Start a Daycare in Iowa – Licensing – Regulations – Laws

In the State of Iowa, there are more than 75,000 children are cared for in more than 1,500 licensed childcare center, preschools, and before- and after-school programs across the state. As a potential center facility provider of care to those children, you play a pivotal role in the development, nurturing, health, safety and support of these children.

Here is a startup qualifications guide to serve your needs regarding information and vital research in starting a daycare in Iowa. These are detailed information about the regulations and basic standards of Iowa Department of Human Services about child care centers and preschools licensing standards and procedures.

Licensing and Procedures

The Licensing Divisions
1. Iowa Department of Human Services – implement and develop the rules setting with the minimum standards for the licensing of child care. It requires centers to comply with state health and safety laws.
2. Iowa Department of Public Health – responsible for the immunization requirements for child care center.
3. State Fire Marshal – reinforce and establish the fire safety requirements for child care center.
Consultation and Assistance

The Department or Bureau offers a free consultation and assistance in acquiring a license and meeting the requirements through the child care consultants located throughout the state. Besides in helping as a resource to the center, the consultant monitors compliance with the regulations through relicensing, annual unannounced visits, evaluation of complaints and a review of the findings of allegations of child abuse in the center.

A license is required to establish or operate a child care center. The center must a have a new license certificate when it expands or remodels to change licensed capacity. For expansion and remodeling the center, you must contact your licensing consultant for a list of items that you must submit for approval.

Child Care Center Operated Programs – must comply the licensing requirements of the Department of Human Services or meet the standards for child care programs adopted by the State Board of Education.

Penalty for Operating without a License – a center that operates without a license is guilty of a serious misdemeanor. For a serious misdemeanor is punishable with a fine of at least $250 but not over $1500 and may also order imprisonment not to exceed one year.

Injunction

When a licensee or a person establishes, conducts, manages or operates a child care center without a license may be restrained by temporary or permanent injunction. Likewise, a licensee or a person who has been convicted of a crime against a person with a record of founded child abuse may be restrained by temporary or permanent injunction from providing child care services in a licensed child care center.

a. Child Care Center Programs That Are Not Required To Be Licensed
1. An instructional or traditional program for children who are attending prekindergarten or elementary education provided by public or non-public schools.
2. A preschool or based child care operated by or contracted for by the school board of an accredited public or non-public school that meets the standards for child care programs adopted by State Board of Education.
3. A church related program.
4. Classes of less than two weeks or short term classes.
5. Child care center provided for sick children as part of the pediatrics unit in a hospital.
6. A program that operated not more than a day or tutoring programs.
7. A program provided and administered by a political subdivision of the state that is primarily for recreational and social purposes for school aged children.
8. A school program or after school program continuously offered throughout the school year calendar for children who are at least 5 years old with nominal membership fee or at no cost.
9. An activity program that meets less than four hours per day or special activity programs like music or dance classes.
10. A child care center that provides school camp and nationally accredited camp.
11. A planned program for the purpose of providing therapeutic, rehabilitative or supervisory services.
12. Care or shelter provided on-site to children of parents residing in an emergency homeless or domestic violence shelter.
13. A child care center facility that provides care to foster children.
14. An activity or program, social and recreation programs where child care is offered on-site and the parents remains at the site.
The Initial Licensure
An assigned child care consultant may review or require submitting the preliminary list of items for review before issuing a license:
1. The operator or the chairperson of the board must complete and submit the form of Application for a License to Operate a Child Care Center.
2. An approved report or fire inspection certificate signed by the State Fire Marshall or local designee.
3. Projected and descriptive floor plan of the building (or center area if co-located in a building) showing the length and width of rooms, location and dimension of windows, and ceiling height. The plan does not have to be drawn to scale and can be drawn on 8 1/2 inch paper. (The space will be inspected and measured by the child care consultant.)
4. Reports and documentation to support that the center director and on-site supervisor meet the qualifications, including certification in CPR, first aid, and mandatory reporting of child abuse.
5. A person or licensee must have a written statement of the program’s purpose and objectives.
6. Must have and submit a written description of the curriculum or program structure and an activity plan that is appropriate to the developmental and special needs of the children served.
7. Prepare a financial agreement and fee policies to be given to parents.
8. Here are the written policies as required by licensing standards for:
  1. Policy list for enrollment and discharge of children (include polices for excluding children)
  2. Schedule and itinerary for field trips and non-center activities
  3. Childcare Security Plan and Transportation Policy
  4. Discipline and standards
  5. Nutrition and Food
  6. Emergency plans for urgent situation
9. A program or written plan for staff orientation to the center’s policies and applicable licensing standards and ongoing training and development of staff.
10. An itinerary and written plan for the ongoing training and development of staff.
11. List of written requirements and procedures for mandatory reporting of suspected child abuse and neglect.
12. Submit the samples of all forms to be used by the center, including parent authorization forms.
13. Create and plan menus for a two-week period.
As a regulation in opening a daycare in Iowa, the Department will conduct an on-site visit of the center and review of additional materials, including staff’s and children’s files, before a license is issued. The potential child care centers should ensure that the location and facility meet all local building and zoning ordinances.
The Renewal Application
The consultant or the Department sends out an application form to renew the license approximately 60 days in advance of each center’s licensed renewal date. The person or licensee submits the signed form, Application for a License to Operate a Child Care Center, to the consultant. With this, it is also required to submit the other updated reports for renewal with the application or make them available to the consultant at the relicensing visit.
1. Certificate of Inspection Report released by State fire marshal.
2. Will conduct Inspection of fuel-burning appliances for carbon monoxide hazards.
3. Check for Water analysis (if on a private, non-public water source).
4. Reports and results of assessment for lead paint (if required by age of building).
5. Reports and results of radon testing (if required by location of center).
The Licensing Decision
1. Full license approval- the center complies the minimum requirements defines in states law and rules governing the standards for child care center.
2. Provisional license approval-the center does not meet all licensing rules and laws.
3. Deny a license-a person or a center does not comply with the essential licensing law and rules
4. uspend or revoke a license- to address the issue of non compliance or an imminent concern arises that jeopardize well-being of children.
5. File an appeal-a person or licensee affected by an adverse action may initiate an appeal by means of a written request directed to the county office or central office of the Department.
Offices and Functions for Child Care Center Inspection
1. The Department of Human Services – a child care consultant will conduct an announced or unannounced periodic inspection of licensed centers to ensure compliance with the licensing requirements.
2. The Department of Public Health – health officials will conduct periodic audits of immunization records to ensure compliance with health related licensing requirements.
3. The State Fire Marshal – the designee will inspect to determine the compliance with rules related to fire safety.
Record Retention Policy
1. Confidential Provision
  Under the daycare law or state law, all information about the person in a child care center or the relative of the person in a child care center is confidential. Even child care consultants must have unrestricted access to children’s’ file in performing their duties. The confidentiality provision allows the disclosure information about the structure and operation of the center.
2. Center Licensing File
  The child care center record of license is maintained at the Department of Human Services for the period of time that the center remains licensed and available to public upon request. This record will be destroyed once a center is no longer licensed for the period of three years.
Measures, Administrative Case and Procedures
1. Parental Rights – parents unlimited access to their children and to the provider during the center’s hours of operation.
2. Parental Survey and Evaluation – to solicit statewide information regarding parental satisfaction with the quality of care being provided to the children.
3. Reporting Child Abuse Case – the child care center must have a written policies established that includes procedure in reporting suspected child abuse.
4. Discrimination on the Grounds of Race – the Civil Rights Act of 1964 as amended and regulations of the U.S. Department of Human Services, a center failure to comply will necessitate the withdrawal of Department financial support.
5. Discrimination against the Children with Disabilities – or Americans with Disabilities Act (ADA) that the center should provide equal opportunity to participate in the center.

Regulations

Administration Requirements
1. As a daycare requirement, the licensee should submit a written statement of purpose and objectives
2. Required to submit written plan and policies
3. Posting required for the certificate of license and health license
4. Reporting case of suspected child abuse
5. Secure a print out of handbook “Child Care Centers and Preschools Licensing Standards and Procedures
Involvement of Parents
1. In preschool child care the parent has unlimited access to their children.
2. Every parent is involved in assessment and survey.
Personnel and Requirements
1. Director’s Requirements – must at least 21 years of age, with high school diploma or passed a general education development test. Must completed at least one course in business administration or 12 hours in administrative training related to personnel, supervision and record keeping or has one year administrative –related experience. The center director should have a certification in infant and adult (CPR), first aid and Iowa’s training for the mandatory reporting of child abuse. Has obtained a total of 100 points on child development-related training.
2. On-Site Supervisor Requirements – the supervisor is in charge for the daily supervision of the center and must be on site daily either during the hours of operation that children are present or a minimum of eight hours of the center’s hours of operation. Information and details shall be submitted in writing to the child care consultant before the start of employment. The daycare or childcare supervisor and must be:
  1. Adult
  2. With high school diploma or passed a general education development test
  3. Certified in infant and adult CPR, first aid, Iowa’s Mandatory reporting of child abuse
  4. Obtained a total of 75 points through a combination of education, experience and child development-related training.
  The facility provider that assigned an on-site supervisor is required to:
  1. The daily function or operation of the center and supervision of direct care-staff.
  2. Make sure that the children are accounted for and proper record keeping is maintained.
  3. Schedule and make plan for activities and transportation needs
  4. Information awareness regarding exposure to communicable disease
  5. Make sure that parents immediately notified of emergency or other serious incidents.
  6. Ensure to communicate with parents at the end of the day.
3. Combined Functions of Director and On – Site Supervisor-in a child care center where the functions of the center director and on-site supervisor are accomplished by the same person, the educational and experience requirements for a center director shall apply.
4. Volunteers and Substitutes – the child care provider should check the record especially with a direct responsibility for child care or with access to a child when the child is alone and for anyone living in the child care facility who is 14 years of age or older.
5. Mandatory Evaluation and Record Checks – it is mandatory to conduct criminal and child abuse record checks in Iowa for each owner, director, staff member or subcontracted staff person with direct responsibility for child care and evaluation shall be conducted.
Plans, Guidelines and Trainings For Qualified Staff
1. Required Training with the First Six Months of Employment – the staff should have at least two hours of Iowa’s training for mandatory reporting of child abuse and at least one hour training regarding universal precautions and infectious disease control.
2. A Staff Employed 20 Hours or More Per Week
  Training for safe and quality programming for children:
  - An hour of universal precautions and training for mandatory reporting of child abuse (within first six months)
  - Certification for infant, child and adult CPR
  - Certification for infant, child and adult first aid
  - Ten hours training that includes: Child Development, Guidance and Discipline, Developmentally appropriate practices, Nutrition, Health and Safety, Communication Skills, Professionalism, business practices and Cross Cultural Competence
3. A Staff Employed Less Than 20 Hours Per Week.
  Training requirements for part-time staff, a member or staff person working less than 20 hours per week can be left alone in the center for opening or closing only if they are certified in CPR and first-aid.
  - An hour of universal precautions and training for mandatory reporting of child abuse (within first six months)
  - 5 hours of training from: Child Development, Guidance and Discipline, Developmentally appropriate practices, Nutrition, Health and Safety, Communication Skills, Professionalism, business practices and Cross Cultural Competence
  - Training expected for mandatory reporting and universal precautions does not count toward the 5 contact hours.
  - The staff member must receive at least 2 hours of the 5 contact hours in a sponsored group setting and 3 hours may be received in Department-approved self-study.
  - The staff member who completed a comprehensive training package of at least 10 contact hours offered through a child care resource and referral agency or community college within 6 months before initial employment are waived from first year’s 5 contact hours of training.
4. A Staff Employed in Summer-Only Programs
  Training requirements for summer staff:
  - An hour of universal precautions and training for mandatory reporting of child abuse
  - With one staff on duty in the center and outdoor play area when children are present and on field trips certified in American Red Cross or American Heart Association infant, child, and adult cardiopulmonary resuscitation (CPR)
  - At least with one staff member on duty in the center and outdoor play area when children are present and on field trips certified in infant, child, and adult first aid that uses a nationally recognized curriculum or is received from a nationally recognized training organization.
5. Training and Educational Plans
  The staff development and in-services provide an opportunity to motivate staff and advance their professional skills. Also to provide up-to-date information on child development, learning strategies, developmentally appropriate practices, and health and safety practices.
Staff Ratio Requirements
1. Staff Requirements – at least 16 years of age, be involved with children in programming activities and certified in CPR and first-aid trainings.
2. Staff Ratio
  AGE:
  
  Children two weeks to two years  -  one staff to every four children
  Children two years               -  one staff to every six children
  Children three years             -  one staff to every eight children
  Children four years              -  one staff to every twelve children
  Children five to ten years       -  one staff to very fifteen children
  Children ten years and over      -  one staff to every twenty children
Records
1. Personnel Records – The child care center shall maintain personnel information sufficient to ensure that persons employed in the center meet minimum staff and training requirements and do not pose any threat to the health, safety, or well-being of the children.
2. Child’s File – the child care centers shall maintain sufficient information in a file for each child, which shall be updated at least annually or when the parent notifies the center of a change or the center becomes aware of a change.
  - Contact and Authorization Information- for unforeseen emergencies that may arise with either the parents or child, it is important that you have sufficient information to contact a responsible adult if the parent cannot be reached or is incapacitated.
  - Child’s Physical Examination- the staff member need immediate access to information on past health history; status of present health, including allergies, medications, and acute or chronic conditions; and recommendations for continued care
  - Children in Foster Care- the Department or bureau, in its capacity as custodian, may sign for routine authorizations, such as enrollment forms, authorizations for field trips or non-center-sponsored activities, permission to seek emergency medical or dental care, authorizing people who may remove the child from the center.
  - Medical and Dental Services- get specific information from the parents regarding where emergency medical and dental services should be obtained. Especially for some children with chronic or special care needs, this information may include medical specialists who need to be contacted for emergencies.
3. Immunization Certificates – this must be signed and dated provided by the state Department of Public Health, shall be on file for each child enrolled as prescribed by the Department of Public Health.
4. Daily Activities – a child under two years of age, the center shall make a daily written record. After the day, the daily written record shall be provided verbally or in writing to the parent or the person who removes the child from the center.

Requirements For Health Concern and Safety Policy
Physical Examination Report
- Preschool-Aged Children- a child five years of age and younger not enrolled in kindergarten, the center shall require an admission physical examination report signed by licensed medical doctor or nurse practitioner
- School-Aged Children-a child five years of age and older and enrolled in school, the center shall require before admission, a statement of health status signed by a parent or legal guardian that certifies that the child is free of communicable disease and that specifies any allergies, medications, and acute and chronic conditions.
Medical and Dental Needs

The child care center shall have sufficient information and authorization to meet the medical and dental emergencies of children. The center itself should have written procedures for medical and dental emergencies and shall ensure, through orientation and training, that all staff are knowledgeable of and able to implement the procedures.

Medications

The child care center should have written procedures for the dispensing, storage, authorization, and recording of all prescription and nonprescription medications.

Daily Contact

A child should have direct contact with a staff person upon arrival for early detection of apparent illness, communicable disease, or unusual condition or behavior that may adversely affect the child or the group.

Infectious Disease Control

The child care centers should establish policies and procedures related to infectious disease control and the use of universal precautions with the handling of any bodily excrement or discharge, including blood and breast milk.

Quite Area for Ill or Injured

The child care center should provide a quiet area under supervision for a child who appears to be ill or injured. With this, the parents or a designated person shall be notified of the child’s status in the event of a serious illness or emergency.

Staff-Hand Washing

The child care center shall ensure that the staff member demonstrates clean personal hygiene sufficient to prevent or minimize the transmission of illness or disease.

Children’s Hand Washing

The child care center should ensure that staff assists children in personal hygiene sufficient to prevent or minimize the transmission of illness or disease.

First-Aid Kit

The child care center shall ensure that a clearly labeled first-aid kit is available and easily accessible to staff at all times whenever children are in the center, in the outdoor play area, and on field trips. The first-aid kit should be sufficient to address first aid related to minor injury or trauma and shall be stored in an area inaccessible to children.

Recording Incidents

With an incident involving a child that includes minor injuries, minor changes in health status, or behavioral concerns, shall be reported to the parent on the day of the incident.

Smoking

The use of tobacco products shall be prohibited at all times in the child care center and every vehicle used to transport the children or in the outdoor play area during hours of operation.

Transportation

The Department requires that all children transported in a motor vehicle subject to registration, except a school bus, must be individually secured by a safety belt, safety seat, or harness, in accordance with federal motor vehicle safety standards and the manufacturer’s instructions.

Field Trip Emergency Numbers

The staff member should get all the emergency telephone numbers for each child, when transporting children to and from school and on field trips and non-center-sponsored activities away from the premises.

Pets

All the animals cared on site shall be in good health with no evidence of disease, be of such disposition as to not pose a safety threat to children, and be maintained in a clean and sanitary manner. It is required to have a documentation of current vaccinations should be available for all cats and dogs.

Emergency Plans

At Iowa, some communities are frequently vulnerable to structural or natural disasters such as fire, tornadoes, floods and flash flooding. The child care centers are also increasingly responding to “social” emergencies such as intruders into a center, intoxicated parents, lost or abducted children. For that reason, it is important to have written procedures that are updated annually and to give all staff an annual orientation to the procedures.
Facilities, Services and Center Needs
1. Room Size – The child care center room size shall be a minimum of 80 square feet of useable floor space or sufficient floor space to provide 35 square feet of useable floor space per child. In each room where floor space occupied by cribs is counted as useable floor space, there shall be 40 square feet of floor space per child. The kitchens, bathrooms, halls, lobby areas, storage areas and other areas of the center not designed as activity space for children shall not be used as regular program space or counted as useable floor space.
2. Infants’ Area – free from the intrusion of children two years of age and older
3. Facility Requirements – the child care facility and premises are sanitary, safe and hazard-free
4. Bathroom Facilities – should have one functioning toilet and one sink for each 15 children shall be provided in a room with natural or artificial ventilation. It should have a training seat or chairs may be used for children under two years of age.
5. Telephone – there should have a working nonpaid telephone available in the center with emergency telephone numbers for police or 911, fire, ambulance, and poison information center posted adjacent to the telephone.
Get -Well Center
1. Staff Requirements – The child care center should have a medical advisor for the center’s health policy. The medical counselor should be a medical doctor or a doctor of osteopathy currently in pediatrics or family practice. It is required that a child care center should have a licensed LPN or RN on duty at all times that children are present.
2. Health Policies – the provider should have emergency contact information from the parent, including the name and phone number of the child’s primary physician as well as telephone numbers where the parent can be reached throughout the day. Parents should submit also complete authorization for medication and permission to seek emergency care.
3. Exception – a child who is ill may requires more personalized or intensive care and staff need to be able to respond to emergency and evacuation situations.
Food and Nutrition
1. Snacks and Meals – the child care center should serve each child a full, nutritionally balanced meal or snack as defined by the USDA Child and Adult Care Food Program (CACFP) guidelines and shall ensure that staff provides supervision at the table during snacks and meals.
2. Menu Planning – the child care center should follow the minimum CACFP menu patterns for meals and snacks and serving sizes for children aged infant to 13 years. Menus should always be planned at least one week in advance, made available to parents, and kept on file at the center.
3. Feeding of Children under Two Years of Age – the staff should attend to the demands of infants for feeding and food.
4. Food Brought from Home – there is a provision that centers cannot restrict school-aged children from bringing snacks or lunch brought from home for their own consumption. When a child or if school-aged children bring their meals to the center, you need to ensure that adequate refrigerator or cooler space exists to keep food from spoiling. The food or items should be marked with each child’s name and dated.
5. Food Preparation, Storage and Sanitation – enough refrigeration for perishable food to prevent spoilage or the growth of bacteria. Observe safe methods and sanitary in food preparation, serving and dish washing technique to prevent the transmission of disease.
6. Water Supply – the child care center should ensure that suitable water and sanitary drinking facilities are available and accessible to children.

Child Care Provider’s Directory of Resources

Contacts
1. Child Care Consultants – In each area, there are assigned child care consultants that are responsible for licensing.
2. Child Care Resource and Referral Agencies – provides training, resources, technical assistance and lending library materials for provider. They provide a newsletter to providers containing topics of interest related to early childhood and school-age care and inform providers of training opportunities in their area.
3. Other State Programs
  - Child Care Licensing:
    Child Care Licensing Program Manager
    Iowa Department of Human Services
    Division of Child and Family Services
    1305 E Walnut, 5th Floor, Hoover Bldg
    Des Moines, IA 50319-0114
    (515) 281-0390
  - Food Program:
    Child and Adult Care Food Program
    Bureau of Food and Nutrition
    Iowa Department of Education
    400 E 14th St
    Des Moines, IA 50319
    (515) 281-5356
  - Immunizations:
    Bureau of Immunization
    Iowa Department of Public Health
    321 E 12th St
    Des Moines, IA 50319
    (515) 281-7301
    Vaccine for Children Hotline: 1-800-831-6293
    Immunization Certificate: 1-800-398-9696
  - State Fire Marshal:
    Iowa Department of Public Safety
    Division of State Fire Marshal
    401 SW 7th St., Suite N
    Des Moines, IA 50309
    (515) 281-5821
  - Healthy Child Care Iowa:
    State Health Consultant
    Healthy Child Care Iowa
    Bureau of Maternal and Child Health
    Iowa Department of Public Health
    321 E 12th St
    Des Moines, IA 50319
    (515) 281-6071
    1-800-383-3826
  - School-Operated Programs:
    Iowa Department of Education
    Bureau of Children, Family, and
    Community Services
    400 E 14th St
    Des Moines, IA 50319
    (515) 281-7844
IOWA Resources
You can acquire supplementary copy on these materials from your child care consultant.
1. Healthy Child Care IOWA
  - A statewide program to increase the health and safety practices within childcare. The Child care consultants are located in the child care resource and referral agencies and can give information and resources on health-related matters.
2. Iowa State University Extension Service
  -Supply and provide publications, workshops, and self study training materials on early childhood and child care. Discussion and resources cover a wide variety of topics, including financial considerations of operating a child care center, child care environmental design, playground safety, nutrition, child development, health and safety, and positive guidance and discipline. This service also works with communities and employers to explore child care options and conduct needs assessments. Quality videos and publications are also available for parents.
3. Area Education Agencies
  -An educational area designed to provide on-site technical assistance and training on a variety of issues, including technical assistance and training for children with developmental disabilities, behavioral issues, and developmentally appropriate practices.
4. Child Care Assistance (Subsidy)
  -A financial assistance program for child care is available to families who meet income guidelines and requirements for participation in education or employment. Child care centers can refer families who might benefit from assistance to the county Department of Human Services office.
5. Child Support
  -An assistance given to some families might have difficulty in meeting the cost of child care when a noncustodial parent fails to make child support payments. Child care centers can refer families who might be in need of assistance in establishing or enforcing child support to the Child Support Recovery Unit that serves the county where the custodial parent resides.
6. Iowa Statewide Poison Control Center
  Iowa’s poison control center is located at 1920 Hamilton Blvd., Lower A, Sioux City, Iowa 51104.
7. Healthy and Well Kids In Iowa (hawk-i)
  -A program that covers health care coverage for families who do not qualify for Medicaid but cannot afford private health care coverage. The assistance for health care coverage is for children birth to age 19 and covers, among other services, doctor and dentist visits, hospital stays, well child visits, and eye exams. To avail or to get more information regarding the program, call the 24-hour number: 1-800-257-8563 or visit the web site at www.hawk-i.org.
8. Child Health Centers
  -There are 25 community-based child health centers that provide a variety of health services to children age’s birth through 21 years. Services offered consist of access to a medical home, physical examination, select health screening laboratory procedures, immunization, and care coordination. You can get the location of the nearest child health center by calling the Healthy Families Line at 1-800-369 2229.
9. Child health Specialty Clinics
  -Health clinics and services are provided by the University of Iowa Child Health Specialty Clinics. The specialty clinics assists the regional health services coordinators, nutritionists, parent consultants, and other professional staff with the provision of on-site technical assistance or training for a variety of issues specific to children with special health care needs. You can contact and access telephone consultation and printed resources through the regional center nearest you or by contacting the Child Health Specialty Clinics central office at (319) 384-6865.
10. Maternal Health Center
  -There are 26 maternal health centers that provide prenatal medical and health related services to women. You can find the location of the nearest maternal health center by calling the Healthy Families Line at 1-800-369-2229.
11. Family Planning Clinics
  -The child care center staff may be able to obtain their required physical examination at a family planning clinic at a reduced cost. You can find the location of the nearest family planning clinic by calling the Healthy Families Line at 1-800-369-2229.
12. Local Health Departments
  -The region health departments can provide consultation and training on health related matters.
State Childcare Reference and Resources
1. Handbook for Public Playground Safety – it can help the center in the design, construction, operation and maintenance of safe playground areas.
2. National Health and Safety Performance Standards – these state standards deal with recommendation for child/staff ratios and personnel, activities for healthy development, health protection and promotion, nutrition and food service, facilities, supplies, equipment, transportation, infectious diseases, children with special needs and administration.
3. National Resource Center for Health and Safety in Child Care – promote health and safety in out-of-home childcare settings.
4. Stepping Stones to Using “Caring for Our Children” – an abbreviated version of the 659 standards that are included in the National Health and Safety Performance Standards.

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