These forms explain the process and documentation needed to enroll a child with special needs. The Process to Support Enrollment of a Child with a Special Need form is an algorithm or map that describes the steps to follow to obtain and use a care plan. The Care Plan is a form to gather key information to provide care for children with special health needs.The majority of early learning practitioners enroll children with special health needs. The form collects the essential information. It includes how to care for a child's daily needs and to handle an emergency. Early learning practitioners should arrange for parents and health professionals to complete the form when the child is first considered for enrollment and anytime a new medical condition develops. Download all three forms in the links below. Reviewed reaffirmed 5/2019

This workshop teaches early learning practitioners how to recognize and manage occupational health risks, drawing on the content in Caring for Our Children: the National Health and Safety Performance Standards. Addresses management of stress, infectious disease risks and musculo-skeletal (ergonomic) challenges intrinsic to providing child care. Includes assessment of personal and work-site health promotion strategies.

The CDC is a comprehensive source of information on public health issues, including immunization, sanitation, and infectious disease. The CDC provides a large library of information to the public on many topics. Some of the categories include: Diseases and Conditions; Emergency Preparedness & Response; Environmental Health; Life Stages & Populations; Healthy Living, Injury, Violence & Safety; Traveler's Health; Workplace Safety & Health. The CDC website includes a powerful search engine as well as alphabetical listings. Users will find fact sheets, videos, photos, posters, and other useful materials to download.

When children have toileting accidents in child care, staff must follow procedures that are appropriate for the child and limit the spread of germs. See Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs Standard 3.2.1.5: Procedure for Changing Children's Soiled Underwear, Disposable Training Pants and Clothing at http://nrckids.org/CFOC or available at https://shop.aap.org. In PA, please send your health and safety request with your name and phone number to This email address is being protected from spambots. You need JavaScript enabled to view it..

This  online self-learning module uses an interactive format with embedded video, case studies, and questions for the user to answer. Learn key strategies for inclusion of children with special needs.  Download the Document Packet, Resource List and Quick Reference Sheets from Managing Chronic Health Needs in Child Care and Schools - A Quick Reference Guide, 2nd Edition.. To open the module online, CLICK SLM Online-Children with Special Needs.  Make sure your computer has a current version of Adobe Flash Player.  Adobe Flash is integrated in Internet Explorer on Windows 10. Download updates of the software for free here. PA early care and education (ECE) providers may submit completed work for review for credit by completing an electronic response form from the link in the Document Packet, by scanning the Response Sheet and Registration Form and attaching them to an e-mail, or by sending them by fax or by surface mail to ECELS. Be sure to follow the instructions in the “Important Reminders” box next to the list of self-learning modules. To have ECELS review your work for state-authorized training credit, select the button that says "Click Here to Order SLM Reviews." Follow the instructions and pay for the review of your work. (ECERS-R, ITERS-R Program Structure, Personal Care Routines. K7-C2-84.) Updated 6/2019.

This extensive list of weblinks, print resources and supports includes both national and Pennsylvania credentialled sources of information. It is intended for early educators, parents and health professionals who are caring for children with chronic physical, behavioral and developmental challenges.  Updated 6/2018

This fact sheet contains general information about diabetes in children for teachers/caregivers of children attending early education and before and after school child care programs.See Managing Chronic Health Needs in Child Care and Schools, 2nd Edition available from the bookstore of the American Academy of Pediatrics at https://shop.aap.org or search www.healthychildren.org for more information. In PA, please send your health and safety request with your name and phone number to This email address is being protected from spambots. You need JavaScript enabled to view it.Updated 6/2018.

Caring for a child with diabetes can be a challenge. Families and early care and education staff need to know what to do. Diabetes affects 7% of the population. About one in 500 children has diabetes. Children with diabetes do not make enough insulin. The body needs insulin to use sugar in food for energy and growth. Insulin is a hormone that must be produced naturally by cells in the pancreas or be given as a medicine at proper times and in the right amounts.

Infants and toddlers in diapers often get rashes-everything from tiny red bumps to more irritated tender areas.

Why do babies get rashes? One or more conditions can cause a diaper rash. The enzymes that help digest food can be irritating when they come out with feces (poop) into the diaper. Wet diapers can cause irritation where they are in contact with the skin. This is more likely to occur where the diaper rubs the creases of the upper thighs. Yeast growing in the warm, wet diaper areas can be another cause of diaper rash.

Some tips to help prevent diaper rashes are:

Change diapers often. Changing a diaper before it gets very wet and as soon after a child has a bowel movement helps. Prolonged contact of the skin with moisture from pee and/or feces irritates the skin.

Avoid irritating soaps and wipes. Use unscented and alcohol-free diaper wipes or just water rather than other skin cleaning products. Scented soaps and wipes that have alcohol in them can irritate a baby's bottom. The ingredients in many soaps remove the skin's natural oils. Without these normal oils on the skin, skin irritation is more likely.

If the diaper area is red and irritated, clean the skin by patting it with a diaper wipe, with cotton balls soaked in warm water or with freshly laundered, well-rinsed, soft, washcloths wet with water. Avoid rubbing the skin. Always use a fresh wipe, or different wet wash cloth each time you swipe. Once soiled, store reusable cloths in a washable, plastic-lined, tightly covered receptacle until they can be laundered.

Consider use of a barrier product . Ask the family to discuss with the child's health care professional the use of a barrier product if an infant has ongoing difficulty with diaper rash. Barrier diaper creams or ointments can help protect the skin from irritation caused by rubbing on the moist and/or soiled surface of a diaper. They are over-the-counter products that contain petroleum or zinc oxide. If the child has had a problem with diaper rash that requires use of a barrier medication, the program should have instructions from the child's health care provider and permission from the child's parent to use it. The product's container should have the child's name and instructions for use too. Put 2 or 3 tablespoons of the barrier cream on a facial tissue and bring it that way to the diaper changing surface. (Do not bring any of the containers of supplies to the diapering surface. Everything on the diapering surface will need to be disinfected after the diaper change.)

Apply the barrier in a thick layer, spreading it gently and smoothly across the diaper area. Be sure to cover the creases of the upper thighs under the edge of the diaper. When cleaning the child, remove only the soiled barrier product. Rubbing to remove the unsoiled lower layer of barrier product will irritate the skin.

The recommended medication administration and diaper changing procedures are in Caring for Our Children, (CFOC3) Standards 3.6.3.1 and 3.6.3.2 for medication administration and Standard 3.2.1.4 for the diaper changing procedure. Access these standards at www.nrckids.org.

Follow the instructions from the child's health care provider and the CFOC3 recommended procedures when using any diaper cream. Some diaper creams contain active ingredients that are not for prolonged use. Documentation of the product applications can be as simple as having a check mark in a diaper cream column on a diaper change log sheet. Note the date and time of the diaper changes there. This lets families know about the frequency of diaper changes and use of recommended medication.

If a diaper rash is bleeding, seems very sore to the child, or lasts more than a few days, be sure to seek guidance from the child's health care provider and check the procedures being used by anyone who is changing the child's diaper.

Contributed by Sarah Macdonald, MD, FAAP, CHOP Care Network High Point

The attached ECELS Health and Safety Checklist includes references. It was updated December 2011 as Version 1.4. This tool guides the user to the appropriate national health and safety standard(s) and other related references for each item. Each item is cross-referenced with corresponding topics from: Caring for Our Children:  National Health and Safety Performance Standards, 3rd Edition, 2011 (CFOC) , the Environmental Rating Scales (ITERS-R, Infant/Toddler Environment Rating Scale - Revised Edition; ECERS-R, Early Childhood Environment Rating Scale - Revised Edition); and the Pennsylvania Child Care Facility Licensing Regulations. Reviewed and reaffirmed 6/2018.