# CDC Childcare Health and Safety Guidelines

## Infection Control and Prevention

### Handwashing Requirements
- **Frequency**: Before and after each diaper change, before food preparation, after using restroom
- **Duration**: Minimum 20 seconds with soap and warm water
- **Hand sanitizer**: Acceptable when soap/water unavailable, must be 60%+ alcohol-based
- **Child supervision**: Adults must supervise all handwashing for children under 6

### Diaper Changing Procedures
1. **Preparation**: Gather supplies, wash hands, put on disposable gloves
2. **Cleaning**: Remove soiled diaper, clean child thoroughly from front to back
3. **Disposal**: Place soiled diaper in sealed container, dispose of gloves
4. **Sanitization**: Clean and disinfect changing surface with bleach solution
5. **Final step**: Both adult and child wash hands thoroughly

### Illness Management
- **Exclusion criteria**: 
  - Fever of 101°F or higher
  - Vomiting (2+ episodes in 24 hours)
  - Diarrhea (3+ loose stools)
  - Persistent cough with fever
  - Unusual behavior suggesting illness

## Environmental Safety

### Indoor Air Quality
- **Ventilation**: Minimum 15 cubic feet per minute of outdoor air per person
- **Humidity levels**: Maintain 30-50% relative humidity
- **Temperature**: Keep between 68-75°F
- **Chemical storage**: All cleaning supplies locked away from children
- **Lead testing**: Annual testing in buildings built before 1978

### Playground Safety Standards
- **Surface materials**: Impact-absorbing surfaces required under equipment
  - Sand, wood chips, or rubber mats minimum 12 inches deep
  - Proper drainage to prevent standing water
- **Equipment inspection**: Daily visual checks, monthly detailed inspections
- **Age-appropriate zones**: Separate areas for different age groups
- **Fall zones**: Clear space extending 6 feet around all equipment

### Water Safety Requirements
- **Pool safety**: 4-foot minimum fence height with self-latching gates
- **Supervision ratios**: 1 adult per 6 children for water activities
- **Safety equipment**: Life preservers and reaching poles readily available
- **Water testing**: Daily chemical balance testing for pools

## Emergency Preparedness

### Emergency Action Plans
Required plans for:
- Fire evacuation (monthly drills required)
- Severe weather response
- Medical emergencies
- Lost child procedures
- Intruder/lockdown situations

### First Aid Requirements
- **Certified staff**: At least one CPR/First Aid certified staff member present always
- **First aid supplies**: Fully stocked kit accessible in each classroom
- **Emergency contacts**: Current emergency contacts for all children
- **Medical information**: Allergies, medications, special needs documented

### Transportation Safety
- **Vehicle requirements**: Commercial insurance, annual safety inspections
- **Child restraints**: Age-appropriate car seats/restraints for all children
- **Driver qualifications**: Commercial driver's license, background check, annual training
- **Supervision**: Adult supervisor in addition to driver for groups of 7+ children

## Nutrition and Food Safety

### Food Handling Standards
- **Staff certification**: Food handler's permit required for kitchen staff
- **Temperature control**: Hot foods kept at 140°F+, cold foods at 40°F or below
- **Storage requirements**: Proper refrigeration, labeled containers with dates
- **Cleaning schedule**: Daily sanitization of all food preparation surfaces

### Allergy Management
- **Documentation**: Written action plans for children with food allergies
- **Staff training**: All staff trained to recognize allergic reactions
- **Emergency medication**: EpiPens accessible and staff trained in administration
- **Meal modifications**: Safe alternatives provided for allergic children