This document is a model Health Policy for family home child care. It
includes both WAC items and what Snohomish Health District considers
to be best practice when caring for children.
To meet licensing requirements a health policy must be individualized for
each family home child care. This document contains many sections
marked in red that need to be filled in with specific information relevant
to your child care. Make sure to take out any red words in parentheses
that were put in to help you complete this document. Do not hesitate to
add additional points to reflect your child care’s policies. Items in green
are best practice, rather than required and can be removed if you
choose.
Make sure you read through the entire policy as you work on it. If any
items are unclear or are in conflict with what you do at your child care,
make any necessary changes to reflect your own practices. For example,
if you do not care for infants, make sure to remove all sections from your
plan that relate to infants. Call the Communicable Disease Outreach
program if you have questions or need clarification on which items are
required by WAC. The WACs can be found on the Department of Early
Learning’s website www.del.wa.gov.
Once finalized, your health policy should reflect exactly what is done in
your child care. Use your health policy to train any volunteers or staff and
to inform parents.
Note: The table of contents has been set up so that it can be easily updated. Make
all changes to the document, including any page breaks. When you are finished,
click once somewhere in the middle of the table of contents which should select the
entire table. Then right click, select “update field” and then “update entire table.”
The table of contents will automatically update itself.
Communicable Disease Outreach Program
FamilyHomeChildCareHealthPolicy_CD
2015_01_MHAS
3020 Rucker Avenue, Suite 202  Everett, WA 98201-3900  fax: 425.339.8706  tel: 425.339.5278
This model health policy references various forms, logs, and other policies that may
be necessary for recordkeeping. Below is a list of these items. The Communicable
Disease Outreach program has examples of all of these forms and policies. Please
contact the Communicable Disease Outreach program for copies or assistance with
personalizing these documents.
 Model Policies
o
o
o
o
Bloodborne Pathogen Exposure Control Plan
Pet Policy
Pesticide Policy
Disaster Plan
 Example Forms
o
o
o
o
o
o
o
o
o
Injury Report
Record of Injury & Incidents
Medication Treatment Form
Medication Count Verification Form
Childhood Health History
CIS Form
Abuse/Neglect Report Form
Diapering Log
Healthy Child Care Cleaning Schedule
 Individual Care Plans
o Individual Plan of Care (general form)
o Asthma Plan
o Emergency Plan for Severe Allergies
 Other Useful Documents
o
o
o
o
Keep Me Home If…
Menu Planner
Child Care Classroom Refrigerator Temperature Log
Playground Maintenance Checklist
Family Home Child Care Health Policy
Snohomish Health District
Page 2
Health Policy
Name of Child Care:
Name of Provider:
Address:
City/State/Zip:
Phone Number:
Ages of Children:
Out-of-Area Contact:
Emergency telephone numbers:
Fire/Police/Ambulance:
Poison Center:
Animal Control:
C.P.S.:
C.P.S. (after-hours):
911
1-800-222-1222
425-388-3440
1-866-363-4267 or 425-339-1830
1-800-562-5624
Hospital used for life-threatening emergencies:
Name of Hospital:
Address:
Phone:
* For non-threatening emergencies, the center will defer to parent preference as listed on the child’s
registration form.
Other important telephone numbers:
DEL Health Specialist:
Lalaine Diaz Lalaine.diaz@del.wa.gov
206 760-2027
DEL Licensor:
Communicable Disease Reporting Line: Snohomish Health District 425-339-5278
Child Care Health Consultation:
Snohomish Health District 425-339-5278
Snohomish Health District Website: www.snohd.org
Family Home Child Care Health Policy
Communicable Disease Outreach Program
FamilyHomeChildCreHealthPolicy_CD
2015_01_MHAS
3020 Rucker Avenue, Suite 300  Everett, WA 98201-3900  fax: 425.339.8706  tel: 425.339.5278
TABLE OF CONTENTS
INJURY/ EMERGENCY PROCEDURES ...................................................................................................... 3
CONTACT OR EXPOSURE TO BODY FLUIDS ........................................................................................... 4
INJURY PREVENTION ................................................................................................................................. 4
MEDICATION MANAGEMENT ..................................................................................................................... 5
POLICY AND PROCEDURE FOR EXCLUDING ILL CHILDREN ................................................................ 10
COMMUNICABLE DISEASE REPORTING ................................................................................................. 12
HEALTH RECORDS ................................................................................................................................... 13
ILLNESS PREVENTION PRACTICES ........................................................................................................ 13
IMMUNIZATIONS ....................................................................................................................................... 13
HANDWASHING ......................................................................................................................................... 14
TOOTHBRUSHING ..................................................................................................................................... 15
GENERAL CLEANING, SANITIZING, AND LAUNDRY ............................................................................... 17
INFANT CARE ............................................................................................................................................ 21
DIAPERING ................................................................................................................................................ 28
FOOD SERVICE ......................................................................................................................................... 30
NUTRITION ................................................................................................................................................ 33
PHYSICAL ACTIVITY ................................................................................................................................. 35
WATER PLAY ............................................................................................................................................. 36
SCREEN TIME............................................................................................................................................ 37
DISASTER PREPAREDNESS .................................................................................................................... 38
STAFF HEALTH.......................................................................................................................................... 38
CHILD ABUSE AND NEGLECT .................................................................................................................. 39
CHILDREN WITH SPECIAL NEEDS / INCLUSION..................................................................................... 40
BEHAVIOR MANAGEMENT/GUIDANCE PRACTICES .............................................................................. 40
DRINKING WATER ..................................................................................................................................... 41
WASTEWATER DISPOSAL ........................................................................................................................ 41
PEST CONTROL ........................................................................................................................................ 42
ANIMAL POLICY ......................................................................................................................................... 43
SMOKING ................................................................................................................................................... 44
TRANSPORTATION SAFETY .................................................................................................................... 45
ATTENDANCE RECORDS ......................................................................................................................... 45
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INJURY/ EMERGENCY PROCEDURES
MINOR EMERGENCIES
The provider is trained in first aid and will refer to the (name of first aid guide) located with the first
aid supplies. Gloves will be used if any body fluids are present. Provider will refer to the child’s
emergency form and call parents/guardians, emergency contacts, or health care provider as
necessary. (WAC 170-296A-2250)
Provider will record the incident (how/where). This documentation will include the date, time, place,
and cause of the injury or illness, if known. A copy will be placed in the child’s file. (WAC 170-296A-2050-2
and -3575) Parents will be notified of the injury (how).
LIFE-THREATENING EMERGENCIES
If more than one adult is present: one person will stay with the injured/ill child and send another
person to call 911. If only one adult is present: person will assess for breathing and circulation,
administer CPR for one minute (for a child), if necessary, and then call 911. (WAC 170-296A-2200)
Provider will provide first aid as needed according to the (name of first aid guide) located with the
first aid supplies. Gloves will be worn if any body fluids are present.
Provider will contact the parent/guardian(s) or the child’s alternate emergency contact person.
If possible, provider or staff person will stay with the injured/ill child, including transport to a hospital
if necessary, until a parent, guardian, or emergency contact arrives.
The incident will be recorded (where).
Serious injuries/illnesses, which require medical attention, will be reported to the licensor
immediately. A copy of the documentation will be sent to the licensor no later than the day after the
incident. A copy will be placed in the child’s file. (WAC 170-296A-3600)
FIRST AID
Provider and staff have current training in Cardio-Pulmonary Resuscitation (CPR) and First Aid.
(WAC 170-296A-1825)
First aid kits are inaccessible to children and located (where – somewhere in licensed space). (WAC
170-296A-4075-1)
The first aid kits contain: (WAC 170-296A-4075-2)
first aid guide
Adhesive bandages
sterile gauze pads
(different sizes)
small scissors
roller bandages
adhesive tape
large triangular bandage
ice packs
gloves (Nitrile or latex)
tweezers for surface splinters
CPR mouth barrier
digital thermometer with sleeves
or single use thermometer
blood cleanup kit
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A fully stocked first aid kit will be taken on all field trips and will be kept in each vehicle used to
transport children (remove red-type if you do not go on field trips or transport children).(WAC 170-296A4075-1) These travel first aid kits will also contain:
 liquid soap and paper towels
 water
 instant hand sanitizer (for staff use only)
 change for phone calls and/or cell phone (choose one or both)
 an emergency dose of critical medication such as an Epipen, Jr. or
asthma inhaler for those children who need it
All first aid kits will be checked and restocked (how often) or sooner if necessary.
CONTACT OR EXPOSURE TO BODY FLUIDS
When the provider or a staff person has blood contact or exposure, the child care will follow the
bloodborne pathogen exposure control plan and the current guidelines set by the Washington
State Department of Labor and Industries. (WAC 170-296A-1850-2b)
The bloodborne pathogen exposure control plan is stored (where).
INJURY PREVENTION
The provider will thoroughly inspect the child care on an ongoing basis for hazards. Any hazard or
contamination found will be removed, made inaccessible, or repaired immediately to prevent injury.
Hazards include, but are not limited to:

safety hazards (broken toys, equipment, drowning, choking, sharp objects, etc) (WAC 170296A-4200 and -6600)









proper security of the child care (secure doors, proper supervision, etc)
trip/fall hazards (rugs, cords, uncontained toys, stairways, etc) (WAC 170-296A-4325 and 4350-3a)
poisoning hazards (plants, chemical storage, art materials, etc) (WAC 170-296A-4100 and -6625)
electrical hazards (electrical cords, outlets etc) (WAC 170-296A-4350)
burn hazards (fireplaces, portable heaters, candles, bare light bulbs, etc) (WAC 170-296A-2600)
window coverings which form a loop (WAC 170-296A-4300)
entrapment hazards (spaces greater than 3½“ and less than 9”) (WAC 170-296A-4325 and -4950-2)
____________________________________________________________
____________________________________________________________
Toys will be age-appropriate, safe, in good repair, and not broken. Provider will remove any
recalled items as soon as they become aware of the recall. (WAC 170-296A-4200) The provider will
periodically review the CPSC website for recalled items at www.cpsc.gov.
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Playground equipment will be free from entrapments, entanglements, protrusions, broken
equipment, and other injury hazards and will be checked weekly for these hazards by the provider.
Unsafe equipment will be made inaccessible to the children until it is repaired. (WAC 170-296A-5000-1)
The area will also be checked daily before use for garbage, animal contamination, environmental
hazards, and areas of low surfacing material such as at the ends of slides and under swings. (WAC
170-296A-5075) Loose -fill surfacing material will be raked (weekly, daily). Proper supervision will be
maintained during all outdoor play. (WAC 170-296A-5750)
MEDICATION MANAGEMENT
Choose one of these three statements and delete the other two:
(WAC 170-296A-3315-1b and 5)
(No medications will be given) Medications will not be provided by the child care. Parents
administer all medications. If a child has a condition where the Americans with Disabilities Act
(ADA) applies, reasonable accommodations will be made and the child will be given medication.
– OR –
(Prescription medications only) Medications are provided only to those children with a health care
provider’s prescription. If a child has a condition where the Americans with Disabilities Act (ADA)
applies, reasonable accommodations will be made and the child will be given medication.
– OR –
(Prescription or over-the-counter medications) Medications are provided to any child with a health
care provider’s prescription or a medication consent form from the child’s parent/guardian as
appropriate. If a child has a condition where the Americans with Disabilities Act (ADA) applies,
reasonable accommodations will be made and the child will be given medication.
MEDICATION RULES
All medication must have a (name of medication authorization form) consent form filled out with the
following information: (WAC 170-296A-2050-2 and -3375)
 the child’s first and last name
 the child’s parent/guardian signature and date
 the medical provider’s signature (if necessary; see next section)
 the name of the medication
 reason for giving the medication
 amount of medication to give
 how to give the medication or route of administration
 how often to give the medication
 start and stop dates
 possible side effects (use package insert or pharmacist’s written information)
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
how to store the medicine consistent with directions on the label
The consent is good for the number of days stated on the consent form. (WAC 170-296A-3375-2)
 Form most medications, the number of days must be 30 calendar days or less. After this
time, a new consent must be obtained.
 For diaper ointments, sunscreens, hand sanitizers, or alcohol-containing hand wipes, the
consent can be used for up to 90 calendar days.
All medications must be in the original container and labeled with the following information:
(WAC 170-
296A-3475-5)




child’s first and last name
instructions and dosage recommendations for the child’s weight and age
duration, dosage, frequency, and amount to be given
expiration date
Medication is not given past the days prescribed on the medication bottle or past the expiration
date even if there is medication left. (WAC 170-296A-3425)
REQUIRED CONSENT
A parent/legal guardian is the sole consent to medication being given, without the consent of a
health care provider, if and only if the medication is over-the-counter and is one of the following
types: (WAC 170-296A-3375)
 non-aspirin fever reducer/pain reliever
 ointment or lotion specifically intended to reduce or stop itching, treat dry skin, or care for
a wound
 diaper ointment or non-talc powder intended for the use in the diaper area
 sunscreen for children over 6 months of age
 cough, cold, or flu medication (not recommended – see next two paragraphs)
 vitamins, herbal supplements (not recommended – see next paragraph)
A health care provider’s consent, along with parent/guardian consent, is required for:
 prescription medications
 over-the-counter medications that are not one of the medications listed above
 over-the-counter medication with a label that does not include the age or weight of the
child being treated
 vitamins, herbal supplements, teething aids, and fluoride
Optional and Recommended paragraph: Many over-the-counter medications are not approved for
young children. The Food and Drug Administration recommends that cough and cold products not
be given to children younger than 2 years. According to the American Academy of Pediatrics,
cough suppressants, antihistamines, and decongestants may not be effective in children younger
than 6 and can have potentially serious side effects, even when given as directed. Based on this
information, over-the-counter cough and cold medications will not be administered to children
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younger than 2 years (optional: 6 years) unless the parent provides written and signed instructions
from a health care provider in addition to the completed consent form.
(Include this paragraph if you will administer any oral medications with only parental consent) This
child care agrees to administer certain over-the-counter medications. It is the parent’s responsibility
to ensure that incompatible medications are not given together or that multiple medications
containing acetaminophen are not given together.
A health care provider’s consent is accepted in 3 different ways:
 The health care provider’s name is on the original pharmacist’s label (along with the
child’s name, name of the medication, dosage, duration, and expiration date).
 The health care provider signs a note that includes the information required on the
pharmacist’s label (such as when medications are given in the clinic). Note: medications
must be in the original container.
 The health care provider signs a completed (name of medication authorization form).
“AS NEEDED” MEDICATIONS
“As needed” medications are given when the above requirements are met and the signed (name of
medication authorization form) also includes the:
 symptoms that require the medication
 the length of time the medication is to be given (ex. 1 week)
 the maximum amount of medication that can be given in a day
 the minimum amount of time between consecutive doses
SUNSCREEN
When sunscreen is necessary, it is applied only when the above requirements are met. In addition,
the following special requirements are adhered to:
 choose 1: the child care provides the sunscreen – or – parents provide sunscreen for
their child
 sunscreen is applied at least 15 minutes before sun exposure
 spray-on sunscreens are not used
 when used, spray on sunscreens are only applied outside and are never sprayed in a
child’s face (apply to face using gloved hand)
 the following method is used to apply sunscreen: (describe method used – examples
include squeezing sunscreen from bottle onto a clean paper towel for each child, having
older children self-apply with supervision, spray-on to gloved hand and then applied,
using clean gloves for each child, etc.).
BULK MEDICATIONS
If the child care does not allow the use of bulk medications (where one container of medication,
like sunscreen, is used for many children), take this section out. “Bulk medications” include
containers of sunscreen; diaper ointments and non-talc powders, intended for use in the diaper
area; etc. These bulk medications are given only when the above requirements are met AND:
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



written parental consent prior to use is obtained
it is used no longer than six months (write the date opened on the container)
parents are notified of the name of the product used, the active ingredients, and Sun
Protection Factor (SPF) of the sunscreen
products are applied in a manner to prevent contaminating the bulk container
When administering bulk medications, the method used to prevent contamination of the bulk
container is (describe method used – examples include squeezing medication from bottle onto a
clean paper towel for each child, or spray-on sunscreens are used, or using clean gloves for each
child, etc.). (WAC 170-295-3080)
ADMINISTRATION
Medications are administered by the licensed provider or primary staff person only.
(WAC 170-296A-
3315c)
Before a staff member may administer medications, parents will provide instructions and
demonstrate the use of specialized medication administration procedures (for example: how to use
the nebulizer or EpiPen, children’s preferences for swallowing pills, how to deliver eye drops, etc).
(WAC 170-296A-3375-1d) This is documented (where – medication administration form, individual health
plan, other).
To give liquid medication, staff use a measuring device designed specifically for oral or liquid
medication. Measuring devices for individual use are provided by (whom – parent, center) and
stored (how).
Medications are not mixed in formula or food unless there are written directions to do so from a
health care provider with prescriptive authority before the medication is given.
Staff administering medications will wash hands before preparing medications and after giving the
medication. Medications are prepared on a clean surface away from toileting/diapering areas.
Staff will carefully read labels on medications before each administration, noting:
 child’s name
 medication name
 amount to be given
 time and dates to be given
 how long to give
 how to give (e.g. by mouth, to diaper area, in ear, etc)
Staff will make sure information on the label is consistent with information on the (name of
medication authorization form).
CHILDREN TAKING THEIR OWN MEDICATION (WAC 170-296A-3550)
Children may take their own medication if the above requirements are met AND:
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



There’s a written statement from the parent requesting the child take their own
medication.
There’s a written statement from the health care provider with prescriptive authority
stating that the child is physically and mentally capable of taking their own medication.
All storage criteria stated in this policy are met.
A staff member observes and documents that the child took the medication.
DOCUMENTATION (WAC 170-296A-2215-2a-c)
Each time medication is administered, it will be immediately documented on (name of medication
treatment form or medication log; can be the back of the medication authorization form). This
written record will include:
 child’s full name, date, time, name of medication, and amount given (indicate if selfadministered)
 the name and full signature of the person giving each dose of medication or observing
the child taking the medication
 a written explanation why a medication that should have been given was not given
 any observations of the child in relation to the medication taken (example: side effects or
relief of symptoms)
 when “as needed” medications are administered, staff must document the symptoms
that prompted administration
Staff will report any side effects that occur to (title of individual) and to the parent immediately. This
will be documented on the (name of medication form; for example, the back of the medication
authorization form).
For children with special health needs, detailed instructions for medications or medication delivery
devices, such as nebulizers, insulin pumps, or EpiPens, will be documented on the (program
name) Individual Plan of Care form.
Medication authorization and documentation forms are considered confidential and will be stored
(where). (WAC 170-296A-3375-5)
Outdated medication authorization/treatment forms will be kept in the child’s file while in care and
are kept up to one year after the child leaves care. (WAC 170-296A-3375-6)
The child care implements the following system for tracking administration of controlled
substances: (Describe system: for example, only 1 week’s worth of medication will be accepted
from the parent at a time. Pills will be counted at each administration. This will be documented on
(name of medication count verification form).)
STORAGE (WAC 170-296A-3315-1a and -3325)
Children’s medication will be kept (where). This is a locked location inaccessible to children; out of
sight; away from sources of moisture, heat, and light; away from food; and protected from sources
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of contamination. Topical non-prescription medications (such as diaper creams, hand lotion,
instant hand sanitizers, etc) will be kept (where – these items do not need to be in a locked
location, but do need to be inaccessible).
The provider’s personal and family medications will be stored (where) inaccessible to children.
Medications for the provider’s pets will be stored (where).
External medications that go on the skin will be kept as stated above but also separate from oral or
injectable medications.
Medications requiring refrigeration will be stored in a labeled, closed container to keep them
separated from food.
EpiPens, inhalers, and other emergency medications will be stored in an unlocked location,
inaccessible to children, but easily accessible to the care provider in an emergency. This location is
(where; the same room as the child is recommended).
MEDICATION ERRORS
The child care works to prevent medication errors by ensuring proper training of staff and reviewing
the 5 “R”s before each medication administration – right child, right medicine, right dose, right time,
and right route of administration.
If a medication error does occur, the provider will contact poison control and the child’s parent
immediately. 911 will be called if the child shows any signs of distress. The error and what was
done to handle it will be documented on (name of form) and will be kept with the child’s records.
The licensor will be notified.
The cause of the error will be reviewed and a plan will be developed to prevent future errors.
DISPOSAL
Outdated medications or medications no longer being used will promptly be returned to parents or
guardians. (WAC 170-296A-3375-4) If the parent/guardian is not available, the provider will call 1-800-7329253 or go to www.MedicineReturn.com for instructions on proper disposal. Medication is not
flushed down the toilet.
POLICY AND PROCEDURE FOR EXCLUDING ILL CHILDREN
The provider will check all children for signs of illness when they arrive and throughout the day. If
the following signs of a possibly contagious illness are present, a child will not be admitted that
day, or will be excluded. The parent will be called to pick up their child. The child will be kept
(where) until the parent arrives and be cared for by (whom). Are there consequences for parents
who do not pick up a child in a timely manner? If so, describe here.
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Children and staff with the following symptoms will be excluded: (WAC 170-296A-3210-3)
 temperature of at least 100º F under arm (axillary) or 101º F orally AND who also have
one or more of the following:
o headache
o earache
o sore throat
o rash
 vomiting on 2 or more occasions within the past 24 hours
 diarrhea (increased fluidity and/or frequency of bowel movements relative to the person's
usual pattern) occurring 3 or more times within 24 hours; or any bloody stool
 any suspected communicable infection of the skin or eyes such as impetigo, MRSA,
pinkeye, scabies, pus or mucus drainage from the eye, or a rash not associated with
heat, diapering, or allergy
 open or oozing sores, unless properly covered and 24 hours have passed since starting
treatment, if treatment is necessary
 fatigue, irritability, or confusion that prevents participation in regular activities, such as
sleeping or resting more than usual for that child, not wanting to eat, or multiple cold
symptoms that keep the child from regular activities
 Optional: lice or nits (for head lice, children and staff may return to child care once no
live lice are visible – or – once no live lice or nits are visible)
 ________________________________________________________________
 ________________________________________________________________
 ________________________________________________________________
Providers and staff/volunteers that are ill with any of the above symptoms will follow the same
exclusion criteria as children and not provide care. Should a provider be unable to care for children
due to illness, (identify what you will do – close the child care, call in an approved assistant, etc.).
Temperatures are taken with a digital thermometer with single-use disposable covers over the
thermometer (or – single use thermometers that are disposed of after a single use – or – a digital
thermometer that is cleaned and sanitized after each use). (WAC 170-296A-4075) Oral temperatures are
taken on preschool- through school-age children; under arm (axillary) temperatures are taken on
all other children. No rectal nor ear temperatures are taken.
Parents are notified in writing when their children have been exposed to infectious diseases or
parasites/lice. The notification may consist of either a letter to parents which will be delivered by
(how – placing in children’s cubbies, placing by the sign-in book, other) and/or posting a
notification for parents (where).
Following an illness or injury, children will be readmitted to the program when:
 they no longer have the above symptoms
 they have been without fever for 24 hours without being treated by an antipyretic such as
acetaminophen (Tylenol) or ibuprofen
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


24 hours have passed since starting appropriate treatment
they no longer have significant discomfort
the child care has been advised by a Public Health Nurse on communicable disease
guidelines for child care
Following surgery or injury requiring medical care, a note from the physician stating that the child
may return to routine child care activities and environment may be required.
COMMUNICABLE DISEASE REPORTING
Licensed child care facilities are required to report communicable diseases to their local public
health department (WAC 246-101-415 and 170-296A-2325). The following is a partial list of the official diseases
that must be reported. They were selected because they represent diseases that are most likely to
be found in child care settings. For a complete list of reportable diseases, call the Snohomish
Health District. Children and staff who have a reportable disease may not be in attendance at the
child care unless approved by the local health department. A provider, staff member, assistant, or
volunteer diagnosed with a reportable disease must not provide care unless approved by the local
health department.
The following communicable diseases will be reported to the Snohomish Health District at 425339-5278, giving the caller’s name, the name of the child care, address, telephone number, and
name of child involved:
Animal bites
Campylobacteriosis (Campy)
Cryptosporidiosis
Cyclosporiasis
Diphtheria
Enterohemorrhagic E. Coli, including E. Coli
0157:H7
Food or waterborne illness
Giardiasis
Haemophilus Influenza Type B (HIB)
Hepatitis A (acute infection)
Hepatitis B (acute and chronic infection)
Hepatitis C (acute and chronic infection)
Influenza (if more than 10% of children and staff
are out ill)
Listeriosis
Measles (rubeola)
Meningococcal disease
Mumps
Pertussis (Whooping cough)
Polio
Rubella
Salmonellosis
Shigellosis
Tetanus
Tuberculosis (TB)
Yersiniosis
In the event of exposure to a case of a reportable illness, the Snohomish Health District will
provide the child care with a letter to be distributed to the parents and legal guardians of children in
care.
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Even though a disease may not require a report, the child care will consult, as appropriate, with the
Communicable Disease Outreach program at the Snohomish Health District at 425-339-5278 for
information about common childhood illness or disease prevention, and to determine when a child
or staff member may return to the center.
HEALTH RECORDS
Each child’s file will contain: (WAC 170-296A-2050)
 identifying information about the child
 health, developmental, nutrition, and dental histories, including known allergies
 date of last physical exam
 health care provider and dentist names, addresses, and phone numbers
 allergies
 Individualized Care Plans for special needs or considerations (medical, physical, or
behavioral)
 list of current medications
 current immunization record (CIS form)
 consents for emergency care
 preferred hospital for emergency care
 authorization to take the child out of the facility to obtain emergency health care
The above information will be collected by the provider before a child enters care. This information
will be updated annually or sooner if changes are brought to the attention of the provider.
ILLNESS PREVENTION PRACTICES
The following additional illness prevention practices will take place:



Children will sleep at least 30 inches apart at the sides and in a head to toe or toe to toe
arrangement.
Windows will be opened at least 15 minutes each day.
Children will have at least 30 minutes of outside time each day. (WAC 170-296A-5125)
IMMUNIZATIONS
The Certificate of Immunization Status (CIS), or comparable form completed by a health care
professional, for each child is kept on file to show the Department of Health and the Department of
Early Learning (DEL) that the child care is in compliance with licensing standards. (WAC 170-296A-20501d and -3250 and -3275 and -3300)
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A completed CIS form is collected upon enrollment in the following manner: (Describe method of
initially collecting immunization information: the parent or staff may transfer the immunization dates
from the health care provider’s immunization record onto a CIS form. The parent must sign the
CIS form to verify the information.)
Children may attend child care without an immunization:
 when the parent signs the exemption form stating they have Religious Membership
Exemption , OR
 when the parent signs the exemption form stating they have
religious/personal/philosophical reasons for not obtaining specific immunization(s), AND
the health care provider signs that the parent has received a consult regarding risks of
not immunizing, OR
 the parent and health care provider sign that the child is medically exempt
The CIS form is kept (where – child’s file, immunizations binder, other) and is returned to
parent/guardian when the child leaves the program. A copy of individual records, including the
CIS, must be kept for one year after the child leaves.
The CIS records are reviewed and updated (how often) by the (title of responsible person).
In the event that a vaccine preventable disease to which children are susceptible occurs in the
child care, the health department will be consulted regarding the potential exclusion of children
who are unimmunized for that disease. (CFOC page 298). This is for the un-immunized child’s protection
and to reduce the spread of the disease. (CFOC page 298). A current list of exempted children is kept
(where).
HANDWASHING
Children and care providers wash their hands using the following method: (WAC 170-296A-3625-1)
(1) Turn on water and adjust the temperature, then wet hands with warm water
(2) Apply a liberal amount of soap to hands.
(3) Rub hands in a wringing motion from wrists to fingertips for not less than 20 seconds.
(4) Rinse hands with warm water.
(5) Dry hands with a paper towel.
(6) Use the paper towel to turn off the water faucet(s).
Providers, volunteers, assistants, and staff will wash hands: (WAC 170-296A-3675)
 at the start of the child care day or upon arrival at the child care
 before handling foods, cooking activities, eating, serving food, or feeding a child
 after toileting self or assisting children
 before and after diapering a child
 after handling or coming in contact with body fluids such as mucus, blood, saliva, urine,
or feces
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







after handling raw or undercooked meat, poultry, or fish
after cleaning or taking out garbage
after attending to an ill child
before and after giving medications
after handling, feeding, or cleaning up after animals
after smoking
after being outdoors or involved in outdoor play
as needed
Children will be assisted or supervised in hand washing: (WAC 170-296A-3675-2)
 upon arrival at the child care
 before and after meals, snacks, or cooking activities
 after toileting or diapering (Staff may wipe the hands of a child under the age of 6
months with a diaper wipe after diapering instead of a hand wash)
 after outdoor play
 after coming in contact with body fluids
 after touching animals
 as needed
All handwashing sinks are stocked with warm water (80°F - 120°F) (WAC 170-296A-4700 and -4675) , liquid
soap, and paper towels (or - single use cloth towels. Single use cloth towels are washed and
sanitized after each use. (WAC 170-296A-3625-2 and -3)
Children are able to access handwashing sinks by themselves (how? child height sinks, by using a
step stool, etc.). (WAC 170-296A-4675-2) Infants’ hands are washed by being held up by the provider.
The use of hand sanitizers (is/is not) permitted at this child care. Hand sanitizer may be used on
children over 24 months old and only with written parent permission when handwashing facilities
are not available. The use of hand sanitizer is NOT a replacement for handwashing. (WAC 170-296A3650)
TOOTHBRUSHING
This section is optional. Delete if the child care does not have a toothbrushing program.
Toothbrushing is done in the (list the classrooms that do toothbrushing) (how often).
Toothbrushing will be supervised to ensure:
 the establishment of a routine which enhances learning
 that children under the age of six use no more than a pea size amount of fluoride toothpaste
 proper toothbrushing technique
 that toothbrushes are not shared and that they are handled properly
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Each child will have his/her own toothbrush that will:
 be stored properly to decrease cross contamination
o open to air with bristles up
o unable to drip on one another
o do not contact each other or any other thing
o toothbrush caps are not used
 be clearly marked with the child’s name on the handle with a non-toxic, permanent marker
 have soft, rounded nylon bristles and be sized appropriately for the child
 be replaced twice each year when used less than twice a day, 5 days a week, or sooner if
the bristles become splayed or the toothbrush is contaminated
Teachers/child care staff will brush their own teeth to model the desired behavior. Staff training will
be provided yearly on the etiology of tooth decay, oral health promotion, and toothbrushing
protocol.
Choose ONE option below (the sink method or the table method):
Children brush teeth at the sink, located (where). The toothbrushing procedure at the sink is:
 A pitcher of water is obtained from a food preparation sink.
 The sink will be cleaned with the 3-step process (wash, rinse, sanitize).
 Teacher will hand each child their toothbrush and a small paper cup with no more than a
pea sized portion of toothpaste on the edge.
 No more than two children will be at the sink at one time.
 Children apply the toothpaste to the brush.
 Teach the children to brush in a pattern and move from area to area (left-to-right, inside and
outside, top-to-bottom) around the mouth. Finish with the top of the teeth.
 Brushing should continue for at least one minute. Exposure to fluoridated toothpaste is
effective even with unsatisfactory brushing technique.
 Child spits excess toothpaste into the sink. A stepping stool is provided.
 Child returns the toothbrush to the teacher who rinses it under the faucet (or in child’s own
cup of water) and replaces it in the toothbrush rack.
 After all the children have brushed, the sink is cleaned with the 3-step process.
– OR –
Children brush teeth while sitting at the table. The toothbrushing procedure at the table is:
 Table area is washed, rinsed, and sanitized.
 Each child is given a paper towel and a small paper cup with no more than a pea sized
portion of toothpaste on the edge.
 Children apply the toothpaste to the brush.
 Teach the children to brush in a pattern and move from area to area (left-to-right, inside and
outside, top-to-bottom) around the mouth. Finish with the top of the teeth.
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





Brushing should continue for at least one minute. Exposure to fluoridated toothpaste is
effective even with unsatisfactory brushing technique.
Child spits the excess toothpaste into the empty paper cup.
Clean water is poured into a new cup for rinsing the toothbrush.
Child returns the toothbrush to the teacher who replaces it in the toothbrush holder.
Cups are immediately discarded.
After all the children have brushed, the table is washed, rinsed, and sanitized.
GENERAL CLEANING, SANITIZING, AND LAUNDRY
The child care is maintained in a clean and sanitary manner that helps protect the children from
illness. Surfaces in the child care are designed and maintained to be easily cleanable. A cleanable
surface is one that is:
 designed to be cleaned frequently
 resistant to moisture
 free from cracks, chips, or tears
PRODUCTS USED
Cleaning supplies are stored in the original containers, inaccessible to children, and separate from
food and food preparation areas. (WAC 170-296A-4100-1a) Cleaning supplies for the kitchen are stored
(where). Other cleaning products are stored (where).
Cleaning means the removal of dirt, grease, food, art material, body fluids, or other substance from
the area. Cleaning is done with (soap and water – or – name of cleaning product).
Surfaces are rinsed with water between cleaning and sanitizing steps.
If using bleach and water as a sanitizer or disinfectant solution, include this section and chart.
Sanitizing means the removal of germs and bacteria to a level that will not cause illness.
Disinfecting removes a larger number of germs than sanitizing. Sanitizing and disinfecting are
done with solutions of bleach and water. The bleach used contains no scents or surfactants.
Bleach is added to a container of cold water and solutions are made fresh daily. Two (2) minutes
of contact time of the solution with the surface is allowed. After the minimum contact time, the
sanitizer may be wiped off with paper towels or the surface may be allowed to air dry. (WAC 170-296A3925)
Only bleach products with the percent of sodium hypochlorite written on the bottle will be used.
The recipes on the following chart will be used to prepare the solutions based on the percent
sodium hypochlorite in the bleach.
Disinfecting Solutions
For use on diaper change tables, hand washing sinks, bathrooms (including
toilet bowls, toilet seats, training rings, soap dispensers, potty chairs), door
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and cabinet handles, etc.
Water
1 Gallon
1 Quart
2.75%
Bleach
1/3 cup + 1
Tablespoon
1 ½ Tablespoons
5.25-6.25%
Bleach
8.25%
Bleach
3 Tablespoons
2 Tablespoons
2 ¼ teaspoons
1 ½ teaspoons
Sanitizing Solutions
For use on eating utensils, food use contact surfaces, mixed use tables, high
chair trays, crib frames and mattresses, toys, pacifiers, floors, sleep mats, etc.
Water
1 Gallon
1 Quart
2.75%
Bleach
1 Tablespoon
1 teaspoon
5.25-6.25%
Bleach
2 teaspoons
½ teaspoon
8.25%
Bleach
1 teaspoon
¼ teaspoon
If using a sanitizer or disinfectant other than bleach and water, include this section and chart.
Sanitizing means the removal of germs and bacteria to a level that will not cause illness.
Disinfecting removes a larger number of germs than sanitizing. General sanitizing is done with
(name of sanitizing solution). The label for this product states that the product is safe for food
contact surfaces. (WAC 170-296A-0010) Floors, bathrooms, and diaper changing areas are disinfected
with (name of disinfectant solution). The use of these products was reviewed by the local health
department and Department of Early Learning on (date). When using these products, the label
directions are followed exactly, including concentration, contact time, and rinsing. (WAC 170-296A-0010)
The label instructions state:
 Sanitizer: (write name of product and label instructions here – include mixing
instructions, contact, time, and rinsing requirements)

Disinfectant: (write name of product and label instructions here – include mixing
instructions, contact, time, and rinsing requirements)
AREA
Diapering area,
bathroom, door
and cabinet
handles,
faucets, toilets
Amount of
Chemical
Fill in amount
needed
Amount of
Water
Fill in water
needed
Contact time
Rinse?
Fill in contact
time
Rinse
needed
–or–
No rinse
needed
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Food contact
surfaces, eating
utensils, mixed
use tables, toys,
sleeping mats,
crib frames and
mattresses,
pacifiers, floors,
kitchen
Fill in amount
needed
Fill in water
needed
Fill in contact
time
Rinse
needed
–or–
No rinse
needed
The following guidelines will be used when preparing and using chemical cleaners, sanitizers, and
disinfectants:
 Wear gloves and eye protection when mixing chemicals.
 A funnel is used when pouring chemicals into the spray bottle to avoid spills.
 Make dilutions of sanitizer and disinfectant in a well-ventilated area. Never mix solutions in
the classroom.
 Never store incompatible chemicals in the same space. For example, bleach and ammonia
products should never be mixed or stored together.
 Adjust spray bottles to a heavy spray setting, rather than a fine mist.
 Avoid applying disinfectant strength when children are in the immediate area.
 If possible, or if chemical odors are present, ventilate the area.
 (include this bullet if mixing chemical/water solutions, such as bleach water) An eyewash is
available and located (where) per Department of Labor and Industries requirements.
Whenever possible, the sanitizer and/or disinfectant solution is made in large quantity, divided into
spray bottles, and labeled with the preparation date.
Cleaner, water-only, sanitizer, and disinfectant spray bottles are labeled with contents. (WAC 170-2954100-1b)
Sponges are not used for food contact surfaces in the child care space.
Disposal of wastewater is done in the where.
CLEANING SCHEDULE
This child care’s minimum schedule for general cleaning is:

Tables, highchairs, and counters used for food service will be cleaned and sanitized
before and after each meal or snack. (WAC 170-296A-3925-2)

Bathrooms will be cleaned and disinfected daily. This includes sinks, toilets, counters,
doorknobs, and floors. Toilet seats will be cleaned and disinfected throughout the day
and as needed. (WAC 170-296A-3925-11,12 and -4650)
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
Remove the following information on potty chairs if you do not use them – use of potty
chairs is not recommended: Potty chairs will be immediately emptied into toilet, washed,
and disinfected. (WAC 170-296A-3925-13 and -7350) The sink used for cleaning the potty chair must
then be immediately cleaned and disinfected. Flooring underneath potty chairs must be
resistant to moisture. (WAC 170-296A-7350)

Carpeting and rugs will be vacuumed daily. (WAC 170-296A-3925-3) Carpets will be cleaned
every (three/six/twelve) months. Carpet cleaning will be done by (name of carpet
cleaning company or person responsible) by (how? Using carpet shampoo machine,
rented carpet cleaner or professional carpet cleaning company - note: professional truckmounted steam cleaning is recommended). Spot cleaning will be done as necessary.
Vacuuming and mopping will not occur while children are present (carpet sweepers are
ok to use). (WAC 170-296A-3700)

Hard floors will be swept and mopped with (name of floor cleaning product) daily and
sanitized daily. (WAC 170-296A-3925-1) Utility mops will be hung to dry in an area with
ventilation to the outside and inaccessible to children. Mop heads are (washed how often
in the washing machine; replaced how often; other).

Toys will be washed, rinsed, sanitized, and air-dried or toys that are dishwasher safe can
be run through a full wash and dry cycle. This is done weekly or more often if necessary.
(WAC 170-296A-3875-1c)

Toys that children place in their mouth will be sanitized between uses by different
children. The following system for ongoing rotation of mouth toys will be implemented:
(describe the system). (WAC 170-296A-3875-1a) Only washable toys will be used.

Cloth toys and dress up toys will be laundered according to the ‘Laundry’ section of this
policy.

Remove this information if water tables are not used. Water tables will be emptied and
sanitized after each use or more often as needed. Children will wash hands before and
after play and be closely supervised.

Nap mats/cots will be cleaned and sanitized (how often – at least weekly), between uses
by different children, after a child has been ill, and as needed. (WAC 170-296A-3750-4) They will
be stored (describe how and where mats/cots will be stored so that sleeping surfaces
don’t touch if they are not sanitized after each use). (WAC 170-296A-3750-7)

Remove this information if you do not care for infants Crib mattresses and railings will be
sanitized (daily or weekly), before use by a different child, after a child has been ill, and
as needed. (WAC 170-296A-3925-9) Highchairs will be washed, rinsed, and sanitized after each
use. (WAC 170-296A-3925-2)
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
General cleaning of the home is done (how often) and more often when children or staff
members are ill. Dusting is done (how often). Toy shelves are cleaned and sanitized
(how often). Door knobs are cleaned and disinfected (how often) and more often when
children or staff members are ill. Wastebaskets will have disposable liners and are
emptied daily or more often if necessary. (WAC 170-296A-3925)

Room deodorizers are not used due to the risk of allergy/lung irritation.
LAUNDRY
Linens and bedding are (sent home – OR – are washed by the child care on a warm or hot cycle
(note: a temperature of at least 140oF is advised) – or – with bleach or other product in the rinse
cycle). (WAC 170-296A-3850) This minimum schedule for laundry is:

Linens and bedding are (washed/sent home) weekly or more frequently as needed. (WAC 170296A-3775-5)

Remove this information if you do not care for infants. Infant bedding is changed (how often
– daily is recommended).

Cloth toys and dress up clothes are laundered (how often). If they cannot be washed in the
washing machine, they will be hand washed in warm soapy water, rinsed, then dipped into a
(bleach or other product) solution for (amount of time) and allowed to air dry.

Bedding will be stored (describe how and where bedding will be stored – such as removed
from mats and stored separately in children’s cubbies). (WAC 170-296A-3775-6)
Soiled laundry is kept inaccessible to children (where/how). Soiled laundry is kept separate
from clean laundry. Laundry machines are separate from kitchen and food preparation areas
and are inaccessible to children. Dryers are vented to the outside.
Children’s coats and other personal items will be stored separately (WAC 170-296A-4750) and not
touch during storage.
A change of clothes is available for the children and is provided by (parents/center). These
clothes are stored (where).
Staff members are encouraged to have a change of clothing available at the child care.
INFANT CARE
INTERACTIONS AND ENVIRONMENT
The provider, staff, volunteers, and assistants understand and react appropriately to infant cues.
Infants will either be held or placed on the floor near and observant and engaged adult.
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Infants are: (WAC 170-296A-6550 and -6575)
 encouraged to handle and manipulate a variety of objects
 provided a safe environment for climbing, moving, exploring
 provided materials and opportunities for large and small muscle development
 read and talked to frequently
 provided daily indoor opportunities for freedom of movement outside their cribs, in an
open, uncluttered space. Infants are placed (choose one: directly on the floor, on mats
on the floor, on blankets). (Note: Mats are recommended because they are easy to clean
and sanitize when soiled). Include this sentence if blankets are used: Floor play
blankets are used only for that purpose and are changed when soiled with spit-up or
other body fluids.
 placed on their tummy at least 3 times each day when they are awake and staff are
observing them (WAC 170-296A-7025)
 provided outdoor opportunities (how often; 20-30 minutes per day is recommended)
 ________________________________________________________________
 ________________________________________________________________
 ________________________________________________________________
 ________________________________________________________________
(Choose one of the following two options):
Use of infant containers (swings, infant seats, saucers, and other confining equipment) will be
limited to short periods of time (such as when the provider is changing the diaper of another
infant). An infant will be placed in these containers for no more than (how long—recommend 20
minutes) collectively each day, unless otherwise specified in writing by the child’s health care
provider. Baby walkers are never used. (WAC 170-296A-7000)
– OR –
To maximize an infant’s physical, emotional, and cognitive development, this center has a “No
Container” policy. Swings, infant seats, saucers, and other confining equipment will not be used.
INFANT BOTTLE FEEDING
Infants will be fed according to their need rather than an adult prescribed time schedule. Infants
are held when fed a bottle. Bottles will not be propped. (WAC 170-296A-7175-1) Infants able to hold their
own bottle will be held when possible (if it is not possible, the provider remain close and interact
with the child during the feeding time). Infants will not be given a bottle while lying down. Lying with
a bottle puts a baby at risk for baby bottle tooth decay, choking and ear infections. (WAC 170-296A-71751d) Bottles will be removed from the infant when he/she finishes feeding. (WAC 170-296A-7075-3) When
feeding an infant, staff will watch for cues (signs) to know when the infant has had enough. (WAC 170296A-7175-1f)
Food preparation areas, including bottle preparation areas, will be cleaned and sanitized daily.
(WAC 170-296A-3925-1)
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All bottles and containers of breast milk must be labeled with the infant’s name and the date. This
is done by (whom – provider or parents). Bottle nipples are kept covered when not in use to
reduce cross contamination. (WAC 170-296A-7125-5)
A refrigerator is used to store bottles and unserved, leftover infant food. The refrigerator
temperature is checked (how often) to ensure it is not more than 41°F. Bottles will be stored in the
coldest part of the refrigerator, not in the door. A thermometer will be kept in the door of the
refrigerator.
If bottles are provided by the parents, include this section: Full bottles will be refrigerated
immediately upon arrival at the child care, unless being fed to an infant right away. Any prepared
formula or thawed breast milk not used will be sent home with the family at the end of the day.
Frozen breast milk is stored at 10°F or less (where). This milk is stored at the child care for no
more than 2 weeks. (WAC 170-296A-7150-2)
If bottles are prepared at the child care, include this section:
This child care prepares bottles (when – in the morning, on demand, other).
 Hands are washed before preparing or serving bottles.
 All infant bottles and baby foods are prepared (where –in the kitchen)
 Water from the bathroom is never used for bottle preparation.
 Powdered formula in cans will be dated when opened and stored in a cool, dark place.
Unused portions will be discarded or sent home one month after opening.
 Formula will be mixed as directed on the can.
 Formula will not be used past the manufacturer’s expiration date.
 If prepared bottles are not warmed immediately, the bottles are stored in the refrigerator.
Formula and breast milk bottles are warmed (how/where – under running warm water, in a bottle
warmer, or in a container of water or crock pot that is not warmer than 120°F). (If a crock pot is
used, include this sentence: The crock pot will be secured to avoid it being knocked off the
counter.) (WAC 170-296A-7125-2 and -7150-2) Bottles are never warmed in a microwave. A microwave heats
unevenly and can cause “hot spots”, posing a burn risk. Microwaving also destroys much of the
nutritional component in breast milk. (WAC 170-296A-7125-3 and 7150-2)
Frozen breast milk is thawed (how – in the refrigerator, under warm running water, in a container of
water less than 120°F) then warmed as stated above. Thawed breast milk will not be refrozen.
(WAC 170-296A-7150-2d)
The contents of any bottle not fully consumed within an hour are thrown away. Bottles that have
been used don’t go back into the refrigerator. Bacteria begin to multiply once bottles are taken from
the refrigerator and warmed. Families are advised to send several small bottles or portions,
enough for one day only, to minimize the amount of breast milk or formula that is discarded. (WAC
170-296A-7125-9)
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BOTTLE CLEANING
Bottles, bottle caps, nipples, and other equipment used for bottle feeding are provided by the
(whom – parent/guardian, child care). These items will not be reused without first being cleaned by
(how – washing in a dishwasher; or washing, rinsing; or the parent/guardian – parents are asked to
bring enough bottles to last an entire day). (WAC 170-296A-7125-4)
CARING FOR BREASTFED INFANTS (OPTIONAL SECTION)
Our child care welcomes breastfed babies and actively accommodates mothers nursing their
babies. Staff knows the benefits of breastfeeding for babies and moms. We encourage pregnant
mothers to continue breastfeeding when returning to work or school. The provider will provide
information and resources to new moms needing assistance with pumping, safe storage and
transfer of breast milk, and other support. Staff safely store and handle breast milk brought into the
center.
We provide comfortable places for nursing and private places for pumping. We can help assist new
moms and babies with the home to child care transition. We communicate often with parents,
encourage parents to drop-in any time and understand the unique needs of the breastfed baby
(may need to feed more often, coordinating bottle feedings with mom’s visits, delayed introduction
to solid foods). We create a positive feeding environment for all infants and recognize and respond
appropriately to infant feeding cues.
INFANT FOOD SAFETY
When they begin to self-feed, infants’ hands are washed with soap and water before eating.
Staff members wash hands thoroughly before preparing any infant foods. Staff never touches
infant food with bare hands. Baby foods are prepared (where – by the food preparation sink in the
classroom, in the kitchen). Cold water used for preparing baby foods is obtained from (where – the
kitchen, a pitcher brought in from the kitchen). Water from a bathroom sink is NOT used to prepare
baby foods.
Baby food is served from a dish with a clean spoon, not from the baby food jar. Food is stirred and
checked to ensure it is at a safe temperature before serving. (WAC 170-296A-7200-2c) Opened baby food
jars are kept covered and refrigerated, and are discarded or sent home with the family after 24
hours. Unconsumed baby food portions in the serving bowl will be thrown away. (WAC 170-296A-7200-2e)
INFANT AND TODDLER SOLID FOODS
The center will work with the infant's parent/guardian to develop a plan for the infant's feedings that
is acceptable to the parent/guardian. (WAC 170-296A-7200-1) New foods are never introduced at the child
care; the introduction of new foods is always done by the family first (Note: The American
Academy of Pediatrics recommends waiting to introduce solid baby food until the child is 6 months
of age.)
The child care uses the following guidelines:
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Developmental Stage/Age of Infant
Under 6 months of age
Type of Feeding
Serve only formula or breast milk unless
family provides a written order from the
child's health care provider.
When baby can: (at about 6 months)
Sit with support
Hold head steady
Close lips over the spoon
Keep food in mouth and swallow it
Continue serving formula or breast milk.
Any substitution requires a written order
from the child's health care provider.
AND
Begin iron fortified baby cereal and plain
pureed fruits and vegetables upon
consultation with parents.
When baby can: (at about 6-8 months)
Sit without support
Begin to chew
Sip from a cup with help
Grasp and hold onto things
Continue serving formula or breast milk.
Any substitution requires a written order
from the child's health care provider.
AND
Start small amounts of water in a cup.
AND
Let baby begin to feed self.
AND
Start semi-solid foods such as cottage
cheese, mashed tofu, mashed soft
vegetables or fruits.
When baby can: (at about 8-10 months)
Take a bite of food
Pick up finger foods and get them
into the mouth
Begin to hold a cup while sipping
from it
Continue serving formula or breast milk.
Any substitution requires a written order
from the child's health care provider.
AND
Begin offering small pieces of cheese, tofu,
chicken, turkey, fish or ground meat.
Begin offering small pieces of soft cooked
vegetables, peeled soft fruits.
Begin offering toasted bread squares,
unsalted crackers or pieces of soft
tortilla.
Begin offering cooked plain rice or noodles.
AND
Serve only formula, breast milk, diluted juice
or water in the cup.
When a baby can: (at about 10-12 months) Continue serving formula or breast milk.
Finger Feed
Any substitution requires a written order
Chew and swallow soft, mashed and
from the child's health care provider.
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chopped foods
Start to hold and use a spoon
Drink from a cup
AND
Begin offering small sized, cooked foods.
Begin offering a variety of whole grain
cereals, bread and crackers, tortillas.
Begin offering cooked soft meats, mashed
legumes (lentils, pinto beans, kidney
beans, etc.), cooked egg yolks, soft
casseroles.
When a baby can: (about 12 months)
Offer small amounts of formula, breast milk
Eat a variety of foods from all food
or water in the cup during meals.
groups without signs of an allergic AND
reaction
Begin offering whole milk.
Begin offering fruit pieces and cooked
vegetables.
Begin offering yogurt and cheese slices.
Cracked high chair trays or table-tops are not approved for food service. Infant finger food can be
placed directly on an appropriate, clean, sanitized high chair tray. (WAC 170-296A-7225-1c,d and -3) Infants
should be allowed to control the pace of the feeding. Toddlers will eat from plates, have a paper
napkin, and developmentally appropriate utensils.
No egg whites (allergy risk) or honey (bacteria risk) will be given to children less than 12
of age.
months
Juice will be limited; it will only be offered in a cup and always diluted.
NAPPING PRACTICES FOR INFANTS AND TODDLERS
Children 29 months of age or younger will be allowed to follow their individual sleep pattern. (WAC
170-296A-6800-3d) Alternative, quiet activities (no TV or video) will be provided for the child who is not
napping. (WAC 170-296A-6800-3b)
Sleeping schedules are discouraged. However, parents may request that an infant be woken up if
sleeping more than 3 hours. This may be necessary to assist with the infant’s 24-hour sleep/wake
cycle.
A (what – crib, basinet, play yard, etc) will be furnished for napping. (WAC 170-296A-7075) When the child
care provider and parent agree, and the infant can safely do so, transitioning to a mat or cot will
happen. (WAC 170-296A-7075-1f) Note: if children sleep in something other than cribs, make all necessary
changes in this section.
Because infants sleeping on their stomachs are at a higher risk of death from
Sudden Infant Death Syndrome, SIDS.:
(WAC 170-296A-7100)
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

Infants will sleep on their backs unless they roll over themselves. Infants are not
awakened to return them to their backs if they roll over themselves. (WAC 170-296A-7100-1)
Crib sheets will fit the mattress snugly and securely in all corners and sides. (WAC 170-296A7100-2)



Cribs will not contain bumper pads, pillows, soft toys, fleece, cushions, or thick blankets.
(WAC 170-296A-7100-3)
Soft bedding and toys will not be allowed in cribs. (WAC 170-296A-7100-3)
Hanging mobiles will be removed once the child is able to sit up and/or reach the mobile.
(WAC 170-296A-7075)


Should a parent or legal guardian request an alternate sleep position it must be specified
in writing by the parent/guardian and the child’s health care provider. (WAC 170-296A-7100-6)
Blankets or sheets to cover the infant will not be used. Children should be dressed
comfortably for the environment. For example, sleep sacks or one-piece sleepers could
be used instead of blankets. (American Academy of Pediatrics recommendation)
If you use something other than cribs, remove this section. Cribs will meet the following safety
requirements: (WAC 170-296A-7075-1a and -7085)
 must meet CPSC requirements (note: this is met if the crib was made on or after June 28,
2011. May also meet requirements if it was made between July 1, 2010 and June 27, 2011 if a
certificate of compliance was obtained from the manufacturer)






not have a drop-side
constructed with vertical slats that are no more than 2 3/8 inches apart or have solid
barriers, such as Plexiglas
corner posts will be the same height as the side and end panel
no cutout designs
sturdy and in good repair (no sharp edges, points, unsealed rough surfaces, splinters,
peeling paint, cracks, missing/broken parts)
mattresses will be firm, snug fitting, intact, and waterproof, and will fit snugly against the
crib frame (WAC 170-296A-7075-1b)
If you use something other than play yards, remove this section. (WAC 170-296A-7075-1a) Play yards will
meet the following safety requirements:
 have no holes in the netting
 play yards will be sturdy and in good repair
 play yards will be checked to ensure they have not been recalled due to sides that do
not properly lock, protruding bolts, or other safety concerns (WAC 170-296A-4200)
Because sleeping in infant seats or swings makes it harder for infants to breathe fully and may
inhibit gross motor development, infants will not sleep in car seats, swings, and infant seats.
Children who arrive at the center asleep in car seats will be immediately transferred to their crib.
(WAC 170-296A-7075-1e)
Cribs and play yards will be arranged to allow easy access to children (WAC 170-296A-7075-1d).Sleeping
equipment will be spaced at least 30 inches apart or separated by a solid barrier, such as
Plexiglas, to help prevent disease transmission.
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Light levels will be high enough so children can be easily observed when sleeping.
Cribs will not be located directly under windows unless windows are constructed of safety glass or
have an applied polymer safety coating.
Write here any additional policies related to infant and toddler napping:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
____________________________________________________________________
DIAPERING
Diapers are changed at the changing area only. The diaper changing area:
 has a nearby sink with hot and cold running water which is not used for food preparation
or clean up (WAC 170-296A-7250-2a)
 has a moisture-impervious surface (WAC 170-296A-7250-2b)
 has a protective barrier that is at least 3.5 inches high
 has a foot-operated garbage can
 is on moisture impervious flooring
 is separate from any area where food is stored, prepared, or served (WAC 170-296A-7250-1)
 does not have safety belts
The proper diaper changing procedure is as follows:
 Wash hands. (WAC 170-296A-7300-4)
 (optional) Put on disposable gloves.
 Gather necessary materials and have them in reach.
 Place child on the changing area and remove diaper.
 Clean child’s bottom with diaper wipes. Wipe from front to back. Use only one swipe
per diaper wipe.
 Remove disposable gloves and use them to wrap up dirty items. Discard all dirty items in
designated garbage container.
 Provider wipes own hands with a wet wipe.
 Diaper and dress the child.
 Wash the child’s hands (WAC 170-296A-7250) with soap and water. For infants younger than 6
months, a diaper wipe can be used to wipe off the child’s hands.
 Return child to a safe area.
 Clean changing surface with soapy water, and then rinse with water. Disinfect the
changing table and any equipment or supplies you touched with (what – bleach water
solution, name of other disinfectant). (WAC 170-296A-3925-13 and -7250-3) Allow (amount of time
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
stated on disinfectant container) minutes of contact time with the disinfectant. Rinse, if
required.
Wash hands with soap and water. (WAC 170-296A-7250-4)
If you do not do stand-up diapering, remove this section. Stand-up diapering is done at this child
care (when – for older children, when children are in pull-ups only, etc). The stand-up diapering
procedure is as follows:
 Wash hands. (WAC 170-295-3020-3)
 (optional) Put on disposable gloves.
 Gather necessary materials and have them in reach.
 Coach child in pulling down pants and removing diaper/pull-up/underpants and assist as
needed.
 Put soiled diaper/pull-up/underpants in plastic bag.
 Coach child in cleaning diaper area front to back using a clean, damp wipe for each
stroke and assist as needed.
 Remove disposable gloves and use them to wrap up dirty items. Discard all wipes and
other dirty items in a foot-operated step can. (WAC 170-295-4120-6a)
 Close and dispose of plastic bag into hands-free covered trash can lined with a plastic
garbage bag or send home.
 Provider and child wipe hands with a wet wipe.
 If a signed medication authorization indicates, apply ointment using disposable gloves.
Then remove gloves.
 Coach child in putting on clean diaper/pull-up/underpants and clothing.
 Wash the child’s hands with soap and water. (WAC 170-295-3040-3)
 Return child to a safe area.
 Any contaminated equipment will be cleaned , rinsed with water and then disinfected
with (what – bleach water solution, name of other disinfectant). Allow (how long – varies
depending on disinfectant) of contact time with the disinfectant. (WAC 170-295-4120-1a)
 Wash hands with soap and water. (WAC 170-295-3020-3)
Children are not left unattended during the diaper changing procedure.
(WAC 170-296A-7300-1c)
Nothing but the child, changing pad (, paper), and diaper supplies is placed on the changing table,
counter, or sink. The changing surface is not used for other activities, including writing. (WAC 170-296A7250-5)
Diapers are disposed of in a designated waste container separate from those used for other
household trash. This container must have a tight cover, be lined with a plastic trash bag, and be
within arm’s reach of the diaper changing area. (WAC 170-296A-7275-1) Disposable diapers are removed
from the child care daily and more often if necessary. These diapers are disposed of with curbside
garbage. (WAC 170-296A-7275-2)
Each diaper change is recorded on a (name of diapering log).
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Note: remove if reusable diapers are not used. Reusable diapers are not rinsed, are individually
bagged, and are (what – given to a commercial service, sent to a laundry, or returned to the parent
or guardian) daily. (WAC 170-296A-7275-3)
Soiled clothing is not rinsed, is individually bagged, and is returned to the parent or guardian.
Soiled diapers and clothing must not be placed with the child’s other belongings. (WAC 170-296A-7275-
FOOD SERVICE
FOOD SUPPLY
Food is purchased from (where). All food meets the following criteria:
 All food served is prepared in the kitchen (or other location?).
 All food that is past the expiration date is discarded.
 Only pasteurized milk and juice is served.

No home canned food may be served (WAC 170-296A-7550).
 Optional: Children (may/must) bring sack lunches from home. Parents are expected to
supply nutritional food for their child’s sack lunch.
 Optional: The child care uses only pre-cooked chicken and ground beef.
 Leftover foods are defined as previously prepared food that has not been served and
were stored at the proper temperature. Choose 1 option: No leftover foods are served. –
OR –Leftover foods that have been cooked will be properly cooled and reheated. Unserved foods are stored at the proper temperature. Leftover foods or opened foods in
the refrigerator are served or discarded within 48 hours.
FOOD STORAGE
Food is stored away from and never below kitchen chemicals.
(WAC 170-296A-4100)
Raw meats and unpasteurized eggs are stored away from and below all other foods. If raw meat is
stored in the refrigerator above produce drawers, it will be placed in a high-sided container to
prevent contamination of produce below. (WAC 170-296A-7680 and FWB 20)
All food items are stored off the floor. Dry food items are stored (where; in cabinets, on shelves, in
a different room, in a shed, etc). All dry goods are stored in labeled containers with tight-fitting lids.
These containers are labeled with the date when the item was opened.
All refrigerated foods are kept sealed or covered (except when cooling foods to 41°F). (WAC 170-296A7680 and FWB 18) All refrigerated foods are dated.
TEMPERATURE CONTROL
Refrigerators and freezers have thermometers placed in or near the door. Refrigerator temperature
is maintained at 41oF or less. (WAC 170-296A-7680 and FWB 18) The refrigerator temperature is checked
daily and is recorded on a (name of form). Freezer temperatures are maintained at 10oF or less.
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Foods are cooked to the correct internal temperature as follows:
 poultry = 165oF
 ground beef and ground pork = 155oF
 beef = 145oF
 pork = 145oF
 eggs = 145oF
 fish & seafood = 145oF
 cooked vegetables = 140oF
(WAC 170-296A-7680 and FWB 17)
All packaged foods are cooked/prepared according to the label instructions.
Food temperatures will be monitored using a stem thermometer. The stem thermometer is stored
(where) and is calibrated (how often). (WAC 170-296A-7680 and FWB 17)
Hot holding food: hot food will be held at a temperature of 135oF or above until served. (WAC 170-296A7680 and FWB 16)
Cold holding food: food requiring refrigeration will be held at a temperature of 41 oF or less until
served. (WAC 170-296A-7680 and FWB18)
If the center uses a microwave, include this paragraph. If the microwave is used to heat food:
 only containers labeled for use in a microwave may be used (WAC 170-296A-7725-1)
 the food is rotated and stirred during heating
 the food is covered to retain moisture
 the internal temperature is monitored and cooked until the food reaches the proper
cooking temperature listed above
 the food is allowed to sit for 2 minutes prior to serving to allow the temperature to spread
evenly throughout the food
Thawing of frozen foods is done:
 by placing in the refrigerator,
 by placing in a pan in the sink with cool water running over the food,
 during the cooking process if the food is to be cooked immediately, or

in the microwave (WAC 170-296A-7680 and FWB 18)
If sack lunches are brought from home, include this paragraph. Sack lunches from home are kept
cool to prevent bacteria growth. (WAC 170-296A-7680 and FWB18) Choose one of the following:
 Parents are expected to include an ice pack, gel pack, frozen juice box, ice cubes in a
leak-proof container, or other cold product to keep the lunch at a cool temperature.
– OR –
 Staff will check sack lunches from home and refrigerate any lunches that contain any of
the following items: meat products, sliced fruit or vegetables, dairy products, other
perishables.
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HANDLING LEFTOVERS Include this section only if the child care serves cooked leftovers.
(WAC
170-296A-7680 and FWB 18-19)
Before storing cooked foods, the food is cooled by (choose one of the following)
 Placing food in shallow containers 2” deep or less. Leave uncovered and immediately
put the pan into the refrigerator on a top shelf.
– OR –
 Cooling to 70oF within 2 hours and then to 41oF within 4 additional hours.
Temperatures during the cooling process will be taken and recorded every hour.
Once they have cooled to a temperature of 41oF or less, the food is covered, dated, and stored in
the refrigerator.
Previously prepared foods may be reheated one time only to an internal temperature of 165 oF
within 2 hours. (WAC 170-296A-7075
Leftovers that were prepared more than 48 hours ago are discarded.
FOOD HANDLING
All staff will wash hands with soap and water at a designated hand washing sink prior to preparing
or serving food, even if food service gloves are worn. (WAC 170-296A-3675-1a and FWB 10)
Prior to food preparation, the sink is washed, rinsed, and sanitized.
A colander is used in the sink when washing/rinsing any produce.
Ill providers or staff will not prepare or handle food.
(WAC 170-296A-7680-2b and FWB 9)
The provider wears gloves or uses utensils when preparing and serving ready-to-eat foods. Gloves
are changed when they become contaminated. (WAC 170-296A-7650-2e and FWB 12)
If the child care serves meals or snacks family-style, include the following paragraph. When meals
are served family-style, children use utensils to serve themselves. Steps are taken to ensure
children only touch their own food. Children are supervised so that they do not touch each other’s
food. Utensils are replaced if they become contaminated. Provider sits with the children during
meals and snacks. (WAC 170-296A-7680 and FWB 24)
KITCHEN CLEANING AND SANITIZING
All chemicals and cleaning supplies are stored away from and below food and food preparation
areas. All chemicals are stored in their original containers. All spray bottles are labeled with the
contents and the date. (WAC 170-296A-4100)
To ensure food safety, the kitchen will be kept clean. Refrigerators will be cleaned and sanitized
monthly, or more often as needed. Tabletops where the children eat are washed and sanitized
before every meal and snack. Kitchen counters, sinks, and faucets will be washed, rinsed, and
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sanitized daily before any food preparation and as needed during food preparation.
(WAC 170-296A-
7680, -7750 and FWB 20)
Sponges are not used on food contact surfaces. Cutting boards will be washed, rinsed, and
sanitized between each use.
All dishes, cups, utensils, etc. will be washed (how – Using a three-step method whereby dishes
are washed with soap and water, rinsed, and then sanitized with (name of sanitizer), or in an
automatic dishwasher capable of reaching 140oF, or in an automatic dishwasher that sanitizes the
dishes with (name of chemical – bleach, iodine, quaternary ammonia). (WAC 170-296A-7700 and FWB 21)
FOOD WORKER EDUCATION
The provider must have a current Washington State Food Worker Card and ensure food is
prepared and served in a safe manner. In the provider’s absence, or if the provider is not able to
supervise food preparation, a secondary individual must have a food handler’s card. (WAC 170-296A7675)
NUTRITION
If parents provide food for their children, include this paragraph. When parents provide their
children meals or snacks, they must meet the nutritional requirements as outlined by the
Washington State Meal Pattern for Child Care. If the meal provided does not meet nutritional
requirements, the provider will supplement the meal with the missing components.
If parents are allowed to bring in food for special occasions, include this paragraph. Parents
are allowed to bring in snacks for all the children that may not meet the nutritional
requirements on special occasions such as birthdays. The snacks provided by parents must
be limited to store purchased uncut fruits and vegetables and foods prepackaged in original
manufacturer’s containers. Before bringing in the food for a special occasion,
parents/guardians must discuss the food choices with staff to address any food safety and
allergy concerns. Parents are discouraged from bringing in treats high in sugar.
Only pasteurized milk or pasteurized dairy products are served. Nondairy milk substitutions will
only be served with written permission from the child’s (parent – or – health care provider) for
children over the age of twelve months. The (provider will – or – parents must) provide an
appropriate milk substitute (such as calcium-fortified rice milk or soymilk. The amount of required
milk fat in the milk product is determined by the child's age: (WAC 170-296A-7600)
If the age of the
child is:
Under 12 months
Then the fat content of the milk must be:
Full strength formula or full strength breast milk unless there are
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specific written instructions from a licensed health care provider.
Between 12 months Full strength whole milk or breast milk unless there is specific
and 24 months
written instruction from a licensed health care provider.
Over 24 months
With fat content of provider’s or parent’s choice; 2% or 1% is
recommended by pediatricians
The child care will prepare, date, and conspicuously post menus of snacks and meals at least
one week in advance. The child care uses a (how many – note: must be 2 or more) week cycle
menu, with no repeated meal/snack combinations, to ensure variety. The past menus will be
kept on-site for 6 months. If needed, substitutions of comparable nutrient value may be made
and any changes will be recorded on the menu.
The menu will: (WAC 170-296A-7500)
 consist of a wide variety of foods that are low in fat, sugar, and salt
 place emphasis on serving fruits and vegetables often
 include a Vitamin-C rich food every day
 include Vitamin-A rich foods three or more times each week
 Optional: include a protein or dairy for each afternoon snack
 Optional: incorporate ethnic, cultural, and seasonal foods regularly
Meals and snacks will be served every 2 to 3 hours. (WAC 170-296A-7625-1) The following
meals/snacks are provided by the center:
Time:
Meal/Snack
___________________
________________________________
___________________
________________________________
___________________
________________________________
___________________
________________________________
___________________
________________________________
If the child care serves breakfast, include the following section. (Note: It is recommended to
serve a breakfast if the center opens before 7:00). Each breakfast meal contains: (WAC 170-296A7500)



a fruit or vegetable (the center serves fruit instead of juice most often)
a dairy product (such as milk, cheese, yogurt, or cottage cheese)
a grain product (such as bread, cereal, rice cake, or bagel)
Each lunch and dinner meal contains: (WAC 170-296A-7500)
 a dairy product (such as milk, cheese, yogurt, or cottage cheese)
 meat or meat alternative (such as beef, fish, poultry, legumes, tofu, or beans)
 a grain product (such as bread, cereal, rice cake, or bagel)
 fruits or vegetables (two fruits, two vegetables, or one fruit and one vegetable to
equal the total portion size required)
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Each snack contains two of the four components: (WAC 170-296A-7500)
 a dairy product (such as milk, cheese, yogurt, or cottage cheese)
 meat or meat alternative (such as meat, legumes, beans, egg)
 a grain product (such as bread, cereal, rice cake, or bagel)
 fruit or vegetable
Each snack or meal includes a liquid to drink. The drink could be water or one of the required
components such as milk or fruit/vegetable juice.
When juice is served in place of a fruit or vegetable it must be one hundred percent fruit or
vegetable juice.
If a child has a food allergy or special dietary need, the parent and the child’s health care
provider will identify a protocol for managing the child’s special dietary need. The child care
will develop an allergy management plan or an individual care plan with parent input for the
child. This plan will include (describe: information on alternative foods with comparable
nutritive value, a requirement that the parents must supply food for the special diet, etc.)
Mealtime and snack time will support children’s development of healthy eating habits. For
safety and role-modeling, the provider or staff sit, eat, and have casual conversations with
children during mealtimes whenever possible. (WAC 170-296A-7650-2g)
Coffee, tea and other hot beverages will not be consumed while children are in the immediate
area, in order to prevent scalding injuries. Provider and staff will not consume pop or other
non-nutritional beverages while children are in their care. During meal and snack times,
provider will eat only those foods that are served to the children.
PHYSICAL ACTIVITY
All children should engage in daily physical activity that promotes fitness for health and movement
skills. Promoting and fostering enjoyment of movement and motor skill competence and
confidence at an early age helps to ensure that children develop active, healthy habits. Current
research also shows that regular physical activity of infants and young children is an important
component of early brain development and learning. Our center follows the NASPE guidelines for
physical activity for children age birth to five (Active Start, NASPE, 2002):
INFANTS (Remove this section if center does not care for infants)
Positive early movement experiences increase the infant’s chances of achieving full developmental
potential throughout life. Infants will:
 be placed in a safe setting (name areas: carpeted floor, mats, sectioned-off areas etc) that
encourages exploration and does not restrict movement for prolonged periods of time;
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
Container use will be limited to (name time frame) – OR – This child care does not use any
containers except for high-chairs when solid foods are introduced.
have help from staff to facilitate movement by:
o receiving regular, attentive interaction (using facial, verbal and non-verbal
expressions) that encourages playful activity
o having an open environment suitable for the exploration and development of rolling
over, reaching, sitting, crawling, creeping and standing
o having daily “tummy time” – placing infant on his/her tummy to promote wiggling and
scooting which contributes to large motor skill development
TODDLERS
With ample opportunity for exploration and learning, basic movement skills like running, jumping,
throwing, and kicking will develop. Toddlers will:
 not be sedentary for more than 60 minutes at a time except when sleeping
 get at least 30 minutes of staff guided, playful activity that contributes to the development of
movement skills (walking, jumping, hopping, side-stepping etc)
 have opportunities throughout the day (several hours) for unstructured physical activities
and play in a safe area both indoors and outdoors that promotes exploration and playful
practice of movement skills
PRESCHOOLERS AND PRE-KINDERGARTEN
Instruction and positive reinforcement is critical during this time in order to ensure that children
develop gross motor and movement skills before entering school. Children 3 – 5 will:
 not be sedentary for more than 60 minutes at a time except when sleeping
 accumulate at least 60 minutes of guided, structured activities that encourage playful
practice of movement skills in a variety of activities and settings
 engage in at least an hour and up to several hours of unstructured physical activities in a
safe area both indoors and outdoors suitable for large muscle activities (gross motor
movement)
SCHOOL-AGERS
Instruction and positive reinforcement will help develop children’s knowledge, skills, and
confidence to enjoy a lifetime of healthful physical activity. Children in grades K-6 will
 not be sedentary for more than 60 minutes at a time except when sleeping
 accumulate at least 60 minutes of guided, structured activities that encourage playful
practice of movement skills in a variety of activities and settings
 engage in at least an hour and up to several hours of unstructured physical activities in a
safe area both indoors and outdoors suitable for large muscle activities (gross motor
movement)
WATER PLAY
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Choose one of the following two paragraphs:
Wading pools are not used at this child care due to the high risk of disease spread. Instead
sprinklers, water-only spray bottles, paintbrushes, watering cans, and other forms of water
play are done.
-
OR -
When wading pools are used: (WAC 170-296A-5175)
 children are directly supervised by the provider or primary staff person
 written parent permission is obtained
 staff-to-child ratios are maintained at all times
 infants and toddlers are kept within reach
 the wading pool is emptied after each use or the wading pool is emptied daily and
door alarms are used to prevent access to pool when children are inside , and
 the pool is cleaned and disinfected daily or immediately if soiled with urine, feces,
vomit, or blood.
Remove the paragraph if you do not go off site for water activities. When water play occurs
outside of the licensed area, written parent permission will be obtained, a certified lifeguard
will be on duty, and infants and toddlers will be kept within reach (with one-to-one staff-to-child
ratio if water depth exceeds 24”).
If you have a swimming pool on site (a pool more than 2 feet deep), add a paragraph here
about the safety measures you put in place. Make sure they comply with WAC 170-296A5200).
SCREEN TIME
Choose one of the following paragraphs to include in your plan.
This child care does not allow screen time at all, with the exception of no more than ½ hour of
educational media used per week. Educational media includes such things as small video clips of
an educational nature.
- OR Our child care allows the use of (television, children’s videos, computers). Our policy is: (write the
details of your screen time policy here. Include where screens are located in your licensed child
care space, the maximum allowable use per day/week, etc.). All screen time must be educational
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and developmentally and age-appropriate, have child-appropriate content, and not have violent or
adult content. (WAC 170-296A-6650)
Screen time is not allowed for children under age two. (WAC 170-296A-6700) For children age 2 and
up, screen time must be limited to less than 2 hours per day. Children must be at least 3 feet
from a television screen. Alternative activities must be provided for children who do not wish to
participate in screen time. (WAC 170-296A-6675)
DISASTER PREPAREDNESS
This child care has developed a disaster preparedness policy. See the (title of child care’s
comprehensive disaster plan). This plan is located (where) and a copy is kept in the disaster kit.
Parents should read, review, sign, and date the plan upon enrollment and annually thereafter.
Annually, staff and parents/guardians will be oriented to this disaster policy and documentation of
staff orientation will be kept in the disaster plan manual. The (title of person) will be responsible for
orienting new staff or substitutes to these plans.
Procedures for medical, dental, poison, earthquake, fire, and other emergency situations will be
posted in each classroom. These plans include:
 which staff is responsible for each part of the plan
 procedure for accounting for all children during and after an emergency
 evacuation routes and meeting location
 Individualized Care Plans for children with special needs
 how children will be cared for until parents are able to pick them up
 how contact will be made with parents/guardians when normal lines of communication
are not available
 transportation arrangements, if necessary
Fire drills are conducted monthly, as per the state fire marshal in WAC 212-12. Documentation,
including date and time of the drill and a debriefing/evaluation of the drill, is kept (where). (WAC 170296A-2900 and -2925)
Earthquake drills are conducted once every 3 months, shelter-in-place/lockdown drills are
conducted annually. All drills are documented. (WAC 170-296A-2900 and -2925)Staff members receive
training on how to use the fire extinguisher (how often) by (whom).
Food, water, medication, and supplies for 72 hours of survival are available for each staff and
child. These supplies are stored (where) and are checked (how often). (WAC 170-296A-2850)
STAFF HEALTH
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TUBERCULOSIS (TB)
Provider, staff, and household members age 16 and older must have the results of a one step
Mantoux Tuberculin (TB) skin test, or negative chest x-ray, or documentation of treatment as
required by licensing (WAC 170-296A-1750).
Individuals must be re-tested for TB if there has been any known exposure to TB. The child care
will comply with the public health department for follow-up.
PERTUSSIS
The provider, staff, and household members age 10 and older (choose 1: have received a Tdap
booster –or – are encouraged to receive a Tdap booster) to help prevent the spread of pertussis,
based on CDC recommendation. All household members under age 10 are up-to-date with their
DTaP vaccinations.
OTHER ILLNESS
Staff members who have a communicable disease are expected to remain at home until the period
of communicability has passed. Staff will also follow the same procedures listed under “Exclusion
of Ill Children” in this policy.
The (title of person) will review the (name of center’s Bloodborne Pathogen Exposure Control Plan)
with each staff person within 10 days of hire. Staff are offered the Hepatitis B vaccine series
(when; upon employment – or – within 24 hours of a bloodborne pathogen exposure event).
WISHA rule http://www.lni.wa.gov/wisha/rules/bbpathogens/default.htm
Staff immunizations will be recorded upon employment. Recommendations of immunizations for
child care providers will be available to staff.
OTHER HEALTH ISSUES
Optional: Step stools will be provided for children to reach the sink and diaper changing table (with
supervision) to help protect employees’ backs.
Staff members who are pregnant or considering pregnancy should inform their health care provider
that they work with young children and discuss possible risks.
For staff who become stressed or frustrated, the following will be provided (describe what is
available).
CHILD ABUSE AND NEGLECT
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Any instance when staff have reason to suspect the occurrence of any physical, sexual, or
emotional child abuse or neglect, child endangerment, or child exploitation as required under RCW
chapter 26.44, a report is filed by the individual directly involved with the child. The child’s file is on
hand when placing the call. Call 1-866-ENDHARM, (1-866-363-4267) or the local C.P.S. office at
425-339-1830. The witnessing individual will make the call, with the assistance of the provider if
needed. The provider will contact the licensor immediately after a report of abuse is made. If there
is an immediate danger to a child, a report is made to local law enforcement. Signs of child abuse
or neglect are recorded (how/where). (WAC 170-296A-2300 and -6275)
CHILDREN WITH SPECIAL NEEDS / INCLUSION
Children with special needs are accepted into the program under the guidelines of the Americans
with Disabilities Act (ADA). Confidentiality is assured with all families and staff in the program. All
families are treated with dignity and with respect for their individual needs and/or differences.
A written (name of form; examples include Individual Care Plan, Plan of Care, Children with
Special Needs Form, etc) is developed by the director, parent/guardian, and teacher for each child
with special needs. It includes instructions from the parent and health care provider regarding
medications, specific food or feeding requirements, life-threatening allergies, treatments, and
special equipment or health needs. The parent provides training to staff on any procedures that will
be done to the child while in care. This written plan of care is updated (how often) or sooner if
needed. The director seeks further information or training if necessary for center staff from local
resources. (WAC 170-296A-0050)
This plan includes how the child’s special need would be met in the case of a disaster. At a
minimum the center will plan for the child to stay at the center for 72 hours without being able to
contact the child’s parents.
Children with special needs are given the opportunity to participate in the program to the fullest
extent possible. This is accomplished by consulting with outside agencies/organizations as
needed. The center cooperates with other agencies that can provide services to the child on-site.
(WAC 170-296A-0050)
BEHAVIOR MANAGEMENT/GUIDANCE PRACTICES
Provider and staff follow the center’s behavior management and guidance practices, which are
based on (what principles – describe).
Noise levels in the child care are kept low, so that adults can be heard without the need to raise
their voices.
Staff members get to know each individual child’s needs and stage of development and guide each
child accordingly. Staff point out positive social interactions rather than only focusing on negative
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behavior. Staff help children problem solve when conflicts arise. Staff members exhibit a range of
techniques such as ignoring, consequences, cool-off, and re-directing when behavior issues occur.
Describe other behavior management practices briefly or refer to parent handbook.
Behavior plans are implemented in coordination with the parent/guardian when necessary.
Community resources are consulted when needed.
DRINKING WATER
Choose one of the following:
This child care obtains drinking water from a public water system. Drinking water is available to the
children throughout the day. (WAC 170-296A-7575)
-
OR –
Drinking water is supplied by a (dug/drilled) well. Drinking water is available to the children
throughout the day. (WAC 170-296A-7575) To ensure the water from our well is safe, the water is tested
for the following:
 Coliform bacteria once every year (note: licensing requirement is once every 3 years at a
minimum – best practice is annually).(WAC 170-296A-1400)

Nitrates once every three years (maximum allowed 10ppm) (WAC 170-296A-1400)
 Arsenic once every three years (maximum allowed 10ppb)
We contact Snohomish Health District at 425-339-5250 for advice on all positive test results, even
when they do not exceed the maximum allowed. Drinking water is available to the children
throughout the day. (WAC 170-296A-7575)
WASTEWATER DISPOSAL
Choose one of the following:
This child care is connected to public sewer.
-
OR –
This child care is served by a private septic system. In an effort to maintain the septic system in
good working order and prevent possible health hazards, the child care provider:

has the septic system is inspected and pumped at least once every three years (WAC 170-296A
1375)
has obtained an as-built drawing which shows the exact location of the drainfield (note – this
can be obtained from Snohomish Health District at 425-339-5250). All roof downspouts are
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



directed away from the drainfield and the playground is not installed right over the drainfield.
There is no driving or parking over the drainfield.
has installed low flow toilets and practices water conservation as much as possible
spreads out laundry as much as possible and sends child care laundry home with parents.
Is knowledgeable about the warning signs of a possible septic system failure and will
contact a professional if any of these occur:
o Odors, surfacing sewage, wet spots or lush vegetation growth in the drainfield
o Plumbing or septic tank back ups
o Slow draining fixtures
o Gurgling sounds in the plumbing system
Keeps septic system inspection and maintenance records on the premises. (WAC 170-296A-13754)
PEST CONTROL
The impact of pesticides on children’s health can range from irritation to skin and mucous
membranes, to difficulty breathing, rash or vomiting. Long term exposure may lead to
developmental delay, immune or endocrine system disruption, or cancer.
In addition, children with special needs, asthma and allergies can be highly sensitive to pesticides
and suffer from mild to severe reactions to pesticides and pesticide residue.
Choose one of the following and modify the text to fit your situation:
(WAC 170-296A-3950)
Pesticides, including weed killers, are not routinely used on the child care property. If pests are
found on the property, non-chemical methods of pest control are used. Pesticides are only used for
emergency situations, such as nests of stinging insects. In such an emergency situation, pesticides
will not be used when children are present and parents will be notified of the situation.
-
OR –
Whenever possible, non-chemical methods of pest control are used. When pest problems persist,
we may choose to use chemical pest control, such as rodent baits, weed killers, or insect sprays.
When chemical pest control measures are taken, they will be applied by a Certified Pest Control
operator, will not be applied while children are present, and will not be placed in a location
accessible to children. All surfaces will be wiped down and rooms aired out before children are
allowed to enter them. Parents will be notified 48 hours in advance of the application, unless the
pesticide is used to control pests that post an immediate risk to children’s health or safety.
-
OR –
Whenever possible, non-chemical methods of pest control are used. When pest problems persist,
we may choose to use to self-apply chemicals to control pests. We may use such products as
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rodent baits, weed killers, or insect sprays. When chemical pest control measures are taken, they
will not be applied while children are present and will not be placed in a location accessible to
children. All surfaces will be wiped down and rooms aired out before children are allowed to enter
them. Parents will be notified 48 hours in advance of the application, unless the pesticide is used
to control pests that post an immediate risk to children’s health or safety.
ANIMAL POLICY
Animals on site
Include this section only if the child care has animals on-site. WAC 170-296A-4800, -
4850, -4875, and -4900)
Animals will be carefully chosen in regards to care, temperament, health risks, and
appropriateness for young children.
The following animals are on-site at the child care: (List what animals and where they are and
potential health risks associated with these animals) __________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Occasionally an animal may visit the child care. Prior to any animals visiting the child care, parents
will be informed of the date and time of the animal’s visit and any potential health risks by (how).
For additional child care animal information, including cleaning and handwashing policies, please
refer to this child care’s pet/animal policy (Title of pet policy, such as “Care and Handling of Pets”)
which is kept (where).
VISITING ANIMALS (Choose one and delete the other)
Occasionally an animal may visit the child care or have contact with animals while on a field trip.
(WAC 170-296A-4800, -4850, -4875, and -4900)
-
or -
This child care program does not have any pets on-site. Parents/families are discouraged from
bringing their own pets on-site. We do not have animal-related educational activities. We may take
an occasional animal-related field trip. (WAC 170-296A-4800, -4850, -4875, and -4900)
When animals visit our child care or we go on a field trip, the following policies will be implemented:
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










Parents will be notified, in writing, of the type of animal that will be visiting and any
potential health risks associated with that animal by (how).
Parents will sign that they understand the potential health risks.(how-)
The provider will ensure that no children are allergic to the animal.
The provider will have primary responsibility of supervising all activities associated with
the animal’s visit as related to safety and hygiene. This includes making sure that the
animal has an acceptable temperament for interactions with children and that the animal
is current on all vaccinations (if appropriate). Any animal that has a history of biting or
other aggressive behaviors will not be allowed on-site. (WAC 170-296A-4875)
The animal will be properly cared for while at the child care. This is the responsibility of
the visiting animal’s owner.
The animal will not be allowed in any food preparation areas.
Items associated with the animal, including cages, food, water, etc., will not be placed on
food-contact surfaces.
Children will be closely supervised while handling the animal. Children will be in small
groups of 3 or fewer while handling the animal.
Children will immediately wash hands after handling or feeding the animal. Handwashing
will be closely supervised by the provider.
After the animal leaves the child care, the provider will clean and sanitize the area. Sinks
that are used for food preparation or cleaning dishes are not used to clean animal
supplies or cages. If necessary, animal supplies will be cleaned (in which sink –
preferably a laundry room or utility sink).
The provider will wash hands after cleaning and sanitizing the area.
SMOKING
Choose which sentence describes your policy regarding smoking.
Smoking is not permitted at any time. Staff, parents, or volunteers are not allowed to smoke in the
home or around children at any time.
(WAC 170-296A-4050)
-
OR –
Smoking is not permitted inside the home, in indoor or outdoor licensed space, or within 25 feet of
any entrance, exit, window, or ventilation intake during operating hours. Staff, parents, or
volunteers are not allowed to smoke in the home or around children during operating hours.
(WAC 170-296A-4050)
-
OR –
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Staff, parents, or volunteers are allowed to smoke outdoors when they are off the premises and out
of view of the children. Hands are washed well after smoking. A smoking jacket is worn while
smoking to reduce exposing children to toxins and contaminants left on clothes and hair from third
hand smoke. These residual chemicals may trigger asthma and allergies in some children.
Employees who smoke are provided information about tobacco counseling.
TRANSPORTATION SAFETY
Include this section if the child care transports children. Otherwise delete. All vehicles will be
maintained in good operating condition. A safety check will be done (how often) by the driver. All
vehicle maintenance is conducted by (who). Vehicles will be properly licensed and insured. (WAC 170296A-6475-3)
Child-adult ratios will be maintained in vehicles. (WAC 170-296A-6475-8) All adults and children riding in
the vehicle will use age-appropriate safety restraints (seatbelts, car seats, booster seats).
Restraints for children with special needs will be appropriate for the child. Car seats and booster
seats are provided by (the child care – or – parents/guardians). To ensure car seats and booster
seats are properly installed, (describe steps taken – examples include taking vehicle with seats
installed to a car seat safety check location, insisting parents provide car seat installation
information from the manufacturer, etc.). (WAC 170-296A-1)
All vehicles will contain a first aid kit, (type of communication – cell phone, two way radio) as a
means of communication, emergency supplies for children with special needs (example: EpiPen or
inhaler), and all children’s emergency information. (WAC 170-296A-6475-2) Drivers will not use cell phones
while operating the vehicle.
A copy of all signed field trip permission slips are kept at the child care.
Drivers will have a current driver’s license
training.
(WAC 170-296A-6475-4),
background check, and CPR/ First Aid
ATTENDANCE RECORDS
Daily attendance records will be kept.
(WAC 170-296A-2125)
The parent or other authorized person will sign their child in upon arrival and sign the child out
upon departure using their full signature and writing the time of arrival and departure. (WAC 170-296a2125-1b,c)
-
OR -
The child’s attendance will be taken using an electronic system that meets the requirements as
outlined in WAC 170-296A-2126. (WAC 170-296a-2125-3 and 2126)
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