This checklist is a quality improvement tool for home-based child care programs. Sharing the checklist results with families of children in child care is likely to help them appreciate what their child’s caregiver is doing to keep their children safe. They may want to use the checklist to see how to make their homes safer for their children. They may offer to help make the improvements the home-based child care facility needs. Reaffirmed 5-2019.

Children die in hot vehicles every year. Heatstroke begins when the core body temperature reaches about 104 degrees and the ability to maintain or control body temperature is overwhelmed. Vehicles heat up quickly – even with a window rolled down two inches. If the outside temperature is in the low 80°s Fahrenheit, the temperature inside a vehicle can reach deadly levels in only 10 minutes! Children’s bodies overheat easily, and infants and children under four years of age are among those at greatest risk for heat-related illness. When left in a hot vehicle, a young child’s body temperature may increase three to five times as fast an adult. High body temperatures can cause permanent injury or even death.

Warning signs of heatstroke include:

• Red, hot, and moist or dry skin
• No sweating, even though the child is warm
• Strong rapid pulse or slow weak pulse
• Throbbing headache
• Dizziness
• Nausea
• Confusion, or acting strangely

If a child exhibits any of these signs after being in a hot vehicle, call 911 or your local emergency number immediately! Cool the child rapidly. Spray the child with cool water - do NOT place child in an ice bath.

ALWAYS LOOK BEFORE YOU LOCK!

• Always check the back seat before you lock the vehicle and walk away.
• Get in the habit of always opening the back door to check the back seat before leaving a vehicle. Put something you will need like your cell phone, handbag, or briefcase, etc., in the back seat to create a reminder to open the back door to retrieve that item every time you park.
• Keep a large stuffed animal in the child’s car seat. When the child is placed in the car seat, put the stuffed animal in the front passenger seat as a visual reminder that the child is in the back seat.
• Distractions and/or a change in routine increase the risk of forgetting a child in a back seat. If someone else is driving your child, or your daily routine is altered, always check to make sure your child has arrived safely.
• Have a strict policy in place with the childcare provider about morning drop-off.
  • If your child will not be attending childcare as scheduled, the parent’s responsibility is to call and inform the childcare provider.
  • If the child does not show up as scheduled, and the child care provider did not receive a call, the childcare provider pledges to contact the parent immediately to ensure the safety of your child.
• Never leave a child alone in a car.
• Never let children play in an unattended vehicle. Teach children that a vehicle is not a play area.
• Never leave a child in a parked vehicle, even if the windows are partially open.
• Observe and Report: If you see a child alone in a car, call 911, especially on warm days!

Resource: National Highway Traffic Safety Administration

It’s unsafe and bad practice to leave a child unattended in a car for any reason, even for a quick stop – e.g. in a parking lot or elsewhere to pick up food from a restaurant. In PA, it is a summary offense as specified in PA Statute Title 75 3701.1 Leaving an unattended child in a motor vehicle.

For heatstroke prevention information cited above, click here. For other traffic injury prevention information, contact the PA Traffic Injury Prevention Project of the PA Chapter of the American Academy of Pediatrics (PA-TIPP) at 1-800-CARBELT, 484-446-3008 or see their website and resource page. Updated 5/31/2022

This workshop enables the user to learn how to assess health and safety practices in programs for infants and toddlers in conjunction with use of the ITERS assessment tool. Discuss feeding, diapering, sleeping, fostering early brain development, managing illness and more. Use the assessment to make improvements in the program. 

Follow the American Academy of Pediatrics policy about preventing sleep related deaths in group care settings. Standards 2.2.0.2, 3.1.4.1, and 3.1.4.2 of the updated, HTML version of Caring for Our Children, say what should be done. Many early childhood programs must change some common practices.

Steps to prevent injury in child care facilities. The approach is useful for all types of facilities, but will be especially helpful to providers who want to meet the PA STARS standards.In this article, you will find active links to checklists that staff, parents and older children can use to hunt for and correct hazards and risky practices.

Involving children with laundry tasks offers opportunities for interactive conversation and practice of some motor skills.  If you bring children into laundry areas, you’ll need to protect them from  hazards commonly found there.  Prevent child access to laundry detergents and other toxic products. Laundry machines can cause injury if children climb into them or hang on doors.

This workshop draws on the curriculum published  by the American Academy of Pediatrics to teach how to manage the risks involved in giving medication in group care settings using the 5 Rights: the right child receives the right medication in the right dose, by the right method at the right time.  Participants practice skills and discuss scenarios to identify gaps in practice.  Key elements that should be in documentation of medication, policies and procedures are reviewed. Demonstrations and discussions include tips for giving a variety of different types of medication: liquids and pills, eye, ear, nose, topical medications such as diaper cream and sunscreen, inhalers and emergency medicines.

Many children's medicines come in liquid form. Household spoons may be handy for giving children liquid medicines, but using them is not a good way to give the correct dose. Parents and educators should use a syringe, special medicine cup, special dosing spoon or dropper. These devices are marked in milliliters (mL).

Different household teaspoons hold different amounts of liquids. Tablespoons vary in size too. A spoon that gives too little medicine may keep the medicine from working. If a spoon gives too much medicine, the overdose may cause a serious problem. For example, repeatedly giving a child too much acetaminophen (Tylenol)can lead to liver failure. More than 70,000 children go to emergency rooms each year for accidental medicine overdoses. Use of the wrong measuring device causes some of these. Many liquid medicines come with a special dose measuring device calibrated to accurately measure the particular medication. Be sure to use it. If there is no device with the medication, a pharmacist can provide one. If a syringe is used, squirt the medication slowly and gently between the child's tongue and the side of the mouth. This makes it easier for the child to swallow the medicine.

The American Academy of Pediatrics urges parents, physicians and pharmacists to use only metric measurements for oral liquid medications. Metric measurements for liquids in milliliters (ml) or cubic centimeters (cc) should be on prescriptions, medication labels, and dosing devices. This helps children get the correct dose of medication. Do not measure liquid medication in teaspoons or tablespoons.

Please share this information with teachers/caregivers and families. Download and display the new poster in English and in Spanish. Copy and distribute the updated article - also available in both English and Spanish. To access the article in in Spanish, click on "en Espanol" on the page. On the same page, you can listen to the article read to you in English or Spanish.

Families and early childhood educators need to understand how much medicine to give. They should know how often and how long to give it. If they are uncertain about the instructions, they should not give the medication until they have asked the child's health care provider about how to do it. Use the forms in the Medication Administration Packet, Appendix X in Model Child Care Health Policies, 5th edition. This publication is available at www.ecels-healthychildcarepa.org.

Health professionals recommend keeping medicine out of children's reach. Use child safety caps, understanding that these are not "child-proof". They make it harder for the child to open the medicine, giving adults more time to stop the child from getting the medicine. Check labels carefully before giving two medicines together because they may have the same ingredient. Do not mix medicine with food unless the instructions on the medicine say to do so. Also, urge families to bring a list of all medicines the child is taking each time the child sees a health professional.

For medicine mistakes, call the Poison Help number at 800-222-1222. If the child is unconscious, not breathing or having seizures, call 911 first. Be careful when getting rid of unused medicines. In some places, you can drop off medicines at a police department. Make sure to remove labels with personal details. Another way to safely dispose of medicines is to mix them with coffee grounds or kitty litter in a plastic bag you can seal. Throw this sealed bag away in a trash container where children and animals can't get to it. Don't dump the medicine in the toilet or drain, unless the medicine label says it is safe to do it. If you aren't sure how to dispose of a medicine, ask a pharmacist about what to do.

Contributed by Nancy Alleman, ECELS Lead Training and Technical Assistance Coordinator, in collaboration with Ian M. Paul, M.D., M.Sc., FAAP, a member of the American Academy of Pediatrics Committee on Drugs.

The PA Chapter of the American Academy of Pediatrics and the American Academy of Pediatrics published the 5th edition of Model Child Care Health Policies in October 2013. Significantly revised and updated, the new edition is a practical tool for adoption and implementation of best practices for health and safety in group care settings for young children. This edition replaces the previously published version and updates of individual policies that were posted on the ECELS website. ECELS encourages early education and child care professionals to adapt the model policies as site-specific documents that fit their programs. Two formats are available: one replicates the hard copy publication. The other format, posted 12-12-2014, has form fields that allow users to insert their site-specific details directly into the PDF document.

The National Center on Health offers visually attractive, simply stated resources for infant, toddler and preschool care. Anyone can down-load the electronic copies from the Internet. Head Start programs can order hard copy from the National Center at This email address is being protected from spambots. You need JavaScript enabled to view it.. These materials have excellent content for teachers/caregivers to use in their programs and to share with families:

Growing Healthy Flipcharts http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/healthy-active-living/HAL_Resources/NCHEnglishFlipChartF011514_7-7final508.pdf

Take a look at the National Center’s Health Tips (Fact Sheets) for Families* (and teachers): Download an individual one page fact sheets when you need a handout on one of the topics or download the complete series in English [PDF, 1.2MB] and Spanish (español) [PDF, 309KB]* The following topic are available as handouts:

Active Play includes tips to help infants, toddlers and preschoolers develop positive active play behaviors.

Health Literacy provides information about how to understand and use health information that doctors and other health professionals give.

Healthy Breathing provides information about eliminating first-hand, second-hand and third-hand exposure to tobacco smoke.

Healthy Eating offers easy tips to help infants, toddlers and preschool-age children learn healthy eating.

Mental Health provides information about how to help infants, toddlers and preschoolers develop positive mental health behaviors.

Oral Health offers tips to promote oral health in infancy through preschool age.

Safety and Injury Prevention: Tips for Families (2 pages) provides easy tips families can use to ensure their children's health and safety at home, outside, in the water, and in a car or truck.

Dealing with Stress is a 4 page guide with simply stated, clear tips to help cope with stress in a healthy way.

*http://eclkc.ohs.acf.hhs.gov/hslc/tta-system/health/health-literacy-family-engagement/family-education/tipsheetfamily.htm

Click here to learn how HPPS fosters supervision, age-appropriate design, maintenance and inspections of playgrounds to prevent injuries and promote childhood development. 12/2012

As of the end of February 2013, all play yards sold in the United States must meet the new and improved federal safety standard to prevent injuries and deaths of children. All child care providers who care for infants and toddlers and new parents, should be aware that newer is better when it comes to the safety of play yards. The new federal standard addresses hazards associated with play yard side rails, corner brackets, and mattress attachments. These changes are meant to prevent strangulation, entrapment, lacerations, and other injuries. New tests add to existing requirements that include a stability test to prevent the play yard from tipping over, latch and lock mechanisms to keep the play yard from folding on a child when it is being used, and minimum side height requirements to  prevent children from getting out of the play yard on their own. The U.S. Consumer Product Safety Commission has a poster that summarizes the new standard and is available in English (PDF). The poster also has Safe Sleep tips to help keep baby safe in his or her sleep environment. Be sure to post this free resource wherever parents and care givers might see it. Reviewed and reaffirmed 7/2021

Poison control centers are available 24 hours a day, 7 days a week. Their staff respond to poisoning emergencies and information calls from the public and from healthcare providers. They educate parents and caregivers of children about prevention. The risk of poisoning is highest among children less than 2 years of age.  Most poisonings happen when adults are busy and not paying close attention to an exploring child. Children like to taste even things that smell bad.

Safe Kids USA is a nationwide network of organizations with a mission to prevent unintentional childhood injury, the leading cause of death and disability for children ages 1 to 14. State and local chapters educate families, professionals who work with children, and provide safety devices to families in need and advocate for better laws to help keep children safe, healthy and out of the emergency room. 12/2012

Materials and links to reliable informaton about preventing sleep-related deaths of infants are available on the website of the  National Institute of Child health and Human Development. For more information go to http://www.nichd.nih.gov/sids/

The federally-funded Healthy Child Care America national resource center at the American Academy of Pediatrics developed a FREE online educational training program for child care providers. To learn more about this program or to take the training for 1 hour of continuing education credit, go to http://www.healthychildcare.org/sids.htm. Reviewed and reaffirmed 3/2018.