Being a child care provider means more than loving children. It means providing a safe environment for and protecting the children in your care so they can explore their world and develop trust.
According to estimates, more than 91 percent of all child care services in the United States are in private homes. Accidents that take place in and around the home are the leading killers of children, taking about 8,000 lives each year.
Home accidents claim more children’s lives than the five leading fatal diseases combined. Not only are accidents the largest single cause of death in children under 15 years of age, but they also are the leading cause of disability, permanent or temporary, in children more than 1 year of age.
Each year in the US, 12 to 14 million children (or one in four) under 15 years of age need medical attention because of accidental injury.
Medical, safety, and health professionals agree that we can prevent most childhood accidental deaths and disabilities. Home accidents usually occur through the child’s curiosity about the environment and inattention from parents and child care providers.
By taking simple precautions and following basic safety rules, we can avoid most “accidental” injuries. Don’t tempt children by leaving dangerous objects around for them to play with, feel, or taste. Never leave a child alone in the house. Keep all nooks and crannies free of hazards.
Children are imitators and will do things they see you doing. Show them how to do things safely.
|Common causes of accidental child injuries and deaths
For children 1 to 4 years of age, home falls are the leading cause of accidental death and serious injury.
To prevent falls
Because infants differ in temperament and activity, never leave babies unattended on anything from which they might fall. Turning your back even for a moment to get a bottle or diaper can be risky. During the “creeper” stage, the baby’s curiosity is developing. Babies quickly learn to pull themselves up, while pulling down everything else.
Teach children not to run in the house, and have them pick up their toys to avoid dangerous obstacles.
Use the following room-by-room checklist to evaluate the safety of your child care home. Identify areas and items to improve.
These are basic recommendations for a child-safe environment. For specific safety regulations, check with local or state regulatory agencies such as the health department, social services, or fire marshal. Regulations vary for child care homes and centers and also from area to area.
Kitchen and dining areas
___ Look through all cabinets within children’s reach and remove any breakable dishes and sharp items. Leave only plastic containers, paper goods, wooden spoons, and metal pots and pans that children can play with to their hearts’ content. (Or put a childproof lock on all child-height cabinets.)
___ Remove all dishwashing soap, cleansing powder, drain cleaner, laundry detergent, bleach, paint, turpentine, bug spray, and similar products from under the sink. Store them out of children’s reach. (About 40 percent of accidental poisonings occur in the kitchen.)
___ Check cleaning product containers for original or proper labeling. Store cleaning products so they do not contaminate any food source or play area.
___ Lock the door to the water heater and any kitchen closets containing dangerous supplies. ___ Place knives, ice picks, meat-turning forks, and other sharp utensils in top cabinets.
___ Eliminate the risk of children scalding themselves by setting the water heater temperature at 100 to 120°F. (Laundering, cleaning, and dishwashing may require higher water temperatures.)
___ Unplug toasters, coffee makers, and other electrical equipment when not in use and store them out of reach.
___ Cover electrical outlets or install safety plugs to keep children from trying to stick things into them.
___ Always keep matches out of children’s sight and reach.
___ Keep hard surface floors from getting slippery by wiping up spills promptly.
___ Make sure chairs and high chairs are sturdy and not easily overturned. Place toddlers in high chairs with a strap or harness.
___ Install a smoke detector close to the kitchen (but not so close that it will go off every time you cook). Do a safety check every month.
___ Install a smoke detector (or detectors) between the children’s area and the kitchen. Do a monthly safety check.
___ Keep a fire extinguisher in the kitchen (such as a 2.5-pound “BC” dry chemical type), and learn how to operate it. (Be sure you or a staff member is trained to operate the extinguisher.) Have it checked and serviced once a year. Ask about regulations in your area.
___ Cover trash containers.
___ Turn handles of pots and pans on the stove to the back of the stove.
___ Make sure adults and children wash their hands when preparing food, before and after meals, and after toileting or diapering.
___ Inspect and remove eating utensils with chips or cracks.
___ Lock medicine cabinets, or place medicine, razors, and glass bottles well out of reach of climbing, curious children.
___ Check under the sink and remove cleanser, shampoo, lotion, toilet bowl cleaner, alcohol, and similar products. Put a childproof lock on the cabinet door. (About 20 percent of accidental poisonings occur in the bathroom.)
___ Remove the door lock so children cannot lock themselves in the bathroom.
___ Adjust the water heater (100 to 120°F) to keep children from scalding themselves while washing their hands, or use scald-prevention devices.
___ Check wastebaskets for hazards. Empty old medicines safely and rinse containers before disposing. Put used razor blades in a solid container (made of metal or heavy plastic or cardboard) and place them outside in the garbage.
___ Unplug appliances such as shavers and hair dryers when not in use. Place out of children’s reach. ___ Place diapering area next to a water source. Use a container with a tight lid for soiled diapers. Living room or indoor play area
___ Remove furniture with sharp corners or that overturns easily.
___ Push the TV set against the wall so children can’t get to the cord or to the back of the set.
___ Move cords from lamps, radios, and other electrical appliances so they do not lie where people walk or children can reach.
___ Remove all extension cords used as permanent wiring.
___ Place ashtrays, lamps, knick-knacks and other breakables out of children’s reach. Check for tablecloths that children may pull off and house plants that they may overturn.
___ Do not smoke around children. Remove all tobacco products, lighters, matches, and smoking
accessories. Tobacco is toxic when eaten by a toddler (for example, butts from an ashtray). Research shows that secondhand smoke may increase childhood respiratory illness.
___ Install safety gates across stairs. (Use sturdy, straight-edge gates. Children can get their necks caught in the expandable type with V-shaped openings at the top.)
___ Keep stairways free of toys or other objects. Do not use scatter rugs at the top or bottom landing. Make sure railings are strong.
___ Avoid using infant walkers around stairways.
___ Place a high latch on doors leading to rooms you don’t want children to use, or to any outdoor area not protected by a fence. Never block fire exits.
___ Install fireplaces and woodstoves in accordance with codes, and use a protective screen to prevent children from getting too close. Do not use portable unvented fuel-fired heating systems.
___ Install a protective shield over radiators and heater vents if they are too hot.
___ Mount electric fans where children cannot reach them. Inspect the protective fan-blade enclosure to be sure children cannot reach the blades.
___ Remove any peeling paint and repaint with lead-free paint. (If children eat paint that contains lead, they may be poisoned. Consult the health department if you suspect the peeling paint is lead-based. You may need professional help to remove or encapsulate it with a protective layer.)
___ Repair any loose nails and splinters in wooden floors and loose threads in carpet. ___ Remove scatter rugs or use non-skid ones to prevent falls.
___ Mark glass doors and low windows with posters, colored tape, or decals to prevent children from running into them.
Bedroom or sleeping area
___ Use cribs or beds with secure sides to keep infants and toddlers from crawling or rolling out onto the floor. Make sure a child in the crib cannot reach or easily release the side lock, and that all edges and bolts are smooth.
___ Measure crib slats. If there is more than 2 3/8 inches between slats, a baby’s head can become wedged between them.
___ Make sure crib mattresses fit snugly and tie bumper pads securely so the baby’s head cannot get caught between them and the crib frame.
___ Remove soft pillows, floppy toys, or loose-fitting plastic sheeting from cribs and playpens to prevent suffocation.
___ Place cribs away from windows unless the windows have guards or sturdy screens.
___ Have separate sheets and blankets for each child, especially if the children use the same beds as your family members.
___ Place vitamins, medicines, cosmetics, perfume, shoe polish, and similar products out of children’s reach.
___ Tie used plastic clothes’ bags into knots and throw them away.
___ Install smoke detectors near the children’s sleeping areas. Do a monthly safety check. Ask about local fire codes.
___ Plan and implement monthly fire drills with children and staff. Specify an outside meeting place to account for all children. Teach children to “stop, drop, and roll” in case of clothing fires.
Toys and learning materials
___ Choose toys that are easy to wash and keep clean. Wash infant and toddler toys daily. Try to give each infant and toddler separate crib toys that another child will not use the same day. Keep a bin handy for soiled toys.
___ Choose fabric toys labeled flame-retardant or non-flammable.
___ Check stuffed toys to be sure eyes and other parts are secure. Fasten squeakers in place. Wash fabric- stuffed toys regularly.
___ Remove any toys with sharp points or rough edges. Some plastic toys become brittle with age. ___ Make sure toys are sturdy so they won’t splinter or break with normal use.
___ Give infants and toddlers only toys too large to swallow. If you are caring for infants do not use any toys or objects with a diameter of less than 1 1/4 inch or with removable parts that have a diameter of less than 1 1/4 inch.
___ Keep plastic bags, tissue, and Styrofoam objects away from young children.
___ Read the labels on crayons, paints, clay, and other materials. Check to be sure they are not poisonous.
___ Store toys and learning materials on low shelves where children can reach them. Place heavy toys near the floor.
___ Keep toys used by older children out of reach of younger children.
___ Avoid toys with electrical parts unless children are school-age and know how to handle them safely. Check toys with batteries to be sure they have tight lids on battery compartments. Use only UL listed or other approved devices.
___ Do not let children play with shooting toys such as BB guns and darts or anything that explodes.
Outdoor play area
___ Have a fenced area outdoors where children may play daily. Check the fence for wires that stick out or loose nails. If you have no fence, walk the children around the boundary to show them where they may play. Check with local and state authorities about fencing regulations for child care homes or facilities.
___ Put away lawn mowers, fertilizers, and gardening tools.
___ Enclose the air-conditioning unit, water well, access to surface water, and electrical and mechanical equipment.
___ Remove doors on old refrigerators and freezers. Children like to hide in these and may suffocate.
___ Remove poisonous indoor and outdoor plants, such as oleander, azaleas, castor beans, dieffenbachia, philodendron, caladium, and some ivies. Contact a horticulturist or poison control center for more information.
___ Shift car gears to park and set the emergency brake if you have to keep a vehicle in the yard. Close the windows, lock the doors, and keep the keys in the house out of children’s reach.
___ Make sure the yard is free of rusty nails, broken glass, and similar objects.
___ Make sure all swings and other play equipment are sturdy and firmly anchored to the ground. The best equipment is simple and adaptable to many uses.
___ Check porches, railings, and steps for splinters, loose nails, and slippery surfaces. ___ Mark glass doors with decals or tape at children’s eye level.
___ If your home or child care facility is near a swimming pool, creek, pond, irrigation canal, or other body of water make sure children cannot wander off to it by themselves and fall in. Enclose swimming pools with a fence at least 4-6 feet high and always lock gates. Check local and state regulations.
___ If you use a wading or splashing pool, drain and clean it after each use. Store the pool where children cannot reach it. Use a pool that is no more than one foot deep. Always watch children when they are using a wading pool because they can drown in just a little water.
___ Check tricycles for sharp edges and missing parts. Tricycles with seats close to the ground generally are safer.
___ Keep grass or sand beneath swings and slides. Check swings and slides to make sure they have smooth edges, no broken or missing parts, and are well anchored.
___ Check all play equipment weekly for loose bolts and screws.
Car safety checklist
___ Consult your highway safety office for state regulations. The number one killer of children, 1 to 5 years of age, is auto accidents.
___ Get written approval from parents or guardians to transport their children. Consult your attorney or insurance agent about liability and safety issues.
___ Use federally approved car safety seats for all infants and children. Generally, children weighing more than 40 pounds can buckle-up in regular seat belts. Place children weighing less than 20 pounds facing backwards in car seats in the back seat of the car. Check your state’s seat belt laws.
___ Use toddler seats until children are ready for regular safety restraints. Some restraints are adjustable.
___ Never leave small children alone in a car.
Fire prevention checklist
In case of danger from fire, your first responsibility as the child care provider is to get the children to safety.
Check with state regulatory agencies such as the state fire marshal’s office or local officials about fire prevention regulations and recommendations for safety. Regulations may vary from area to area and for child care homes and child care centers.
___ Keep a 2.5-pound “ABC” dry chemical fire extinguisher in good working order and learn to operate it. Check with regulatory agencies or the fire department about your specific child care home or facility and where to place extinguishers.
___ Always have an adult who knows how to operate fire extinguishers present when children are in your care.
___ Service fire extinguishers after each use. At least once a year, have extinguishers serviced and inspected.
___ Have at least two unblocked exits from each floor or level to the outside of your child care home. Two unblocked exits from each room is even safer and may be required. Check with your state and local regulatory agencies about existing codes in your area.
___ Make sure the electrical wiring system is in good repair.
___ Check the fuses or circuit breakers in the fuse box. Be sure they are in good operating condition. Do not use a larger fuse than the circuit requires.
___ Consider a home sprinkler system for ultimate fire protection. Check with state and local regulatory agencies about requirements.
___ Inspect and make sure the cords for electrical items are in good condition and are approved.
___ Do not overload extension cords or use them as permanent wiring. Do not run them under rugs or hook them over nails.
___ Have a qualified technician inspect the central heating units as often as the manufacturer recommends.
___ Protect woodburning or gas log fireplaces and open flame heaters with a spark screen or guard. ___ Vent space heaters properly to the outside.
___ Always keep lighters and matches where children cannot reach them.
___ Store flammable liquids in safety cans where children cannot reach them.
___ Do not place rags, paper, and other flammable materials near heat.
___ Establish a fire escape plan and practice an escape drill monthly.
___ Teach children to “stop, drop, and roll” in case of clothing fires.
For specific sanitation guidelines, contact your local or state social services or health department.
___ Keep the home or facility and grounds clean.
___ Keep the kitchen, all food preparation, storage, and serving areas, and utensils clean.
___ If you have pets, keep them clean. Make sure pets have all vaccinations, including for distemper and rabies. Empty kitty litter boxes daily. Some pets may transmit illnesses to children.
___ Use a public water supply or a private well approved by health authorities.
___ Keep plumbing in good working condition.
Before the children arrive each day, take a quick walk around your child care facility or home and yard to make sure you have a safe environment for them.
___ Vacuum or sweep the floors to make sure there are no buttons, coins, paper clips, or similar items lying around.
___ Put away cleaning fluids, bug spray, cosmetics, and other poisonous products that someone in your family may have used.
___ Turn pot handles to the back of the stove, and put the hot coffee pot out of reach.
___ Put up the gate to the stairs, and latch any doors that you don’t want children to use, but don’t block fire exits.
___ Have a transistor radio and flashlight–and fresh batteries–on hand in case of a storm or power failure.
___ Post emergency and parents’ numbers near the telephone. ___ List medical emergency information about each child.
___ Arrange for emergency transportation if needed.
___ Establish a health policy with parents of children in your care. Require immunization records for each child.
For a more detailed listing of safety guidelines, refer to Caring for Our Children, Health and Safety Guidelines published by the American Public Health Association and the American Academy of Pediatrics.