Domains of Health and Safety Quality in ECE
| Domains of Health/ Safety in ECE | Specific Areas of Health Safety in ECE |
| Immunization | Staff |
| Children | |
| Infection control | Hand washing with soap and running water after diapering, before handling food, and when contaminated by body fluids |
| Children wash hands after toileting and before eating | |
| Routinely cleaned facilities, toys, and equipment | |
| Nutrition | Safe food storage |
| Sanitary food preparation | |
| Healthy meals and snacks | |
| Monitoring choking hazards | |
| Environment | Clean air |
| Integrated pest control | |
| Smoke-free environments | |
| Oral health | Teeth brushing |
| Physical activity | Active play |
| Limited screen time | |
| Staff ratios and supervision | Small group sizes |
| High staff-to-child ratiosa | |
| Staff qualifications | Consistent caregiving |
| College degrees in ECE | |
| Child development associate’s credential | |
| Ongoing in-service training | |
| Low turnover rate | |
| Strong background checks | |
| Policies for children with special health care needs | Medication administration |
| Child care health consultation | |
| Care plans completed at the medical home | |
| Emergency procedures | Cardiopulmonary resuscitation and first aid training |
| Written policies | |
| Disaster planning procedures | |
| All staff and children familiar with procedures | |
| Up-to-date parent contact lists | |
| Injury prevention | Play equipment safe, including proper shock-absorbing materials under climbing toys |
| Safe sleep practices (especially for infants) | |
| Developmentally appropriate toys and equipment | |
| Toxins out of reach | |
| Safe administration of medicines | |
| Child abuse prevention training | |
| Policies on discipline and restraint | |
| Sunscreen and insect repellent use policies | |
| Water play safety | |
| Facility safety (fire and carbon monoxide detectors, etc) |
| Domains of Health/ Safety in ECE | Specific Areas of Health Safety in ECE |
| Immunization | Staff |
| Children | |
| Infection control | Hand washing with soap and running water after diapering, before handling food, and when contaminated by body fluids |
| Children wash hands after toileting and before eating | |
| Routinely cleaned facilities, toys, and equipment | |
| Nutrition | Safe food storage |
| Sanitary food preparation | |
| Healthy meals and snacks | |
| Monitoring choking hazards | |
| Environment | Clean air |
| Integrated pest control | |
| Smoke-free environments | |
| Oral health | Teeth brushing |
| Physical activity | Active play |
| Limited screen time | |
| Staff ratios and supervision | Small group sizes |
| High staff-to-child ratiosa | |
| Staff qualifications | Consistent caregiving |
| College degrees in ECE | |
| Child development associate’s credential | |
| Ongoing in-service training | |
| Low turnover rate | |
| Strong background checks | |
| Policies for children with special health care needs | Medication administration |
| Child care health consultation | |
| Care plans completed at the medical home | |
| Emergency procedures | Cardiopulmonary resuscitation and first aid training |
| Written policies | |
| Disaster planning procedures | |
| All staff and children familiar with procedures | |
| Up-to-date parent contact lists | |
| Injury prevention | Play equipment safe, including proper shock-absorbing materials under climbing toys |
| Safe sleep practices (especially for infants) | |
| Developmentally appropriate toys and equipment | |
| Toxins out of reach | |
| Safe administration of medicines | |
| Child abuse prevention training | |
| Policies on discipline and restraint | |
| Sunscreen and insect repellent use policies | |
| Water play safety | |
| Facility safety (fire and carbon monoxide detectors, etc) |
Adapted from Stepping Stones20
There are different staff-to-child ratios for small-family homes, large-family homes, and centers. Ratios are also based on the ages of the children. Specific staff-to-child ratios are described in standard (1.1.1.2).21