CDC DNPAO Performance Measure FAQs for State Public Health Actions
Purpose:
This document is intended to address Frequently Asked Questions (FAQs) related to Domain 2, Nutrition,
Physical Activity and Obesity (NPAO) performance measures, specifically Basic strategies 1 and 3 and
Enhanced Domain 2 strategies 1, 2, 4, 5, and 7. This document is divided into three parts: Part 1: General
questions; Part 2: Basic measure questions and Part 3: Enhanced measure questions, and provides
responses to specific performance measure questions asked by grantees. In addition, an Appendix “1305
ECE Reporting Guidance” is attached to this FAQ. It provides detailed guidance on ECE related
performance measures. Please refer to that guidance for any issues related to performance measures in
ECE settings.
This FAQ provides the most current guidance on NPAO performance measures and should be used for Year
2 APR reporting. Once progress on performance measures has been entered, as part of the Year 2 APR
reporting, all performance measure profiles will be updated and provided to grantees.
Part 1: General DNPAO FAQs
General FAQs
Question: Do grantees have to report denominators for short-term REACH measures (i.e. Number of ….)?
Answer: A number of grantees have indicated that providing denominators for Reach measures (basic and
short-term enhanced strategies and interventions) is difficult given that several grantees did not target a
specific number of sites for inclusion in 1305 initiatives. In addition, several grantees have had difficulty
identifying and accessing appropriate data sources for an accurate denominator. While we encourage the
greatest reach of these interventions and promote statewide reach where possible, most grantees are
targeting settings at the community or district level and are working to recruit a maximum number of sites.
As a result, denominators for all short-term Reach measures are no longer required for reporting, with the
exception of 2.7.02). While we encourage grantees to include denominators where possible, reporting
only the numerator for these measures is acceptable. Targets, baselines, and progress on these measures in
the reporting tool should be reported in the numerator column. Where available, please include
denominators as well. If reporting only the numerator, please indicate in the comments column at the end
of each row that no targets were identified or available. Please refer to the Performance Measure Tips
document for a detailed list of measures (DNPAO Short-term Numerators Only).
Question: What should be reported in the “Measure Notes” field?
Answer: The “Measure Notes” field should be used to provide detailed information about the performance
measure data that is being reported. Some details to enter include:




information about efforts to obtain data and the anticipated timeline for completing the measure
rationale for using alternative data sources and detailed data source descriptions or rationale for
optional sub-measures
description of population identified or used for performance measure data (e.g., county, district,
worksite, etc.)
challenges in obtaining specific performance measure data
Question: There are no profiles for the DNPAO long term measures. Are there expectations of reporting on
these measures?
Answer: You are correct that no profiles exist for the long term measure for all DNPAO strategies.
Grantees are not required to report any long-term measures for interventions that are part of DNPAO
strategies. These strategies include: 1. Increase access to healthy foods and beverages; 2. Implement food
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service guidelines/nutrition standards where foods and beverages are available. Guidelines and standards
should address sodium; 4. Increase physical activity access and outreach; 5. Implement physical activity in
early care and education; and 7. Increase access to breastfeeding friendly environments.
DNPAO realizes that obesity rates are unlikely to change during the timeframe of FOA 1305, based on
available surveillance data. CDC has access to this data, BRFSS and YRBS, if this measure is requested by
the Center or Agency. In addition, for the ECE population, there is no data source for obesity rates. There
are proxy measures that grantees can access, for example WIC obesity rates, if they wish to report this
measure but are not required to do so.
Question: For measures that appear in both the basic and the enhanced, should targets for each year be
different between the basic and enhanced? That is, basic funding can only cover a particular level and it is
the enhanced funding that helps meet a larger target. I ask because of the guidance in B.3.01 that says: "If
licensed and/or unlicensed ECEs benefit from both basic and enhanced funding/activities, states may count
them twice by indicating them in both the basic and enhanced numerator and denominator.” This point led
me to believe that maybe the numbers should be the same as opposed to differentiated the way I explained
above.
Answer: Targets should be established to appropriately reflect grantee activities. For enhanced, grantees
are expected to either increase their target settings if conducting similar activities to those in their basic
strategy or increase the intensity/number of activities within the same target settings. For example, for
enhanced strategies, grantees can either increase the number of ECEs in which they are conducting similar
activities or increase the number and/or intensity of activities in the same number of ECEs. If the latter is
the case, then targets for both basic and enhanced can be the same. Please document this in the notes field
next to that performance measure.
In other cases grantees may have decided, after discussion with their DNPAO project officer and evaluator,
that a 30% basic/70% enhanced split best reflects their activities. For example, State A is working with 100
ECEs, and reports on 30 ECEs for basic, and 70 ECEs for enhanced. This is also acceptable. Please
document this in the notes field next to that performance measure.
Question: For some performance measures, our data source is a survey that is administered once every
two (or three) years. What should grantees report in the years when there is no new data?
Answer: In the years with no new data, please report the most recent data available (e.g., last year’s data).
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Part 2: Basic Strategies 1 & 3
Basic Strategy 1: Promote the adoption of food service guidelines/nutrition standards which
include sodium
General Q&A for all ECE measures except 2.2.07 ECE (see special instructions in Appendix, (p5)
“General formula for 2.2.07 ECE”) and 2.5.04 (optional):
Question: How should grantees use sub-rows to report on ECE performance measures?
Answer: To aid CDC’s nationwide comparison of ECE outcomes, please report (using 4 sub-rows per PM)
on the # of ECEs with 100%, 75%, 50%, and <50% of [nutrition] or [PA] policies present; and the # of
children that attend these ECEs. For formulas and guidance on using sub-rows, please see “Appendix: 1305
ECE Reporting Guidance,” sections:
•
•
(p2) Report using 4 sub-rows (except 2.2.07 ECE)
(p2) General formula for all ECE data sources
Question: How are ECE performance measures operationalized?
Answer: Please see “Appendix: 1305 ECE Performance Measure (PM) Guidance,” section (p6-14) “Survey
items mapped to performance measures”
Question: Is there an existing data source which measures policies and/or practices in ECEs?
Answer: Yes. Grantees may drive 1305-targeted ECEs to the free online Let’s Move Childcare (LMCC) Quiz
(https://www.healthykidshealthyfuture.org/home/startearly/quiz.html ). Upon request, CDC can provide
grantees with aggregate LMCC data for 1305-targeted ECEs.
Information was sent to PI’s in late January 2015. The data source was described during the second half
hour of the 1/28/15 ECE networking call, which can be played back at (866) 392-1727; slides can be
requested from eceobesity@cdc.gov. (Unfortunately, there is no way to fast forward to the second half of
the 1/28/15 call. Plan to budget an hour and five minutes total, to let the first half of the call play before
arriving at the second half about the LMCC data pull and related Q&A.) Interested grantees should ask their
DNPAO project officer for further guidance.
Note: (Optional) Some grantees may choose to request facility-level ECE quiz data by submitting
permission forms from the ECEs granting permission for the CDC to share quiz data with the state. Please
consider this privileged and confidential information, to be used solely by grantees to identify which ECEs
are participating in 1305-funded activities. Please do not use this as a compliance mechanism (e.g., please
do not penalize ECEs which are not currently fully meeting all best practices or contact them for
compliance purposes)
Question: Should grantees use items from the Let’s Move Childcare (LMCC) checklist/online quiz to track
nutrition consumption in targeted ECEs?
Answer: We recommend that grantees use LMCC or Go NAP SACC. Some grantees may choose to use other
instruments, and that is acceptable, as long as the measurement instruments can provide the data
requested by the performance measure.
Question: Will LMCC items accurately measure consumption or child physical activity (PA)?
Answer: The LMCC quiz measures ECE-level provision of healthy foods and beverages, and is a proxy for
child-level consumption of healthy foods and beverages. Similarly, the quiz measures provision of time for
PA, which is a proxy for actual PA. This is acceptable.
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Question: Some grantees are using a data source other than LMCC or Go NAP SACC. What should they
report for ECE performance measures?
Answer: Please follow the format specified above (i.e., # of ECEs with 100%, 75%, 50%, and <50% of
[nutrition] or [PA] policies present; and the # of children that attend these ECEs), and also see “Appendix:
1305 ECE Reporting Guidance,” section (p14) “State-specific data.”
Question: Some grantees’ LMCC data will include ECEs that are participating in LMCC through non-1305
activities (e.g., ECE Learning Collaborative). Is there a way to report data from only the ECEs that are
participating in 1305?
Answer: Yes, if your state knows which ECEs were targeted by 1305. Please email ECEobesity@cdc.gov for
further guidance.
Measure: B.1.04 Number of children that access settings (i.e., ECEs) that have developed and/or
adopted policies to implement food service guidelines/nutrition standards.
Question: Some ECEs have after-school programs that serve school-age children. Should grantees include
these school-age children in this count?
Answer: No. These school-age children should not be included in the count for B.1.04, for two reasons: 1.
The nutrition standards are targeted primarily at ECE-aged, not school-aged children; and 2. We want to
avoid double-counting children who are already captured in School Health-related performance measures.
Basic Strategy 3: Promote the adoption of physical activity (PA) in early care and education (ECE)
and worksites
Measure: B.3.01 Number of ECEs that adopt strategies to increase physical activity
Please see Basic Strategy 1: “General Q&A for all ECE measures except 2.2.07 ECE” and “Appendix: 1305
ECE Performance Measure (PM) Guidance.”
Measure: B.3.03 Number of worksites that adopt (or add) strategies to increase physical activity
Question: How should grantees report on settings for this strategy?
Answer: Use the comments field to add clarification notes for each measure. If using one setting for
multiple strategies make a note of the appropriate setting. For example, if using schools or ECE as a
worksite, be sure to include information in the notes column explaining this.
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Part 3: Enhanced Domain 2 Strategies 1, 2, 4, 5, & 7
Enhanced Strategy 1: Increase Access to Healthy Foods and Beverages
Measure: All
Question: For those performance measures that ask grantees to report on the number of
adults/youth/families that are accessing selected settings (e.g., farmers markets, small retail venues),
tracking this data is difficult. Are grantees expected to develop tracking systems or assessments to obtain
these numbers? How should grantees handle reporting numerators for these performance measures? (i.e.,
measures 2.1.02, 2.1.05)
Answer: For those measures that are in community settings, such as farmers markets and small retail
venues, grantees should report the number of adults/youth/families that HAVE ACCESS to the specific
setting of interest. The recommended method is to use a geographic boundary that defines the target
population to be served by the environmental change. We suggest census data and/or GIS mapping to
determine access. Census data are readily available at the U.S. Census website (http://www.census.gov/)
and should include the number of people who reside in the census with the intervention. GIS mapping, if
available, can also be used to determine boundaries around a particular intervention for determining
access. Please refer to the Reach guidance provided to all grantees for more information.
This does not apply to ECE and worksite settings since the number children attending and employees
working in those targeted settings should be available.
Measure: 2.1.06 Percent of adults or youth who increase consumption of nutritious food and
beverages (also PM 2.2.07)
Question: How is this measure operationalized and what data should grantees report?
Answer: CDC recommends that grantees report the median daily intake of fruits and vegetables for both
adults and adolescents (the performance measure profile will be revised to reflect this change). This data
can be found for each state in the Fruit and Vegetable Indicator Report which can be accessed from the
DNPAO website (http://www.cdc.gov/nutrition/downloads/state-indicator-report-fruits-vegetables2013.pdf )
Given the measure indicates that grantees report median intake of fruit and vegetables for both adults and
youth, we are asking grantees to report the median daily intake of fruits for adults in the first row and add
3 additional subrows to report: median daily intake of vegetables for adults; median daily intake of fruits
for adolescents; and median daily intake of vegetables for adolescents. In addition, use the “Measure
Notes” field to indicate which row is vegetable intake and which row is fruit intake. CDC recognizes that
this data is not collected for every state and that some grantees have identified other measures/sources to
report this data. Reporting on this measure using other sources is acceptable to CDC.
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Enhanced Strategy 2: Implement food service guidelines/nutrition standards where foods and
beverages are available. Guidelines and standards should address sodium.
Measure: 2.2.07 Percent of adults or youth who increase consumption of nutritious food and
beverages
Question: [2.2.07] Our state is working with youth for Domain 2, Strategy 2. However, the 2013 State
Indicator Report on Fruits and Vegetables does not give YRBS data for median fruit and vegetable intake.
What data source(s) should grantees use, and what should be reported?
Answer: If your state conducts a state-level YRBS-type questionnaire that would be a suitable data source.
Please report measures that are as similar as possible to “median daily intake of fruit for youth” and
“median daily intake of vegetables for youth,” or to “percent of youth increasing intake of fruits and
vegetables.
For comparison purposes, you may wish to refer to the algorithm, SAS code, and BRFSS item text used to
generate the median intake from BRFSS data (see Appendices):
http://www.cdc.gov/brfss/data_documentation/PDF/fruits_vegetables.pdf
For your reference, raw YRBS and BRFSS data, respectively, are available in a variety of formats at (e.g.,
ASCII, SAS): http://www.cdc.gov/healthyYouth/yrbs/data/index.htm and
http://www.cdc.gov/brfss/annual_data/annual_2013.html
Measure: 2.2.01 Number of ECEs that develop and adopt policies to implement food service
guidelines/nutrition standards, including sodium
Measure: 2.2.04 Number of children that access settings (i.e., ECEs) that have developed and/or
adopted policies to implement food service guidelines/nutrition standards
Please see Basic Strategy 1: “General Q&A for all ECE measures except 2.2.07 ECE” and “Appendix: 1305
ECE Performance Measure (PM) Guidance.”
Measure: 2.2.07 ECE Percent of (children in ECEs) who increase consumption of nutritious foods and
beverages
Question: [2.2.07 ECE] The Performance Measure Profiles document includes both 2.2.07 and
2.2.07ECE. Are grantees expected to track both?
Answer: The measure selected depends on the setting the state has selected to implement their activities.
If the setting is either worksite or community, use 2.2.07. If setting is ECE, use 2.2.07ECE. Grantees
working in ECEs in addition to worksites or communities will report on both measures.
Question: [2.2.07 ECE] How is this measure operationalized and what data should grantees report?
Answer: We are asking grantees to report the # of children attending ECEs which have at least the median
baseline percentage of nutrition policies for your state. Please report this on the 5th sub-row of 2.2.07.
Please see Appendix, (p5) “General formula for 2.2.07 ECE” for formula details.
Question: Some grantees are using a data source other than LMCC or Go NAP SACC. What should they
report for 2.2.07 ECE?
Answer: To aid CDC’s nationwide comparison of ECE outcomes, please report on the # of children
attending ECEs which have at least the median baseline percentage of nutrition policies for your state. For
formulas, please see “Appendix: 1305 ECE Reporting Guidance,” sections: (p5) General formula for 2.2.07
ECE (sub-row 5 of 2.2.07) and (p14) State-specific data
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Enhanced Strategy 4: Increase physical activity access and outreach
Measure: 2.4.01: Number of local or state policies that include language that supports environmental
changes to enhance places for physical activity, emphasizing walking
Question: Are grantees required to report on all local or state policies that include language that supports
environmental changes to enhance places for physical activity?
Answer: Grantees may report on any number of types of policies, as applicable to the environmental
change interventions they are implementing. For example, if a state is implementing joint use agreements,
they may choose to only include the number of joint use agreements established and/or implemented.
Measure: 2.4.03: Number of communities that develop and/or adopt a pedestrian or transportation
master plan
Question: What unit of analysis should be reported for this measure?
Answer: When reporting on this performance measure, provide the NUMBER not the proportion of
communities that develop and/or adopt a pedestrian or transportation master plan. The profile will be
updated to reflect this change.
Measure: 2.4.04: Percent of adults or youth who have increased physical activity with an emphasis on
walking
Question: How should grantees present data for this performance measure?
Answer: When reporting on this performance measure, add additional subrows to report adults separately
from youth. CDC recommends the following two BRFSS measures for adults: 1) Number of adults aged >=
18 years who meet aerobic physical activity guidelines and 2) Number of adults who report walking as one
of their two most common types of physical activity. See Guide to Analyzing Physical Activity Rotating Core
for more specific information on calculating numerator:
http://www.cdc.gov/brfss/pdf/PA%20RotatingCore_BRFSSGuide_508Comp_07252013FINAL.pdf
For youth, CDC recommends the following YRBS measure: 1) Students in grades 9–12 who report doing
any kind of physical activity that increased their heart rate and made them breathe hard some of the time
for a total of at least 60 minutes per day on each of the 7 days before the survey. See Software for Analysis
of YRBS Data Guide: http://www.cdc.gov/healthyyouth/yrbs/pdf/YRBS_analysis_software.pdf and the
2013 YRBS Data User’s Guide: http://www.cdc.gov/HealthyYouth/yrbs/data/index.htm
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Enhanced Strategy 5: Implement physical education and physical activity in early care and
education
Measure: 2.5.01 Number of ECEs that develop and implement strategies to increase physical activity
Measure: 2.5.02 Number of children who attend ECEs that adopt and implement guidelines to increase
physical activity
Measure: 2.5.03 Percent of children in ECEs who engage in levels of age-appropriate physical activity
as recommended by Caring for Our Children (CFOC)
Please see Basic Strategy 1: “General Q&A for all ECE measures except 2.2.07 ECE” and “Appendix: 1305
ECE Performance Measure (PM) Guidance.”
Enhanced Strategy 7: Increase access to breastfeeding friendly environments
Measure: All
Question: For the performance measures that use the Breastfeeding Report Card data that comes from the
National Immunization Survey, do grantees put the "date data collected" as the year the report came out
(ex. 2012) or the year the data is from which went into the report (ex. 2009)?
Answer: The year the data was released, in other words when the report came out. So using your example
it would be 2012.
Measure: 2.7.01 Number of birthing facilities with ideal practice on those specific practices that
facilities are addressing
Question: How should this performance measure be reported (rate/percent or numerator/count)?
Answer: This should be reported as a numerator/count.
Question: In the mPINC survey, what is the minimum threshold for ideal practice for each Baby friendly
step? May a grantee count this only if the hospital reaches 100% or can a lower percentage count as well?
Answer: It isn’t 100% for every practice, but a score of 100. The mPINC scoring algorithm defines how the
score of 100 is calculated for each step/ideal practice:
http://www.cdc.gov/breastfeeding/pdf/mPINC/mPINC_Scoring_Explanation.pdf.
Table 8 from mPINC defines ideal practices for each step:
http://www.cdc.gov/breastfeeding/data/mpinc/results-tables.htm
Measure: 2.7.02 Total composite quality score from CDC’s Maternity Practices in Infant Nutrition and
Care Survey (mPINC)
Question: How should this performance measure be reported (rate/percent or numerator/count)?
Answer: This should be reported as a Rate.
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Question: As grantees work with you throughout these upcoming years to answer the evaluation questions
listed on page 33 of the FOA, there is concern that grantees won’t be able to definitively answer Enhanced
Question #3 (To what extent has breastfeeding initiation, duration, and exclusivity increased?) because
access to that data is not available until 2017 at the earliest.
Answer: The average state total mPINC scores will only be available from CDC every 2 years (Baseline =
use 2011, Year 2 = 2013, Year 3 = no data, Year 4 = 2015, Year 5 = no data (available 2017)). Information
from the 2013 mPINC survey will be available by fall 2014. CDC is aware of this and grantees are not
required to do any additional reporting for the years that data is not available. For those years with no data,
please use data from the previous mPINC survey and document this in the notes column. Grantees can
request hospital level mPINC data from CDC every 2 years, starting with the 2011 survey, by e-mailing
mpinc@cdc.gov.
Question: The performance measure for m.2.7.02 differs on the profile and the workplan.
Answer: The language on the workplan, Total composite quality score from CDC’s Maternity Practices in
Infant Nutrition and Care Survey (mPINC), is correct and CDC will revise the profile to be consistent.
Measure: 2.7.03 Number of facilities designated as Baby-Friendly
Question: If a hospital has completed all the Baby Friendly Steps but does not want to pay $3000 for the
certification, may they still count this as a success as baby friendly?
Answer: No, the hospital has to have completed each of the four “Ds” of Baby Friendly Designation to be
counted as Baby Friendly.
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Appendix: 1305 ECE Performance Measure (PM) Guidance
CONTENTS
 1305 ECE performance measures (PM’s)
 Report using 4 sub-rows (except 2.2.07 ECE)
 General PM formulas across ECE data sources
o Basic vs. enhanced ECEs
o 2.2.07 ECE: Additional formula
 Survey items mapped to performance measures for a variety of data sources:
o LMCC (Online quiz:
https://www.healthykidshealthyfuture.org/home/startearly/quiz.html ;
PDF: https://az1.qualtrics.com/ControlPanel/File.php?F=F_0PNOU9y913Gu3sx)
o GO NAP SACC (http://gonapsacc.org/resources/nap-sacc-materials)
o NAP SACC (http://appliedresearch.cancer.gov/mfe/instruments/benjamin-nap-saccnutrition-and-physical-activity-self-assessment-for-child-care-instrument/)
o State-specific data
1305 ECE performance measures (PM’s)
Topic
Nutrition
Funding
Basic
plus
PM ID
PM summary
B.1.03/B.1.04 # ECEs that develop and adopt policies to implement nutrition
2.2.01/2.2.04 standards
# children attending ECEs that develop and/or adopt policies to
implement
nutrition standards
Enhanced
2.2.07 ECE
% ECE children increasing consumption of nutritious foods and
beverages
Physical
activity
(PA)
Basic
B.3.01/B.3.02 # ECEs/children that adopt strategies to increase PA
plus
Enhanced 2.5.01/2.5.02 # ECEs/children that develop and implement strategies to increase
2.5.03
PA
2.5.04
% ECE children engaging in levels of age-appropriate PA (as per
CFOC)
(Optional) % ECE children overweight or obese
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Report using 4 sub-rows (except 2.2.07 ECE)
All ECE performance measures except 2.2.07 ECE will each be reported as numerators on 4 sub-rows as
follows:
Sub-row 1 = # of ECEs with 100% of nutrition policies present
Sub-row 2 = ………………..… 75-99% ……………………………………….
Sub-row 3 = ………………..… 50-74% …………………..…………………..
Sub-row 4 = ………………..… <50% …………………..…………………..…
Sub-row 1 = # of children in ECEs with 100% of nutrition policies present
Sub-row 2 = ………………..………………..… 75-99% ……………………………………….
Sub-row 3 = ………………..………………….. 50-74% …………………..…………………..
Sub-row 4 = ……………………………..…..… <50% …………………..…………………..…
PM 2.2.07 ECE will be reported in sub-row 5 of PM 2.2.07 with the proxy measure “# of children
attending ECEs which have at least the median baseline percentage of nutrition policies for that state”

Note: Please indicate your median baseline percentage of nutrition policies in the notes field.
General PM formulas across ECE data sources
Step 1: For each ECE, calculate the % of policies and/or practices (hereafter “policies”) where each
ECE is meeting or exceeding guidelines (hereafter “meeting” guidelines,” (e.g., Caring for Our Children, 3rd
edition (CFOC) guidelines, or state-specific licensing guidelines on nutrition and PA)
𝐒𝐮𝐦 𝐨𝐟 [𝐧𝐮𝐭𝐫𝐢𝐭𝐢𝐨𝐧]𝐨𝐫 [𝐏𝐀](𝐡𝐞𝐫𝐞𝐚𝐟𝐭𝐞𝐫, “[𝐧𝐮𝐭𝐫𝐢𝐭𝐢𝐨𝐧]”)𝐩𝐨𝐥𝐢𝐜𝐢𝐞𝐬 𝐰𝐡𝐞𝐫𝐞 𝐭𝐡𝐞 𝐄𝐂𝐄 𝐢𝐬 𝐦𝐞𝐞𝐭𝐢𝐧𝐠 𝐠𝐮𝐢𝐝𝐞𝐥𝐢𝐧𝐞𝐬
𝐓𝐨𝐭𝐚𝐥 # 𝐚𝐠𝐞 − 𝐚𝐩𝐩𝐫𝐨𝐩𝐫𝐢𝐚𝐭𝐞1 [𝐧𝐮𝐭𝐫𝐢𝐭𝐢𝐨𝐧] 𝐩𝐨𝐥𝐢𝐜𝐢𝐞𝐬
= % of age-appropriate [nutrition] policies the ECE is meeting
Note: The exact wording for “meeting” guidelines will vary by instrument. For the purposes of the
1305 Annual Progress Report (APR):

LMCC: “Fully meeting best practice” = meeting CFOC guidelines
1
The total # of age-appropriate nutrition policies varies by the ages of children that each ECE serves. For example, some
items (e.g., breastfeeding) are relevant only to infants. Infant items would not apply to an ECE that serves preschoolers and
toddlers only; therefore, infant items would not be included in the denominator for that ECE.
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


Go NAP SACC: Depends on individual survey item. Please consult your Go NAP SACC partner for
scoring.
NAP SACC: Depends on individual survey item. Please consult your NAP SACC partner for scoring.
State-specific data, with item answer choices are “Yes/No”2 or “Acceptable/Not Acceptable”3:
“Yes” or “Acceptable” = meeting state guidelines
Example:
State A is using LMCC. River Falls ECE serves preschoolers and toddlers only; there are 8 LMCC quiz
items/policies that apply to preschoolers and toddlers. This ECE is meeting (i.e., “fully meeting”) 5 out of 8
policies. River Falls ECE’s Step 1 formula would be:
𝟓 𝐧𝐮𝐭𝐫𝐢𝐭𝐢𝐨𝐧 𝐩𝐨𝐥𝐢𝐜𝐢𝐞𝐬 (𝐢. 𝐞. , 𝐛𝐞𝐬𝐭 𝐩𝐫𝐚𝐜𝐭𝐢𝐜𝐞𝐬) 𝐰𝐡𝐞𝐫𝐞 𝐑𝐢𝐯𝐞𝐫 𝐅𝐚𝐥𝐥𝐬 𝐄𝐂𝐄 𝐢𝐬 𝐦𝐞𝐞𝐭𝐢𝐧𝐠 𝐠𝐮𝐢𝐝𝐞𝐥𝐢𝐧𝐞𝐬
𝟖 𝐭𝐨𝐭𝐚𝐥 𝐧𝐮𝐭𝐫𝐢𝐭𝐢𝐨𝐧 𝐩𝐨𝐥𝐢𝐜𝐢𝐞𝐬 𝐭𝐡𝐚𝐭 𝐚𝐩𝐩𝐥𝐲 𝐭𝐨 𝐩𝐫𝐞𝐬𝐜𝐡𝐨𝐨𝐥𝐞𝐫𝐬 𝐚𝐧𝐝 𝐭𝐨𝐝𝐝𝐥𝐞𝐫𝐬
= River Falls ECE is meeting (i.e., “fully meeting”) 62.5% of age-appropriate policies
Step 2: Apply the above formula to all 1305 ECEs in your state.
ECEs will probably display a range of % of policies present at baseline (e.g., 24% to 85%)
Example:
State A is targeting 50 ECEs. This screenshot shows targeted ECEs, and highlights % of policies each ECE
has met.
Ages served Policies met Total # policies2 % policies met
ECE
Young Dreamers ECE
River Falls ECE
Neighborhood CDC
Cloud Creek Home
Smithfield ECE
Red Apple Family Home
Grandma's Family Home
Etc.
PTI1
PT
TI
PI
P
T
I
5
5
3
2
7
4
1
9
8
8
9
8
7
1
56%
63%
38%
22%
88%
57%
100%
Notes:
1. P = preschoolers; T = toddlers; I = infants
2. Age-appropriate policies
2
E.g., ECEs complete a policy checklist. Sample item: “Water is visible and available inside and outside for self-serve:
Yes/No”
3
E.g., A state licensing agency rates ECEs on whether their individual nutrition (or PA) practices are “acceptable” or
“unacceptable,” according to state licensing guidelines.
12 | U p d a t e d
9/03/2014
Step 3 (# ECEs): Sort by percent of policies present in ECE, and report:
PM B.1.03 (# ECEs)
Sub-row 1 = # of ECEs with 100% of nutrition policies present
Sub-row 2 = ………………..… 75-99% ……………………………………….
Sub-row 3 = ………………..… 50-74% …………………..…………………..
Sub-row 4 = ………………..… <50% …………………..…………………..…
Example:
This screenshot shows targeted ECEs with the categorized % of policies each ECE has met, and the
corresponding # of ECEs that would be reported in APR sub-rows that correspond with the percent
categories (e.g., 75-99%).
% policies met % policies met
ECE
Ages served Policies met Total # policies
(sorted)
(categorized)
1
100%
Grandma's Family Home
I
1
100%
7
88%
Smithfield ECE
P
8
75-99%
River Falls ECE
PT
5
8
63%
50-74%
Red Apple Family Home
T
4
7
57%
50-74%
5
56%
Young Dreamers ECE
PTI
9
50-74%
Neighborhood CDC
TI
3
8
38%
<50%
2
22%
Cloud Creek Home
PI
9
<50%
PM B.1.03
Sub-row 1 (100%)
Sub-row 2 (75-99%)
Sub-row 3 (50-74%)
B.1.03:
# ECEs
1
1
3
Sub-row 4 (<50%)
Step 4 (# children): Generate the sum of the # of children in each percent category (e.g., 75-99%), and
report:
PM B.1.04 (# children)
Sub-row 1 = # of children in ECEs with 100% of nutrition policies present
Sub-row 2 = ………………..………………..… 75-99% ……………………………………….
Sub-row 3 = ………………..………………….. 50-74% …………………..…………………..
Sub-row 4 = ……………………………..…..… <50% …………………..…………………..…
13 | U p d a t e d
9/03/2014
2
Example:
This screenshot shows the number of children attending ECEs in each percent category.
E.g., for sub-row 3 (50-74%), there are 3 ECEs with 58+7+115 children = 180 children.
Ages Policies
ECE
served
met
I
1
Grandma's Family Home
P
7
Smithfield ECE
River Falls ECE
PT
5
Red Apple Family Home
T
4
PTI
5
Young Dreamers ECE
Neighborhood CDC
TI
3
PI
2
Cloud Creek Home
Total #
policies
1
8
8
7
9
8
9
% policies met % policies met
(sorted)
(categorized)
100%
100%
88%
75-99%
63%
50-74%
57%
50-74%
56%
50-74%
38%
<50%
22%
<50%
B.1.03:
B.1.04:
PM B.1.03/B.1.04 # ECEs # Children # children
1
Sub-row 1 (100%)
6
6
1
Sub-row 2 (75-99%)
35
35
Sub-row 3 (50-74%)
3
58
180*
7
115
Sub-row 4 (<50%)
2
47
52§
5
* I.e., sum of children served in the 3 ECEs with 50-74% policies
§ I.e., sum of children served in the 2 ECEs with <50% policies
Note: States which do not have the # of children served by individual ECEs may request the mean number
of children per center and per family home (based on LMCC data for that state) from
eceobesity@cdc.gov.
Step 5: For enhanced-funded grantees: How to report on basic vs. enhanced outcomes:
Option 1: As per guidance provided in the DNPAO FAQ’s (Part 1: General DNPAO FAQ’s): “For enhanced,
grantees are expected to either increase their target settings or increase the intensity/number of activities
within the same target settings. For example, for enhanced strategies, states can either increase the
number of ECEs they are conducting similar activities in or increase the number and/or intensity of
activities in the same number of ECEs. If the latter is the case, then targets for both basic and enhanced can
be the same. Please document this in the notes field next to that performance measure.”
Option 2: For states that are having difficulty distributing ECEs to either basic or enhanced strategies,
and/or have discussed this approach with their DNPAO project officer and evaluator, an alternative is to
apply a 30% basic plus/70% enhanced split to the total number of targeted ECEs and children served
with 1305 funds. Please document this in the notes field next to that performance measure.

Example: State A is working with 100 ECEs. State A would report on 30 ECEs (and the children
attending these 30 ECEs) for basic plus measures (i.e., B.1.03/B.1.04 and B.3.01/B.3.02), and 70
ECEs (and their children) for enhanced measures (i.e., 2.2.01/2.2.02; 2.2.07 ECE; 2.5.01/2.5.03;
2.5.07).
14 | U p d a t e d
9/03/2014
General formula for 2.2.07 ECE (sub-row 5 of 2.2.07)
Note: For PM 2.2.07 ECE, please use sub-row 5 of PM 2.2.07 to report the # of children attending ECEs
which have at least the median baseline percentage of nutrition policies for your state.
Steps 1 and 2. Same as above, but for a reduced # of items specific to nutritious foods and beverages.
(For a list of items, please see row “2.2.07 ECE” for your data collection instrument.)
Step 3. Sort by % of policies present in ECE. Calculate median (e.g., 72%). You can use the Excel cell
formula “=MEDIAN(column)”.
Step 4. Sum the # of children that attend the ECEs that are meeting [median]% or more of the policies
measured.
Example:
In this screenshot, the median % of policies that your ECEs are meeting is 75%. You will report the sum
of the number of children that attend the ECEs that are meeting 75% or more of the policies measured.
I.e., 58+6+35+7 children in ECEs above the median = 106 children reported for 2.2.07 ECE/sub-row 5 of
2.2.07. Please also put the median (75%) in the notes field.
ECE
River Falls ECE
Grandma's Family Home
Smithfield ECE
Red Apple Family Home
Young Dreamers ECE
Neighborhood CDC
Cloud Creek Home
15 | U p d a t e d
Ages
served
PT
I
P
T
Policies
met
4
1
3
3
PTI
TI
PI
3
2
1
9/03/2014
Total # % policies met
policies
(sorted)
# Children
4
100%
58
1
100%
6
4
75%
35
4
75% = median
7
5
5
5
60%
40%
20%
115
47
5
2.2.07 ECE:
# children
Sub-row 5, 2.2.07
=106
(i.e., 58+6+35+7 = 106)
Notes
BL median = 75%
Survey items mapped to performance measures: LMCC
Note: For the 2015 APR, CDC will populate ECE measures for states that opt in to using the LMCC
data.
B.1.04
#
LMCC quiz items/best practices (BP’s)
items
(Numbering is out of 15 items on LMCC quiz)
Up to 9 Items included in the calculation for this PM: #1-8, 14
Answer if you (ECE) serve TODDLERS and/or PRESCHOOLERS:
1. Drinking water is visible and available inside and outside for self-serve
2. 100% fruit juice is limited to no more than 4-6 oz. per day per child and
parents are encouraged to support this limit
3. Sugary drinks, including fruit drinks, sports drinks, sweet tea, and soda,
are never offered
4. Children 2 years and older are served only 1% or skim/non-fat milk
(unless otherwise directed by the child’s health provider)
5. Fruit (not juice) and/or a vegetable is served to toddlers and
preschoolers at every meal (French fries, tator tots, and hash browns
don’t count as vegetables)
6. French fries, tator tots, hash browns, potato chips, or other fried or prefried potatoes are offered to toddlers and preschoolers no more than
once a month (Baked fries are okay)
7. Chicken nuggets, fish sticks, and other fried or pre-fried forms of frozen
and breaded meats or fish are offered to toddlers and preschoolers no
more than once a month
Answer if you serve PRESCHOOLERS:
8. All meals to preschoolers are served family style so that children are
encouraged to serve themselves with limited help
Answer if you serve INFANTS:
14. Breastfeeding mothers are provided access to a private room for
breastfeeding or pumping, other than a bathroom, with appropriate
seating and privacy
Sum of # of children attending ECEs that are have nutrition policies, as per B.1.03
2.2.01
2.2.04
Up to 9 See B.1.03
Sum of # of children attending ECEs that are have nutrition policies, as per 2.2.01
Basic plus
Nutrition
PM
ID
B.1.03
16 | U p d a t e d
9/03/2014
PM
ID
2.2.07
ECE
#
LMCC quiz items/best practices (BP’s)
items
(Numbering is out of 15 items on LMCC quiz)
Up to 5 # of children attending ECEs which have at least the median baseline percentage
of nutrition policies for that state
2.5.01
2.5.02
Up to 6 See B.3.01
Sum of # of children attending ECEs that are have PA policies, as per 2.5.01
17 | U p d a t e d
9/03/2014
Basic plus
B.3.01
Physical activity (PA)
B.3.02
Up to 6 Items included in the calculation for this PM: #9-13, 15
Answer if you serve PRESCHOOLERS:
9. Preschoolers, including children with special needs, are provided with
120 minutes or more of active play time every day, both indoor and
outdoor (for half-day programs, 60 minutes or more is provided for
active play every day)
10. We strive to limit total screen time (e.g., TV and DVD viewing, computer
use) to no more than 30 minutes for preschoolers at child care per week
or never, and we work with parents/caregivers to ensure that children
have no more than 1-2 hours per day (for half-day programs, we strive to
limit total screen time to no more than 15 minutes per week or never)
11. Parents of preschoolers are provided screen time reduction and/or
media literacy education such as special programs, newsletters, or
information sheets, 2 or more times per year
Answer if you serve TODDLERS:
12. Toddlers, including children with special needs, are provided with 60-90
minutes or more of active play time every day, both indoor and outdoor
(for half-day programs, 30 minutes or more is provided for active play
every day)
Answer if you serve INFANTS or TODDLERS:
13. Screen time for toddlers and infants is limited to no more than 3-4 times
per year or is never allowed
Answer if you serve INFANTS:
15. Short supervised periods of tummy time are provided for all infants,
including those with special needs, several times each day
Sum of # of children attending ECEs that are have PA policies, as per B.3.02
En
ha
nc
ed
Enhanced
Items included in the calculation for this PM: #1, 2, 4, 5, 14
Answer if you (ECE) serve TODDLERS and/or PRESCHOOLERS:
1. Drinking water is visible and available inside and outside for self-serve
2. 100% fruit juice is limited to no more than 4-6 oz. per day per child and
parents are encouraged to support this limit
4. Children 2 years and older are served only 1% or skim/non-fat milk
(unless otherwise directed by the child’s health provider)
5. Fruit (not juice) and/or a vegetable is served to toddlers and
preschoolers at every meal (French fries, tator tots, and hash browns
don’t count as vegetables)
Answer if you serve INFANTS:
14. Breastfeeding mothers are provided access to a private room for
breastfeeding or pumping, other than a bathroom, with appropriate
seating and privacy
PM
ID
2.5.03
2.5.04
18 | U p d a t e d
#
LMCC quiz items/best practices (BP’s)
items
(Numbering is out of 15 items on LMCC quiz)
Up to 3 Answer if you serve PRESCHOOLERS:
12. Preschoolers, including children with special needs, are provided with
120 minutes or more of active play time every day, both indoor and
outdoor (for half-day programs, 60 minutes or more is provided for
active play every day)
Answer if you serve TODDLERS:
14. Toddlers, including children with special needs, are provided with 60-90
minutes or more of active play time every day, both indoor and outdoor
(for half-day programs, 30 minutes or more is provided for active play
every day)
Answer if you serve INFANTS:
16. Short supervised periods of tummy time are provided for all infants,
including those with special needs, several times each day
N/A
(Optional. LMCC does not collect child BMI.)
9/03/2014
Go NAP SACC (Centers):
Basic plus
PM ID
B.1.03
# items
Up to
68
B.1.04
2.2.01
2.2.04
Up to
68
2.2.07
ECE
Up to
15
Go NAP SACC (Centers) survey items
All items in:
Child nutrition (23 items)
Breastfeeding & infant feeding (45 items)
Sum of # of children attending ECEs that are have nutrition policies, as per
B.1.03
See B.1.03
Sum of # of children attending ECEs that are have nutrition policies, as per
2.2.04
# of children attending ECEs which have at least the median baseline
percentage of nutrition policies for that state
Items included in the calculation for this PM:
Enhanced
Nutrition
Child nutrition: #1-5, 9, 10, 15, 17, 36
1. Our program offers fruit
2. Our program offers fruit that is fresh, frozen, or canned in juice (not in
syrup)
3. Our program offers vegetables
4. Our program offers dark green, orange, red, or deep yellow vegetables
5. Our program offers vegetables that are cooked or flavored with meat fat,
margarine, or butter
9. Our program offers meats or meat alternatives that are lean or low fat
10. Our program offers high-fiber, whole grain foods
15. Our program offers children a 4–6 oz. serving of 100% fruit juice
17. For children ages 2 years and older, our program offers milk that is
36. During indoor and outdoor physically active playtime, teachers remind
children to drink water
Physical
activity (PA)
Enha
Basic
nced
plus
Breastfeeding & infant feeding: #1-3, 10-11
1. A quiet and comfortable space, set aside for mothers to breastfeed or
express breast milk, is available
2. The following are available to mothers in the space set aside for
breastfeeding or expressing breast milk
3. Enough refrigerator and/or freezer space is available to allow all
breastfeeding mothers to store expressed breast milk
10. When our program purchases cereal or formula for infants, it is iron rich
11. When our program purchases or prepares mashed or pureed meats or
vegetables for infants, these foods contain added salt
B.3.01
Up to
54
B.3.02
2.5.01
2.5.02
19 | U p d a t e d
All items in “Section II: Physical Activity”
(PA1) Active Play and Inactive Time – (PA5) Physical Activity Policy
Sum of # of children attending ECEs that are have PA policies, as per B.3.01
Up to
54
9/03/2014
See B.3.01
Sum of # of children attending ECEs that are have PA policies, as per 2.5.01
PM ID
2.5.03
# items
Up to 8
Go NAP SACC (Centers) survey items
Sum of # of children attending ECEs that are meeting CFOC guidelines in 2.5.01
Items included in the calculation for this PM:
Infant & child physical activity: #1-4
1. The amount of time provided to preschool children for indoor and
outdoor physical activity each day is
2. The amount of time provided to toddlers for indoor and outdoor
physical activity each day is
3. Our program offers tummy time to non-crawling infants
4. The amount of adult-led physical activity our program provides to
preschool children each day is
Outdoor play & learning: #1-4
1. Outdoor playtime is provided to preschool children and toddlers
2. The amount of outdoor playtime provided to preschool children each
day is
3. The amount of outdoor playtime provided to toddlers each day is
4. Infants are taken outdoors
Screen time: None
2.5.04
20 | U p d a t e d
N/A
9/03/2014
(Optional. Go NAP SACC does not collect child BMI.)
Go NAP SACC (Family homes):
Basic plus
Nutrition
PM ID
B.1.03
# items
Up to 66
B.1.04
2.2.01
Up to 66
2.2.04
21 | U p d a t e d
9/03/2014
Go NAP SACC (Family homes) survey items
All items in:
Child nutrition (23 items)
Breastfeeding/Infant feeding (45 items)
Sum of # of children attending ECEs that are have nutrition policies, as
per B.1.03
See B.1.03
Sum of # of children attending ECEs that are have nutrition policies, as
per 2.2.04
PM ID
2.2.07
ECE
# items
Up to 16
Go NAP SACC (Family homes) survey items
# of children attending ECEs which have at least the median baseline
percentage of nutrition policies for that state
Physical
activity (PA)
E Basic plus
n
h
a
n
c
e
d
Enhanced
Items included in the calculation for this PM:
Child nutrition: #1-5, 9, 10, 14, 15, 17, 35
1. My program offers fruit
2. My program offers fruit that is fresh, frozen, or canned in juice
(not in syrup)
3. My program offers vegetables
4. My program offers dark green, orange, red, or deep yellow
vegetables
5. My program offers vegetables that are cooked or flavored with
meat fat, margarine, or butter
9. My program offers meats or meat alternatives that are lean or
low fat
10. My program offers high-fiber, whole grain foods
14. Drinking water is available
15. My program offers children a 4–6 oz. serving of 100% fruit juice
17. For children ages 2 years and older, my program offers milk that
is
35. During indoor and outdoor physically active playtime, I remind
children to drink water
Breastfeeding & infant feeding: #1-3, 9-10
1. A quiet and comfortable space for mothers to breastfeed or
express breast milk is available
2. The following are available to mothers in the space for
breastfeeding or expressing breast milk
3. Enough refrigerator and/or freezer space is available to allow all
breastfeeding mothers to store expressed breast milk
9. When I purchase cereal or formula for infants, I choose iron-rich
products
10. When I purchase or prepare mashed or pureed meats or
vegetables for infants, these foods contain added salt
B.3.01
Up to 47
B.3.02
2.5.01
22 | U p d a t e d
Up to 47
9/03/2014
All items in “Section II: Physical Activity”
(PA1) Active Play and Inactive Time – (PA5) Physical Activity Policy
Sum of # of children attending ECEs that are have PA policies, as per
B.3.01
See B.3.01
PM ID
2.5.02
# items
2.5.03
Up to 5
2.5.04
23 | U p d a t e d
N/A
9/03/2014
Go NAP SACC (Family homes) survey items
Sum of # of children attending ECEs that are have PA policies, as per
2.5.01
Sum of # of children attending ECEs that are meeting CFOC guidelines in
2.5.01
Items included in the calculation for this PM:
Infant & child physical activity: #1-3
1. The amount of time I provide for children’s indoor and outdoor
physical activity each day is
2. I offer tummy time to non-crawling infants
3. The amount of adult-led physical activity my program provides to
children each day is
Outdoor play & learning: #1-2
1. I provide time for outdoor play
2. The amount of time I provide for outdoor play each day is
Screen time: None
(Optional. Go NAP SACC does not collect child BMI.)
NAP SACC:
Note: CDC recognizes that not all NAP SACC items reflect the latest CFOC guidelines (3rd ed.). CDC
recognizes that some grantees may have a lag in moving from NAP SACC to Go NAP SACC. For the 2015
APR, this is acceptable. For future years, CDC recommends that grantees consider migrating from NAP
SACC to Go NAP SACC, as staffing and resources allow. (Please see “Main changes” below for a summary of
differences between the instruments.)
PM ID
Basic plus
B.1.03
#
items
37
B.1.04
2.2.01
37
2.2.04
2.2.07
ECE
11
NAP SACC Survey items
All items in “Section I: Nutrition” (pg. 1-4)
(N1) Fruits and Vegetables – (N9) Nutrition Policy
Sum of # of children attending ECEs that are have nutrition policies, as per
B.1.03
See B.1.03
Sum of # of children attending ECEs that are have nutrition policies, as per
2.2.04
# of children attending ECEs which have at least the median baseline
percentage of nutrition policies for that state
Enhanced
Nutrition
Items included in the calculation for this PM:
Fruits and vegetables: (N1) A-E
(N1) A. Fruit (not juice) is offered
(N1) B. Fruit is offered canned in own juice (no syrups), fresh, or
frozen
(N1) C. Vegetables (not including French fries, tater tots, hash
browns, or dried
beans) are offered
(N1) D. Vegetables, other than potatoes, corn, and green beans, are
offered
(N1) E. Cooked vegetables are prepared with added meat fat,
margarine or butter
Meats, fats, and grains: (N2) D-E
(N2) D. Beans or lean meats (baked or broiled chicken, turkey, or
fish) are offered
(N2) E. High fiber, whole grain foods (whole wheat bread, oatmeal,
brown rice,
Cheerios®, etc) are offered
Beverages: (N3) A-C, E
(N3) A. Drinking water outside is
(N3) B. Drinking water inside is
(N3) C. 100% fruit juice is offered
(N3) E. Milk served to children ages 2 years and older is usually
Physical
activity (PA)
Enh
Basic
anc
plus
ed
B.3.01
17
B.3.02
2.5.01
2.5.02
24 | U p d a t e d
All items in “Section II: Physical Activity”
(PA1) Active Play and Inactive Time – (PA5) Physical Activity Policy
Sum of # of children attending ECEs that are have PA policies, as per B.3.01
17
9/03/2014
See B.3.01
Sum of # of children attending ECEs that are have PA policies, as per 2.5.01
PM ID
2.5.03
2.5.04
#
items
1
N/A
NAP SACC Survey items
Sum of # of children attending ECEs that are meeting CFOC guidelines in
2.5.01
Item: (PA1) Item A. Active play time is provided to all children: “91-120
minutes each day,” or “More than 120 minutes each day”
(Optional. NAP SACC does not collect child BMI.)
Main changes from NAP SACC to Go NAP SACC—in Go NAP SACC:
1. Physical activity duration question is broken out by age group into 3 questions to reflect agespecific CFOC guidelines (i.e., preschoolers: 90-120 minutes; toddlers: 60-90 minutes; infants:
tummy time)
2. Added:
a. New breastfeeding/infant feeding section
b. New screen time section
c. New items in existing sections (i.e., preschooler and toddler nutrition, physical activity,
outdoor physical activity environment)
3. Separate set of instruments for family homes
25 | U p d a t e d
9/03/2014
State-specific data:
Example: State B has 35 items on their state-specific ECE instrument:



20 are nutrition items (e.g., meals are served family style)
o Six (6) items discuss the provision of nutritious foods and beverages (e.g., a vegetable at
every meal)
10 are PA items (e.g., screen time limits)
o Three (3) items discuss age-appropriate levels of PA.
5 are not relevant to PA or nutrition (e.g., sanitation). These should not be included in 1305 PM
calculations.
Enhanced
Nutrition
Basic plus
Sample crosswalk of how State B’s ECE survey items map onto 1305 ECE PM’s
PM ID
Survey items
B.1.03/B.1.04 20 nutrition items
2.2.01/2.2.04 Can pertain to any aspect of the ECE nutrition environment. For example:
 Healthy and/or unhealthy foods and beverages served
 Teacher nutrition practices (e.g., asking child before serving seconds)
 Parent nutrition education
2.2.07 ECE
Note: Please report the # of children attending ECEs which have at least the
median baseline percentage of nutrition policies for that state
6 items on healthy foods and beverages (including water and breastmilk)
For example:
 Serves a fruit and/or vegetable at lunch
 Offers water throughout the day
 Provides a place to breastfeed or express milk (not a bathroom)
 Note: Please do include items on breastfeeding facilities (e.g., a private
room) and amenities (e.g., refrigerator space) for nursing mothers
 Note: Please do not include items on unhealthy foods and beverages (e.g.,
fried potatoes, chips, soda)
Physical activity
(PA)
E
Basic plus
n
h
a
n
c
e
d
B.3.01/B.3.02 10 PA items
Can pertain to any aspect of the ECE PA environment. For example:
 Amount of time provided for active play (e.g., as per CFOC guidelines,
provide 90-120 minutes daily for preschoolers)
 Teacher-led PA
 Teachers cannot withhold PA as punishment
 Limits on screen time, parent screen time education
2.5.01/2.5.02 See B.3.01/B.3.02
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2.5.03
2.5.04
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3 items on age-appropriate levels of PA
For example:
 Daily duration for preschoolers: 90-120 minutes for an 8-hour day
 ………………………… toddlers: 60-90 minutes……………………………………
 ………………………… infants: daily tummy time…………………………………
 Note: CFOC recommendations on the daily duration of PA vary by age.
Some grantee instruments may not distinguish between age groups for PA;
this is acceptable for the 2015 APR. For future years, we encourage
grantees to move towards incorporating age-specific PA duration
guidelines into their instruments.
(Optional. Some state-specific data sources may not collect child BMI. This is
acceptable.)
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