective as of [Month] [Day], [Year].

VI. POLICY CONTACT INFORMATION

For questions about this policy, contact: [Name, Title & Contact Information]

This policy is accepted by and for [Company]:

______________________________________________________________________

Name:

______________________________________________________________________

Date:

______________________

Successful Implementation

The following are suggested steps for successful implementation of this policy.

Staff members play an important role in modeling behavior and setting a good example for others in complying with the policy.

For this reason, the following are suggested:

Ongoing and clear communication about the rationale, components and enforcement of the tobacco-free environment policy.

Prominently placed signage that clearly explains the policy. Clear messaging that all staff members, regardless of classification or job status,

are expected to adhere to the policy. Thus, all staff members are prohibited from using or possessing prohibited products while working for or representing the company, either on site or at other business locations.

Low to no-cost cessation assistance for staff members who want to quit using tobacco.

Education on how to most effectively react to individuals found violating the policy.