Healthy Surroundings for Child Care Settings with Infants and Toddlers
How to Use This List
- Go through each item on the list.
- Check off the things you already do.
- Don’t worry if you can’t check off everything!
- Use the items you DO NOT CHECK off to create an action plan for improvement.
Furniture and Space
Relaxation and Comfort
o Rugs or other soft materials are available for children to play on.
o Several easy-to-clean soft toys are available to children most of the day.
o A special cozy area with rugs, cushions, bean bags, upholstered furniture or other soft furnishings is always available to children.
o The cozy area is protected from active play.
o Non-mobile infants are placed in the cozy area when appropriate.
o The cozy area is used for reading, singing, and other quiet play.
Room Arrangement
o There is enough space for both routine daily activities and play.
o All children are visible to the caregiver at all times, including while changing diapers.
o Open areas are used for crawling, walking, and play.
o Children are not crowded.
o Cribs are placed for easy access.
o Diapering supplies are at hand.
o Hot, running water is available where needed.
o Feeding tables are easy to clean.
o Areas for quiet and active play are separated (for example, by low shelves).
o Young infants are given space and materials to explore while protected from more mobile children.
o A variety of learning experiences are available in both routine and play areas (for example, there is a mobile over the diapering table that is changed often and there are many age appropriate toys available in the play areas).
o Materials with a similar use are placed together to make interest areas with suitable play space (for example, for infants there are rattle and soft toy areas; for toddlers there are book, music, and push-toy areas).
o Traffic patterns don’t interfere with activities.
Safety Practices
o There is a phone in the home.
o Transportation is available in case of emergency.
o First aid supplies are well stocked and ready to use.
o Emergency numbers are posted near the phone.
o Hot water is managed safely.
o No obvious safety problems indoors or outdoors: medicines are in a locked cabinet, cleaning supplies are out of reach, toys and objects small enough to be swallowed are kept away from infants and toddlers, etc.
o Parents are informed about any accidents.
o Caregiving area is planned to avoid safety problems (for example, younger children are separated from older children during active play, and outdoor play equipment is child-sized).
o Caregiver uses car safety seats for infants and toddlers.
o Children are taught safety rules as soon as possible.
o Caregiver shares safety information with parents (for example, staff provides parents with pamphlets on car restraints and home safety and explains program safety plans to parents).
Safety Policy
o All staff is trained is safety and emergency procedures.
o The facility has passed official fire safety inspection.
o A substitute caregiver is available for emergencies.
o The substitute is familiar with the children and the activities at the home and knows the emergency plans.
o Emergency exit plans are posted and practiced at least monthly with children.
o At least one person with first aid training, including CPR, is in the facility at all times.
o All regular caregivers have current first aid training, including CPR.
Active Physical Play
o Safe outdoor play for all ages provided at least three times per week
o Uncluttered indoor space provided for infants and toddlers to crawl and walk around much of the day.
o Outdoor and indoor play is closely supervised.
o At least a few age appropriate toys and equipment are available for daily use.
o Play things and equipment are in good repair.
o There is a convenient outdoor area where infants and toddlers are separated from older children; the area is used for at least one hour per day except in very bad weather.
o Play things and equipment exercise a variety of muscle skills, such as crawling, walking, balancing, climbing, swinging, and playing ball.
o Active play areas are not crowded.
o Physical play equipment is changed or rotated weekly to provide new challenges (for example, an obstacle course, a tunnel, or a new ball game is added).
o Toys and equipment are all age appropriate.
o Caregiver talks to children about their activities (for example, the caregiver explains safety rules).
Supervision
o Caregiver is within sight, hearing, and easy reach of children at all times.
o Caregiver is focused on children and not on other tasks or interests.
o There is sufficient supervision to meet every child’s routine care needs with little crying, waiting, or regimentation.
o Even while working with one child or a small group of children, the caregiver maintains supervision of the whole group.
o Caregiver watches carefully and intervenes to avoid problems (for example, the caregiver avoids conflict by bringing out a duplicate toy, moving active play that is disrupting quiet play, etc.).
o Caregiver plays with children and shows appreciation for what they do.
o Caregiver reacts quickly to solve problems in a comforting and supportive way.
o Supervision is provided with each child’s learning needs in mind (for example, the caregiver moves non-mobile infants to avoid boredom, does a planned activity with a small group while others are sleeping, etc.).
o Balance is maintained between a child’s need for independent exploration and his need for caregiver support.
Interactions between Caregivers and Children
o Caregiver often smiles at, talks to, and listens to children.
o Caregiver shows warmth in physical contact while doing routine activities (for example, the caregiver smiles while feeding the child).
o Caregiver gives each child equal attention.
o Caregiver responds sympathetically to children who are hurt or upset
o Children appear happy most of the time.
o There are frequent positive interactions between caregivers and children throughout the day (for example, the caregiver initiates verbal and physical play, responds when child initiates interactions, and shows delight in child’s activity).
o Caregiver and children seem relaxed.
o Voices are cheerful and children smile often.
o There is much holding, patting, and physical warmth shown throughout the day.
o Interactions with children are consistent across all caregivers, including substitutes.
o Each caregiver is assigned primary responsibility for a small number of children.
o Caregiver varies interactive style to meet children’s individual needs (for example, caregiver is calmer with timid babies, more active with outgoing babies).
o Caregiver is sensitive about children’s feelings and reactions (for example, the caregiver avoids abrupt interruptions and warns the baby before picking him or her up).
Diapering/Toileting
o Diapers are checked and changed often.
o Adults wash their hands with soap after changing diapers or helping children with toileting.
o Potty chairs are sanitized immediately after use.
o Children aren’t left on the toilet too long.
o Toilet training isn’t started too early.
o Caregiver treats toileting accidents as unintentional mishaps instead of punishable offenses.
o Diapering area is cleaned thoroughly after each use.
o Children’s hands are washed after using the toilet and, if needed, after diapering.
o Caregiver handles toileting accidents calmly.
o Diapering is done near a source of hot water.
o Toilets are child-sized (potty chairs for toddlers also work).
o Sinks are equipped with steps or are low enough for children to easily use.
o Caregiver works with parents to toilet train toddlers.
o A child-sized toilet is used in place of a potty chair.
o Caregiver uses diapering as a time to warmly relate with children.
o Diapering and toileting are used to teach children self-help, cleanliness, and dressing skills (handwashing, using toilet paper, buttoning and snapping, etc.).
o Parents are informed about child’s diapering / toileting during day (for example, a written record is kept for infants).
Personal Grooming
o Hands are washed before and after meals, after using the toilet, and after messy play.
o Each child has his own towel or washcloth (paper or cloth).
o Extra clothes are available and children are change when needed.
o Children are cleaned up and hair is brushed after messy playing or napping.
o Bibs are used during meals if needed.
o Caregiver encourages children to care for themselves by letting them help in changing clothes and by encouraging children to wash their own hands.
o Caregiver makes personal activities more pleasant for children by singing songs, gently washing babies’ faces, and avoiding making babies cry.
o Grooming is used as a learning experience (for example, by teaching names for body parts and clothing and by letting children look in the mirror).
o Each child has his own toothbrush.
o Individual toothbrushes are properly stored and teeth are brushed at least once per day.
o A low sink or steps make it easy for children to reach the sink and wash their hands.
Health Practices
o Child care areas are clean, well-lighted, and the correct temperature.
o Sandbox is kept covered when not in use.
o Outdoor and water play areas are protected from contamination.
o Caregiver cuts down on the spread of germs by wiping runny noses with clean tissues for each child and by frequently washing hands.
o Equipment is well maintained.
o Sick children’s needs are met (for example, there is a quiet area for sick children to rest and fussy children are held).
o Caregiver is a living example of good health practices by eating healthy foods and refraining from smoking in front of children.
o Health information is provided for parents.
o Caregiver encourages good health through the use of health-related books, pictures, and games.
o Surfaces of the room and equipment are easy to keep clean.
Health Policy
o Smoking is prohibited in care giving areas.
o Caregiver has a yearly health exam.
o Caregiver keeps a record of immunization for each child.
o Caregiver has emergency care and health information for each child, including contact information for the child’s parents, doctor, and dentist.
o Caregiver reports suspected child abuse.
o Special health problems such as allergies, hearing loss, or hyperactivity are written down and the caregiver uses the information in planning activities.
o Parents are told about the illness of others in the program.
o Rules are set up to govern attendance during an illness at a child’s home and parents are told about the rules.
o Medication is given only from the original container with written permission from parents and exact instructions.
o Caregiver has arranged for a medical consultant, such as a local doctor or nurse practitioner, to handle child care questions.
o Staff assists parents in assuring that children’s health needs are met (for example, by helping parents recognize health problems and by providing referrals).
Planning Activities
o Each day includes enough time for both routine activities (meals, grooming, changing diapers, etc.) and play.
o Schedule for basic routines is flexible and individualized to meet each child’s needs (for example, infants are on individual schedules and toddlers are eased into a group schedule).
o Caregiver provides play activities as part of the daily schedule.
o The schedule is posted and accessible for use by substitute caregivers and parents.
o Several activity periods, some indoors and some outdoors, are planned each day.
o Play is varied between active and quiet play to meet children’s needs.
o Learning and play experiences are incorporated into routines (for example, the caregiver sings to babies during diapering, lets toddlers help set the table for snacks, etc.).
o Appropriate learning activities are planned and carried out with each child daily, alone or in a very small group.
o Caregiver creates smooth transitions from one activity to the next to prevent waiting and disruption (for example, the caregiver sets out play materials for toddlers before putting babies down for a nap).
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