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• Preventing Burns
• Are hot radiators, wood stoves, portable heaters, grills and fireplaces out of the reach of children?



• Are bottles (with formula or milk) and infant foods warmed under running tap water or placed in a container of water that is no warmer than 120 degrees F.?



• After warming, are bottles mixed gently and the temperature tested?



• Are foods and liquids mixed carefully after heating?


Note: Microwaves should NOT be used for this purpose since they can heat unevenly.


• Are pot handles turned in toward the back of the stove?



• Do cooks and others preparing food avoid wearing long, wide open sleeves?



• Do all electrical outlets have safety covers attached with a screw or other means to prevent easy removal by a child?



• Safety covers that a child can remove from electrical outlets must not be used.


• Are children kept away from the steam from pots and pans, dishwashers and hot beverages?



Note: Caregivers should never hold a child while standing and cooking over the stove.


• Is the water temperature in children's handwashing sinks between 60° F and 120° F?



• Cold water should be turned on first, and then hot water added for a comfortable temperature.


• Are matches out of the reach of children?



• Are caregivers prohibited from drinking hot liquids or eating hot foods while in the presence of children?



• Are tablecloths removed when toddlers are present?



Note: Toddlers may try to pull themselves up by the tablecloth, spilling hot food or liquids.


• Are metal playground surfaces (slides, bars, chains) shaded, if necessary, and the surface temperature tested by adults before children touch or play on them?



• Preventing Choking and Strangulation (See also Food Preparation and SIDS Risk Reduction Sections)

• Have all drawstrings and cords that are long enough to go around a child's neck or catch on play equipment been removed?



• Pacifiers attached to strings or ribbons must not be placed around infants' necks or attached to infants' clothing.


• Do all window coverings and blind cords have tie down or tension devices to hold cords tight?



• Looped cords that could go around a child's neck are not permitted.


• Are infants held by a caregiver when being fed?



• Bottle "propping" is never allowed.



Example: Resting a bottle on an infant's stomach as the infant is feeding would be considered "propping".


• Do caregivers make sure that children do not eat when walking, running, playing, lying down, or riding on and in vehicles?



• For children under 4 years of age, foods that are round, hard, thick and sticky, smooth or slippery should not be served.



Examples are:

• Hot dogs and carrots (whole or sliced like coins).
• Grapes, whole peas, marshmallows, peanuts, popcorn, hard pretzels.
• Spoonfuls of peanut butter.
• Chunks of meat larger than can be swallowed whole.


• Other choking hazards that should not be present:



• Band-aids on children under 4 years of age (can come loose and become choking hazards).



Note: Gauze and tape should be used for bandaging instead.


• Styrofoam cups and plates used with children under 4 years of age (they can bite them and choke).


• Gum.


• Balloons.


Note: Tiny toys or objects can end up in the pocket of an older child, and then in the hands of an infant or toddler. Caregivers need to watch constantly and carefully.


• Special note for children under 3 years of age (or for older children who still put objects in their mouths) - they should not have access to:


• Toys or objects less than 1¼ inches wide and 2¼ inches long.
• Balls that are smaller than 1¾ inches in diameter.
• Plastic bags, balloons or latex gloves.
• Coins.
• Marbles.
• Styrofoam.



• Preventing Cuts, Bites and Scratches
• Are knives and sharp pointed scissors out of children's reach?



• Are surface areas and equipment (such as playground equipment) regularly inspected? Look for sharp edges, splinters, loose rusty parts, nails, bolts, and other hardware that could snag or poke through skin.



• Are sidewalks and pathways kept in good repair to prevent tripping?



• Are there no standing pools of water?



Note: Standing water attracts insects and can lead to potential bites.


• Are children closely supervised when in the presence of pets?



Note: Caregivers should be very close to a child who is handling an animal so that they can immediately separate the two if the animal shows signs of distress or if the child is treating the animal roughly.


• Does the program have a policy and written procedures on how to deal with children who bite or hit other children? (See also Biting and other Aggressive Behaviors)



Notes:

• Children sometimes express frustration through scratching, biting and hitting. This is particularly true of those who have not yet developed verbal language.



• Aggressive behavior can occur because of:


• Inadequate child: staff ratios (too many children per caregiver).


• Long transition periods between activities where children are expected to wait patiently.


• Activities, toys and materials that are not suited to the age of the children.


• Caregiver training, planning and preparation can reduce these behaviors.

• Preventing and Cushioning Falls (See also Playground Safety Section)
• Are baby walkers (that can move a child across the floor) prohibited at the program?



Note: Baby walkers are NOT SAFE for use in child care. Children can move quickly and reach dangerous objects or fall down open stairways.


• Are floors free of hazards?



Examples are:

• Wet spots are wiped up immediately.
• Caregivers routinely pick up toys, shoes, and other clutter.


• Are sidewalks and pathways cleared frequently of trash and weather elements such as ice and snow?



• Are all windows made so that they do not open to more than 3 ½ inches?



Note: Children under 5 years of age can fall out of or be trapped in a window left open wider than 3 ½ inches.


• Are gates/guards installed at the top and bottom of each open stairway where infants and toddlers are in care?



• Do gates have latching devices that adults can open but children can not?



Note: Pressure gates or accordion style gates should not be used. Children can fall through or be trapped in these kinds of gates.


• Do changing tables have railings or barriers that extend at least 6 inches above the changing surface?



• Do high chairs meet national ASTM safety requirements including a wide base, safety strap to prevent climbing, and designed to prevent slipping between tray and seat? Is there an ASTM label of approval?



• Do height limits for play equipment meet national standards? Generally one foot per year of age of the intended users. See the U.S. Consumer Product Safety Commission's Handbook for Playground Safety.



Examples of height limitations for playground equipment in some states:

• 48 inches for preschoolers.
• 6½ feet (78 inches) for school-age children.


• Are fences constructed in a manner that discourages or prevents children climbing?



• Is playground surfacing / cushioning material, under climbing structures, between 6 - 12 inches deep (depending on the material and the height of the equipment)? See Appendix V Depth Required for Tested Shock-absorbing Surfacing Materials for Use Under Play Equipment from Caring for Our Children, 2nd Ed. for sample depths per type of material.

• Preventing Drowning

• Are children constantly and closely supervised near any body of water including swimming pools, wading pools, tubs, pails, sinks, toilets, ponds?



• When infants/ toddlers are participating in any swimming/ wading activity, is there one caregiver to each infant/ toddler?



• Are containers of water such as buckets, bathtubs, diaper pails, emptied immediately after use?



Example: 5 gallon–size buckets are extremely dangerous to young children – top heavy infants and toddlers can not get out of a bucket this size if they accidentally fall in.


• When children are near bodies of water, is there at least one caregiver who has current infant and child CPR training?



• Are swimming pools and stationary wading pools enclosed by a fence that is at least 5 feet high and the bottom of the fence comes within 3½ inches from the ground?



• Are the steps to an above–ground pool removed or otherwise inaccessible when the pool is not in use and not supervised?



• Are all swimming pools covered with a safety cover that meets or exceeds ASTM standards when not in use? Does it have an ASTM label of approval?



• Is lifesaving equipment present?



• Are ditches, quarries, canals, wells and other bodies of water completely fenced off from outside play areas?



• Are children, who need assistance with toileting, under direct in sight supervision when using toilet or bathroom facilities?



• Are children less than 5 years of age, who are using the bathtub or shower, under direct in sight supervision?



• Are grab bars in bathtubs and showers located at the appropriate height for the child?


• Does the tub or shower have a non–skid surface?


• Preventing Injuries in the Kitchen (See also Food Safety Section)

• Are young children kept out of the kitchen area?



• Are cooking projects for young children (for example, buttering bread) done outside the kitchen where a caregiver can safely supervise the group?


• Are sharp knives, microwaves, deep fat fryers, toasters, blenders, food processors, grinders and other equipment that can cause serious injury out of a child's reach?



• Are electrical cords in good repair- no breaks, cuts, or frayed areas?



• Are cords, including extension cords, kept away from counter edges where children can grab them?



• Are there enough electric outlets for the number of appliances?



• Are outlets not overloaded with multiple plug extensions?



• Are safety covers for outlets attached by a screw or other means to prevent easy removal?



Note: Safety covers that a child can remove from electrical outlets must not be used.


• Are appliances located and used far from the sink or other water fixtures? A wall socket near the sink must have a "Ground Fault Circuit Interrupter (GFCI)" socket assembly to prevent shock and electrocution.



• Are garbage cans and their contents out of reach to children?



• Are dishes smooth? No chips or cracks?



• Preventing Poisonings (See also Toxic Substances Section)

• Is the poison control number - 1-800-222-1222 - posted near every phone?



• Are toxic chemicals (pesticides, house paint, lawn products) avoided or ONLY used when children are not present? Children are allowed back ONLY when areas have had time to air out.



• Are disinfecting chemicals (like bleach) stored out of reach of children?



Note: The bleach solution that's required for controlling infection and germs should be mixed at the right ratio (¼ cup bleach to 1 gallon water or 1 tablespoon bleach to 1 quart water) and mixed fresh every day. The bottle should be properly labeled.


• Are caregivers' personal items (like handbags that may contain aspirin, medications) stored safely where children can not reach?



• Are all medications stored and locked away from children?



• Do all medications have child safety caps?



• Are only safe nontoxic plants allowed both indoors and outdoors? (See Appendix U from Caring for Our Children, 2nd Ed. for a list of plants)



• Are all art and craft supplies that are used by children labeled nontoxic?



• Sleep Safety (See also SIDS Risk Reduction Section)

• Are children supervised at all times (seeing and hearing them) EVEN WHILE SLEEPING?



• Are infants placed on their backs to sleep (reduces the risk of SIDS)?



• Crib safety pointers:



• The distance between crib slats must be 2 3/8 inches or less (prevents strangulation).



• Mattresses must fit snugly so that no more than 2 fingers can fit between the mattress and the crib side (prevents strangulation).



• The minimum height from top of mattress to top of crib rail is 20 inches (prevents falling out).



• There should be no corner posts (prevents hanging when clothing gets caught).



• Pillows, fluffy toys and quilts are prohibited for infants (prevents suffocation).


• See Transportation Section for Car Safety

For more information on how an injury or emergency should be handled, see Emergency and Disaster Preparedness Section