ITERS Summary Report Phases Reminders: These phrases are meant to be used as examples, to spur our thinking when facing a difficult rationale to write. Although many can be cut and pasted and may provide the basis of the “why” behind the score, always review what you observed and determine if the pasted rationale should be tweaked to most accurately represent the practices you observed, thus providing the reader with a full picture of why a particular score was given. These sample rationales should not be used as guidance for scoring of items/indicators, because many factors other than what are represented here might need to be considered. SPACE AND FURNISHINGS 1. Indoor space 1.4 It was observed that shelves used to store children's belongings and other materials were dusty and had accumulations of dirt. Blistering paint was observed low on the wall near the children's cribs and there was debris on the carpeted floor. 3.1 At this quality level the expectation is for there to be enough indoor space to allow children and adults to move freely around the room, and to provide for open areas where children can play. Due to the size of the room, play occurred in the same small central space where traffic patterns interfered with children’s activities, and teachers’ movement throughout the room was precarious due to many toys and children playing. Please refer to the All About the ITERS-R book for more information on the expectations of this indicator. 3.2 The classroom space is located in a large room divided into separate group areas by low walls and central hallways. It was observed that music, activities, and conversations from the adjacent groups, and children and adults walking through the space created a noise level that was disruptive to the group being observed. Teachers and children were observed having to raise their voices to be heard, and on several occasions children did not hear teachers speaking to them. 3.2 There was no sound barrier between the infant and toddler classrooms. The sounds from the neighboring room, including talking, singing, and playing recorded music could be heard throughout the day. At this quality level the expectation is for the indoor space to support teachers and children in communicating with little difficulty throughout the day. 3.4 It was observed that the child-sized table and the sink basin in the child-sized kitchen had an accumulation of dirt. Food residue was observed on the child-sized chairs used for snacks, meals, and table activities. Although the teachers swept up much of the sand that spilled during sand play, some remained on table surfaces and on the floor and children were observed putting toys in the sand and mouthing the sandy toys. 3.4 It was observed that crumbs and large cracker pieces from snack remained on the carpet under the feeding table. Children used this space for play, and the food on the floor presented a health concern for an age group that is prone to put materials in their mouth. 5.1 At this quality level, the expectation is for there to be ample indoor space allowing children and adults to move freely around the room, and spacious open areas for children to play. Although the classroom had sufficient space to accommodate teachers, children, and furnishings, the teachers were observed having to move furniture out of the way to access and assist children engaged in play and routine care activities. Children’s activities often occurred in traffic pattern areas where they were interrupted by other children moving through the room. Revised 03.2010 5.1 At this quality level, children and adults are able to move freely around the room and there are spacious open areas for children to play. It was observed that children had no large open area for play and activities often occurred in traffic pattern areas where they were interrupted by adults and other children moving through the room. 5.2 At this level of quality, it is expected that daylight directly enters the room through windows. Although some natural lighting entered the room through the open doorways, it was not sufficient to meet the expectations at this quality level. 5.2 At this level of quality, it is expected that daylight directly enters the room through windows. There were no windows or doors opening toward a natural lighting source. 5.3 To meet the expectations of this indicator, the space must be accessible for all children and adults with disabilities that require such provisions, regardless of whether anyone with a disability uses the room or is currently enrolled in the program. It was observed that narrow doorways leading to the restroom would make access challenging for persons with limited mobility. Doorways and stalls must be at least 32" wide to be considered accessible. 5.3 see wording in italics which can be replicated for many situations. The following barriers to accessibility were observed: a cement step leading from the front office must be navigated to enter the center; the classroom door was equipped with a round-handled doorknob; doorway openings into the classroom measured 31 inches. These situations did not provide universal access. At this level of quality, accessibility is required regardless of whether or not individuals with disabilities are involved in the program. 2. Furniture for routine care 3.2 It was observed that all toys were stored in two toy boxes. Although these provisions were large enough to contain all toys used by the group, toy boxes make it difficult for children to find and access the toys they wish to use. At the minimal level, toys should be stored on low open shelving for easy access by children and teachers. 3.3 At the minimal level of quality, it is expected that all furniture is sturdy and in good repair. The vinyl covered, child-sized chairs in the reading center had tears in the fabric which exposed the foam padding where germs can collect. . 3.4 It was observed that children were placed in group feeding tables for meals and snacks. These seats are not considered comfortable or supportive because children’s legs and feet hang in open space. Please refer to the All About ITERS-R book for additional information. 3.4 The children used cube style seats with high sides and a deep seating area. It was observed that all the children slid down and forward seeking comfortable positions at the table. At the minimal level, the expectation is for seating to be comfortable and supportive. 5.1 At this level of quality, the furniture used with children promotes individual care and allows teachers to space children in a way that supports positive interactions. Although two of the children in the group were seated at a separate small table, it was observed that most of the children were crowded at one table used during several play activities and during lunch. There was no room at the table for teachers to interact with the children individually and children interrupted each other as they attempted to share the limited space. 5.2 The children use cube-shaped chairs at the tables during meals, snacks, and activities. It was observed that most children were not able to get into and out of the chairs without adult assistance. At this level Revised 03.2010 of quality, children have access to at least one seating arrangement that is child-sized and does not require them to be put into the chairs by an adult. Please refer to the All About the ITERS-R book for more information. 5.3 Although low open shelves were observed to support self-help in play activities, the expectation at this quality level is that there is also a minimum of one provision to support self-help in daily routines. It was observed that no such provision was available to the children during routines. Please refer to the All About the ITERS-R book for more information. 5.5 It was observed that teachers sat in the toddler chairs when eating with the children. At this level of quality, it is expected that teacher’s furnishings are larger than those used by the children. Please refer to the Notes for Clarification and All About the ITERS-R for more information. 3. Provision for relaxation and comfort 1.2 During the observation, children were rarely allowed to leave the whole group gathering to play by themselves. For example, one child who tried to leave the parachute activity to dance by herself in a corner was told to rejoin the group. Children should have the freedom to play privately away from the rest of the group when they need to escape the stress of group activities. 3.2 Although many soft dolls and stuffed animals were observed stored on an open shelf, it was observed that a child wanting to play with a doll was not permitted to do so. No other soft toys were accessible. At this level of quality, children have access to at least three soft toys for much of the day. Please refer to the Notes for Clarification and the All About the ITERS-R book for more information. 5.1 There was no cozy area observed in the classroom. A large bin filled with soft toys and cushions was located near the book center and children were observed using these materials to create soft places to sit and snuggle with soft toys. At this level of quality, it is expected that there is an area set up for children to use in the classroom which has a significant amount of softness and is accessible for much of the day 5.1 Stuffed animals, soft toys, and a soft couch and chair were observed in the dramatic play area. Soft vinyl ramps and cushions were also observed for use in active play. The expectation of this indicator is for there to be an area set up for children to use in the classroom that has a significant amount of softness, is accessible for much of the day, and is not in an active play area. This cozy area allows children to relax, look at books, and participate in quiet activities protected from other children's active play. 5.2 This indicator refers to the presence of a cozy area in the classroom as described in indicator 5.1. 5.2 It was observed that the cozy area was frequently used for group activities, dramatic play, music and movement, and other active play. At this level of quality, the cozy area is protected from active play for much of the day to give children a quiet place to relax. 5.1 A cozy area provides children with substantial softness. Cribs, playpens, and padded furniture for routine care are not considered in scoring this item. It was observed that the children used the same area of the room for all play activities and no area was set aside for quiet, comfortable relaxation. Please see the All About ITERS-R book for more information. 5.3 At this level of quality, at least 10 soft toys are expected to be accessible to children for much of the day. Although a number of soft books were observed, less than 10 soft toys were accessible. Please refer to the Notes for Clarification and All About the ITERS-R for more information. 4. Room arrangement Revised 03.2010 3.2 It was observed that the interior of the dramatic play house was difficult to visually supervise from other areas of the classroom. In addition, an easel/magnetic board was positioned in front of the sink used for meal time hand washing. On several occasions, children were observed behind this easel playing in the sink without the teacher’s knowledge. The changing table was positioned so the teacher had her back to a large portion of the room when engaged in routine care activities. The teacher indicated that early in the morning and later in the afternoon one teacher is with the children when ratios permit. At the minimal level of quality, the expectation is for the arrangement of the room to provide for easy visual supervision at all times with minimal difficulties. 3.2 The arrangement of the spaces used by children in a classroom affects how well the teacher can supervise the children to protect their health and safety. It was observed that the teacher’s ability to visually supervise certain areas depended on the physical placement of teachers around the classroom. It was observed that tall cubbies obstructed the teacher’s view of the cozy/book area. This furniture created a visual barrier causing difficulty in providing adequate supervision of the space from different angles and positions in the room. 3.2 The observed classroom was split into two play spaces divided by a center kitchenette and diapering area. It was observed that teachers were unable to see the play area during diapering routines and that they often needed to leave activities on one side of the room to supervise children who wandered to the other side of the room. Children were repeatedly brought back to one side of the room during the morning when two teachers were present to enable appropriate supervision to occur. 5.1 At this level of quality, it is expected that routine care areas are arranged for the convenience of the teachers so that they can carry out routines efficiently. It was observed that the changing table was located in a bathroom down the hall. When a child needed a diaper change, the teacher took a group of children with her to maintain teacher/child ratios. Additionally, the rest mats were located in the hall, requiring that a teacher leave the group to bring in the mat cart at rest time. 5.2 At this level of quality, it is expected that the room is arranged so that it is possible for teachers to see all the children at a glance. The high furnishings that divided the dramatic play area from other areas of the room made it difficult to observe children playing in that area when teachers were at the front of the room. Please refer to the All About the ITERS-R book for more information. 5.3 The intent of this indicator is to provide clear physical barriers and a sufficient distance to separate quiet and active areas, so that children engaged in quiet play are not interrupted. It was observed that (XXX add in what was observed during the assessment.) 5.4 There was one low open shelf in the classroom that had a few toys on it. The rest of the toys were stored in bins under the cribs or in a crate. These containers were difficult for the children to access without help and could not be opened without the teacher’s assistance. 5. Display for children 5.1 It was observed that there were limited pictures displayed in the room and several of those were too small to be easily seen by the children. At this level of quality, there are many colorful, easy to see displays that are meaningful to the children in the group. Please refer to the All About the ITERS-R book for more information. 5.2 The expectations of this quality indicator include a minimum of two three-dimensional objects hanging in space which are visible at some time to all of the children. No hanging objects of this nature were observed. Please refer to the All About the ITERS-R book for more important information on this quality practice. Revised 03.2010 5. 2 At this level of quality, it is expected that a minimum of 2 three-dimensional objects are hanging in space and are visible at some time to all of the children. Although some hanging artwork was observed, these items were not three-dimensional in nature. Please refer to the Notes for Clarification and the All About the ITERS-R book for more information. 5.2 Within the classroom, several snowflakes were observed hanging from the ceiling as display. Although they may be considered three dimensional in nature, the depth was thin and may be difficult for infants to see. Please refer to the All About the ITERS-R book for more information. 5.3 At this level of quality, it is expected that at least 50% of the displayed items can be easily seen and touched. Most of the display was observed on the upper half of the wall. Two pictures were displayed low on the wall, but these were blocked by furniture in the room and were not within children’s reach. 5.3 At this level of quality, 75% of the items on display should be located where children can see them without additional assistance. Non-mobile infants should also have opportunities to view the display and should be moved to be able to see and touch it when appropriate. Although it was observed that pictures were displayed on the group feeding table, there were no other displays easily seen in the areas most often used by the children and none were within easy reach. Please refer to the All About the ITERS-R book for additional information. 5.4 At higher quality levels, the teacher uses the classroom display as a vehicle for educational interactions with children. The teacher engages children in conversation about items displayed in the room, helping them recall activities that they engaged in to create the items or to introduce or reinforce developmentally appropriate concepts. The teachers were not observed talking to children about the displayed materials. PERSONAL CARE ROUTINES 6. Greeting/departing 3.3 The practice of moving children into different classrooms to maintain adequate ratios and group sizes was observed. Children who arrived in a classroom with their parents were moved to a different classroom if the child’s regular group was already at capacity. In other instances, children who had been dropped off in one room were later moved to another group. As a result, parents did not consistently have the opportunity to bring the child into the classroom in which the child would ultimately spend the day. Other parents did not have the opportunity to interact with the child's main teachers. At this level of quality, parents have access to their child’s classroom and the opportunity to speak with their child’s teacher. 3.3 The teacher reported that parents are met by a staff member in the child care center foyer, and that parents seldom enter the caregiving area either upon arrival or departure. The intent of this indicator is for parents to come into the child's classroom to see what their children experience daily in terms of materials, display, staff, and other children. Additionally, the safety of the children is best ensured when the parent turns over responsibility for the child directly to the child's teacher. Parents learn from seeing what happens in the classroom and hearing what the teacher has to say, and teachers benefit from daily information given by the parent. 3.4 The expectation at the minimal level is for teachers to make an attempt to speak briefly with each parent upon arrival or have them write down necessary information that will assist them in supporting a nurturing environment for each child daily. Although the teacher indicated that parents are provided with a daily written sheet detailing their child's day, it was observed that several of the parents who dropped off their child during the observation did not provide in writing or through conversation information to teachers about their child to assist them during the day. Please refer to the All About the ITERS-R book for more information on this quality practice. Revised 03.2010 3.4: The expectation at the minimal level is for teachers to make an attempt to speak briefly with each parent upon arrival or have them write down necessary information that will assist them in supporting a nurturing environment for each child daily. During several of the observed greetings, the teacher said a general hello to both the parent and child. Information was not shared between the parent and the teacher about the child's health, well-being, and/or safety. 5.2 It was observed that one of the children was having difficulty with separation from her father after arrival. She was crying and distressed. Few attempts by teachers to comfort the child or to involve her in any activities were observed. At this level of quality, teachers are expected to support children in smooth transitions upon arrival or when it is time to go home. Please refer to the All About the ITERS-R book for more information. 5.3 The intent of this indicator is that parents have accurate information related to their child's routines to support continuity between the child care program and home. To be accurate, records need to be completed as routines are performed. It was observed that records were available for each child, but they were not updated as routines were completed. 7. Meals 1.4 Two instances of infants not being held for bottle feeding were observed and one older infant was placed in a crib with a bottle. Teachers were also observed bottle-feeding more than one infant at a time. Please refer to the All About the ITERS-R book for more information about appropriate feeding practices. 3.2 Children were served (indicate foods served) for (indicate meal or snack). As per the PA Position Statements, at the minimal level the expectation is for all of the required USDA/CACFP components to be served at meals and snacks. Milk is a required component of breakfast for infants and toddlers. 3.3 Although children washed their hands following the diapering routines before lunch, it was observed that all but one child's hands were re-contaminated when they touched toys and other objects in the classroom before sitting down at the table. 3. 3 It was observed that the children and the teachers used the restroom sink for all hand washing routines. This sink was not sanitized following its use during toileting/diapering routines. If the same sink is used for both diapering/toileting and food related routines, the sink basin and faucets must be sanitized between these routines. 3.3 The teacher reported that bleach and water solution is used for sanitizing surfaces. It was observed that following snack, the trays of the highchairs were sprayed with the bleach and water solution and then immediately wiped with a rag. To effectively sanitize, bleach and water solution must remain in contact with the surface for two minutes. Single use towels or disposable paper towels should be used for sanitizing purposes to ensure that germs are not spread from one surface to another or from one use to the next. 3.3 It was observed that a commercial cleaner (name of cleaner) is used to sanitize. Following morning snack, the trays of the highchairs were sprayed with the solution and then immediately wiped with a disposable towel. To effectively sanitize, the instructions for use on the original label of the solution must be followed. The product directions indicated that the solution must remain in contact with the surface for (indicate contact time) to sanitize. 3.3 It was observed that the teacher had limited space for food preparation and placed children's lunch plates on a low table. Children were observed touching the lunches and eating off the plates while waiting for hand washing routines to be completed. Revised 03.2010 3.4 As young children begin to feed themselves, there is a high risk for aspiration or choking. At this level of quality, an adult is always within arm's reach of any child who is eating or drinking. It was observed that teachers were engaged with children playing on the floor while others were eating snacks and meals in the high chairs on the opposite side of the classroom. 3.4 It was observed that teachers sat down with the children after the entire group had washed their hands, were seated, and served lunch. At the minimal level, the expectation is that children are closely supervised during meals/snacks as eating is considered a high risk activity for infants and toddlers. 3.4 At the beginning of lunch the teacher was still preparing some children's food at the counter top while other children were seated and eating at the table. In addition, the children faced the wall while they ate which made it difficult for the teacher to see if a child needed help. At the minimal level, the expectation is that children are closely supervised during meals/snacks as eating is considered a high risk activity for infants and toddlers. 5.3 The classroom was equipped with a child-size sink including a hands-free faucet which was used for all hand washing routines. Several children were observed touching the faucet in their attempts to activate the sensor. Although it was observed that teachers periodically sanitized the children's sink and surrounding surfaces after hand washing related to toileting or diapering, this did not happen consistently. 5.3 The intent of this indicator is that each of the three basic sanitary expectations (hand washing, clean, sanitary eating surfaces, and uncontaminated foods) must be met 75% of the time. Although adult hand washing surpassed 75%, it was observed that child hand washing occurred 55% of the time. In addition, the same sink was observed to be used for both toileting and diapering routines. Although sanitizing the sink was clearly part of the procedures, it was observed that the faucet was sprayed with the solution but the sink basin and surrounding counter surface were not. 8. Nap 1.1 Although children will assume a preferred sleeping position, an infant under one year old should initially be placed on his or her back to sleep. It was observed on two separate occasions that an infant was put in a crib on (his/her) stomach. A soft pillow observed in one crib also created a risk of smothering. Please refer to Caring for Our Children, available from the Regional Key for more information on appropriate nap practices for infants. 1.1 At least 24 inches of open space between rest equipment and other furniture/materials is required on three sides. It was observed that cribs used for sleeping were placed with less than 24 inches of open space from other classroom furniture/equipment. Please refer to the PA Position Statement for Nap. It was also noted that children’s bedding was stored piled together in a closet. Most of the bedding was contained in pillow cases or other fabric bags. If bedding is stored together, each child’s items must be in a separate, nonporous container to prevent the spread of germs. Please refer to the PA Position Statements for more information. 1.1 It was observed that four of the nine cots were positioned with less than 24 inches of open space from other cots or furniture on three sides. Additionally, it was observed that many of the children were tired well before nap time. Several went directly to their cots upon returning to the classroom from outdoors where they spent 10 minutes lying down before hand washing for lunch. Many of the children spent lunch time and the half hour after lunch while waiting for their diaper to be changed rubbing their eyes, yawning, and engaging in inappropriate behavior. At the minimal level, the expectation is for cots to be appropriately spaced and nap to be scheduled at an appropriate time to meet the needs of each child. Revised 03.2010 1.1 The posted schedule had a nap time designated for 1:00 PM. However, many children showed signs of tiredness much earlier. It was observed on two different occasions the teacher remained with the planned schedule and attempted to keep the children awake, even though they were crying, rubbing their eyes, and lying on the floor beginning at 10:45 am. Children were placed on mats beginning at 12:10 pm. One child, who fell asleep on the carpet after lunch at 11:45 am, was awoken for story time. Minimal expectations for quality include appropriate sleep schedules for all children. 1.3 It was observed that a child was left in a crib for 35 minutes after the morning nap. Although the child appeared content, children should not be left in cribs for more than 15 minutes when happily awake. 3.2 At least 36 inches of open space from other napping children or furniture/equipment is required on three sides of nap equipment. It was observed that (insert appropriate reference, e.g. cribs, cots, mats, etc.) were placed with less than 36 inches of space from other furniture/equipment. The expectation is for all children to be separated in this manner to prevent the spread of germs during sleep as well as to ensure adequate space for access in case of an emergency. 3.2 At the minimal level, at least 36 inches of clear space on three sides of nap/rest equipment is expected. It was observed that cribs were not positioned with at least 36 inches of separation from other furniture/equipment on at least three sides. Additionally, it was observed that (list equipment and materials) and other materials were stored in between some of the cribs. Appropriate separation helps to prevent the spread of germs during sleep as well as to ensure adequate space for access in case of an emergency. 3.2 It was observed that children used sleeping bags or blankets during nap and slept directly on top of the carpet. Because young children are prone to toileting accidents, surfaces for nap should be easy to clean and sanitize. 9. Diapering/toileting 1.1 It was observed that the same sink was used for all hand washing routines. This sink was not sanitized after hand washing related to diapering. If the same sink must be used for more than diapering/toileting hand washing, the faucet, handles, and sink basin should be sanitized after use related to diapering/toileting. Please refer to the All About the ITERS-R book for additional explanation of quality procedures related to use of the same sink. 1.1 Observed toilet training routines included instances which compromised the sanitary nature of the bathroom. Children who were in the process of potty training but still in diapers or pull-ups were changed while standing up in the bathroom. In these cases, the child's clothing was partially removed with their pants or other garments left around their ankles while the diaper was removed. It was observed that the soiled diaper/pull-up was then placed on the floor for the remainder of the toileting routine. It was observed that the child was standing over an area rug during these instances. The surface upon which diaper changes take place should be able to be sanitized following diaper changes. No action was taken to sanitize the surface. Please refer to the “Diapering - Changing Soiled Underwear for Toddlers” guidelines at www.ecels-healthychildcarepa.org 1.1 It was observed that the teacher did not remove the gloves used during diaper changes after the dirty phase of the routine (gloves should be removed after the dirty diaper is removed and the child's diaper area has been cleaned). The teacher continued to wear the gloves throughout the diaper change as well as while touching the child’s face and head in order to wash the child’s face after the change was complete. In addition, a wipe was not used on the teacher’s hands or the child's hand after the dirty diaper was removed and before a clean diaper was put on. It was observed that the same sink was used for all hand washing routines without sanitizing the sink and faucets before other hand washing, including hand washing before meals and food prep. Please refer to the All About the ITERS-R book for additional explanation of quality procedures related to use of the same sink. Revised 03.2010 3.1 The teachers did not remove their gloves after the dirty phase of the diaper change (gloves should be removed after the dirty diaper is removed and the child's diaper area has been cleaned). In addition, a wipe was not used on the teacher's hands and the child's hands after the dirty diaper was removed and before a clean diaper was put on. For additional information on best practice during diaper changing, please refer to "Caring For Our Children" which is available from the Regional Key. 3.1 It was observed that the same sink was used for adult hand washing routines (the children's hands were not washed). The sinks were not appropriately sanitized after hand washing related to diapering. If the same sink must be used for more than diapering/toileting, the faucet, handles, and sink should be sanitized after diapering/toileting use. Please refer to the All About the ITERS-R book for additional explanation of quality procedures related to use of the same sink. 3.1 It was observed that some of the steps of the diaper changing procedure were not consistently followed. The hand wiping step between the dirty and clean phases of the routine did not always occur. Additionally, it was noted that during all changes, diapers were placed in plastic bags prior to being placed in a garbage can located inside a cupboard with a child proof lock. Please be advised that new Pennsylvania child care facility regulations for child care centers (make sure to change for Group or Family based facilities where the ITERS was used to assess) became effective on Sept. 22, 2008. The new regulations prohibit placing disposable diapers in plastic bags before putting them in an appropriate trash container. As per the regulation: “If disposable diapers are provided by a parent or by a facility, a soiled diaper shall be discarded by immediately placing the diaper into a plastic-lined, hands-free covered can.” If you have questions about this new regulation, please contact your regional certification representative. 3.1 It was observed that the preparation step in the diapering procedure did not always occur. The teacher took out a clean diaper and the other materials needed after the child was on the diaper changing table. In addition, while it was observed that children and the teacher consistently washed their hands after diapering routines, a hand cleaning step in the middle of the diapering process was not always followed. Caring for Our Children explains that a clean wipe should be used on the adult's hands and a second wipe should be used to clean the child's hands after the dirty diaper is removed and before putting on the clean diaper. It was observed that sometimes this part of the process did not happen. Finally, it was observed that some teachers allowed the sanitizer to remain on the diaper changing pad while other teachers immediately wiped it dry after spraying the sanitizer. The directions on the sanitizer label state that the solution must remain wet on the surface for ten minutes before being wiped dry. 3.1 While it was observed that children and the teacher consistently washed their hands after diapering routines, a hand cleaning step in the middle of the diapering process was not followed correctly. Caring for Our Children explains that a clean wipe should be used to clean the adult's hands and a second wipe should be used to clean the child's hands after the dirty diaper has been removed and before putting on the clean diaper. It was observed that wipes were used to clean the adult and child's hands after the clean diaper was already on the child, which promotes transfer of germs and bacteria. 3.2 The teacher reported that all children in the group, except one, were learning to use the toilet. Although all children were taken to the restrooms after lunch, it was observed that not all children were taken to the restrooms or asked if they needed to use the toilet during the first four hours of the observation. It was noted that two children had accidents during the assessment. Please refer to the All About ITERSR book for more information on expectations at this level of quality. 10. Health practices 1.1 It was observed that multiple children spit-up during the assessment. While the teacher wiped the fluid from the children’s faces, play surfaces, and classroom materials with tissues or her hand, the soiled Revised 03.2010 surfaces were not sanitized and the teacher’s and children’s hands were not washed. It was also noted that in one instance children crawled through the spit up without the teacher’s knowledge prior to it being cleaned up. This spread germs throughout the room. Expectations for health practices include minimizing the spread of germs. Please see the ITERS-R scale and the All About the ITERS-R books for more information on this important topic. 1.1 The following health concerns were observed: mouthed toys remained in circulation without being cleaned or sanitized; some children's noses were wiped with the wipe that was used to clean the child's hands during the diapering procedure; other noses were left running for extended periods of time before being wiped; and paper towels used to dry the child's hands after hand washing were also used to wipe splashed water off the counter of the sink and then to finish drying the child's hands. Expectations for health practices include minimizing the spread of germs. Please refer to the Notes for Clarification and the All About the ITERS-R book for more information. 1.3 The teacher reported that a child with a contagious illness is made comfortable in the classroom until he or she can be picked up. Because infants and toddlers have immature immune systems, it is especially important to reduce their exposure to potential sources of germs by removing them from contact with other children. 3.1 Although some toys that children put in their mouths were removed from circulation, many were not. At the minimal level, the expectation is for teachers to minimize the spread of germs throughout the classroom. Practices of this nature include allowing children to come to a comfortable stopping point when play includes mouthing toys. Once a child is finished with a toy, the teacher then removes the toy for cleaning and sanitizing before returning it to the accessible toys. 3.1 On several occasions, pacifiers that children dropped to the floor or that were mouthed by another child were rinsed and returned to the children without being cleaned and properly sanitized. At the minimal level, the expectation is for the spread of germs in the classroom to be minimized. Please refer to the All About the ITERS-R book for more information regarding sanitary health practices. 3.2 The expectations for this indicator include that the hands of adults and children are washed 75% of the time when needed as defined in the Notes for Clarification and the All About the ITERS-R book. It was observed that some children did not wash their hands (list what was observed here). Lapses in practice for teachers included (list lapse categories here). Appropriate hand washing for adults occurred XX% of the time and for children XX% of the time. 3.2 It was observed that several children were asked to rewash their hands after touching walls or hand rails. The children grew frustrated at being sent to wash numerous times. Hand washing generally needs to occur 75% of the time and occasional lapses may occur, as long as it is evident that these healthy practices are a part of the classroom routine and have been taught to the children. For instance, if one or two children re-contaminate their hands before meals, the children may or may not re-wash depending on several factors ranging from the location of the sink to the disposition of a child. If they do not re-wash their hands, this may be counted as a lapse in practice. However, if several children re-contaminate their hands during meal time routines, the program should focus on what factors may be causing the repeated lapses. 11. Safety practices 1.1 Cleaning products, labeled “Keep Out of the Reach of Children,” were observed stored unlocked on shelves in the restroom and classroom. In addition, two electrical outlets were uncovered and the changing table did not have a 6 inch raised lip surrounding the surface to prevent falls. Please refer to the PA Position Statements and the All About the ITERS-R book for more information. 1.1 The following hazards were observed in the indoor space posing injury to children: hand sanitizer, dish washing liquid and carpet cleaner labeled “Keep Out of the Reach of Children” were stored unlocked; a Revised 03.2010 window shade pull cord was within reach an unplugged battery pack and power cord behind the refrigerator were accessible; a dime, metal nuts and other debris was on the floor. Additionally there was not a 6 inch raised edge on the surface of the diapering table. A soft pillow was observed in a child’s crib and it was noted that one infant was placed on her stomach to sleep and another was placed in her crib with a bottle for nap with her bib still on. A toy with a torn seam and exposed stuffing was observed among accessible toys. Please refer to the PA Certification Regulations, PA Position Statements, and the All About the ITERS-R book for more information about indoor safety hazards. 1.2 It was observed that the outdoor play space was not fenced. A fence is necessary for safety because of the hazards associated with children “wandering off” or the entry into the play area of unexpected visitors or animals. (Remember that depending upon the circumstance observed the absence of a fence as the only hazard could also be addressed at 3.1.) 3.1 The mulch under the fall zones of slides and swings measured between 3and 6inches (ASTM F 1292 standards expect 9 inches) and did not extend throughout the entire fall zones of 2 slides. Fall zones, the areas under and around equipment where impact absorbing materials are expected, must be a minimum of 6 feet. In addition, climbing/slide structures were not spaced the expected 12 feet apart. Two slide chutes were located less then than 24 inches from other equipment. Please refer to the Playground Information Sheet attached to the PA Position Statements for more information. 3.1 The mulch on the playground was frozen and presented a hard surface which cannot be considered as appropriate impact absorbing cushioning. Proper drainage is required for mulch to retain its cushioning capabilities during freezing temperatures. Please refer to the Playground Information Sheet attached to the PA Position Statements for more information. 3.1 The facility was unable to provide documentation that the rubber mats under climbing equipment meet the ASTM F-1292 standards for impact absorbing materials in fall zones. The mats also did not extend throughout the entire fall zone of the equipment. (Fall zones are the areas under and around equipment where impact absorbing materials are required; a minimum of 6 feet is required.) The fenced in playground is adjacent to a commercial parking lot and was littered with trash such as cigarette butts, pop cans and other garbage. In addition, an A -frame swing set was present. This type of swing set structure is no longer considered safe because it encourages children to climb up the sides. Please refer to the Playground Information Sheet attached to the PA Position Statements and the Handbook for Public Playground safety at www.cpsc.gov for more information. LISTENING AND TALKING 12. Helping children understand language 3.3 At the minimal level, the expectation is for adults to be aware of their tone of voice and the message it conveys when talking to children, ensuring that negative or harsh tones and words are not used. It was observed that one teacher became more quickly frustrated with the children and multiple instances of negative interactions with the children were observed. One extremely harsh interaction was observed when the teacher used profanity when speaking to a child who was using the restroom. Please refer to the item Notes for Clarification and the All About the ITERS-R book for more information about this item. (We must use caution when including rationales that make specific reference to things teachers did or said during an observation. When in doubt try to reference the instance, not the person and consult your supervisor for assistance with appropriate wording.) 5.1 This indicator examines the quality and frequency of the teachers talking with children. The content of the communication, topics discussed, range of words used and the tones of conversations are taken into account during both routines and play. It was observed that the quality of the teacher/child conversations was neutral or pleasant and that the teacher generally talked with the children frequently Revised 03.2010 during play. However, during routines such as greeting, diaper changing, and feeding times, talking with the children occurred less frequently than expected at this quality level. 5.1 This indicator examines the quality and frequency of the teacher talking with children. The content of the communication, topics discussed, range of words used and the tones of conversations are taken into account during both routines and play. It was observed that the quality of the teacher and child conversations was neutral or pleasant, but not frequent. Children benefit from frequent communication with their teachers. This practice helps children build their vocabulary as well as nurtures the meaningful relationship between the child and teacher. Verbal comments should accompany almost all interactions between children and staff, whether during play or during routines. 5.4 Although teachers spoke to the children in an encouraging manner and used a positive tone, it was observed that descriptive language was (rarely, infrequently, etc.) used. At this level of quality, teachers use language to describe actions and feelings and to name unique attributes of objects. Using specific words helps children build their understanding of language and gain information about the world around them. Please refer to the All About ITERS-R book for more information on the use of descriptive language. 13. Helping children to communicate 5.1 It was observed that one child was distressed throughout the assessment. The child’s attempts to interact with the teachers for comfort were not responded to, or the child was told she would be ok. It was observed on two occasions that the child managed to calm herself and then attempted to initiate interactions with a teacher. Neither of these attempts received a response. Please refer to the Notes for Clarification and the About the ITERS-R book for more information. 5.1 Although there were three teachers in the room with eight infants, several instances of children showing signs of distress through crying were observed. They included: (list for example in cribs, bouncy seats, on the floor) During these instances, the teachers were engaged in routine care tasks such as feeding or diapering. Although the teachers verbally acknowledged the children in need, it was not possible for them to address their needs until the routine task was completed. At this level of quality, the expectation is that the needs of the individual children are met without long periods of waiting. This supports young children's growing understanding that using communication serves a purpose and aids them in having their needs met. Please refer to the All About the ITERS-R book for further information. 5.2 When teachers narrate what is happening with young children throughout the day, it supports their awareness of the world around them and the expansion of their auditory and oral vocabulary. Although some examples of this type of interaction were observed, at this level of quality many examples of teachers describing their actions during routines and play are expected. Please refer to the All About ITERS-R book for more information. 5.3 Although the teachers correctly interpreted children's attempts to communicate, they did not always follow through appropriately. Following through means that the teachers indicate verbally that they understand what the child is trying to communicate, and then take action in a timely way to meet the child's needs. It was observed (add what was observed here as needed). At higher quality levels, this follow through supports children’s rapidly growing ability to communicate, letting them know that communication efforts result in responses. Please refer to the All About the ITERS-R book for more information. 14. Using Books 3.1 To be considered accessible for non-mobile infants, materials must be placed close to the child or the child must be brought within reach of the item. Although some books were observed, none were made accessible to the non-mobile children. Additionally, the expectation is that there is a minimum of one Revised 03.2010 accessible book per child, based on the maximum number of children enrolled in the group. The teacher reported that only the soft books were used with the children. Less than (list number of books)) soft cloth books were observed in the classroom. Please refer to the Notes for Clarification for more information. 3.2 At the minimal level, the expectation is for accessible books to be in good repair, with intact covers and no missing or torn pages. When damaged books are removed from access to children it supports them learning how to treat and care for books. (List number) books in the classroom were observed with the cover missing or torn. Please refer to the Notes for Clarification for more information. 5.2 Of the (list number of books) books that were accessible, most depicted cartoon animals doing human tasks. There were few books with realistic pictures, photos, or stories. A wide selection should include books about people of varying races, ages, and abilities; animals; familiar objects; and familiar routines. Please refer to the All About the ITERS-R book for more information. 5.4 At this quality level, the expectation is for children's experiences with books to support their emotional and social development as well as their awareness and understanding of language. When teachers engage children on a more personal level while reading books, the experience supports their learning of the enjoyment of being read to. Interactions between the teacher and child(ren) include an element of warmth and engagement in the content of the book. This indicator refers to observed times when teachers read to the children in the group as detailed in indicator 5.3. Please refer to the All About the ITERS-R book for more information on this quality practice. ACTIVITIES Rationale STARTER for MUCH OF DAY ITEMS: Children were frequently observed with no access to (insert info for appropriate item) for lengthy periods due to being placed in (insert furnishings). At this quality level, the expectation for (insert appropriate item) materials includes all children having access for much of the day to support growing skill development. Please refer to the All About the ITERS-R book for more information on this item. (More information might be inserted to provide more detail of the specific situation you observed.) 15. Fine Motor 3.3 Appropriately working fine motor materials support children’s rapidly developing skills. The expectation at the minimal level is that at least 80% of the accessible materials are complete and in good repair. The following materials were observed to be incomplete or in poor repair: puzzles were incomplete;, cause and effect toys did not work or were missing pieces; and shape sorters had no pieces. 5.1 Accessibility of materials requires that the children can reach and use the materials themselves throughout much of the day. Expectations for many and varied materials at this quality level promote the learning of different skills through multiple options, with the total number of options being based upon the number of children enrolled in the group. Although children had access to fine motor materials for much of the day, few fine motor materials appropriate for the toddlers in the group were observed. Additionally, it was noted that the infants’ access to fine motor materials were limited to the few toys attached to the (list items such as exersaucers and bouncy seats) that children were placed in. Please refer to the All About the ITERS-R book for more information. 5.1 For this indicator, "many" is defined as no fewer than 15 toys/materials for a group of five toddlers. It was observed that fewer than 15 fine motor materials or toys were accessible to the children. Three knobbed puzzles and a busy-box were observed on a low shelf. A ring stacker was also accessible, but did not have all its rings. A large set of small waffle blocks was accessible higher up on another shelf. It was observed that when children made the attempt, they were not able to independently access the set Revised 03.2010 of toddler sized interlocking blocks. Crayons stored on top of this shelf were also out of the children's reach. Please refer to the ITERS-R for the definition of accessible as well as the All About the ITERS-R book for more information. 5.1 For the observed group, "many" is defined as at least XX (insert number of toys needed based on size of group observed) fine motor toys. It was observed that (insert what was observed to be accessible) were accessible to the children. Although multiple children could use many of these materials, fewer than XX toys were observed. Additionally, the accessible toys did not provide variety in the type of fine motor skill development they supported. Please refer to the Notes for Clarification and the All About the ITERS-R book for more information. 5.1 Children had access to many rattles, small grasping toys, and cause/effect toys which stimulate the development of fine motor skills in infants. However, there were few accessible materials that challenge and stimulate the development of fine motor skills in the older children in the group. In addition to the toys for infants, it was observed that (list toys) were accessible. Although other fine motor toys were available, it was reported they are only made accessible about once a week. Please refer to the Notes for Clarification and Terms Used Throughout the Scale in the ITERS-R for additional clarification on "many and varied" and "accessible." 5.2 The intent of this indicator is that materials are organized in a way that promotes children's independence and also makes clean-up more efficient. It was observed that all toys and materials, including fine motor materials, used and scattered by the children, were not picked-up until just before lunch time. Additionally, it was noted that toy storage in the interest areas was minimal and toys were crowded on shelves and disorganized. Please refer to the All About the ITERS-R book for more information about expectations at this level of quality. 16. Active physical play 3.1 It was observed that the infants spent long periods of time in swings, walkers, and infant seats. At this level of quality, all children have the option for active physical play. For young infants, this would include space to move freely, kick their legs, and reach with their arms. Please refer to the All About the ITERS-R book for more information about space for active physical play. 3.1 At this level of quality, sufficient open space for large muscle movement is expected. For toddlers, this would include space to walk and run a short distance. It was observed that the children had no open space available for active physical play. Additionally, the toys and books that remained scattered on the floor prevented children from moving freely through the room. Please refer to the All About ITERS-R book for more information about the expectations for open space for active physical play. 3.2 The teacher reported that the group usually goes outside in the stroller for walks around the building. At this level of quality, it is expected that children have active physical play outdoors 3 times per week year-round, except in very bad weather. Stroller rides provide access to fresh air outdoors; however, they do not provide the opportunity for children to engage in active physical movement. 3.2 The teacher reported that the children do not go outside if the temperature is below 32 degrees. This may prevent children having outdoor physical play experiences at least 3 times per week. Please refer to the PA Position Statements for the definition of "weather permitting." 3.2 The teacher reported that the children do not go outdoors if it is raining, too windy or if there is a weather advisory. However, when asked about temperature, the teacher reported that outdoor play does not take place if it is too hot or cold, which was based on the personal determination of the teacher's comfort. This may prevent children having outdoor physical play experiences at least 3 times per week. Please refer to the PA Position Statements for the definition of "weather permitting." Revised 03.2010 3.2 Although the teacher reported that children are taken out on weather permitting days for free play, it was reported that they go for walks when the playground has snow covering it. Although recent snow fall has been excessive, the expectation is that generally children have the opportunity for free play outdoors daily weather permitting. This can mean that an alternative space is available or that measures are put in place to remove the snow from the active play space. 3.2 This indicator considers the availability of outdoor space, as well as the safety of the available space. It was observed that there was no impact absorbing surfacing beneath the outdoor gross motor play equipment. Slides, see-saws, and a merry-go-round were placed directly on the grass. Please refer to the Playground Information Sheet in the PA Position Statements for more information on appropriate impact absorbing materials. 3.3 The pads under the climber and swings on the playground did not extend into the fall zone and did not meet ASTM expectations for impact absorbing material. Please refer to the Playground Information Sheet in the PA Position Statements for more information on fall zones and appropriate impact absorbing materials. 5.1 The teacher reported that the group usually goes outside for 45 minutes in the morning. At this level of quality, it is expected that children have active physical play outdoors for 1 hour daily year-round, except in very bad weather. In addition, it is expected that the outdoor area is easily accessible for the children in the group. It was observed that the group had to walk through an office and bathroom area to get to the outdoor area. Please refer to the Notes for Clarification and the All About the ITERS-R book for more information. 5.3 It was observed that there were limited materials for active physical play accessible to the children in the indoor gross motor play space (list materials). Children were observed competing for preferred items. Teachers were frequently interrupted when engaged with other children to manage negative interactions and soothe upset children. 5.5 The rails of the interior section of fence surrounding the infant outdoor play space were spaced 4 inches apart. This spacing is considered an entrapment hazard. Please refer to the Playground Information Sheet attached the PA Position Statements for more information. 17. Art 1.2 It was observed that accessible art materials included paste-on eyes and sequins. The bags for these materials were labeled “Not Recommended for Use by Children 3 and Under.” The teacher also reported using glitter with the children which is not recommended for use by infants and toddlers. Nearly all of the children in this group were under the age of three. 3.2 It was observed that the children used glitter in several art projects. Glitter is not considered an appropriate material for toddlers because it is a potential eye irritant. 5.2 Children were observed using coloring books and coloring sheets as an art activity. At this level of quality, children should be able to have the flexibility to be creative and produce individualized work where the child determines the outcome. According to the All About ITERS-R book, all art projects used with infants and toddlers should encourage individual expression. 18. Music and movement 5.2 Although some musical instruments were accessible and music played on a CD throughout most of the observation, the teacher did not sing informally with the children. At this level of quality, it is expected Revised 03.2010 that teachers informally sing/chant with the children frequently throughout the day, and that this practice is observed at least once during an observation. 5.2 High quality infant practices include informal singing or chanting with children during daily play and routines. This activity supports infants learning about the rhythms and vocal sounds needed later for language development. No instances of this practice were observed. 5.3 At higher quality levels, the expectation is for teachers to provide children with a variety of music experiences throughout the day. Although there were musical instruments present in the room for the children, the teacher did not sing with the children and no other musical experiences were provided. 5.4 The intent of this quality indicator is to assure that music is used at limited times and with a specific purpose. A CD played music throughout most of the observation and no attempts were made to integrate the music into the activities of the children. 5.4 The intent of this quality indicator is to assure that music is used at limited times and with a specific purpose. A CD played music throughout most of the observation. Although the music was at times integrated into the activities of the children, it continued to play even after children lost interest. Please refer to the Notes for Clarification and the All About the ITERS-R book for more information. 19. Blocks 5.2 Although the blocks were sorted by type, all accessories including cars, plastic little people, and zoo animals were stored in one bin. At this quality level, the expectation is for these materials to be stored in a manner that assists children in finding what they need as well as replacing toys when they are cleaning up. 5.2 It was observed that the blocks and accessories were stored with other materials including puzzle pieces and dramatic play props, and that blocks and accessories scattered by the children were not resorted by the teachers. When materials are not organized and sorted by type, children are less able to independently select materials and assist with clean up. 5.3 It was observed that the blocks were stored on a shelf in a high traffic area that was used by the teacher and children to get to the office and the toileting/diapering area. Children engaged in block play were often interrupted as others moved through the area. At this level of quality, block spaces support in-depth play, ensuring that children are not disturbed by others seeking to access other areas of the classroom. 20. Dramatic play 3.2 It was observed that props for dramatic play, including (list props) were stored in closed bins and the play kitchen unit was turned around and not accessible to the children until after 10 am. The teachers put the dramatic play materials were away at 11 am in preparation for lunch. Dolls were accessible to the children for approximately 1 hour. At this level of quality, it is expected that some dramatic play materials are accessible to children for “much of the day”. Please refer to All About ITERS-R for more information on accessibility and "much of the day". 5.1 At this level of quality, two or more examples of each of the categories of toys/materials described in the Notes for Clarification are expected to be accessible for toddlers. It was observed that there was not sufficient representation of “Dress-up Clothes” and “Cooking/Eating Equipment.” Please refer to the All About the ITERS-R book for more information. Revised 03.2010 5.3 Although the soft toys were stored together in the cozy area, the rest of the dramatic play materials were stored unsorted in bins under the cribs or in a crate. Organized materials at this quality level support children in finding items they wish to play with and cleaning up when finished. 5.3 Dolls and soft animals were stored stacked together in the cozy area. Telephones were stored with other types of play materials in a low open toy box. At this level of quality, the expectation is for dramatic play materials to have separate storage. When materials are not organized and sorted by type, children are less able to independently select materials and assist in cleaning up. 5.4 As toddlers learn more about the world around them, their dramatic play begins to include imitations of the daily activities they experience. Including child-sized play furniture in the classroom supports their growing ability for pretend play. No child-sized play furniture was observed in the classroom. Please refer to the All About the ITERS-R book for more information. 22. Nature/science 3.3 No experiences with nature were provided indoors, such as through living plants, an aquarium, or classroom pets. It was observed that the classroom windows were high up on the walls and had lattice work placed in front of them on the outside. This limited view of the outside offered no opportunity for children to observe outdoor natural items from the classroom. At the minimal level, children should have indoor or outdoor interaction with nature daily. 5.1 The teacher reported that they do not go outside if the temperature is below 30 degrees or over 100 degrees, which may prevent children from the opportunity to have outdoor experiences with nature science at least 2 times per week. Please refer to the PA Position Statements for the definition of “weather permitting”. OR The teacher reported that children do not go outdoors if it is below 32 degrees which may prevent children's access to outdoor nature experiences at least twice per week year round. Please refer to the PA Position Statements for the definition of the term “weather permitting”. 5.2 The expectation at this level of quality is that children have daily opportunities to interact with living plants or animals indoors. Although the teacher reported that the children have occasional outdoor experience with nature, there were no plants or animals observed indoors. 5.2 While there were flower boxes outdoors for the children to look at, no experiences with nature were provided indoors, such as through living plants, an aquarium, or classroom pets. Including nature indoors increases children’s awareness of nature and enriches their learning about the world around them. At this quality level, the expectation is for daily indoor experiences to occur. 23. Use of TV, video, and/or computer 1.1 or 3.1 A few of the movies observed near the television contain frightening scenes that are not appropriate for children who are yet unable to separate fantasy from reality. At this level of quality, all movies should carry positive messages and therefore not contain frightening, or stereotypical images. This phrase could also be used at indicator 3.1 as well depending upon the severity of the images contained in observed movies. Additionally, more information on the titles and ratings of the observed movies might in some instances strengthen the rationale. Consult with your supervisor to determine whether to include them. Revised 03.2010 3.2 Children watched a video prior to nap. The teacher indicated that because some children were already sleeping, no alternate activity was offered to those still awake. At this level of quality, at least one alternate activity is accessible during the use of TV/video in the classroom. 3.3.1 The children use the computer room for 30 minutes each day. During this time, the children have the option to watch a video or use the computer for the 30 minute time period. Computer turns for this age group should be limited to approximately 10 minutes. 24. Promoting acceptance of diversity 5.1 The early childhood classroom environment plays an important role in increasing children's awareness and acceptance of diversity through teacher guidance, the toys and materials that are used, and the pictures and photos displayed in the classroom. At this level of quality, it is expected that at least 10 examples showing diversity are observed in books, pictures, and materials. Although 2 books showed diversity in a positive way, there was not sufficient representation of diversity in books, pictures or materials. 5.1 At this level of quality, it is expected that at least 10 examples showing diversity are observed in books, pictures, and materials. Many examples of racial diversity were observed in accessible pictures. Although dolls and play people depicting diversity were accessible to the children, they are considered in indicator 5.2. No other examples of diversity were observed. 5.2 Dolls representing Caucasian and African American skin tones were observed in the classroom. At this quality level, the expectation is for accessible dolls to represent at least three races in skin tone or facial features. INTERACTION 25. Supervision 3.1 The observed classroom was split into two play spaces divided by a center kitchenette and diapering area. It was observed that teachers were unable to see the entire play area during diapering routines. During play time, children who wandered to the other side of the room were unsupervised for extended periods when teachers were engaged with other children and did not notice their absence. 5.1 During preparations to go outside, two children were near the door and managed to open it briefly. While the door was open another child left the classroom and entered the neighboring classroom through an open child security gate. Later in the morning while a small group was engaged in toileting routines, several children began to engage in play at the water table without the teachers’ knowledge. While these incidents were brief, they reflected moments when the teachers were not aware of the actions of several of the children. 5.1 It was observed that the teachers were frequently engaged in routines at the same time or were both working with an individual child or a small group. During these times, children were observed in repeated conflict: one child was observed (list what was observed). At this level of quality, the expectation is for teachers to be aware of the entire group even when engaged in other routine activities or interacting with other children. 5.2 It was observed that one child had difficulty with separation at arrival and remained distressed throughout the assessment. Teachers did not respond to the child or responded in a neutral tone. Additionally, it was observed that children engaged in negative interactions – (list observed interactions)- during long periods of waiting while transitioning to new activities or routines. It was observed that teachers attempted to verbally redirect these behaviors, but continued to complete Revised 03.2010 routines and did not comfort children who were upset. Please refer to the All About the ITERS-R book for more information. 5.2 At higher quality levels, the expectation is that teachers console and support children in ways that are meaningful to them. It was observed that a child was distraught on the playground for approximately 1 hour. Although intermittent attention was initially given to the child, the child continued to cry throughout the outdoor play period and no additional attempts were made to soothe him. 5.3 There were a few times during the observation (list the times) that the teachers were engaged with the children and showing interest in what they did. However, it was observed that considerable time was spent engaged in routine care tasks including hand washing, diaper changes and meal preparation. This left teachers with little time to respond to the children's interests during much of the assessment. Please refer to the All About the ITERS-R book for more information about the expectations at this quality level. 26. Peer interaction 5.1 Although it was observed that the teachers attempted to stop negative interactions, at this quality level the expectation is for teachers to also support children in engaging in positive interactions. Children were observed competing for play space and for favorite toys and activities without teacher redirection. It was observed that several children repeatedly took toys and materials from others and teachers did not intervene or guide them toward more acceptable behavior. Please refer to the All About the ITERSR book for more information at this level of quality. 5.1 At this level of quality, teachers not only stop negative behavior but also help children develop positive interactions with peers. Although teachers stopped negative peer interactions, they did not remind children of the rules and support them in moving on to appropriate interactions with their friends. Please see the All About the ITERS-R book for more information. 5.2 It was observed that a child who was uninterested in the group activity played in another area of the room. The other children were asked to turn their attention to the child because his actions were considered inappropriate. At this level of quality, teachers serve as role models for children, treating them the way they themselves would want to be treated. Please see the All About ITERS-R book for more clarifying information on this indicator of quality. 5.2 This indicator addresses opportunities for children to learn social skills by observing adult interactions. When teachers model good social skills, they are responsive, polite, interested, and cooperative. It was observed that the majority of the teachers’ interactions with one another were directive in nature, including some emotional exchanges. Few examples which modeled appropriate social interaction were observed. 5.2 When teachers assist children with social skill development, they are proactive and help children become aware of their actions, support children’s efforts to cooperate with others, and guide children who are involved in conflict. The teachers intervened and stopped negative conflicts between the children, but did not help children develop the skills and practices needed to engage in positive problem-solving interactions with their peers. 27. Staff-child Interaction 3.3 It was observed that the physical contact used by the teacher when trying to control children's behavior was not carried out in a warm and responsive manner. Children who continually left group circle time and the time out corner where abruptly picked up and carried back to those spaces. Please refer to the All About the ITERS-R book for more information. Revised 03.2010 3.3 At the minimal level, the expectation is for teachers to support children’s growing understanding of how what they say and do affects the interactions they have with others. As harsh teacher-child interactions present children with an antisocial message, even when instances of misbehavior occur, teacher’s responses to children should be warm and supportive, addressing the unacceptable behavior, but also acknowledging the child’s worth and their current level of social development. On several occasions, children engaged in behavior that was not acceptable to the teachers. Although many of these actions were within age appropriate expectations, the teacher responded by moving children physically and with verbal reprimands that did not convey understanding of the child's developmental abilities or emotional distress 5.2 This indicator focuses on the overall tone of the room throughout the observation and the attitude of both children and teachers. It is expected that new children in the group may experience more distress and this was not considered in scoring. However, it was observed that several other children engaged in on-going negative interactions and many children were frequently in conflict. Two children with quieter temperaments were observed becoming upset (list actions that demonstrated upset) during the repeated negative interactions. It was also noted that several children became distressed during the long waits for hand washing, lunch and nap. The overall tone of the room throughout the observation was tense. 28. Discipline 3.2 Although the teacher often stopped negative interactions between children, the active nature of the toddlers in the group required teachers to be constantly moving throughout the room providing assistance in using materials, as well as addressing inappropriate behaviors. Many times children were observed pulling hair or hitting and pushing each other without the knowledge of teachers, because they were already engaged in assisting other children in expressing themselves in appropriate ways. Since there were few appropriate toys for toddlers, there was a lot of competition among the children which exacerbated these behaviors. At the minimal level, the expectation is for the teacher to stop negative peer interactions at least 75% of the time. 3.3 It was observed that children were expected to wait for very lengthy periods with nothing to do and to exercise self-control when they were hungry and tired. As there were a limited number of toys accessible to children, this led to children needing to share or wait for their turn. It was observed that children often fought over toys that they wished to use. When these incidents occurred, it was observed that children were then expected to surrender their toy to the other child whether or not they were finished using it. At the minimal level, children’s developmental levels and abilities are considered when structuring daily schedules and developing discipline policies. Please refer to the All About the ITERSR book for more information. 5.1 For groups of young children, appropriate interactions can be promoted and much conflict avoided when the program is set up to minimize problems. It was observed that duplicates of favored toys were not available and children competed for preferred items. When children were divided into groups for activities, it was observed that the children in the dramatic play area had access to only a limited number of materials because one shelf was turned away from the play space. This led to increased competition for toys and materials. Additionally, children were kept waiting for long periods before going outside and before lunch. Although teachers sang and interacted with the waiting children, the lengthy waits caused observable distress to many in the group. Please refer to the All About the ITERS-R book for more information. 5.1 It was observed that accessible materials were limited and children were observed competing for preferred items. Teachers were frequently focused on completing routines, and did not respond to negative peer interactions. At higher levels of quality, the expectations include teacher support to solve problems when they occur. Revised 03.2010 5.1 It was observed that children were crowded and competed for favored toys and activities. Additionally, their activities were often interrupted by traffic flow and the active play of others in the group. During transitions and routines, children were unsupervised while both teachers prepared materials, cleanedup, or assisted with hand washing or toileting. During these times, it was observed that teachers did not see or were unable to respond to conflict and negative interactions. High quality programming supports teachers in helping children learn appropriate problem solving skills. Please refer to the All About the ITERS-R book for more information on discipline for infants and toddlers. 5.2 It was observed on several occasions that when children engaged in an activity that was considered unacceptable, they were told they made the teacher feel sad or angry. This may convey the notion that their actions should please the adults in the classroom, which may discourage the development of selfdiscipline in children. Please refer to the All About the ITERS-R book for more information on positive methods of discipline. 5.2 It was observed that positive methods of discipline were used consistently. However, while children were frequently redirected, this was often not followed by a change in behavior and no further attempts were made to gain cooperation. Instances observed included both redirection of negative social behavior and attempts to have the children cooperate in clean up. At higher levels of quality, the expectation is for teachers to be reflective of the results of their methods of discipline and to alter them, using different approaches when current methods are not helping children learn to monitor and manage their own behavior. 5.2 It was observed that the children who engaged in risky and unacceptable behaviors were abruptly physically removed from the group. On several occasions, this resulted in an escalation of inappropriate behavior and did not produce the desired outcomes of effective discipline strategies. At this level of quality, the expectation is for teachers to reflect on the current methods being used and alter these methods when efforts are not helping children gain the skills necessary for self monitoring of their own behavior. 5.3 It was observed that the majority of attention children received was disciplinary in nature. Attention was not given when children were engaging in positive social behaviors that indicate the development of skills and attitudes necessary for self regulation. When children experience attention from and interactions with teachers when they are behaving appropriately, they are less likely to choose inappropriate behavior as a means to gain attention. 5.3 Although a limited number of warm positive interactions were observed between the teachers and some of the children, it was noted that the majority of teacher-child interactions were in an attempt to manage behavior. Teachers consistently supervised, but rarely participated in, the children's play. High quality discipline practices include teachers engaging children when they are behaving, which reinforces its appropriateness. PROGRAM STRUCTURE 29. Schedule 3.2 Although some play activities were observed, at this level of quality children are actively engaged much of the day. It was observed that children spent most of the morning in routines, waiting during transitions, or in passive, teacher- led group activities. 5.1 The teacher reported that they will try to engage a tired child in active play in order to keep him or her awake until the scheduled naptime. At this level of quality, the schedule is flexible enough to accommodate children's individual needs. Please refer to the All About the ITERS-R book for more information. Revised 03.2010 5.1 It was observed that children were awakened from a morning nap because the group was scheduled for outdoor play time. Although the older children in the group became engaged in play outdoors, the youngest child was obviously distressed and was given a bottle and put down to continue napping in an infant seat outdoors. At this quality level, each child’s needs are considered and the schedule is flexible enough to accommodate these individual daily differences in routine care patterns. Please refer to the Notes for Clarification and the All About the ITERS-R book for more information. 5.4 A long period of waiting is considered any time 3 minutes or longer that children must wait without something to do when transitioning between activities. It was observed that children waited for a long period of time when preparing to go outside. The expectation at this level of quality is that teachers structure transition periods in order to minimize children’s wait times. 5.4 It was observed that children had long periods of waiting at the table before meals were served to them as well as after they were finished eating while waiting to be taken out of their chairs for hand washing. At higher quality levels, the expectation is for teachers to structure transitions between daily events to minimize the length of time that children must wait without something to do. 5.4 Children were kept waiting for long periods before going outside. Although most children waited no more than 3 minutes, the first children with their coats on waited over 5 minutes before the group moved to the outdoor play space. Children also experienced a long wait prior to sitting down for lunch, and several children were hungry and visibly distressed. At this level of quality, the expectation is for transitions to be structured in such a way that wait time is reduced and children have a positive activity to engage in when waiting must occur. 5.4 It was observed that children were frequently expected to wash their hands multiple times – often in situations not supported by high quality healthful practices. These extra times lead to children experiencing increased time in line waiting for their turn. Children had no activity to engage in during these waits. At higher quality levels, transitions are structured to ensure that children are actively engaged for the majority of their day, with little time spent waiting. 5.4 Although there were 3 teachers in the room with 8 infants, several instances of children located in cribs, bouncy seats, or on the floor showing signs of distress through crying were observed. During these instances, the teachers were engaged in routine care tasks with other children, such as feeding or diapering. Although they were observed to verbally acknowledge the children's needs (e.g. needing to eat or sleep), it was not possible for them to address these needs until the task at hand was completed. At this level of quality, the expectation is that the daily scheduling for the children in the group supports the teachers in being able to attend to each infant’s needs without long periods of waiting. Please refer to the All About the ITERS-R book for further information. 30. Free play 5.1 It was observed that much of the day was used for whole group gatherings where children were expected to do the activities that everyone else was doing. Free play allows children to choose both their play companions and their type of play. Opportunities for this type of play were not observed. Please refer to the All About ITERS-R book for more information. 5.2 Facilitating children's play includes helping them learn to use and care for materials, stopping negative interactions, and setting up activities so that children have positive play experiences. It was observed that the teachers managed almost all clean-up of materials and many negative interactions were not stopped. Additionally, materials were set-up in spaces that created crowding and competition. Uncooked pasta was put out for the children in the sensory table without any guidance on appropriate use and the children were observed attempting to eat it, throwing it, and carrying it throughout the room. Please refer to the All About ITERS-R book for more information about expectations at this level of quality. Revised 03.2010 31. Group play activities 3.1 It was observed that children were required to participate in circle time, which included flash cards and a group story. Children who left the circle to sit in the reading area were told to return to the group and the books that these children brought back to circle were taken away from them. In addition, children were required to listen to a book on tape before nap. As there was no paper book provided to accompany the tape, the children quickly lost interest in listening but were told to return to the group. Please refer to the All About the ITERS-R book for more information about the expectations at this quality level. 3.2 It was observed that children were expected to remain in group time for a review using flash cards and to listen to a book on tape, which was not accompanied by any visuals. In both instances children quickly lost interest. At this level of quality, the expectation is for group activities to be planned to address the developmental level of the children. Please refer to the All About the ITERS-R book for more information about appropriate activities for this age group. 5.3 During circle time, it was observed that children who were not actively participating in the group activities were becoming distracted and attempted to play with other materials in the classroom. While children were sometimes allowed to move away from the group to other activities, this behavior was frequently discouraged by the teachers. At higher quality levels ,the expectation is that alternative activities are accessible during all group times, for those children who lose interest. PARENTS AND STAFF 34. Provisions for personal needs of staff 1.2 The teacher reported that because she does not work more than 8hours a day, she does not receive a scheduled break away from the children. Scheduled breaks support teachers in addressing personal needs as well as serving as a way for them to regroup, de-stress, and return to the classroom with renewed energy. 3.4 The teacher works a full day and reported that there are no scheduled breaks; however, teachers may take a break to attend to their personal needs when needed. Scheduled breaks support teachers in addressing personal needs as well as serving as a way for them to regroup, de-stress, and return to the classroom with renewed energy. 5.2 It was reported that teachers have individual lockers in the hall way; however, this cannot be considered convenient as it would require them to leave the classroom to access their personal belongings. High quality provisions support teachers storing their belongings in the classroom. 5.3 The teacher reported that she receives an hour midday break. The expectations at this quality level include that a morning, afternoon, and midday break are provided to the teacher daily. 5.3 The teacher, who works full-time, reported that she receives a break from 12:30-1:00 daily. At this level, teachers receive at least 3 breaks per day, supporting their ability to attend to personal needs throughout the day. 5.5 The round door knob that was observed on the adult bathroom door makes access challenging for individuals with limited use of their hands. At this quality level, provisions for ease of access are in place even when current staff members do not need these considerations. Revised 03.2010 35. Provisions for professional needs of staff 5.3 The teacher reported that the office could be used for adult group meetings when it is not already in use. It was observed that the office is very small, thus not providing enough space for more than two adults to use at one time. In addition, as children and teachers must walk through the office to use the bathroom or get to the playground, privacy cannot be assured. At higher quality levels, expectations for adult meeting space include providing privacy to support all types of conversations. 5.3 The teacher stated that staff meetings and parent/teacher conferences are held at the children's tables. At this level of quality, the expectation is for spaces used for adult meetings allow for the use of adult size furnishings. Additionally, visual and auditory privacy of this arrangement cannot be assured and the dual use may make scheduling difficult. At higher quality levels, spaces used for private meetings with parents provide the environment needed for teachers and parents to have detailed conversations regarding their child's development and experiences while children are in attendance, without fear of being overheard. Please refer to the All About the ITERS-R book for more information on this practice. 36. Staff interaction and cooperation 5.3 It was observed that teachers were frequently both engaged in routines and children were not closely supervised in their activities and play or had a long wait for a response to their needs. At higher quality levels, teachers have previously delegated classroom management activities, ensuring that routines, activities, and children’s needs are all handled efficiently and in a timely fashion. 37. Staff Continuity 1.2 The practice of switching children into different classrooms to maintain adequate ratios and group sizes was observed. Children would arrive in a classroom with their parents and would be told to go to a different classroom if there were already too many children in the group. As a result of this, children may be shifted to new groups, sometimes on a daily basis despite being enrolled in a particular classroom. When it is not clear which adult caregiver will be responsible for a particular child from day to day, that child's unique needs and personality can be overlooked and the child will not have an opportunity to bond with a consistent adult. 3.1 The teacher reported that several different rooms are used in the late afternoon for departure. The children may be moved to any of these rooms based on staffing and ratios. This practice does not allow for continuity and support for children establishing a stable relationship with a familiar adult. 3.3 This indicator requires that a stable transition preparation takes place before children move to a new group. Although the teacher reported that some children get a chance to go into the next age group's classroom, this was an accommodation made by the center due to overcrowding and in order to maintain ratio, and not to prepare the children for permanent transition to the new group. As a result of this, children experience abrupt transitions as they are changed to new groups frequently, despite being enrolled in a particular classroom. When it is not clear which adult caregiver will be responsible for a particular child from day to day, that child's unique needs and personality can be overlooked and the child will not have an opportunity to bond with a consistent adult. Please refer to the All About the ITERS-R book for more information. 5.3 The teacher reported that when children are ready to transition into an older classroom, the general practice is the parents or the teacher drop the child off with the new teacher in the new classroom. She indicated that due to enrollment patterns, children rarely get the opportunity to visit the new classroom prior to joining the new group permanently. High quality transition practices include three components: gradual introduction to the new group, time for the child to adjust prior to the completion of the Revised 03.2010 transition, and presence of a familiar adult during the transition process. Please refer to the All About the ITERS-R book for more information on transitioning practices for infants and toddlers. 38. Supervision and Evaluation of Staff 5.1 The teacher reported that her supervisor is in and out of the room on a daily basis, attending to administrative and custodial activities. During these times, she observes the teacher’s performance. The emphasis of this indicator is that the supervisor devotes her time exclusively to the observation using previously established written evaluation criteria. Please refer to the PA Position Statements for more information. General Comments These comments are provided as examples of the type of general information that is on occasion included in a summary report. Examples should be reviewed to determine their alignment with what was observed at the site or the quality practice that being referenced, and adjusted as needed. Safety: There were a few items labeled "Keep Out of the Reach of Children" which were not kept in locked storage. Typically this situation results in a low score due to the PA Position Statements requirement that such items are kept in locked containers/areas. However, due to the young age of these children (all non-mobile infants) and the areas where the items were stored (on shelving located high on the wall by the door), this safety hazard was addressed at 5.1, not 1.1 or 3.1. It was observed that a walker was used with the children. Walkers are no longer recommended for use with young children due to hazards associated with their use. STAR 4 Accredited sites general note: Keystone STARS Environment Rating Scales observations include consideration of the PA Position Statements which are scoring decisions made for the Keystone STARS Program. These decisions were influenced by certification regulations and they are based on the concept of continuous quality improvement. These statements can be found on the Pennsylvania Key's website at http://www.pakeys.org – Quick Links: ERS. This report also references the "All About the ITERS-R" book which was written by the authors of the ITERS-R scale and adds valuable information that is helpful for understanding the scoring of the indicators. This book is available free of charge to any center that attends the Keystone STARS ITERS-R session and submits a request using the self-addressed postcard distributed during the ITERS-R session. STAR 4 accredited sites are not required to attend these courses, but it is helpful to do so in order to understand the expectations. Hand washing notes: It was observed that several children were asked to rewash their hands after touching the lid of the trash can. Children were observed losing their balance and grabbing the lid while trying to properly use the peddleoperated hands-free can. Hand washing generally needs to occur 75% of the time and there is room for lapses to occur, as long as it is evident that healthy practices are a part of the classroom routine and have been taught to the children. In groups with young children enrolled, the teacher’s support and assistance during hand washing is beneficial and may make rewashing unnecessary, especially if the trash can lid is kept clean. The children in this classroom and others observed were instructed to wash hands many times throughout the observation. For example, they washed their hands each time they entered the classroom, even if they had just washed hands following toileting in the bathroom. While cleanliness and sanitary practices are very important in the care of young children, washing hands when it is not necessary does not add to the benefits of healthful practices and may take away time from learning opportunities. Additionally, it can discourage some children from wanting to participate in appropriate ongoing hand washing. Please review the Personal Care Revised 03.2010 Routines section of the Environment Rating Scales for when hand washing and other sanitary practices are required. Being strategic about ways to alter routines in order to reduce the number of times children wash their hands would be recommended. Changing pull-ups/diapers when potty training and no problems are observed: Children's diapers and pull-ups were changed while the child was lying on the bathroom floor. It should be noted that the surface upon which diaper changes take place should be able to be sanitized following diaper changes. Please see the “Diapering - Changing Soiled Underwear for Toddlers” guidelines at www.ecelshealthychildcarepa.org for more information to consider when developing sanitary practices for changing pullups and soiled underwear. OR Although no problems were observed, children's diapers and pull -ups were changed while children stood in the restroom. Best practices recommend that diaper/pull up/soiled underwear is changed on a surface that may be sanitized should any contamination occur. Please see the “Diapering - Changing Soiled Underwear for Toddlers” guidelines at www.ecels-healthychildcarepa.org for more information to consider when developing sanitary practices for changing pull-ups and soiled underwear General comment for rooms where a one child is over the age of 12 months: There are certain items and indicators that pertain specifically to toddlers. Since all of the children in the room were under 12 months of age, with the exception of a child who was 13 months, a score of NA was given for those items or indicators. The expectation is that the developmental needs of all enrolled children are met. If children remain in the classroom for any time past their first birthday, consideration should be made to give them opportunities that are developmentally appropriate for their changing needs. General comment on accessibility for non-mobile infants: In the Books and Activities items, the expectations for the number and types of materials apply to all age groups present, unless otherwise noted. All of the expectations for the amount or variety of books (15), dramatic play materials (20) and materials representing diversity (24) were not necessarily accessible to the infant. However, since only one 4 month old infant was enrolled, and there were at least some examples from all of the required materials accessible to him, did not negatively impact the scoring for those items. General comment on use of food for art activities: The teacher reported that food is often used as an art material. Although not considered in scoring, the use of food for art activities is discouraged. It sends mixed messages to children about food and can be a health concern for young children who tend to put materials in their mouth. General comment for fencing: There is an expectation that a fence will totally enclose the outdoor play area. It was observed that flexible construction-type fence was used. Although this type of fence can deter children from leaving the area or the entrance of unwanted visitors or animals, it does not provide the protection that sturdy, permanent fencing would provide. General comment for extensive snow: The playground was not assessed for safety due to the heavy snow conditions. It should be noted that the expectation for use of outdoor play spaces includes the timely removal of snow and ice. However, the unusually heavy snow coverage was taken into consideration when scoring. The posted schedule and teacher report supported that the expectations for outdoor play are usually met; therefore applicable items were scored accordingly. Revised 03.2010