Start Right Table of Contents
1. Emergency Preparedness
1.1: Emergency preparedness plan/policy
Example template
1.2: Emergency drills
Example drill record sheet
1.3: Staff training in emergency drills
Example staff training log
2.1: Emergency radio, batteries, telephone
2.2: Emergency plan reviewed and updated
Example emergency plan review log
2.3: Parent education on emergency preparedness
http://health.mo.gov/emergencies/readyin3/index.php
www.cdc.gov
http://www.preparemetrokc.org
3.1: Shelter in Place
Example shelter in place maintenance log
Supply list
3.2: Emergency backpacks
Suggested supplies
3.3: Grab and Go binder
Suggested list of information for binder
3.4: Trained in emergency preparedness/ready in 3
Staff training log
DHSS online training: http://health.mo.gov/safety/childcare/training.php
2. Indoor Safety
1.1: Play equipment
1.2: Facility ventilation
1.3: Window barriers
2.1: Product Safety
Consumer Product Safety Commission: www.cpsc.gov
2.2: Parent education indoor safety
www.safekids.org
www.kidshealth.org
www.cdc.gov
2.3: Poison Prevention for children
Child’s training certificate
3.1: Medication Administration training
Staff training log
3.2: Asthma management training
Staff training log
3.3: Medication Administration & Poison Prevention Policy
Example Medication Administration Policy
Medication Administration packet:
http://cfoc.nrckids.org/WebFiles/AppedicesUpload/AppendixAA.pdf
Example Poison Prevention Policy
List of non-poisonous and poisonous plants:
http://cfoc.nrckids.org/WebFiles/AppedicesUpload/AppendixY.pdf
3. Outdoor Safety
1.1: Outdoor equipment
1.2: Children training for equipment use
Children training certificate
1.3: Sunscreen use
Example sunscreen authorization form
2.1: Playground safety
Playground inspection sheet
2.2: Parent education on carseat safety
www.safekids.org
www.kidshealth.org
2.3: Bike helmets
Bike helmet fact sheet:
http://cfoc.nrckids.org/WebFiles/AppedicesUpload/AppendixII.pdf
3.1: Outdoor safety staff training
Staff training sheet
3.2: Simple Shelter
3.3: Outdoor safety policy
Example outdoor safety policy
4. Safe Sleep
1.1: Placed on back to sleep
1.2: No sharing crib, bed, bedding
1.3: Facility uses firm tight-fitting mattress
2.1: Infants observed at all times
2.2: Parent education on safe sleep
www.safekids.org
http://www.healthychildcare.org/sids.html
2.3: Designated sleep areas are labeled
Example label
3.1: Safe Sleep policy
Example policy
3.2: Safe Sleep training
Staff training sheet
3.3: Soft/loose bedding and blanket-free cribs
5. Communicable Disease
1.1: Immunization record on file
1.2: Tracking system for immunizations
1.3: Communicable disease policy
Example communicable disease policy
2.1: Trained in immunizations and or record keeping
Staff training log
2.2: Parent education on communicable diseases
www.cdc.gov
http://www.healthychildren.org/english/safety-prevention/immunizations/Pages/default.aspx
2.3: Hand-washing classes
Children training certificate
2.4: Flu vaccination
Declination letter
3.1: 100% compliant initial immunization audit
3.2: Trained in communicable disease
Staff training sheet
DHSS online training: http://health.mo.gov/safety/childcare/index.php
3.3: Tdap vaccination
Declination letter
3.4: Surveillance site
Surveillance form
6. Physical Activity
1.1: Daily schedule of activities
1.2: Appropriate play
Reference sheet with example age-appropriate activities
http://www.healthykidshealthyfuture.org/content/dam/hkhf/filebox/khchildcareguide.pdf
1.3: Outdoor play
2.1: Structured play
2.2: Supervised infant play
2.3: Physical activity training
Staff training sheet
3.1: Physical activity policy (reference Model policies for creating a healthy
nutrition & physical activity environment in child care settings)
http://health.mo.gov/living/wellness/nutrition/eatsmartguidelines/pdf/Model_Policies.pdf
Example 1 physical activity policy
Example 2 physical activity policy
3.2: Screen time
3.3: Daily physical activity
7. Nutrition
1.1: Drinking water
1.2: Nutritional requirements
Copy of diet plan: http://health.mo.gov/safety/childcare/pdf/I-TBCC-12.pdf
1.3: Milk and meals
Weekly menu: http://health.mo.gov/safety/childcare/pdf/BCC-9.pdf
2.1: Staff eats with children
2.2: Parent education on breastfeeding
www.womenshealth.gov
http://www.healthychildren.org/english/ages-stages/baby/breastfeeding/Pages/default.aspx
2.3: Trained in nutrition
Staff training log
3.1: Nutrition policy (reference Model policies for creating a healthy nutrition &
physical activity environment in child care settings)
http://health.mo.gov/living/wellness/nutrition/eatsmartguidelines/pdf/Model_Policies.pdf
Example nutrition policy
3.2: Fresh fruits & vegetables
Weekly menu: http://health.mo.gov/safety/childcare/pdf/BCC-9.pdf
3.3: Beverages
Weekly menu: http://health.mo.gov/safety/childcare/pdf/BCC-9.pdf
8. General Safety
1.1: Read/reviewed licensing rules: http://health.mo.gov/safety/childcare/lawsregs.php
1.2: CPR/First Aid (1:20)
1.3: Background checks
2.1: CPR/First Aid (all staff)
2.2: Parent education on CPR/First Aid
www.heart.org
2.3: Children Health Promotion
Children training certificate
www.independencemo.org/health/MatChildHealth.aspx
2.4: Trained in facility safety
Staff training log
3.1: Call system for absent children
3.2: Smoke-free campus
Example policy
Tips for implementation
3.3: Critical violation environmental health
Sanitation report
Emergency Preparedness
1.1: Facility has an emergency preparedness plan/policy
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The plan will be visually checked off during a site visit
An example plan is provided if the center does not have a plan developed
Example plan can be found on the MO DHSS website label Emergency
Plan Template http://health.mo.gov/safety/childcare/forms.php
1.2: Holds emergency drills monthly and quarterly
 The drills will be checked using the drill record sheet included in this book
 Emergency drills include but not limited to: fire, tornado, and earthquake
 Fire drills will be conducted monthly and disaster drills every three months
1.3: All staff trained upon hire in facility emergency operations
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The trainings will be checked using the training log. Included in this book
are example logs if the center does not have one developed
 Training for staff should include but not limited to: fire, tornado,
earthquake, and basic “what to do in an emergency”
 The training is only required one time: upon hire
2.1: Has an emergency radio, batteries, and telephone at each site

The emergency radio, batteries, and telephone will be visually checked off
during a site visit and checked to be in working condition
2.2: Emergency preparedness plan is reviewed and updated annually by director or
designee

The plan review will be checked off using the “emergency plan review log”
provided in this book during a site visit
 The purpose of reviewing the plan is to make any updates, changes, and
to keep current on procedures
2.3: Parent education on emergency preparedness is displayed at pick-up/drop-off area
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The educational materials will be visually checked off during a site visit
Educational brochures and fliers are available through the Independence
Health Department, Center for Disease Control, Missouri Department of
Health and Senior Services, Independence Emergency Management
3.1: Each site has created and maintained a (24 hr.) shelter in place kit

The shelter in place kit will be visually checked and the maintenance log
will be checked during site visits
 A list of supplies needed for the kit and maintenance log are included in
this book
 The kit needs to be contained in a plastic durable container
 The kit should be checked annually for expired supplies and to replace or
add supplies
3.2: Emergency backpack kit is in each classroom
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The backpacks will be visually checked during site visit
A list of suggestions for the backpacks are included in this resource book
3.3: Grab & Go binder
 The binder will be visually checked during site visit
 A list of suggestions for what to include in the binder is included in this
resource book
3.4: Trained one time in “Ready in 3”
 The trainings will be checked using the training log.
 Included in this book are example logs if the center does not have one
developed
[Insert Child Care Facility] Emergency Drill Record
Date of Drill _______________
Time of Drill _______________
Type of Drill_______________________________
Brief Description of Drill:
Rooms Participating in Drill:
Lessons Learned & Future Changes:
Facility Director Signature:_________________________________
*record staff in attendance on the staff training sheet
Date:______________________
Staff Member Training Log
Staff Member Name: ____________________________________Date Hired: ______________
Does this staff member work with infants? YES NO
Training Topic:____________________________________ Training Date: ________________
Instructor Name: ______________________
Training Topic:____________________________________ Training Date: ________________
Instructor Name: ______________________
Training Topic:____________________________________ Training Date: ________________
Instructor Name: ______________________
Training Topic:____________________________________ Training Date: ________________
Instructor Name: ______________________
Training Topic:____________________________________ Training Date: ________________
Instructor Name: ______________________
Emergency Plan Review Log
Date
Changes Made (list sections for reference)
Reviewed By
Shelter In Place: Maintenance Log
Date
Supplies Needed
Supplies Added
Supplies Replaced
No Action
needed
Checked By
Notes about supplies:
Supplies can be expensive. To “grow” your stock of appropriate supplies:

 Review the lists and decide which supplies are priorities at your site.
 Develop a supply rotation system that allows you to use perishable supplies in
your normal operations before the expiration date. For example, buy canned food
that is normally on your menu, and plan to replace and serve it every 6 months.
 Team up with another program to buy supplies in bulk.
 Request a small disaster supply fee from families or specific donations.
 Seek specific donations from the community.
1-Day Supplies per 50 people
SURVIVAL
Water
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32 oz per person and child (2 plastic water bottles) - Required
1 gallon of water per adult – (recommended)
1/2 gallons of water per child – (recommended)
any tools needed to open water containers
cups to dispense water
Stored: _____________________________
Food
Emergency Food:
 Is easy to serve
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Does not require cooling or heating
Has a long shelf life
Is stored protected from heat, cold, and pests
 Our emergency food is part of our regular menu rotation. Food for 1 extra day is
always on site. (Familiar food can be a comfort during a disaster.) It is rotated
_____________________ (how often) by ____________________ (whom).
 We have a separate supply of emergency food. Expiration dates are checked
_____________________ (how often) by ____________________ (whom).
We include food for those with food allergies or on special diets.
We include age-appropriate food, such as formula and pureed food for infants (when
enrolled).
Supplies kept with food include:
 Plastic dishes and utensils
 Manual can opener
 Bottles for infants
Stored: ________________________________
General
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flashlight w/ extra set of batteries per every 2 staff person
blanket (fleece, wool, &/or “__________”) per person
(5) extra blankets
(10) plastic sanitation bags
privacy shelter
(10) rolls toilet paper
(25) sanitary napkins
(10) plastic garbage bags
(10) rolls paper towels
(250) soap towelettes packets or baby wipes
(5) bars of soap (recommended)
(2) 5 gal plastic buckets for
sanitation/emergency toilets (recommended)
(10) 12-hour light sticks
battery-operated lanterns w/ extra batteries - recommended
battery powered or handcrank radio (NOAA Weather Radio, if possible)
multipurpose tool
first aid kit
medications
(1) small bottle bleach
plastic sheeting
duct tape
(25) dust masks
Stored: ________________________________
Special Equipment/Other
 Medical supplies for children with special health care needs:
____________________________________________________
__________________________________________________________________
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____________
__________________________________________________________________
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____________
Stored: ________________________________
Backpack Kit Supply List
Be sure the back packs are located somewhere you can grab it on the way
out the door every time your class leaves the classroom!
□ Backpack, labeled for easy identification
□ Emergency forms for students (& staff)
□ “Rescue” medications with authorization forms
□ First aid kit
□ Flashlight(s) & batteries
□ Whistle
□ Bottle of water with small paper cups &/or (infant) bottles
□ Tarp or ground cover
□ (2) Mylar blankets
□ Tissues, toilet paper, &/or wipes
□ Age-appropriate snacks (including infant formula)
□ Diapers (& plastic bags for disposal) for infants, toddlers, & children
with special needs
□ Age-appropriate time passers (books, crayons, paper, etc…)
What is a “Grab & Go” bag?
A Grab & Go bag contains essential items for an emergency. It includes things that you may
need in the first hour or so following an emergency/disaster. A Grab & Go bag contains only
a small portion of your disaster supplies, but is a key part of your preparedness and
response. A Grab & Go bag should be easy to transport. A backpack (daypack) usually
makes the best carrier.
What should our Grab & Go bag contain?
A Grab & Go bag should include current emergency contact information, a first aid kit,
“rescue” medications* with paperwork, and a flashlight. Tarps and/or blankets are also
helpful for all ages. Include other items appropriate to the age(s) of children served. (Just
make sure that you can easily carry your Grab & Go bag!)
Should the Grab & Go bag have enough formula and diapers for all infants?
No. Remember that this bag is designed to meet immediate needs for a limited time. Make
sure that you have additional supplies in your 24 hour disaster supply kit.
How many Grab & Go bags do we need?
A Grab & Go bag should be assembled for each class in your child care center or for each
child care area of your home.
Where should we keep our Grab & Go bags?
Your Grab & Go bag should accompany your class everywhere. In the classroom, the best
place to keep it is on a hook by the door that you usually use to exit (and that you are most
likely to evacuate through). When you leave the classroom, always take it along. Your Grab
& Go bag should be with you on the playground, field trips, fire drills, or any other planned
or unplanned classroom departure. Some programs have installed hooks on their
playgrounds to hang their Grab & Go bags when they are outside. The Grab & Go bag
should be out of children’s reach at all times. (Again, don’t make it too heavy – no one
should be tempted to set it on the ground where it would be easily accessible to children.)
We’ll have to update our Grab & Go bag from time to time, won’t we?
Absolutely, Make sure you have a system in place for keeping emergency contact
information current. Check expiration dates of food, water, batteries, and any medication,
and replenish those items regularly. Keep first aid supplies fully stocked.
*Rescue medications include EpiPens®, asthma inhalers, or any other medications that a
specific child may need to keep him/her alive.
**Information provided by Missouri Department Health and Senior Services and Seattle & King County Public Health Department
Grab and Go Binder
The grab and Go binder should be located in the facility and the designated person in
charge should have access to the binder for emergency purposes. The binder should
include but not limited to the following items:
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Emergency contact information for each child
Medical information for each child (rescue medications, allergy information, list of
medications, etc)
 Release information for each child
 Basic information on each child (name, age, parents/guardian)
This binder should be kept current and updated throughout the year and reviewed
annually by director or designee.
Indoor Safety
1.1: Play equipment and materials are cleaned daily & in good working condition
 This will be visually checked during site visit
 A log is provided in this book and it will be checked during site visit
1.2: Facility is dry, well-ventilated, free of drafts and temperature controlled
 This will be visually checked during site visit
1.3: Barriers to prevent children from falling into or through windows are in place
 This will be visually checked during site visit
2.1: Facility is on a listserve for product safety and recall notifications
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Print outs of recalls will be visually checked
Recalls should be posted at pick-up/drop-off area
To sign up to receive recall information visit: Consumer Product Safety
Commission www.cpsc.gov
2.2: Parent education on indoor safety is displayed at pick-up/drop-off area

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This will visually checked during site visit
Safety information can be obtained online at Center for Disease Control
and Prevention, Missouri Department of Health and Senior Services, and
Safe Kids USA or you can contact the Independence Health Department
2.3: Poison prevention education is provided for preschool age children annually
 Training log will be checked
3.1: Director or designee are trained in medication administration and in turn train staff

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Director and staff will need to complete training every three years after
initial training
The training log will be checked for staff training
3.2: Director or designee are trained in asthma management and in turn train staff

Director and staff will need to complete training every three years after
initial training
 The training log will be checked for staff training
3.3: Has a written policy on medication administration and poison prevention
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Policies will be checked and reviewed during site visit
Example policies on both medication administration and poison prevention
are provided in this book if the site does not have a policy developed
Included in the book are forms that can be used for medications
(permission form, receiving medications, medication log, incident report,
check list for giving medication). These can be used if site does not have
forms developed
An informational list of poisonous and non-poisonous plants is also
included in this book
Independence Start Right Childcare Program
Written Policy on Use of Medications
Administering medication requires skill, knowledge and careful attention to detail.
Parents/guardians and prescribing health professionals must give a caregiver/ teacher
written authorization to administer medication to the child. Caregivers/teachers must be
diligent in their adherence to the medication administration policy and procedures to
prevent any inadvertent medication errors, which may be harmful to the child
Consent Forms:
The use of written parental/guardian consent forms for each prescription and OTC
medication to be administered at the child care facility. The consent form should
include:
 The child’s name
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The name of the medication
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The date(s) and times the medication is to be given
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The dose or amount of medication to be given
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How the medication is to be administered
The period of time the consent form is valid, which may not exceed the length of time
the medication is prescribed for, the expiration date of the medication or one year,
whichever is less.
The use of the prescribing health professional’s authorization forms for each
prescription and OTC medication to be administered at the child care facility.
Medication:
The circumstances under which the facility will agree to administer medication. This
may include the administration of:
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Topical medications such as non-medicated diaper creams, insect repellants,
and sun screens
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OTC medicines for fever including acetaminophen and ibuprofen

Long-term medications that are administered daily for children with chronic health
conditions that are managed with medications
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Controlled substances, such as psychotropic medications
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Emergency medications for children with health conditions that may become lifethreatening such as asthma, diabetes, and severe allergies

One-time medications to prevent conditions such as febrile seizures.
The circumstances under which the facility will not administer medication, this should
include:
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No authorization from parent/guardian and/or prescribing health professional
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Prohibition of administering OTC cough and cold medication
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Not administering a new medication for the first time to a child while he or she is
in child care
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If the instructions are unclear or the supplies needed to measure doses or
administer the medication are not available or not in good working condition

The medication has expired
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If a staff person or his/her backup who has been trained to give that particular
medication is not present (in the case of training for medications that require
specific skills to administer properly, such as inhalers, injections, or feeding
tubes/ports).
Accepting Medication:
The process of accepting medication from parents/ guardians, this should include:

Verifying the consent form

Verifying the medication matches what is on the consent form

Accepting authorization for prescription medications from the child’s prescribing
health professional only if the medications are in their original container and have
the child’s name, the name of the medication, the dose and directions for giving
the medication, the expiration date of the medication, and a list of warnings and
possible side effects

Accepting authorization for OTC medications from the child’s prescribing health
professional only if the authorization indicates the purpose of the medication and
time intervals of administration, and if the medications are in their original
container and include the child’s name, the name of the medication, dose and
directions for use, an expiration date for the medication, and a list of warnings
and possible side effects

Verifying that a valid Care Plan accompanies all long-term medications (i.e.,
medications that are to be given routinely or available routinely for chronic
conditions such as asthma, allergies, and seizures)
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Verifying any special storage requirements and any precautions to take while the
child is on the prescription or OTC medication
Handling of Medication:
The proper handling and storage of medications, including:

Emergency medications – totally inaccessible to children but readily available to
supervising caregivers/teachers trained to give them

Medications that require refrigeration
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Controlled substances
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Expired medications

A policy to insure confidentiality
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Storing and preparing distribution in a quiet area completely out of access to
children
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Keeping all medication at all times totally inaccessible to children (e.g., locked
storage)
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Whether to require even short-term medications to be kept at the facility
overnight
Administering Medications:
The procedures to follow when administering medications, these should include:

Assigning administration only to an adequately trained, designated staff
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Checking the written consent form
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Adhering to the “six rights” of safe medication administration (child, medication,
time/date, dose, route, and documentation)
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Documenting and reporting any medication errors
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Documenting and reporting and adverse effects of the medication
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Documenting and reporting whether the child vomited or spit up the medication.
The procedures to follow when returning medication to the family, including:

An accurate account of controlled substances being administered and the
amount being returned to the family

When disposing of unused medication, the remainder of a medication, including
controlled substances
Disposal:
 A medication administration record should be maintained on an ongoing basis by
designated staff and should include the following

Specific, signed parental/guardian consent for the caregiver/teacher to administer
medication including documentation of receiving controlled substances and
verification of the amount received

Specific, signed authorization from the child’s prescribing health professional,
prescribing the medication, including medical need, medication, dosage, and
length of time to give medication
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Information about the medication including warnings and possible side effects

Written documentation of administration of medication and any side effects

Medication errors log
When the policy applies:
This policy is applicable at all times.
Communication plan for staff and parents:
• ________________________ will cover policies, plans, and procedures with all
new staff (paid and volunteer) during orientation training. They will sign that they
have read, understand, and agree to abide by the content of the policies.
• During enrollment this policy will be reviewed by ________________________
with the parents. Parents will sign that they have read, understand, and agree to
abide by the content of the policies.
• A copy of all policies will be available during all hours of operation to staff and
parents in the policy handbook located _____________________________.
• Parents may receive a copy of the policy at anytime upon request. A summary
of this policy will be included in the parent handbook.
• Parents and staff will receive written notification of any updates.
Reviewed by: _________________________________Director/Owner
_________________________________Health Professional (physician,
nurse, health department, EMS, Health consultant)
_________________________________Staff member
_________________________________ Other (parent, advisory
committee, police, CPS)
Effective Date and Review Date:
This policy is effective _____/_____/_____ and will be reviewed annually by
____/_____/_____ or sooner if needed. Parents and staff will be notified of any
upcoming policy review.
Standard 9.2.3.9: (Caring for Our Children: National Health and Safety Performance Standards;
Guidelines for Early Care and Education Settings. Third Edition, 2011)
Independence Start Right Childcare Program
Poison Control Policy: Storage and use of hazardous materials
Reason this policy is important: Children are naturally curious and are unaware
about what substances may be harmful to their health. Adult caregivers are responsible
for safeguarding children from harmful items including medications, plants, chemicals,
and animal waste.
Procedure and Practices, including responsible person(s):
• Poisonous plants will not be permitted in the childcare program. Staff must
identify plants and determine “safe” prior to bringing to the facility. (see poison
plant list) If the plant is not on the poisonous plant list, please contact the poison
control center (1-800-222-1222) for guidance.
• Outdoor plants will be labeled and whenever possible removed if poisonous.
• The Poison Control Center phone number will be posted on the list of
emergency numbers by the telephone. Poison emergencies or requests for
poison information will be made by contacting the Poison Control Center Hotline
at 1-800-222-1222 first – unless the person who has been poisoned is
unconscious, not breathing, having trouble breathing or is having convulsions. If
any of these conditions are present, CALL 9-1-1 FIRST.
• Chemicals, medications, pesticides, paints, cleaning agents and other
potentially harmful substances will be stored in locked areas that are inaccessible
to children.
• Toxic substances will be stored away from food and food preparation areas.
• All chemical products and medications shall be stored in their original
containers with original labels intact.
• Kitchen staff will be trained in and follow Integrated Pest Management practices
for prevention of pests.
• If additional pest control is necessary, only a licensed exterminator will apply
pesticides. Pesticides must be EPA approved with natural pesticides that are
non-toxic to humans given first consideration.
• Pesticides and other potentially toxic chemicals will not be applied while
children are present. Application shall be in a manner that prevents skin contact
and other exposure and minimizes odors. A staff member will observe the
application of the chemicals and verify that they are applied according to
instructions on the label or otherwise directed by a regulatory authority.
• _______________________ (staff title/name) will notify parents and staff
before using pesticides and/or herbicides.
• Following use of pesticides, herbicides or other potentially toxic chemicals the
treated area shall be ventilated for the period recommended on the product label,
the State Chemist Office, or by a nationally certified poison control center before
being reoccupied.
• Children will not have access to animal waste. Staff will do all cleanup of animal
waste after hours.
• All staff purses and personal belongings will be securely stored to prevent
access by children. Purses and other personal belongings may contain items
unsafe for children including medications, lighters, pocketknives, and etcetera.
• Sanitizing solutions will be mixed fresh daily prior to arrival of children.
Sanitizers will be in a marked spray bottle available for staff use, out of reach of
children.
• Syrup of Ipecac will not be kept on premises.
When the policy applies:
This policy is applicable at all times.
Communication plan for staff and parents:
• ________________________ will cover policies, plans, and procedures with all
new staff (paid and volunteer) during orientation training. They will sign that they
have read, understand, and agree to abide by the content of the policies.
• During enrollment this policy will be reviewed by
______________________________ with the parents. Parents will sign that they
have read, understand, and agree to abide by the content of the policies.
• A copy of all policies will be available during all hours of operation to staff and
parents in the policy handbook located _____________________________.
• Parents may receive a copy of the policy at anytime upon request. A summary
of this policy will be included in the parent handbook.
• Parents and staff will receive written notification of any updates.
Reviewed by: _________________________________Director/Owner
_________________________________Health Professional (physician,
nurse, health department, EMS, Health consultant)
_________________________________Staff member
_________________________________ Other (parent, advisory
committee, police, CPS)
Effective Date and Review Date:
This policy is effective _____/_____/_____ and will be reviewed annually by
____/_____/_____ or sooner if needed. Parents and staff will be notified of any
upcoming policy review.
*This format is adapted from Caring for Our Children: National Health and Safety Performance Standards;
Guidelines for Early Care and Education Settings. Third Edition, 2011
Outdoor Safety
1.1: Outdoor equipment is safe and in good condition
 This will be visually checked during site visit
1.2: Children will be taught annually on safe equipment use


Training for children log will be checked
An example log is provided in this book if site does not have one
developed
1.3: Sunscreen used on children while outside (exemption: note from parent)

Should be included in outdoor policy

Parents would be required to supply sunblock and signed permission letter
stating usage (considered same as OTC medication)

Parents can sign an exemption form
2.1: Site does a daily visual playground safety inspection

Playground inspection log will be checked during site visit

Example logs/checklist are provided in this book if site does not have one
developed
2.2: Provides parent information in the pick-up/drop-off area on local car seat checks
and never leave children unattended

This will be visually checked during site visit

Never leave children unattended is referring to information on not leaving
children in cars unattended or the “not even for a minute” campaign

Informational materials can be found at Safe Kids USA, Center for
Disease Control and Prevention, Missouri Department of Health and
Senior Services, and the Independence Health Department
2.3: Safety approved bike helmets are used in conjunction with appropriate riding toys

This will be visually checked during site visit

A fact sheet on proper helmet fit is included in this book

Approved bike helmets is defined as any age appropriate child’s helmet
that meets federal safety standard set by Consumer Product Safety
Commission (CPSC). The helmet should have a label stating it meets the
CPSC standards

Appropriate riding toys is defined as bicycles, tricycles, scooters, etc
(anything riding or wheeled)

All children one year and over should wear a helmet when using riding or
wheeled toys. Under one year should not be on a riding or wheeled toy

When done with riding/wheeled toy, the child should remove helmet
before playing on the playground. Helmets could pose a strangulation
hazard
3.1: Director or designee is trained in outdoor safety and in turn trains staff

The training log will be checked for staff training

Director and staff will need to complete training every three years after
initial training
3.2: Has a simple shelter for sun protection in outdoor play area

This will be visually checked during site visit

Simple shelter is defined as a tent with sides up, awning, or other simple
shelter from the sun can be available
3.3: Has a written policy on outdoor safety

Written policy will be checked during site visit

An example policy is provided in this book for site if it does not have a
policy developed
Sunscreen Authorization Form
(Sunscreen Brought from Home)
Child’s Name:
Date of Birth & Age:
(do not apply on infants 6 months and younger without written
permission from health care provider)
Name of Sunscreen & SPF:
Active Ingredients:
Start Date:
Stop Date:
Times to be applied:
Possible Side Effects:
Special Instructions:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Reason for medication: Protection from sun
Amount to be given: Cover exposed areas of skin
Route: Topical
Storage: Room temperature
_________________________________ ______________________
Parent/Guardian Signature
Date
_______________________________________
Daytime Phone Number
Independence Child Safe Program
Visual Playground Safety Inspection Log
Safety Checklist
Missing parts
Broken parts
Protrusion of nuts and/or
bolts
Chipping/peeling paint or
rust
Sharp edges, splinters,
rough surfaces
Debris (i.e. glass)
Animal excrement and
other foreign material
Standing water, ice, snow
Fencing secure
Gates closed and locked
Other
Visible cracks
Stability of play equipment
Wear and deterioration
Completed
Staff Name
Comments
Independence Start Right Childcare Program
Policy on Use and Maintenance of Play Areas
Properly laid out outdoor play spaces, age-appropriate, properly designed and
maintained equipment, installation of energy-absorbing surfaces, and adequate
supervision of the play space by caregivers/teachers/parents/ guardians help to reduce
both the potential and the severity of injury. Active play areas are associated with the
most frequent and the most severe injuries in child care.
Safety:
 Outdoor equipment for gross motor play is age-appropriate
 Sunscreen and repellant is used on children when outside (parent note with
permission and parent will provide sunscreen and repellant
 A simple shelter is provided for sun protection in outdoor play area
 Bike helmets are used on appropriate riding equipment
Supervision:
 Children will be supervised at all times outdoor play
 Children will be accounted for before and after outdoor play
 No child will be allowed to play in or around a vehicle
Training:
 Staff training will be trained in outdoor safety upon hire and review policy
annually or upon any changes
 Children will be taught annually and as new children are enrolled in playground
safety and correct use of equipment
Inspections:
 Recommended inspections of the facility and equipment, as follows:
o Inventory, once at the time of purchase, and updated when changes to
equipment are made in the playground
o Monthly inspections to check for U.S. Consumer Product Safety
Commission (CPSC) recalled or hazard warnings on equipment, broken
equipment or equipment in poor repair that requires immediate attention
o Daily safety check of the grounds for safety hazards

Outdoor play areas and equipment should be inspected daily for
the following
 Missing or broken parts








Protrusion of nuts and bolts
Rust and chipping or peeling paint
Sharp edges, splinters, and rough surfaces
Stability of handholds
Visible cracks
Stability of non-anchored large play equipment (e.g.,
playhouses)
Wear and deterioration
All loose-fill surfacing material, particularly sand, should be
inspected daily for:
 Debris (such as glass)
 Animal excrement, and other foreign material
 Depth and compaction of surface
 Standing water, ice, or snow
When the policy applies:
This policy is applicable at all times.
Communication plan for staff and parents:
• ________________________ will cover policies, plans, and procedures with all
new staff (paid and volunteer) during orientation training. They will sign that they
have read, understand, and agree to abide by the content of the policies.
• During enrollment this policy will be reviewed by ________________________
with the parents. Parents will sign that they have read, understand, and agree to
abide by the content of the policies.
• A copy of all policies will be available during all hours of operation to staff and
parents in the policy handbook located _____________________________.
• Parents may receive a copy of the policy at anytime upon request. A summary
of this policy will be included in the parent handbook.
• Parents and staff will receive written notification of any updates.
Reviewed by: _________________________________Director/Owner
_________________________________Health Professional (physician,
nurse, health department, EMS, Health consultant)
_________________________________Staff member
_________________________________ Other (parent, advisory
committee, police, CPS)
Effective Date and Review Date:
This policy is effective _____/_____/_____ and will be reviewed annually by
____/_____/_____ or sooner if needed. Parents and staff will be notified of any
upcoming policy review.
STANDARD 9.2.6.1: (Caring for Our Children: National Health and Safety Performance Standards;
Guidelines for Early Care and Education Settings. Third Edition, 2011)
Safe Sleep
1.1: Child is place on back to sleep in under 12 months
 This will be visually checked during site visit
 Must show medical exemption letter if not on back
1.2: No child shall share a crib, bedding, or bed with another child
 This will be visually checked during site visit
1.3: Facility uses firm, tight-fitting mattress in safety-approved cribs
 This will be visually checked during site visit
2.1: Infants should be directly observed by sight and sound at all times
 This will be visually checked during site visit
2.2: Education materials on Safe Sleep are provided to parents at pick-up/drop-off area


This will visually checked during site visit
Safe sleep information can be obtained online at Center for Disease
Control and Prevention, Missouri Department of Health and Senior
Services, and Safe Kids USA or you can contact the Independence Health
Department
2.3: Designated sleep areas are labeled with child’s name


This will be visually checked during site visit
An example label is provided in this book if the site does not have one
developed
3.1: Has a written safe sleep policy in place


The policy will be checked and reviewed during site visit
An example policy on Safe Sleep is provided in this book if the site does
not have a policy developed
3.2: Director or designee is trained on current safe sleep practices and policies, in turn
will train staff


Director and staff will need to complete training every three years after
initial training
The training log will be checked for staff training
3.3: Soft or loose bedding should be kept away from sleeping infants and out of safe
sleep environments.

This will visually checked at site visit

Should be included in safe sleep policy

These include, but are not limited to: bumper pads, pillows, quilts,
comforters, sleep positioning devices, sheepskins, blankets, flat sheets,
cloth diapers, bibs, etc

Also, blankets/items should not be hung on the sides of cribs
Independence Start Right Childcare Program
Safe Sleep Example Policy
Providing infants with a safe place to grow and learn is very important. For this reason,
___________ has created a policy on safe sleep practices for infants up to 1-year-old.
We follow the recommendations of the Missouri Department of Health and Senior
Services, the American Academy of Pediatrics (AAP), Caring for Our Children: National
Health and Safety Performance Standards, and the Consumer Product Safety
Commission to provide a safe sleep environment and reduce the risk of sudden infant
death syndrome (SIDS). The staff, substitute staff, and volunteers at _______________
follow the safe sleep policy.
Sleep Position: Add State requirements if not listed
 Infants will be placed flat on their backs to sleep every time unless there is a
physician, practitioner or clinician signed sleep position medical waiver up to date
on file. In the case of a waiver, a waiver notice will be posted at the infant’s crib
without identifying medical information. The full waiver will be kept in the infant’s
file.
 Infants will not be placed on their side for sleep.
 Devices such as wedges or infant positioners will not be used since such devices
are not proven to reduce the risk of SIDS.
 Infants who use pacifiers will be offered their pacifier when they are placed to
sleep, and it will not be put back in should the pacifier fall out once they fall
asleep.
 Pacifiers will be cleaned between each use, checked for tears, and will not be
coated in any sweet or other solution.
 Parents are asked to provide replacement pacifiers on a regular basis.
 While infants will always be placed on their backs to sleep, when an infant can
easily turn over from back to front and front to back, they can remain in whatever
position they prefer to sleep.
Sleep Environment: Add State requirements if not listed
 Our program will use Consumer Product Safety Commission guidelines for
safety-approved cribs and firm mattresses.
 Crib slats will be less than 2 3/8” apart
 Infants will not be left in bed with drop side down
 Playpen weave will be less than ¼”












Consumer Product Safety Commission safety-approved cradles and bassinets
may also be used for sleeping if the infant meets the weight and height
requirements.
Infants should not nap or sleep in a car safety seat, bean bag chair, bouncy seat,
infant seat, jumping chair, play pen or play yard, highchair, chair, futon, or any
other type of furniture/equipment that is not a safety-approved crib
Only one infant will be placed to sleep in each crib. Siblings, including twins and
triplets, will be placed in separate cribs.
The crib will have a firm tight fitting mattress covered by a fitted sheet and will be
free from loose bedding, toys, and other soft objects (i.e., pillows, quilts,
comforters, sheepskins, stuffed toys, etc.)
To avoid overheating, the temperature of the rooms where infants sleep will be
checked and will be kept at a level that is comfortable for a lightly clothed adult.
Sleep clothing, such as sleepers, sleep sacks, and wearable blankets, may be
used as alternatives to blankets.
Bibs and pacifiers will not be tied around an infant’s neck or clipped on to an
infant’s clothing during sleep.
Smoking will not be allowed in or near _______________
If an infant arrives at the facility asleep in a car safety seat, the parent/guardian
or caregiver/teacher should immediately remove the sleeping infant from this
seat and place them in the supine position in a safe sleep environment (i.e., the
infant’s assigned crib);
If an infant falls asleep in any place that is not a safe sleep environment, staff
should immediately move the infant and place them in the supine position in their
crib;
Soft or loose bedding should be kept away from sleeping infants and out of safe
sleep environments. These include, but are not limited to: bumper pads, pillows,
quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets,
cloth diapers, bibs, etc. Also, blankets/items should not be hung on the sides of
cribs.
Toys, including mobiles and other types of play equipment that are designed to
be attached to any part of the crib should be kept away from sleeping infants and
out of safe sleep environments
Supervision: Add State requirements if not listed
 Infants will spend limited time in car seats, swings, and bouncer/infant seats
when they are awake.
 When caregivers/teachers place infants in their crib for sleep, they should check
to ensure that the temperature in the room is comfortable for a lightly clothed
adult, check the infants to ensure that they are comfortably clothed (not
overheated or sweaty), and that bibs, necklaces, and garments with ties or hoods
are removed (clothing sacks or other clothing designed for sleep can be used in
lieu of blankets);
 Infants should be directly observed by sight and sound at all times, including
when they are going to sleep, are sleeping, or are in the process of waking up;



Bedding should be changed between children, and if mats are used, they should
be cleaned between uses.
The lighting in the room must allow the caregiver/teacher to see each infant’s
face, to view the color of the infant’s skin, and to check on the infant’s breathing
and placement of the pacifier (if used).
A caregiver/teacher trained in safe sleep practices and approved to care for
infants should be present in each room at all times where there is an infant. This
caregiver/teacher should remain alert and should actively supervise sleeping
infants in an ongoing manner. Also, the caregiver/teacher should check to ensure
that the infant’s head remains uncovered and re-adjust clothing as needed.
Training: Add State requirements if not listed
 All staff, substitute staff, and volunteers at _______________will be trained on
safe sleep policies and practices every three years.
 Safe sleep practices will be reviewed with all staff, substitute staff, and volunteers
each year. In addition, training specific to these policies will be given before any
individual is allowed to care for infants.
 Documentation that staff, substitutes, and volunteers have read and understand
these policies will be kept in each individuals file.
When The Policy Applies:
This policy applies to all staff, substitute staff, parents, and volunteers when they place
an infant to sleep at _________________________
Communication Plan for Staff and Parents:
Parents will review this policy when they enroll their child at __________________and a
copy will be provided in the parent handbook. Parents are asked to follow this same
policy when the infant is at home. These policies will be posted in prominent places.
Information regarding safe sleep practices, safe sleep environments, reducing the risk
of SIDS in child care as well as other program health and safety practices will be shared
if any changes are made. A copy will also be provided in the staff handbook.
Any individual who has questions may ask:
Program Contact:
Health Professional Contact: (if applicable)
Child’s Name _________________________
Signed by:
DOB: ____/_____/____
_________________________________Director/Owner
_________________________________Health Professional/Consultant
(if appropriate)
_________________________________Staff Member
_________________________________Parent
Date:
Effective Date and Review:
This policy is effective _____/_____/_____ and will be reviewed annually by
____/_____/_____ or sooner if needed. Parents and staff will be notified of any
upcoming policy review.
Communicable Disease
1.1: All Children have an immunization record on file

This will be visually checked off during a site visit
1.2: Each site should have a tracking system for child immunizations

This will be visually checked off during a site visit (audits)
1.3: Has a written policy on communicable disease management and procedures

The policy will be visually checked off during a site visit

Policy follows the guidelines and recommendations from Independence
Health Department and Missouri Department of Health and Senior
Services

An example policy is provided in this book
2.1: Director or designee are trained in immunizations and record keeping annually

The Health Department will hold a training at least once a year
2.2: Parent education on communicable diseases are displayed at pick-up/drop-off area

This will visually checked during site visit

Safety information can be obtained online at Center for Disease Control
and Prevention, Missouri Department of Health and Senior Services, or
you can contact the Independence Health Department
2.3: Hand-washing classes are provided to staff and children annually

Training log will be checked

The Independence Health Department provides a class for preschool age
children
2.4: All staff have Flu vaccination (exemption: physician letter, sign declination)

Staff vaccination records will be checked

Example declination is provided in this book if center does not have one
developed
3.1: Site is 100% compliant on IHD immunization initial audit

The Health Department will need to see sites copy of last audit

The IHD will send out an email before immunization audits with any
changes/updates to immunizations

To help prepare for audits, sites should review records monthly or
quarterly
3.2: Director or designee are trained in communicable disease annually and in turn will
train staff upon hire

The training log will be checked for staff training
3.3: All staff that work with infants have Tdap vaccination (exemption: physician letter,
signed declaration)

Staff vaccination records will be checked

Example declination is provided in this book if center does not have one
developed
3.4: Site is a participating surveillance site

The Health Department will have record of participating sites

Participating sites is defined as sites that turn in disease report weekly

An example surveillance form is provided in this book
Independence Start Right Childcare Program
Communicable Disease Example Policy
___________________ daycare follows the guidelines and recommendations from
Missouri Department of Health and Senior Services and the Independence Health
Department with regards to disease control, hence there may be times when we are
forced to send an ill child home, or not accept an ill child into the program. Once the
child is removed from the program, they will NOT be allowed to return until they meet
the recommendations for that specific disease. ______________ daycare will follow the
exclusion and re-entry guidelines listed in Prevention and Control of Communicable
Diseases manual from the Department of Health and Senior Services.
_______________ will follow the following guidelines.





Each child shall be observed for contagious diseases and for other signs of
illness on arrival and throughout the day.
Each child’s parent(s) shall be notified immediately when any contagious disease
occurs in the facility.
Unusual behavior shall be monitored closely and parent(s) shall be contacted if
the behavior continues or if other symptoms develop. These behaviors include,
but shall not be limited to:
1. Is cranky or less active than usual;
2. Cries more than usual;
3. Feels general discomfort or seems unwell; or
4. Has loss of appetite.
The parent(s) or his/her designee shall be contacted when signs of illness are
observed. Unless determined otherwise by the parent(s) or provider, a child with
no more than one (1) of the following symptoms may remain in care:
o A child with a temperature of up to one hundred degrees Fahrenheit
(100°F) by mouth or ninety-nine degrees Fahrenheit (99°F) under the arm;
o After an illness has been evaluated by a physician, medication has been
prescribed and any period of contagion has passed as determined by a
licensed physician;
o When it has been determined that a child has a common cold unless the
director and the parent(s) agree that isolation precautions should be
taken;
o When a child has vomited once with no further vomiting episodes, other
symptoms, or both; or
o When a child has experienced loose stools only one (1) time with no
further problems or symptoms.
If children exhibit any of the following symptoms, they must be sent home:



o Diarrhea—more than one (1) abnormally loose stool. If a child has one (1)
loose stool, s/he shall be observed for additional loose stools or other
symptoms;
o Severe coughing—if the child gets red or blue in the face or makes highpitched croupy or whooping sounds after coughing;
o Difficult or rapid breathing (especially important in infants under six (6)
months);
o Yellowish skin or eyes;
o Pinkeye—tears, redness of eyelid lining, irritation, followed by swelling or
discharge of pus;
o Unusual spots or rashes;
o Sore throat or trouble swallowing;
o An infected skin patch(es)—crusty, bright yellow, dry or gummy areas of
the skin;
o Unusually dark, tea-colored urine;
o Grey or white stool;
o Fever over one hundred degrees
o Fahrenheit (100°F) by mouth or ninety-nine degrees Fahrenheit (99°F)
under the arm;
o Headache and stiff neck;
o Vomiting more than once; and
o Severe itching of the body or scalp, or scratching of the scalp. These may
be symptoms of lice or scabies.
Parental contact and the decision made shall be recorded and filed in the child's
record.
The ill child shall be kept isolated from the other children until the parent(s)
arrives.
The caregiver shall be in close proximity to the child until the parent(s) arrives.
Close proximity means that a caregiver is close enough to hear any sounds a
child might make that would indicate a need for assistance
Reporting:
 Policy complies with the state’s reporting requirements for children who are ill.
 All notifiable diseases should be reported to the Independence Health
Department at 816-325-7204
 ________________ daycare will work with the Independence Health Department
on reporting, fact sheets, parent letter’s, etc
Training:
 All staff, substitute staff, and volunteers at _______________will be trained on
communicable disease management and practices.
 Practices will be reviewed with all staff, substitute staff, and volunteers each
year.
 Documentation that staff, substitutes, and volunteers have read and understand
these policies will be kept in each individuals file.
When The Policy Applies:
This policy applies to all staff, substitute staff, parents, and volunteers at all times.
Communication Plan for Staff and Parents:
Parents will review this policy when they enroll their child at __________________and a
copy will be provided in the parent handbook. A copy will also be provided in the staff
handbook.
Any individual who has questions may ask:
Program Contact:
Health Professional Contact: (if applicable)
Child’s Name _________________________
Signed by:
DOB: ____/_____/____
_________________________________Director/Owner
_________________________________Health Professional/Consultant
(if appropriate)
_________________________________Staff Member
_________________________________Parent
Date:
Effective Date and Review:
This policy is effective _____/_____/_____ and will be reviewed annually by
____/_____/_____ or sooner if needed. Parents and staff will be notified of any
upcoming policy review.
Declination of Influenza Vaccination
My employer and the Centers for Disease Control and Prevention (CDC), have recommended
that I receive influenza vaccination in order to protect myself and the children I care for.
I acknowledge that I am aware of the following facts:
 Influenza is a serious respiratory disease that kills an average of 23,607 persons and
hospitalizes more than 200,000 persons in the United States each year.
 Influenza vaccination is recommended for me and all other childcare providers to
prevent influenza disease and its complications, including death.
 If I contract influenza, I will shed the virus for 24–48 hours before influenza symptoms
appear. My shedding the virus can spread influenza infection to children in this facility.
 If I become infected with influenza, even when my symptoms are mild, I can spread
severe illness to others.
 I understand that the strains of virus that cause influenza infection change almost every
year, which is why a different influenza vaccine is recommended each year.
 I cannot get influenza disease from the influenza vaccine.
 The consequences of my refusing to be vaccinated could endanger my health and the
health of those with whom I have contact, including
o children in this setting
o my coworkers
o my family
o my community
Despite these facts, I am choosing to decline influenza vaccination right now.
I understand that I may change my mind at any time and accept influenza vaccination, if the
vaccine is available.
Signature: ___________________________________Date: ___________________
Name (print): _______________________________ Employer: ___________________
I decline vaccination for the following reason(s). Please check all that apply:
__ I believe I will get the flu if I get the shot
__ I don’t like needles
__ I never get the flu
__ My philosophical or religious beliefs prohibit vaccination
__ I am concerned about side effects
__ Other:___________________________________________________
Have you received information about influenza vaccine? (Please circle): Y N
If yes, please indicate where you received that information:
________________________________________________________________________
Declination of Tdap (Tetanus, Diphtheria, and Pertussis)
My employer and the Centers for Disease Control and Prevention (CDC), have
recommended that I receive the Tdap vaccination in order to protect myself and the
children I care for.
I acknowledge that I am aware of the following facts:
 Tdap vaccination is recommended for me and all other childcare providers to
prevent pertussis and its complications, including death.
 If I contract pertussis, I can infect the children I care for by coughing or sneezing
while in close contact with others, who then breathe in the pertussis bacteria.
 Many infants who get pertussis are infected by parents, older siblings, or other
caregivers who might not even know they have the disease.
 The consequences of my refusing to be vaccinated could endanger my health
and the health of those with whom I have contact, including
o children in this setting
o my coworkers
o my family
o my community
Despite these facts, I am choosing to decline the Tdap vaccination right now.
I understand that I may change my mind at any time and accept the Tdap vaccination, if
the vaccine is available.
Signature: ___________________________________Date: ___________________
Name (print): _______________________________ Employer: ___________________
I decline vaccination for the following reason(s). Please check all that apply:
__ I don’t like needles
__ My philosophical or religious beliefs prohibit vaccination
__ I am concerned about side effects
__ Other:___________________________________________________
Have you received information about the Tdap vaccine? (Please circle): Y N
If yes, please indicate where you received that information:
_____________________________________________________________________
Physical Activity
1.1: Daily Schedule of activities for all ages of children
 Written document of daily activities will be checked during site visit
1.2: Provides developmentally appropriate play experiences for all ages of children per
day
 Should be included into the daily activity document
 Included in this book is a reference sheet of age-appropriate activities
1.3: A total of at least one hour of outdoor play per day for children in attendance a full
day

Should be included in written document of daily schedule, schedule will be
checked during site visit
 Outdoor play will be based on weather conditions
 Does not have to be one hour at one time but throughout the entire day child
should have one hour of outdoor play
2.1: Have structured play for a minimum of 30 minutes a day
 Should be included in written document of daily activities
 Structured play is considered “teacher-led” activities
 Structured play lesson plans will be checked during site visit
2.2: Provide supervised opportunities for infants (newborn-12 months) to practice new
skills (tummy time, rolling over, sitting up, crawling) per day
 Should be included in written document of daily activities for infants
2.3: Director or designee is trained in physical activity every three years and in turn will
train facility staff upon hire


The training log will be checked for staff training
Director and staff will need to complete training every three years after initial
training
 Health department holds trainings yearly and/or can receive training from
another entity but will need to provide training certificate
3.1: Has a physical activity policy in place


Written policy will be checked during site visit
Example policies are provided in this book for site if it does not have a policy
developed
 Policy minimum requirements include model policies: 1, 2, 3, 6, 8,11 from
“Model Policies for Creating a Healthy Nutrition and Physical Activity
Environment in Child Care Settings” (included in this book) on page 31
3.2: No screen time for children under two and no more than one hour (daily) for
children over two years old.
 Should be included in physical activity policy
 Will review daily schedule for screen time
3.3: Has two hours of physical activity daily (1 hour structured, 1 hour free play),
including outside play per day


Will review written document of daily activities
Provide lesson plan for structured play activities
Socializing Healthy Habits in Young Children: Physical Activity
"Structured" Physical Activity and Movement Ideas (Birth to Age 5)
INFANTS
To encourage infants' reaching, holding, picking up, turning, and shaking objects:
o Provide safe, attractive, and age-appropriate toys such as hand, wrist, and ankle rattles, soft blocks,
soft balls, floor mirrors, pop-up toys, mobiles, empty containers to put things in and to take out.
o Move attractive objects slowly back and forth in front of infants' faces; use an exaggerated face and
voice to capture infants' attention and encourage them to reach for and grab the objects.
o Put safe, attractive objects in places that infants can get to by themselves, such as on low shelves and
in small baskets.
o Play social games such as peek-a-boo and pat-a-cake.
To encourage infants' pushing up, rolling, sitting up, crawling, pulling up, standing up, and walking:
o Place infants in different positions: Hold them upright in your arms and support their heads so they
can look around; place infants on a blanket on their backs, sides, and stomachs; sit infants at different
angles in baby seats and bouncers. Be sure to change infants' positions often so that they use different
muscles and see the world from many perspectives.
o Use a soft puppet to touch and label infants' body parts.
Kick Kick Kick: Lay babies on a soft surface, on their backs, and sit across from them. Hold a stuffed toy
or some other soft object near babies’ feet and with your voice and facial expressions, encourage them
to "kick kick kick" the object. Make sure that babies have the chance to use both of their feet. Also, use a
toy that makes noise when kicked. This helps babies understand that their actions can cause things to
happen.
Sitting and Reaching: Sit facing a sitting baby and hide an enticing toy behind your back. Using your right
or left hand, pull the toy out from behind your back and encourage the baby to twist and reach for the
toy. Repeat the activity and alternate hands so that the infant has to reach in both directions. Variations:
with babies sitting up, encourage them to drop objects into short cans or baskets and to reach in and
pull the objects out; with babies sitting up on a plastic sheet, help them learn about eye-hand
coordination by pouring water or sand from one cup into another.
What’s Up There?: Place age-appropriate, safe toys on ottomans, coffee tables, or low benches and
encourage babies to crawl over, pull themselves up, stand, and explore. Variations: Using safely secured
toy shelves, regularly rotate toys and encourage babies to explore what is on the shelves. With a soft
stuffed toy, like a rabbit or frog, begin a game of chase, encouraging the baby to crawl after the toy.
Bring the toy to eventually rest in a location (on a shelf, chair, or low table) that requires babies to pull
up so they can retrieve it.
Other Ideas: Socializing Healthy Habits in Young Children: Physical Activity
TODDLERS
My Body: To help toddlers learn their body part names, engage them in simple games of "Head,
Shoulders, Knees, and Toes". Start by having toddlers touch just 2 body parts (head, stomach) and as
they become comfortable, add another body part (head, stomach, knees). Let children take turns and
decide which body parts to touch.
Beanbag Drop: Set up stations of empty containers (paper lunch sacks or large coffee cans) and other
containers holding items to drop into the empty ones. Encourage toddlers to stand and drop the items
into the containers and then reach in and pull the items out. Variations: Painting with water outside
(paint brushes and buckets of water); holding items up high and dropping them in / holding items down
low and dropping them in.
Follow-the-Leader: Engage toddlers in simple games of follow-the-leader. For instance, have toddlers
walk, jump, and tiptoe behind you. As toddlers acquire more traveling skills, add them into the activity,
such as hopping and walking on their "tip toes". Variations: Add "standing still" activities: walk several
steps, stop, and reach for the sky or touch the ground in front of you. Provide toddlers with musical
instruments, such as wrist bells or shakers, and have a parade. Sing simple songs while walking or clap
hands. Play "let's see, I'll be...." a tree moving in the wind, a kangaroo jumping, a squirrel scampering, a
choo-choo train.
Balancing Act: Provide a chair for each child to hold onto. Encourage children to stand on one foot, using
the chair for balance if they need it; try the other foot. Variations: Hold onto the chair with two hands,
hold on with one hand, without hands.
Musical Chairs: Provide a chair for each child, with enough room for children to walk around their own
chair without running into the other children. Play music and have children slowly walk around their
own chair. Stop the music and tell children to sit down.
Dress-Up Relay: Gather enough hats and sunglasses for all children to have one of each; place hats and
sunglasses in small piles (one for each child), spread out so that children can easily get to their own pile
without running into another child. Identify a "starting point" across from the hats and sunglasses, such
as a line of masking tape along the floor with cross marks for each child to stand on. When you say "go"
or ring a bell, children run to their own pile, put the hat and sunglasses on, and run back to their spot.
Recognize all children's abilities and participation and avoid competition. Variations: Use different
articles of clothing (large t-shirts, baggy shorts).
Other Ideas: Socializing Healthy Habits in Young Children: Physical Activity
PRESCHOOLERS
Personal Space: Introduce the concept of personal space: the space immediately within the child's
reach. Have children sit on carpet squares and draw an imaginary line around their bodies.
General Space: Introduce the concept of general space: all of the space in the learning environment that
is not being occupied by another child. Have children stand in their personal space and point to all of the
areas of the room that are not being occupied by other children. Have children hold a "hula-hoop"
around their waist and move through the general space without interfering with another child's
personal space.
Stretching and Curling Activities
Terrific Tunnels and Bridges: Have children sit in their personal space. Ask children to identify the objects
that use bridges and tunnels. Have children move their bodies into shapes that resemble bridges and
tunnels. Allow children to pair-up, with one child the vehicle and the other the bridge or tunnel.
Encourage children to take turns.
Stand, Stretch, and Smile: Have children stand in their personal space and reach in all directions.
Encourage children to stretch and push on the boundaries of their personal space. Variation: have
children sit in their personal space and pretend to be a baby chick, hatching out of a shell.
I can stretch and/or curl my body like: With children sitting in a group, ask them to identify all of the
ways that they can stretch and curl. Record their responses on chart paper to display and use for future
stretching and curling activities.
Balance Activities
Body Balancing: Have children sit in their personal space. Encourage them to balance their bodies in
different ways. For example, have them lie on their back and roll over onto their stomach; balance on
one foot and move quickly to the other foot; stand and turn around twice and stay balanced. Variations:
have children stretch and balance their bodies to look like objects in the room (a table, a chair, a rug)
Statuettes: Have children stand in their personal space. Introduce the ideas of statues and use your own
body to show them what a statue might look like. Tell children that when you say "move", they can
move through general space. When you call out "statues freeze", they will stop and freeze into a statue
in their personal space. Variations: Call out different instructions such as "tall statues freeze", "happy
statues freeze", "sleepy statues freeze".
Balancing Act: Create enough large squares (5 foot sides) on the floor with masking tape for each child
to have his/her own side of the square (4 children per square). Have children stand on corners and
practice walking to the opposite corner with a bean bag on his/her head.
I can use my body to make different shapes: With children sitting in a group, ask them to identify all of
the ways that they can move their bodies to create different shapes (such as letters of the alphabet).
Record their responses on chart paper to display and use for future stretching and curling activities.
Socializing Healthy Habits in Young Children: Physical Activity
Traveling Activities
"Walk my Way": Children are spread out in the classroom general space. Encourage children to slowly
walk through general space, taking care not to run into anyone else, and: clap hands high up, clap in
front of body, walk with hands very close to ground, taking giant steps, taking tiny steps, walk on heels.
Variations: create pairs or small groups of children and have them play "follow the leader" and mimic
the way their partner/leader is walking; take turns being the leader. This activity can also be done
outside, with different kinds of traveling (running slowly, hopping, galloping, etc) that require more
space.
"Dancing Ribbons": Children are standing in their personal space. Provide children with 2, 3-foot long
pieces of colorful ½ inch ribbon, one ribbon for each hand. In personal space, have children move ribbon
in different shapes (big circles around your head, wiggle ribbon along floor like a snake, spin around
while holding ribbon, make letters in the air with ribbons. Variations: Play different kinds of music, such
a popular or classical, and have children move their ribbons to the music. Have children take turns giving
directions to the group. Incorporate the "freeze" concept: tell children that when the music stops
playing, they need to freeze their bodies and ribbons.
I can move throughout general space by: With children sitting in a group, ask them to identify all of the
ways that they can move throughout general space. Record their responses on chart paper to display
and use for future stretching and curling activities.
Preschool Ideas adapted from:
National Association for Sport and Physical Education. (1993). Let's Move / Let's Play: Developmentally
Appropriate Movement and Classroom Activities for Preschool Children.
Materials Compiled by:
Sara Gable, Ph.D.
University Outreach and Extension
Department of Human Development and Family Studies
University of Missouri, Columbia
306 Gentry Hall
Columbia, MO 65211
gables@missouri.edu
Independence Start Right Childcare Program
Sample Policy on Physical Activity
Birth through 11 months old:
Following the American Academy of Pediatrics recommendations and to encourage
1. Optimal motor development, this program will plan engaging activities for Tummy
Time with all infants at least 2-3 times per day while the child is awake. Our staff will
respond promptly to cues for frustration, boredom or fatigue.
2. To promote lifelong physical activity, this program will provide planned daily physical
activity that is safe, engaging and appropriate for each infant to safely support their
physical development and health.
3. All infants and children will be provided outdoor time daily. Children will go outside
when the temperatures are above ____º F (including wind chill factor) and below
___ºF.
4. To support infant development, swings, bouncy chairs and other confining
equipment (except high chairs and strollers) will be used minimally in the infant
classroom.
Children ages one year and older:
We at (name of center) are committed to our children’s health. We recognize the
importance of staff as positive role models for children as they learn to live healthy lives.
Therefore, we will:
1. Role-model positive behaviors by being physically active with the children, both
indoors and outdoors.
2. Encourage all children to try new physical activities and respond positively when
they do.
3. Share our own positive experiences with physical activity and facilitate
conversations with the children about their experiences.
4. Provide at least 120 minutes of fun, engaging active playtime daily in our lesson
plans.
5. Provide structured-play (teacher-led) and free-play daily for children.
6. Make safe equipment accessible in the classroom at all times (e.g. soft balls,
push-pull toys, low carpeted blocks to climb on, etc.).
7. Not use physical activity as punishment.
8. Re-direct children to safe physical activities and/or involve them in discussions
about what to do when safety issues or other concerns (e.g. mud, arguments
over play equipment, etc.) arise.
9. All children will be provided at least two times or more a day of outdoor time.
Children will go outside when the temperatures are above ___º F (including wind
chill factor) and below ___ºF.
10. Screen time will not be permitted for children under two years old and no more
than one hour daily for children two years and older.
When the policy applies:
This policy is applicable at all times.
Communication plan for staff and parents:
• ________________________ will cover policies, plans, and procedures with all new
staff (paid and volunteer) during orientation training. They will sign that they have read,
understand, and agree to abide by the content of the policies.
• During enrollment this policy will be reviewed by ________________________ with
the parents. Parents will sign that they have read, understand, and agree to abide by
the content of the policies.
• A copy of all policies will be available during all hours of operation to staff and parents
in the policy handbook located _____________________________.
• Parents may receive a copy of the policy at any time upon request. A summary of this
policy will be included in the parent handbook.
• Parents and staff will receive written notification of any updates.
Reviewed by: _________________________________Director/Owner
_________________________________Health Professional (physician, nurse, health
department, EMS, Health consultant)
_________________________________Staff member
_________________________________ Other (parent, advisory committee, police,
CPS)
Effective Date and Review Date:
This policy is effective _____/_____/_____ and will be reviewed annually by
____/_____/_____ or sooner if needed. Parents and staff will be notified of any
upcoming policy review.
Independence Start Right Childcare Program
Sample Policy on Physical Activity
Purpose: To provide clear guidance on physical activity in the childcare facility for staff
and parents.
Scope: Childcare center
Background: When children are physically active on a daily basis, not only are they
more effective learners, but they are less likely to be overweight or obese. Overweight
and obese children have an increased risk of being overweight or obese as adults and
are at high risk for developing immediate health problems such as type 2 diabetes,
heart disease, high blood pressure, asthma, and sleep apnea. Children who are
physically active early in life and stay active throughout childhood enjoy many positive
benefits to their physical health, building strength, flexibility, endurance and developing
and maintaining healthy bones. In addition, being physically active supports emotional
health, reducing feelings of anxiety and depression, while promoting psychological wellbeing. It is important to provide a positive environment for physical activity by giving
children of all ages daily opportunities to be physically active, surrounded by positive
and responsive adult role models. (Nemours; Best Practices for Physical Activity: For
Organizations Serving Children and Youth, A Guide To Help Children Grow Up Healthy)
Active Play & Inactive Time: (__insert facility name_) will provide for each child in our
care:
 At least 120 minutes of active playtime each day (for children enrolled full day)
 Children will participate in structured physical activities (teacher-led) two or more
times a day
 Children will participate in outdoor active play two or more times a day (weather
permitting)
 Television or videos are rarely or never shown in the facility
Play Environment: ( __insert facility name__) will provide for each child in our care:
 A wide variety of portable play equipment available for children to use at the
same time
Supporting Physical Activity: (__insert facility name__) will provide for each staff
member in our facility:
 Receive training on physical activity (not including playground safety) at least
twice per year
Approved by:
_________________________
Director of (insert facility name)
___________________
Date
Nutrition
1.1: Drinking water shall be available for children at all times

Will visually be checked during site visit
1.2: Site shall provide nourishing foods appropriate for child’s nutritional requirements
as specified by his/her parent(s) written diet plan


Will visually check children’s diet plan filled out by parent
Copy of diet plan included in this book
1.3: One serving of milk shall be served with each meal


Should be included in weekly menu
Serving considered as ½ cup ages 1-2, ¾ cup ages 3-5, and 1 cup ages 6-12
2.1: Staff shall eat meals with children and be served the same foods


Will be visually checked during a site visit
Staff should sit with children during meal time and eat the same foods served
to children
2.2: Provide education materials on breastfeeding and support for breastfeeding
mothers to parents in the pick-up/drop-off area


This will visually checked during site visit
Breastfeeding information can be obtained online at U.S. Department of
Health and Senior Services-Women’s Health (www.womenshealth.gov) or
you can contact the Independence Health Department
2.3: Director or designee is trained in nutrition every three years and in turn will train
facility staff upon hire



The training log will be checked for staff training
Director and staff will need to complete training every three years after initial
training
Health department holds trainings yearly and/or can receive training from
another entity but will need to provide training certificate
3.1: Site shall have a nutrition policy in place




Written policy will be checked during site visit
An example policy is provided in this book for site if it does not have a policy
developed
Policy minimum requirements include model policies: 1,2,3,7,8,10,11,13,17
from “Model Policies for Creating a Healthy Nutrition and Physical Activity
Environment in Child Care Settings” (included in this book) on page 8
Policy should also include “no fried foods”, fresh fruits and vegetables at
every meal
3.2: Site shall serve fresh fruits and vegetables at every meal



Should be included in weekly menu and nutrition policy
Provide copy of weekly menu
Will also be visually checked during a site visit
3.3: Facility shall provide only 100% fruit juice (limited amounts), water, or milk
beverages




Should be included in weekly menu and nutrition policy
Provide copy of weekly menu
Will also be visually checked during a site visit
Limited fruit juice is defined as no more than ½ cup or 4 oz per day
Independence Start Right Childcare Program
Sample Policy on Nutrition
Purpose: To provide clear guidance on nutrition in the childcare facility for staff and
parents.
Scope: Childcare facility
Background: Overweight and obese children have an increased risk of being
overweight or obese as adults and are at high risk for developing immediate health
problems such as type 2 diabetes, heart disease, high blood pressure, asthma, and
sleep apnea. Children who are given healthy food options during early childhood are
more likely to continue healthy eating habits when they are older. You and your program
play an important part in introducing your children to healthy food, by both providing
nutritious food and teaching children how to make healthy food choices. By sharing
information with families, you can work with them as partners to support healthy
children. (Nemours; Best Practices for Healthy Eating: A Guide To Help Children Grow Up
Healthy)
Beverages: (__insert facility name_) will provide for each child in our care:
 Drinking water is available at all times for self-serve, both indoors and outdoors
 100% juice is offered no more than three times a week
 Only skim or 1% milk is served to children age 2 or older
Mealtime Environment: (__insert facility name_) will provide for each child in our care:
 Staff members allow children to decide how much to eat. Children are never
forced to eat or to try new foods
 Staff members encourage children to try new or less favorite food but never force
them to try new foods or to eat something they do not like
 Staff members join children at the table for meals and snacks
 Staff members consume the same food and drinks as children. Staff members
do not consume other foods or drinks in front of the children
 The center displays pictures or posters that support healthy eating
Nutrition Education: (__insert facility name__) will provide for each staff member in
our facility:
 Staff members receive training on nutrition (other than food safety and food
program guidelines) at least twice per year
Approved by:
_________________________
Director of (insert facility name)
___________________
Date
General Safety
1.1: All staff has read and reviewed a copy of the Licensing Rules for Group Day Care
Homes & Child Day Care Centers in Missouri upon hire and as updated


Should be included in hiring orientation
Written document with staff signature stating employee has read and
reviewed document
1.2: At least one caregiver per 20 children shall have current CPR & First Aid
certification


Will check CPR/First Aid certification
Copy of employees certification on file at site
1.3: Childcare provider shall have on file criminal background check on all staff


Should be included in hiring process
A copy of background check is located in each personal staff file
2.1: All staff has CPR & First Aid certification


Will check CPR/First Aid certification
Copy of employees certification on file at site
2.2: Parent education on CPR/First Aid is displayed at pick-up/drop-off area


This will visually checked during site visit
CPR/First Aid information can be obtained online at Center for Disease
Control and Prevention, Missouri Department of Health and Senior
Services, and American Heart Association, Safe Kids USA, or you can
contact the Independence Health Department
2.3: Children at the facility participate in at least one IHD health promotion class per
year

Will check the children’s training log sheet



The Independence Health Department (IHD) provides five health promotion
classes for children free of charge.
Five classes offered include: poison prevention, handwashing, oral health,
organ wise guys (physical activity), My Plate (nutrition)
Contact 325-7185 to schedule a class
2.4: Director or designee are trained in emergency facility safety recommendations
(intruder safety)



Director will need to complete training every three years after initial training
and train staff upon hire in procedures
The training log will be checked for staff training
Can contact Independence Health Department on training resources
3.1: Facility has a call system in place for absent children


Written document stating procedures for when child has not shown up to
daycare
Needs to include procedures for parents to call in when child not attending
and for staff if child has not shown up and no parent phone call
3.2: Facility has a smoke-free indoor and outdoor campus policy in place



Policy will be checked off during site visit
Example policy provided in this book
Tips for successful implementation are included in this book
3.3: Has not had a critical violation from environmental public health division



Will review most current copy of sanitation inspection
Critical violation is defined as a violation that relates directly to factors which
lead to foodborne illnesses and communicable disease prevention
Copy of an inspection form included
Independence Start Right Childcare Program
Sample Policy on Smoke-free campus (outdoor)
I. PURPOSE
The purpose of this policy is to provide for and promote the health, safety and welfare
for all persons who enter [Company]’s property.
Each year, approximately 440,000 people in the United States die prematurely of
diseases caused by tobacco. The Surgeon General concluded that there is no risk-free
level of tobacco smoke, including secondhand smoke and smoke residue.
Medical studies have shown that any exposure to tobacco smoke causes immediate
damage to the body that can lead to serious illness or death. Evidence has also shown
that the use of smokeless tobacco products, such as chewing tobacco, snuff and snus,
also cause adverse health effects and can result in oral cancer, increased risk of heart
attack, other cardiovascular disease and addiction.
Restricting tobacco use throughout a campus reduces these risks and promotes the
health and well-being of members of the entire campus community. Because campuses
are often highly visible within a community, adopting a strong tobacco-free policy
educates the public, local government and organizations about the advisability of such a
policy, and encourages them to adopt similar measures. A campus-wide policy can also
help reduce youth initiation to tobacco use, through positive modeling behavior.
In addition to promoting public health, a campus-wide tobacco-free policy can be
economically beneficial as well, especially if supported by an effective cessation policy.
Benefits include reduced employee health care costs and absenteeism, increased
employee productivity, as well as cost savings in areas such as grounds maintenance.
Therefore, this policy is designed to include all products that contain tobacco or that
deliver nicotine in a manner that is not approved by the FDA for the treatment of
nicotine addiction. Because there is no safe tobacco product, the only logical action is to
promote a campus that is completely tobacco-free.
II. DEFINITIONS
For purposes of this policy, the terms set forth below shall have the following meanings:


“Tobacco product” means any product containing tobacco in any form.
“Unapproved nicotine delivery product” means any product containing or
delivering nicotine intended or expected for human consumption that has not
been approved or otherwise certified for sale by the United States Food and Drug
Administration (FDA) as a tobacco use cessation product. This listing can be
found at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm198176.htm
III. TOBACCO-FREE CAMPUS POLICY
The use and visual possession of tobacco and unapproved nicotine delivery products
are prohibited on all property under the control of [Company] at all times, including, but
not limited to:






Grounds
Adjacent sidewalks
Parking lots
Buildings
Company vehicles whether or not that vehicle is on [Company] property
Private vehicles parked on [Company] property
This policy applies to all persons on [Company]’s campus, regardless of their purpose
for being there.
[Job Title] will establish a procedure for informing parents, staff, visitors, contractors,
etc. of the ban on the use and visual possession of tobacco products, unapproved
nicotine delivery products and associated paraphernalia in, or on the grounds of
[Company].
IV. EMPLOYEE TOBACCO-FREE WORKDAY POLICY
Employees are prohibited from using tobacco products and unapproved nicotine
delivery products during their working hours, including breaks, whether on or off
campus. Clothing worn during an employee’s shift must be free from the odor of
tobacco.
V. POLICY EFFECTIVE DATE
This policy is effective as of [Month] [Day], [Year].
VI. POLICY CONTACT INFORMATION
For questions about this policy, contact: [Name, Title & Contact Information]
This policy is accepted by and for [Company]:
______________________________________________________________________
Name:
______________________________________________________________________
Date:
______________________
Successful Implementation
The following are suggested steps for successful implementation of this policy.
Staff members play an important role in modeling behavior and setting a good example
for others in complying with the policy.
For this reason, the following are suggested:





Ongoing and clear communication about the rationale, components and
enforcement of the tobacco-free environment policy.
Prominently placed signage that clearly explains the policy.
Clear messaging that all staff members, regardless of classification or job status,
are expected to adhere to the policy. Thus, all staff members are prohibited from
using or possessing prohibited products while working for or representing the
company, either on site or at other business locations.
Low to no-cost cessation assistance for staff members who want to quit using
tobacco.
Education on how to most effectively react to individuals found violating the
policy.