Features
Safety: A first step in quality care

by Barbara Langham

Editors note: The following recommendations are derived from best industry practices but may not align with your local fire and building codes or licensing regulations. Always consult and follow state- and regional-specific regulations.

Whether your program is housed in a custom-built school, a renovated warehouse, or your family’s home, your first obligation is the safety of the children in your care.

Some safety hazards are largely hidden from view. They include air, soil, and water contamination as well as toxic building materials such as lead and asbestos, all of which can profoundly affect the development of children.

In addition, a natural disaster such as a flood or earthquake can leave behind hazards, seen and unseen, such as structurally unsafe buildings, damaged electrical wiring, leaking gas lines, and mold growth, to mention a few.

Ideally, an environmental audit will identify such hazards before construction of a new building, before renovation of an older building, or after a disaster and before re-occupation of a building.

Many hazards can be detected by inspections and actually are required by city codes before a building can be used for early care and education. These inspections look at such things as electrical and HVAC systems, plumbing fixtures (sinks, toilets), food service, and fire prevention. Plus, state regulation covers a wide range of safety issues, from cribs and swimming pools to sanitation and medication.

Which hazards can and should you do something about? This article will review some of the most important safety practices indoors and outdoors to protect children from illness and injury. All safety practices need constant monitoring and training of staff to ensure a safe environment for children, teachers, and families.

Fire prevention
A fire needs three things: an ignition source, fuel, and oxygen. Ignition sources can include matches, lighters, mechanically produced sparks, static electricity, the sun, and lightning. Fuel is anything that burns (such as paper, wood, cloth, and gasoline), and oxygen is in the air.

Smoke detectors can alert you to a fire before it gets out of hand.

Install and test smoke detectors
Install a detector in every room occupied by children as well as in the kitchen and the hall. Locate detectors high on walls (but not more than 12 inches from the ceiling) and away from drafts, such as air-conditioning and heating registers. Mount the kitchen detector at least 10 feet from a cooking appliance to minimize the chance of false alarms.
Test battery-operated detectors monthly. A periodic chirp means you need to replace the battery immediately. Replace all batteries twice a year. A good way to remember is when you change your clocks for Daylight Savings Time.

Ideally, your program will have a sprinkler system to extinguish any fire that may occur. You should also have hand-held fire extinguishers.

Mount and test fire extinguishers
Mount one in the main hall and one in the kitchen. Mount according to the manufacturer’s instructions, but no higher than 5 feet from the floor and no lower than 4 inches from the floor.
Buy extinguishers labeled 3A-40BC. The dry chemical inside will be effective on all types of fires, including grease.
Check the charge level monthly, and have it professionally checked once a year and after use.
Most important, make sure all adults in your program know how to use the extinguisher.

The state or local fire marshal will test the smoke detection and sprinkler systems once a year. Post a log in an accessible place so that employees who test smoke detectors and fire extinguishers can record their names and the dates of each test.

In case of fire, your first duty—before trying to extinguish the fire—is to move children to safety. If a fire gets out of hand, follow your written disaster plan, which will include a call to 9-1-1 as well as evacuation and relocation procedures. (For information on creating a disaster plan, see the Summer 2013 issue of the Texas Child Care Quarterly.)

Practice drills
Practice fire and emergency evacuation drills once a month. Schedule them at different times a day, including nap time.
Document drills by noting the date, time, and amount of time it took to evacuate. The goal for evacuation time is less than 3 minutes.
Teach children the stop-drop-and-roll survival skill to use if clothes catch on fire. Help them understand that running worsens the fire, and rolling on the ground will snuff out the flames.
Share your emergency evacuation plan with parents, preferably at the time of enrollment.

Use caution with appliances
Pay attention to food cooking on the stovetop. Don’t leave pots unattended.
Keep dish cloths, pot holders, and paper products away from stovetop burners.
Turn off and unplug appliances such as electric skillets and toasters immediately after use.
Avoid using electrical appliances near sinks, bathtubs, and other water sources.
When cooking with a microwave oven, use only those containers and utensils recommended by the manufacturer.
After using the clothes dryer, clean the lint filter. Check the vent pipe outside to make sure it’s not blocked.
Repair or replace faulty appliances.

Remove these hazards
Carpet, curtains, and furnishings that aren’t fire-resistant. Note: The words inflammable and flammable mean the same thing—easily set on fire.
Frayed electrical cords and wires with pinched or cracked insulation
Multiple cords plugged into power strips and plug adapters (cube taps), which can overload outlets
Bulbs in light fixtures that exceed the fixture’s wattage limit—for example, using a 100-watt bulb in a 60-watt socket
Piles of combustible papers, trash, and rags
Matches and combustible substances such as gasoline, lighter fluid, turpentine, and kerosene
Loose storage of 9-volt batteries. Keep batteries in original packaging until ready to use. Don’t store near metal such as paper clips and keys. Take used batteries to a hazardous waste site for disposal.

Use heating devices wisely
If you use a fireplace, wood-burning stove, or space heater, install a screen strong enough to keep children from away from the heat source.
Safeguard floor and wall furnace grates and steam and hot water pipes so children don’t have access to them.
Make sure space heaters are enclosed and bear a U.S. laboratory seal of approval (or approval of state or local fire marshal).
Remove any open-flame or liquid fuel heaters.

No smoking
Cigarettes and other smoking materials, such as matches and pipes, are the leading cause of fire deaths (NFPA, 2016). Carelessness in using lighters, disposing of butts, or inadvertently dropping embers is all it takes to start a fire. Plus, breathing in the second-hand smoke can expose lungs to carcinogens.

Vaping, according to the National Fire Protection Association (2016), poses a possible risk: “Fires have occurred while e-cigarettes were being used, the battery was being charged, or the device was being transported.”
Post “No Smoking/No Vaping” signs around your facility, and enforce the rule.

Poison prevention
Most substance poisoning occurs when caregivers are not paying attention. The most dangerous substances with the potential for poisoning, according to the American Academy of Pediatrics (June 6, 2018) are medicines, cleaning products, liquid nicotine for e-cigarettes, car products such as antifreeze and wiper fluid, pesticides, and gasoline.

Prevent poison ingestion
Store medicine, cleaning products, paints, and pesticides in their original packaging in locked cabinets out of sight and reach of children. Safety latches that automatically lock cabinet doors upon closure are a good idea.
Never refer to medicine as candy.
Secure devices that contain button-cell batteries (such as musical children’s books and hearing aids) out of reach. Swallowed batteries can burn through a child’s esophagus.
Identify all plants indoors and outdoors, and remove those that are poisonous. For an illustrated list, see the website of the National Capital Poison Center, www.poison.org/articles/plant.

Poisoning can also occur from breathing carbon monoxide, a colorless, odorless, poisonous gas formed when heating units that burn fuel with a flame do not have a sufficient source of air. Carbon-containing fuel that is not burned completely can cause asphyxiation.

Prevent inhalation of carbon monoxide
Install an electric or battery-operated detection system—at least one detector on every level of each building.
Test the system annually. Test battery-operated detectors monthly.
Document the test date and the person conducting the test.

Transportation safety
The automobile has been indispensable to many Americans since the heyday of the Model T Ford, despite its increasing cost, pollution, and complexity. Yet motor vehicle injuries are a leading cause of death among children (CDC, April 11, 2017). Many of these deaths can be prevented.

Establish one-way entry and exit
Accidents can happen when parents drive children to your program and later pick them up. You can reduce the risk when all vehicles move in the same direction.
If possible, designate a driveway as a one-way route with entrance at one end and exit at the other. If street parking is necessary, establish a one-way route to ensure that children enter and exit along the curb or in a protected parking area rather than the street.
If children must cross the street, make sure they do so with an adult.
Develop a procedure for keeping everyone safe while entering and exiting a vehicle. As children exit a car, for example, have an adult guide them into the building. As children enter a car, have them wait to be buckled up. A rule such as “Wait with one hand on the car at all times” beats repeatedly asking a child to “Stay close” and “Come here.”

Buckle up
All 50 states require by law that children riding in a car be secured in a child safety restraint system. To see your state’s law, see SafeRide4Kids at https://saferide4kids.com/car-seat-laws-by-state/

The American Academy of Pediatrics recommends the types of restraints shown in the chart below.

Encourage parents to choose a reliable safety seat system for their children. Many hospitals, health departments, public safety groups, law enforcement agencies, and fire departments can check for proper installation of seats and refer parents to agencies where they can get seats free.

When you offer transportation
Some child care programs provide transportation for children: from children’s homes or school to your program, and from your program to a school or children’s homes. You may also provide transportation for field trips.

Hire a safe driver
A safe driver will have the following:
Valid driver’s license, with number and expiration date kept on file
Safe driving record, as shown by records from the state’s motor vehicle agency
No use of any substance (drugs, alcohol, tobacco) that could impair driving ability
No medical condition that could compromise driving and supervision
Training in pediatric CPR and first aid.

Ensure supervision
Consider having two adults in a vehicle—one to drive and the other to supervise the children.
Develop a foolproof system for accounting for all the children all the time. Count heads often, and use a written list to make sure everyone gets into and out of the vehicle.
Never leave a child alone in a vehicle.
Never hesitate to cut a trip short because of mechanical difficulties or a child’s unmanageable behavior.
Display a sign on the vehicle that identifies your program by name and the program’s phone number.
Have a list of children’s names, their parents’ names, emergency contact numbers, and parents’ authorization to seek emergency medical care in case of an accident.
Carry a cell phone, fire extinguisher, and first-aid kit.
Keep vehicles in good repair, and lock them when not in use.

Water play safety
According to the Centers for Disease Control, “drowning kills more children 1-4 years of age than anything else except birth defects.” Children in that age group are most likely to drown in swimming pools, hot tubs, and spas. Children younger than 1, however, are more likely to drown in bathtubs, toilets, and buckets (Sept. 15, 2017).

With appropriate care and caution, water play is highly enjoyable for children. Many child care programs have a pool on the premises, install an above-ground pool, or take children to a public pool. In Texas minimum standards, a swimming pool is defined as having a depth of more than 2 feet; a wading pool is 2 feet or less.

Prevent drowning
Closely supervise children around water. Children in distress are rarely able to call for help and thus can drown silently.
With infants and toddlers, provide touch supervision. That is, an adult should be in the water and within arm’s reach.
Make sure you are able to clearly see all parts of the swimming area, including the bottom of the pool.
Ensure that every adult supervising children knows how to swim.
Make sure a certified lifeguard is on duty, and have life-saving devices handy.
If the pool is on the premises, install a 6-foot high fence or wall around it.
Lock fence gates when the pool is not in use.

Remove mechanical and chemical hazards
Make sure drain gates are in place and in good repair.
Keep machinery rooms locked when any child is present.
Keep pool chemicals inaccessible to children.
Ensure that pool areas are free of furniture or equipment that would allow a child to scale a fence or release a lock.

Use care with wading pools and sprinklers
Do not set up on a hard, slippery surface, such as a concrete driveway, sidewalk, or patio.
Store out of children’s reach when not in use.
Drain and sanitize at least daily.
Do not leave a child alone with the equipment.

Classroom safety
Plan for safety in the learning environment—in daily routines, curriculum, and activities. Supervise children with your eyes, ears, and whole body, and be a role model in safety practices.

Provide equipment and materials that are appropriate to the ages, interests, and skills of the children in your care. Establish and maintain rules for safe behavior and enforce them consistently.

Childproof the room
Arrange furniture and materials for easy supervision. You should be able to see all areas of the classroom from wherever you stand.
Remove breakable items such as glass vases, and lock away adult-use supplies such as knives and pointed scissors.
Install protective barriers at open sides of stairs, ramps, balconies, porches, and other elevated surfaces where children might fall.
Firmly anchor bookshelves, chests, video screens, and other furnishings that could tip over.
Stick decals on floor-length doors and windows to alert children to the glass surface.
Arrange bookcases and other furniture to block children’s access to electrical outlets and cords.
Make sure cribs comply with international safety standards, and position them away from window blinds or draperies with cords that could cause strangling.
Mount fans and air conditioners out of children’s reach.
Arrange materials and toys on low, child-accessible shelves. Avoid storage chests and trunks that children can climb into.
Use safety straps on highchairs, strollers, and diaper-changing surfaces.
Check toys and equipment daily. Repair or replace any hazardous material before sharing it with children.
Schedule routine maintenance or work days to clean, repaint, or mend equipment.
To avoid scalding from hot water faucets, turn down the water heater to a maximum of 120 degrees.
Keep plastic bags out of children’s reach to avoid suffocation.
With children 4 and younger, don’t offer choking hazards, such as nuts, seeds, chunks of meat and cheese, whole grapes, hard candy, popcorn, raw vegetables and fruits, and chunks of peanut butter. Don’t allow balloons—they can pop and become a choking hazard.
Remove guns, bows and arrows, hunting knives, BB guns, darts, fireworks, and other projectile or exploding devices. They have no function in child care, and there is no foolproof way to make them safe from curious children.
Before accepting animals, insist they have visited a veterinarian and are free of disease and infection. Refuse turtles and birds, which can carry communicable disease, and reject furry animals, such as dogs, cats, hamsters, and guinea pigs, if children or adults in your program have allergies.
Adopt an integrated pest management system, including removing conditions conductive to pest infestation.

Outdoor spaces
The play yard offers an endless array of opportunities for physical exercise, discovery, creativity, and socialization. Grassy lawns invite tumbling and running, wheel toys need hard tracks, gardens satisfy the urge to dig and plant, and shady corners make sand and mud play more comfortable.

Be safe outdoors
Enclose the outdoor space with a fence. Gates should have self-latching mechanisms high enough so children cannot reach them.
Arrange large play equipment for easy supervision. You should be able to see all areas from wherever you are. Outdoor play is not a time for caregivers to visit with each other or check their cell phones.
Anchor large equipment with metal pins or concrete.
Refer to regulatory standards for guidance on the minimum space required for use (fall zones), ground cushioning depths, and entrapment hazards.
Make sure stairs on climbing equipment have handrails the children can reach. Enclose platforms with protective barriers.
Monitor the play yard every morning for debris such as animal droppings, wire, broken glass, and insects.
Inspect equipment daily for jagged or sharp edges, loose bolts or screws, and broken or missing parts.
If you cannot repair dangerous equipment, remove it.
Limit sun exposure when ultraviolet rays are strongest, keep babies younger than 6 months out of direct sunlight, and apply sunscreen with parents’ permission.
Have children drink water before, during, and after active play, especially in hot weather.
Cover sandboxes overnight, and empty water from buckets and tubs.
Refer to regulatory standards for prohibited equipment, such as trampolines and heavy metal swings. Make sure equipment is suited to children’s ages.
If storms and lightning threaten, take children inside. Remember the slogan: “When thunder roars, go indoors.”
Beware of fallen electric power lines. Standing water can energize downed lines, so keep children away from the area.

Accident prevention and healthy environments reflect four principles: planning ahead, establishing and maintaining clear and consistent policies, supervising diligently, and modeling safety. Adhering to these principles will minimize your liability risk and reassure parents that you can keep their children safe.

References
Centers for Disease Control and Prevention. (Sept. 15, 2017). Drowning, www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/Drowning.html.
Centers for Disease Control and Prevention. (April 11, 2017). Child Passenger Safety: Get the Facts, www.cdc.gov/motorvehiclesafety/child_passenger_safety/cps-factsheet.html.
Classroom pets: Cute, educational, and maybe dangerous. (Winter 2009). Texas Child Care. Austin, TX: Texas Workforce Commission.
Creating a disaster plan. (Summer 2013). Texas Child Care, www.childcarequarterly.com/summer13_business.html.
Field trips: Ensuring the safety of children. (Spring 2015). Texas Child Care, www.childcarequarterly.com/spring15_licensing.html.
Food allergies and child care. (Spring 2017). Texas Child Care, www.childcarequarterly.com/spring17_licensing.html.
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Install car seats properly. (Spring 2007). Texas Child Care. Austin, TX: Texas Workforce Commission.
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Smoking & Home Fire Safety. (2016). National Fire Protection Association, www.nfpa.org/-/media/Files/Public-Education/Resources/Safety-tip-sheets/SmokingSafety.pdf.
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