Caring for Our Children: Chapter 5 - Facilities, Supplies, Equipment, and Transportation Chapter 5: Facilities, Supplies, Equipment and Transportation 5.1 OVERALL SPACE AND EQUIPMENT REQUIREMENTS GENERAL LOCATION, LAYOUT, AND CONSTRUCTION OF THE FACILITY STANDARD 5.001 LOCATION OF CENTER A center shall not be located in a private residence unless that portion of the residence is used exclusively for the care of children during the hours of operation. RATIONALE: Centers in these standards are generally defined as "providing care and education for any number of children in a non- residential setting.". When there are a large number of children in care who may span the age groups of infants, toddlers, preschool and school-age children, special sanitation and design are needed to protect children from injury and prevent transmission of disease. Undivided attention must be given to these purposes during child care operations. COMMENTS: The portion of a private residence used as a child care facility is variable and unique to each specific situation. If other people will be using the private residence during the child care facility's hours of operation, then the caregiver must arrange the residence so that the activities of these people do not occur in the area designated for child care. See also STANDARD 5.009, for more information on the use and purpose of child care facilities. TYPE OF FACILITY : Center STANDARD 5.002 INSPECTION OF BUILDINGS Newly constructed, renovated, remodeled, or altered buildings shall be inspected by a public inspector to assure compliance with applicable building and fire codes before the building can be made accessible to children. RATIONALE: Building codes are designed to ensure that a new or altered building is safe for occupants. TYPE OF FACILITY: Center STANDARD 5.003 COMPLIANCE WITH FIRE PREVENTION CODE Every 12 months, the child care facility shall obtain written documentation to submit to the regulatory licensing authority that the facility complies with a state-approved or nationally recognized Fire Prevention Code. If available, this documentation shall be obtained from a fire prevention official with jurisdiction where the facility is located. Where fire safety inspections or a Fire Prevention Code applicable to child care centers is not available from local authorities, the facility shall arrange for a fire safety inspection by an inspector who is recognized by the National Fire Protection Association (NFPA) and is qualified to conduct such inspections using the NFPA-101 Life Safety Code . RATIONALE: Regular fire safety checks by trained officials will ensure that a licensed child care facility continues to meet all applicable fire safety codes. TYPE OF FACILITY: Center STANDARD 5.004 ACCESSIBILITY OF FACILITY The facility shall be accessible for children who use wheel chairs and for other children and adults with motor disabilities, in accordance with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA). Accessibility includes access to buildings, toilets, sinks, drinking fountains, outdoor play areas, and all classroom and therapy areas. Special provisions shall also be made, as needed, for the child with health, vision, or hearing impairment. RATIONALE: Accessibility has been detailed in full, in Section 504 of the Rehabilitation Act of 1973. It is also a key component of the Americans with Disabilities Act barring discrimination against anyone with a disability. COMMENTS: Any facility accepting children with motor disabilities must be accessible to all children served. Small family child care home providers may be limited in their ability to serve such children, but are not precluded from doing so if there is a reasonable degree of compliance with this standard. Not all children with motor disabilities live in fully physically accessible accommodations at home. Nevertheless, access to public and most private facilities is a key to the implementation of the ADA. If toilet learning/training is a relevant activity, the facility may be required to provide adapted toilet equipment in addition to that specified in Toilets and Toilet Learning/Training Equipment, STANDARD 5.117 through STANDARD 5.125 For more information on requirements regarding accessibility, the Americans with Disabilities Act Accessibility Guidelines (ADAAG) and the U.S. Access Board's Guide to ADA Accessibility Guidelines for Play Areas . Contact information is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.005 SITE LOCATION FREE FROM HAZARDS Facilities shall be located on a well-drained site, free from hazards, in areas protected from: a) High air pollution; b) Loud or constant noises; c) Heavy traffic; d) Unsafe buildings; e) Deep excavations; f) Radiation hazards; g) Radon hazards; h) Pits, abandoned wells or other risks of entrapment or inhumation (burial); i) Any other unsafe or harmful environmental elements. RATIONALE: This requirement will reduce exposure to conditions that cause injury or adversely affect health. Epidemiological studies indicate a relationship between outdoor air pollution and adverse respiratory effects on children(1). Risk of injury and risk of disease from insects, which breed in poorly drained areas, must be controlled to have a safe facility and outdoor play areas. Among 471 childhood suffocation deaths in California between 1960 and 1981, 111 were caused by burial beneath earth, sand, or other material (56). Some occurred at construction sites where children were playing, and others occurred at beaches and other remote areas. Children also can fall into wells, pits, and other excavations and can become trapped in refrigerators and other home appliances. COMMENTS: An environmental audit should be conducted before construction of a new building or renovation of an older building (2). The environmental audit should include assessments of the following: Historical land use, seeking possibility of toxic contamination of soil; The possibility of lead and asbestos in older buildings; Potential sources of infestation, noise, air pollution, and toxic exposures; The location of the playground in relation to infested stagnant water, roadways, industrial emissions, building exhaust outlets, and any other hazards to children. For information on noise levels, see STANDARD 5.046. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.006 STRUCTURALLY SOUND FACILITY Every exterior wall, roof, and foundation shall be structurally sound, weather-tight, and water-tight and shall be finished to control mold, dust, and entry of pests into the child care space. Every interior floor, wall, and ceiling shall be structurally sound and shall be finished to control exposure of the occupants to levels of toxic fumes, dust, mold, ventilation, heating, lighting, or noise deemed hazardous by local health authorities. RATIONALE: Children must be protected from hazardous exposures. COMMENTS: Child care operations often use older buildings or buildings designed for purposes other than child care. Both the design of structures and the lack of maintenance can lead to exposure of children to mold, dust, pests, and toxic materials. "Sick building syndrome" is a term used to describe problems inside structures due to finishing that exposes occupants to hazardous conditions. Environmental health authorities have special training in identification of these potential health risks. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.007 use of BASEMENTS Finished basements may be used for children 2 years of age and older, if the space is in compliance with STANDARD 5.008 and STANDARD 5.020. Basements shall be: a) Dry and well ventilated; b) Well lighted; c) Maintained at required temperatures and humidity; d) Free of radon in excess of 4 picocuries per liter of air; e) Free of friable asbestos. RATIONALE: Basement areas can be quite habitable and should be usable as long as environmental quality and fire safety is satisfactory. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.008 buildings of wood construction In buildings of wood construction, children, including infants and toddlers, shall be housed and cared for only on the ground floor, with one exception. Older, preschool-age and school-age children shall be able to use floors other than the ground floor in a building of wood construction that has required exits and care is provided in: a) A daylight-lit basement with exits that are no more than a half flight high; b) A tri-level facility with half flights of stairs; c) A facility that is protected throughout by an automatic sprinkler system, which has its exit stairs enclosed by minimum 1-hour fire barriers with openings in those barriers protected by minimum 1-hour fire doors; d) Any door encountered along the egress route shall be easy for caregivers and older preschool-age children to open. RATIONALE: Fire and building safety experts recommend that children, including infants, be permitted above ground level only in certain types of construction. COMMENTS: Infants and toddlers should always be on the main floor with access directly to the outdoors. Doors along the egress route need to be easy to open. Consult local or state fire safety codes and child care licensing laws. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.009 UNRELATED BUSINESS IN A CHILD CARE AREA Child care areas shall not be used for any business or purpose unrelated to child care when children are present in these areas. RATIONALE: Child care requires child-oriented, child-safe areas where the child's needs are primary. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.010 OFFICE SPACE Office space separate from child care areas shall be provided for administration and staff in centers. Children shall not have access to this area unless they are supervised by staff. RATIONALE: For the efficient and effective operation of a center, office areas where activities incompatible with the care of young children are conducted should be separate from child care areas. These office areas can be expected to contain supplies and equipment that should not be accessible to children. In addition, where records and documents, some of them confidential, are kept, staff should be free from the distractions of child care (3, 4). Adults need space, too. Care providers, if they are to avoid burnout, need a place to make a phone call, or to sit quietly for a few moments. TYPE OF FACILITY : Center STANDARD 5.011 sepAration of OPERATIONS from CHILD CARE areas Rooms or spaces that are used for the following activities or operations shall be separated from the child care areas and shall not be encountered along the route of egress: a) Commercial-type kitchen; b) Boiler, maintenance shop; c) Janitor closet; d) Laundry; e) Woodworking shop; f) Flammable or combustible storage; g) Painting operation; h) Rooms that are used for any purpose involving the presence of toxic substances. The exit and the fire-resistant separation shall be approved by the appropriate regulatory agencies responsible for building and fire inspections. In small and large family child care homes, a fire-resistant separation shall not be required where the food preparation kitchen contains only a domestic cooking range and the preparation of food does not result in smoke or grease-laden vapors escaping into indoor areas. RATIONALE: Hazards and toxic substances must be kept separate from space used for child care to prevent children's and staff members' exposure to injury. Cleaning agents must be inaccessible to children (out of reach and behind locked doors). Food preparation surfaces must not be contaminated by diaper changing procedures. Children must be restricted from access to the stove when cooking surfaces are hot. Egress must not require travel through hazardous areas. COMMENTS: In small family child care homes, mixed use of rooms is common. Some combined use of space for food preparation, storage of cleaning equipment and household tools, laundry, and diaper changing require that each space within a room be defined according to its purpose and that exposure of children to hazards be controlled. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.012 USE OF ROOMS FOR MULTIPURPOSES Children may play, eat, and nap in the same room (other than bathrooms, hallways, and closets), if that room is large enough to provide a defined space for each activity while that activity is under way and if the room meets other building requirements. Programming shall be such that the use of the room for one purpose does not interfere with use of the room for other purposes. RATIONALE: Multipurpose use is permissible as long as bathrooms, exit routes, and uninhabitable spaces are not included in multipurpose activity areas. COMMENTS: Compliance may be measured by structured observation. TYPE OF FACILITY : Center OPENINGS STANDARD 5.013 WEATHER-TIGHTNESS AND WATER-TIGHTNESS of openings Each window, exterior door, and basement or cellar hatchway shall be weather-tight and water-tight when closed. RATIONALE: Children's environments must be protected from exposure to moisture, dust, and temperature extremes. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.014 possibility of exit from wINDOWS All windows in areas used by children under 5 years of age shall be constructed, adapted, or adjusted to limit the exit opening accessible to children to less than 3.5 inches, or be otherwise protected with guards that prevent exit by a child, but that do not block outdoor light. Where such windows are required by building or fire codes to provide for emergency rescue and escape, the windows and guards, if provided, shall be equipped to enable staff to release the guard and open the window fully when escape or rescue is required. Such release shall not require the use of tools or keys. RATIONALE: This standard is needed to prevent children from falling out of windows. Standards from the U.S. Consumer Product Safety Commission (CPSC) and the American Society for Testing and Materials (ASTM) require the opening size to be 3.5 inches to prevent the child from getting through or the head from being entrapped. Some children may be able to pass their body through a slightly larger opening but then get stuck and hang from the window opening with their head trapped inside. Caregivers must not depend on screens to keep children from falling out of windows. Windows to be used as fire exits must be immediately accessible. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.015 SCREENs for ventilation OPENINGS All openings used for ventilation shall be screened against insect entry. RATIONALE: Screens prevent the entry of insects, which may bite, sting, or carry disease. See STANDARD 5.014 for safety precautions for windows. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.016 SAFETY GUARDS FOR GLASS WINDOWS/DOORS Glass windows and glass door panels within 36 inches of the floor shall have safety guards (such as rails or mesh) or be of safety-grade glass or polymer (such as Lexan) and equipped with a vision strip. RATIONALE: Glass panels can be invisible to an active child or adult. When a child collides with a glass panel, serious injury can result from the collision impact or the broken glass. COMMENTS: In areas where glass windows are repeatedly broken, installation of polymer material (Lexan, for example) should be considered. See STANDARD 5.014 for safety precautions for windows. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.017 FINGER-PINCH PROTECTION DEVICES Finger-pinch protection devices shall be installed wherever doors are accessible to children. These devices include: a) Rubber gaskets designed to fit into an inset on the door where the door meets the door jamb and over the opening where the door is hinged; b) Other types of flexible coverings for the hinged opening; c) Door closing devices that force the door to close slowly or keep the door from closing fully if it strikes an obstacle. RATIONALE: Finger-pinch injuries in doors are a significant cause of injury among claims against liability insurance in child care. Installation of inexpensive gaskets, barriers, and closing devices that prevent entrapment of a child's fingers will reduce these injuries. COMMENTS: Easily installed, inexpensive, and flexible joints for finger-pinch protection are in widespread use in French and Australian child care programs and increasingly in US child care programs. Manufacturers sell rubber gaskets, accordion-pleated plastic, thin strips of flexible plastic, and carpeting fixed to the door and opposing door jamb edge by molding strips. These can be used on the hinge opening and some are designed to fit the closing edge of the door to fill a small gap between the closing edge and door jamb with a yielding material. Adjustable door closing devices are available to slow the rate of door closing. Slowing the door closing rate helps prevent finger pinching in the latch area of the door or abrupt closing of the door against a small child. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.018 DIRECTIONAL SWING OF INDOOR DOORS Interior doors from a building area with fewer than 50 persons shall swing in the direction of most frequent travel. Doors from a building area with more than 50 persons and exit enclosure doors shall swing in the direction of egress travel. An exception is that boiler room doors shall swing into the room. RATIONALE: This standard is to provide easy, quick passage and to prevent injuries. Boiler room doors should swing inward to contain explosions. The NFPA-101 Life Safety Code from the National Fire Protection Association (NFPA), and the model building codes in wide use throughout the United States, require that doors serving an area with 50 or more persons swing in the direction of egress travel (8). This is important because large numbers of persons might push against each other leaving those up against a door without the ability to step back and allow the door to swing back into the room. Contact information for the NFPA is located in Appendix BB. COMMENTS: Doors in homes usually open inward. The requirement for door swing may be addressed in local building codes. TYPE OF FACILITY: Center STANDARD 5.019 UNOBSTRUCTED EGRESS Doorways, exit access paths, and exits shall be free of debris and equipment to allow unobstructed egress travel from inside the child care facility to the outside. RATIONALE: This provision permits a fast exit in the event of an emergency. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home EXITS STANDARD 5.020 alternate EXITS and emergency shelter Each building or structure, new or old, shall be provided with a minimum of two exits, at different sides of the building or home, leading to an open space at ground level. If the basement in a small family child care home is being used, one exit must lead directly to the outside. Exits shall be unobstructed, allowing occupants to escape to an outside door or exit stair enclosure in case of fire or other emergency. Each floor above or below ground level used for child care shall have at least two unobstructed exits that lead to an open area at ground level and thereafter to an area that meets safety requirements for a child care indoor or outdoor area where children may remain until their parents can pick them up, if reentry into the facility is not possible. Entrance and exit routes shall be reviewed and approved by the applicable fire inspector. Exiting shall meet all the requirements of the current edition of the NFPA-101 Life Safety Code from the National Fire Protection Association (NFPA). RATIONALE: Unobstructed exit routes are essential for prompt evacuation. The purpose of having two ways to exit when child care is provided on a floor above or below ground level is to ensure an alternative exit if fire blocks one exit. COMMENTS: Using an outdoor playground as a safe place to exit to may not always be possible. Some child care facilities do not have a playground located adjacent to the child care building and use local parks as the playground site. Access to these parks may require crossing a street at an intersection with a crosswalk. This would normally be considered safe, especially in areas of low traffic; however, when sirens go off, a route that otherwise may be considered safe becomes chaotic and dangerous. During evacuation or an emergency, children, as well as staff, become excited and may run into the street when the playground is not fenced and immediately adjacent to the center. In the event of a fire, staff members and children should be able to get at least 50 feet away from the building or structure. If the children cannot return to their usual building, a suitable shelter containing all items necessary for child care must be available where the children can safely remain until their parents come for them. An evacuation plan should take into consideration all available open areas to which staff and children can safely retreat in an emergency. For information about the NFPA-101 Life Safety Code , contact the National Fire Protection Association. Contact information is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.021 Evacuation of children with disabilities In facilities that include children who have physical disabilities, all exits and steps necessary for evacuation shall have ramps approved by the local building inspector. Children who have ambulatory difficulty, use wheelchairs or other equipment that must be transported with the child (such as an oxygen ventilator) shall be located on the ground floor of the facility or provisions shall be made for efficient emergency evacuation to a safe sheltered area. RATIONALE: The facility must meet building code standards for the community and also the requirements under the Americans with Disabilities Act (ADA) and their access guidelines. All children must be able to exit the building quickly in case of emergency. Locating children in wheelchairs or those with special equipment on the ground floor may eliminate the need for transporting these children down the stairs during an emergency exit. In buildings where the ground floor cannot be used for such children, arrangements must be made to remove them to a safe location, such as a fire tower stairwell, during an emergency exit. COMMENTS: Assuring physical access to a facility also requires that a means of evacuation meeting safety standards for exit accommodates any special needs of the children in care. For additional information on additional access requirements, see STANDARD 5.004 and STANDARD 5.008. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.022 path of EGRESS The minimum width of any path of egress shall be 36 inches. An exception is that doors shall provide a minimum clear width of 32 inches. The width of doors shall accommodate wheelchairs and the needs of individuals with physical disabilities. Where exits are not immediately accessible from an open floor area, safe and continuous passageways, aisles, or corridors leading to every exit shall be maintained and shall be arranged to provide access for each occupant to at least two exits by separate ways of travel. Passageways and corridors shall be kept free of materials and furniture that would prevent clear access. RATIONALE: Unobstructed access to exits is essential to prompt evacuation. The hallways and door openings must be wide enough to permit easy exit in an emergency. The actual exit is the enclosed stair or the actual door to the outside; doors from most rooms and the travel along a corridor are considered exit access or the path of egress. The NFPA-101 Life Safety Code from the National Fire Protection Association permits the usual 36 inches minimum to be reduced to a clear opening of 32 inches for doors (8). This is consistent with ADAAG (Americans with Disabilities Act Accessibility Guidelines) as it affords enough width for a person in a wheelchair to maneuver through the door opening. Contact information for the NFPA is located in Appendix BB. TYPE OF FACILITY: Center STANDARD 5.023 locks The facility shall have no lock or fastening device that prevents free escape from the interior. All door hardware in areas that school-age children use shall be within the reach of the children. In centers, only panic hardware (hardware that can be opened by pressure in the direction of travel) or single-action hardware (hardware that allows a door to open either way but keeps it from swinging back past the center point) shall be permitted on exterior doors. A double-cylinder deadbolt lock which requires a key to unlock from the inside shall not be permitted on any door along the path of egress from any child care area of a large or small family child care home except the exterior door, and then only if the lock is of a key-capturing type and the key is kept hanging near the door. If emergency exits lead to potentially unsafe areas for children (such as a busy street), alarms or other signaling devices shall be installed on these exit doors to alert the staff in case a child attempts to leave. RATIONALE: Children, as well as staff members, must be able to evacuate a building in the event of a fire or other emergency. Nevertheless, the child care provider must assure security from intruders and from unsupervised use of the exit by children. COMMENTS: Double cylinder deadbolt locks that require a key to unlock the door from the inside are often installed in private homes for added security. In such situations, these dead bolt locks should be present only on exterior doors and should be left in the unlocked position during the hours of child care operation. Locks that prevent opening from the outside, but can be opened without a key from the inside should be used for security during hours of child care operation. Double cylinder deadbolt locks should not be used on interior doors, such as closets, bathrooms, storage rooms, and bedrooms. TYPE OF FACILITY: Center; Large Family Child Care Home STANDARD 5.024 labeled emergency exits Emergency exits shall be clearly identified and visible at all times during operation of the child care facility. The exits for escape shall be arranged or marked so the path to safety outside is unmistakable. RATIONALE: As soon as children can learn to recognize exit signs and pathway markings, they will benefit from having these paths of escape clearly marked. Adults who come into the building as visitors need these markings to direct them as well. TYPE OF FACILITY: Center STANDARD 5.025 access to exits An exit to the outside or a common hallway leading to the outside shall be directly accessible from any room. If it is necessary to pass through another room for direct access to the outside, the other room shall not have a barrier or door that can be latched to prevent access through it. No obstructions shall be placed in the corridors or passageways leading to the exits. RATIONALE: A room that requires exit through another room to get to an exit path can entrap its occupants when there is a fire or emergency condition if passage can be impeded by a barrier or door that is latched. An obstruction in the path of exit can lead to entrapment, especially in an emergency situation where groups of people may be exiting together. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home FINISHES STANDARD 5.026 FINISHes of Doors, floors and walls The hand contact and splash areas of doors, and walls shall be covered with a finish that is at least as cleanable as an epoxy finish or enamel paint. Each bathroom, toilet room, and shower room floor and wall shall be impervious to water up to a height of 5 feet and capable of being kept in a clean and sanitary condition. RATIONALE: Impervious surfaces for floors and walls prevent deterioration and mold and ensure clean and sanitary surfaces. Surfaces that are easily cleaned facilitate removal of filth and disease-producing germs. TYPE OF FACILITY: Center, Large Family Child Care Home; Small Family Child Care Home HEATING, COOLING, VENTILATION, AND HOT WATER STANDARD 5.027 fresh air As much fresh air as possible shall be provided in rooms that children use. Wherever possible, windows shall be capable of being opened. When windows are not kept open, rooms shall be ventilated, as specified in STANDARD 5.028 through STANDARD 5.032. RATIONALE: The health and well-being of both the staff and the children can be affected by air quality indoors. The air that people breathe inside a building is contaminated with organisms shared among occupants and sometimes more polluted than the outdoor air. Young children may be affected more than adults by air pollution. Children who spend long hours breathing contaminated or polluted indoor air are more likely to develop respiratory problems, allergies and asthma (10, 11). Although insulation of a building is important in reducing heating or cooling costs, it is unwise to try to seal the building completely. Air circulation is essential to clear infectious disease agents, odors and toxic substances in the air. Levels of CO 2 are an indicator of the quality of ventilation (7). TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.028 indoor temperature and air exchange A draft-free temperature of 65 degrees F to 75 degrees F shall be maintained at 30% to 50% relative humidity during the winter months. A draft-free temperature of 68 degrees F to 82 degrees F shall be maintained at 30% to 50% humidity during the summer months (9). All rooms that children use shall be heated, cooled, and ventilated to maintain the required temperatures, humidity, and air exchange and to avoid accumulation of odors and fumes. Air exchange shall be a minimum of 15 cubic feet per minute (or 7.5 liters/second) per person of outdoor air. RATIONALE: These requirements are based on the standards of the American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE), which take both comfort and health into consideration (9). High humidity can promote growth of mold, mildew, and other biological agents that can cause eye, nose, and throat irritation and may trigger asthma episodes in people with asthma. These precautions are essential to the health and well-being of both the staff and the children. When planning construction of a facility, it is healthier to build windows that open. COMMENTS: Airflow can be adjusted by using fans and open windows. To promote air circulation, windows should be opened whenever weather permits or when children are out of an area. Heat loss can be controlled by using a heat-recovery ventilator in the window or in the ventilation system that circulates outdoor air (11). Simple and inexpensive devices that measure the ambient relative humidity indoors may be purchased in hardware stores or toy stores that specialize in science products. For further information on air quality, contact ASHRAE, the U.S. Environmental Protection Agency (EPA) Public Information Center, the American Gas Association, the Edison Electric Institue, the American Lung Association, the U.S. Consumer Product Safety Commission (CPSC), and the Safe Building Alliance. Contact information is located in Appendix BB.. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.029 art materials and ventilation Areas where arts and crafts activities are conducted shall be well ventilated. Materials that create toxic fumes or gases shall not be used. Caregivers shall ensure that all art materials are properly cleaned-up and stored in original containers that are fully labeled. RATIONALE: Children in child care should not be exposed to fumes or gases. Labels are required on art supplies to identify any hazardous ingredients, risks associated with their use, precautions, first aid, and sources of further information. COMMENTS: Staff should be educated to the possibility that some children may have special vulnerabilities to certain art materials (such as children with asthma or allergies). TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.030 electric fans Electric fans, if used, shall bear the safety certification mark of a recognized testing laboratory, such as UL (Underwriters Laboratories) or ETL (Electrotechnical Laboratory) and be inaccessible to children. RATIONALE: Children having access to electric fans might insert objects and otherwise interfere with the safe operation of the fan. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.031 air recirculation systems Filters on air recirculation systems shall be checked and cleaned or replaced according to the manufacturer's instructions. RATIONALE: Clogged filters will impede proper air circulation required for heating and ventilation. Filters must be cleaned to prevent airborne transmission of microorganisms. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.032 heating and ventilation equipment inspection and maintenance All heating and ventilating equipment shall be inspected before each cooling and heating season by a heating/air conditioning contractor, who shall verify in writing that the equipment is properly installed, cleaned, and maintained to operate efficiently and effectively without emitting chemical or microbiological substances. The system shall be operated in accordance with operating instructions. RATIONALE: Routinely scheduled inspections and proper operation ensure that equipment is working properly. COMMENTS: Emissions are measured on a sample of air coming from the heating or ventilating system. This test is done by a professional laboratory based on microscopic and chemical testing. To prevent harmful emissions, the system must be operated strictly in accordance with the operating instructions that the manufacturer warrants safe. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.033 type and placement of thermometers Thermometers that will not easily break and that do not contain mercury shall be placed on interior walls in every indoor activity area at children's height. RATIONALE: The temperature of the room can vary between the floor and the ceiling. Because heat rises, the temperature at the level where children are playing can be much cooler than at the usual level of placement of interior thermometers (the standing, eye level of adults) in the room. Mercury, glass, or similar materials in thermometers can cause injury and poisoning of children. Placing a safe thermometer at the children's height allows proper monitoring of temperature where the children are in the room. A thermometer should not break easily if a child or adult bumps into it. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.034 gas, oil or kerosene heaters, portable gas stoves and charcoal grills Inadequately vented or unvented gas or oil heaters and portable open-flame kerosene space heaters shall be prohibited. Portable gas stoves and charcoal grills shall not be used for space heating or any other indoor purposes. Heat in units that involve flame shall be vented properly to the outside and shall be supplied with a source of combustion air that meets the manufacturer's installation requirements. RATIONALE: Improper venting of gas and oil heaters can lead to fire and the poisoning of building occupants. Proper venting can prevent accumulation of carbon monoxide gas inside a building. Carbon monoxide is a colorless, odorless, poisonous gas formed when carbon-containing fuel is not burned completely and can cause asphyxiation. Without a sufficient source of combustion air, heating units that burn fuel with a flame will be inefficient and can produce more toxic by-products. Kerosene and other open-flame heaters discharge fumes into the living area. The potential for carbon monoxide poisoning from incomplete combustion of fuels exists if there is no proper outside ventilation (12, 13). Other pollutants that heaters can release include nitrogen dioxide, particles, polycyclic aromatic hydrocarbons, and acid aerosols. These chemicals can cause both short-term and chronic respiratory disease. Some space heaters are easily tipped over and do not shut off when tipped over. Many become hot enough to start fires in adjacent objects. Many burns have been caused by contact with space heaters and other hot surfaces. COMMENTS: When possible, fresh air should be used to supply combustion air. The local health and fire departments should approve any exceptions to this standard before use. For more information about air pollutants associated with the use of heaters, contact the U.S. Consumer Product Safety Commission (CPSC), the U.S. Environmental Protection Agency (EPA) Public Information Center, and the Occupational Safety and Health Administration of the U.S. Department of Labor. Contact information is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.035 electric space heaters Electric space heaters shall: a) Be inaccessible to children and be stable; b) Have protective covering to keep hands and objects away from the electric heating element; c) Bear the safety certification mark of a recognized testing laboratory, such as UL (Underwriters Laboratories) or ETL(Electrotechnical Laboratory); d) Be placed at least 3 feet from curtains, papers, furniture and any flammable object; e) Be properly vented, as required by the regulatory agency. RATIONALE: Portable electric space heaters are a common cause of fires and burns resulting from very hot heating elements being too close to flammable objects and people (13). COMMENTS: To prevent burns and potential fires, space heaters must not be accessible to children. Children can start fires by inserting flammable material near electric heating elements. Curtains, papers, and furniture must be kept away from electric space heaters to avoid potential fires. Some electric space heaters function by heating an oil contained in a heat-radiating portion of the appliance. Even though the electrical heating element is inaccessible in this type of heater, the excessively hot surfaces of the appliance can cause burns. To prevent burns or potential fires, consideration must be given to the ages and activity levels of children in care and the amount of space in a room. Alternative methods of heating may be safer for children. If portable electric space heaters are used, electrical circuits must not be overloaded. Portable electric space heaters are usually plugged into a regular 120-volt electric outlet connected to a 15-ampere circuit breaker. These circuit breakers are designed for lights and small appliances. A circuit breaker is an overload switch that prevents the current in a given electric circuit from exceeding the capacity of a line. Fuses perform the same function in older systems. If too many appliances are plugged into a circuit, calling for more power than the capacity of the circuit, the breaker reacts by switching off the circuit. Constantly overloaded electrical circuits can cause electrical fires. A n electrical inspector or electrical contractor should be consulted if necessary. This standard is based on the Safe Home Checklist (14). TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.036 inspection of heating systems Heating systems, including heaters, stoves used for heating (or furnaces), stovepipes, and chimneys shall be inspected and cleaned before each heating season by a certified heating contractor, who shall furnish a letter or certificate warranting the heating system to be safe and sound. Documentation of these inspections and certification of safety shall be kept on file in the facility. RATIONALE: Heating equipment is the second leading cause of ignition in fatal house fires (14). Heating equipment that is kept in good repair is less likely to cause fires. COMMENTS: All heating equipment is intended to be included in this standard. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.037 protective screen for heating equipment A protective screen shall be in place with a stove used for heating, or any heating equipment with high surface temperature located in an occupied area. RATIONALE: Heating equipment can become very hot when in use, potentially causing significant burns. Protective screens reduce children's accessibility to hot stoves. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.038 fireplaces Fireplaces and fireplace inserts shall be inaccessible to children. Fireplaces shall be properly drafted and the front opening equipped with a secure and stable protective safety screen. The facility shall provide evidence of cleaning the chimney at least once a year, before the heating season, or as frequently as necessary to prevent excessive build-up of burn residues or smoke products in the chimney. If a fireplace is used when children are present, an adult must be in the same room and the children must be within easy reach of the adult. RATIONALE: Fireplaces provide access to surfaces hot enough to cause burns. Children should be kept away from fire because their clothing can easily ignite. Children should be kept away from a hot surface because they can be burned simply by touching it. Fireplaces are sources of toxic products of combustion that proper drafting removes. Improperly maintained chimneys can lead to fire and accumulation of toxic fumes. Having an adult present on the same floor but in another room is not sufficient to prevent injuries. A protective safety screen over the front opening of a fireplace will contain sparks and reduce a child's accessibility to an open flame. Heating equipment is the second leading cause of ignition of fatal house fires (14). This equipment can become very hot when in use, potentially causing significant burns. COMMENTS: This standard is consistent with the majority of state and local building and fire codes for fire prevention. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.039 barriers/guards for heating units Heating units, including hot water heating pipes and baseboard heaters with a surface temperature hotter than 110 degrees F, shall be made inaccessible to children by barriers such as guards or other devices. RATIONALE: A mechanical barrier separating the child from the source of heat can reduce the likelihood of burns (15, 16). COMMENTS: For additional information on heating, cooling, and ventilation, see Openings, STANDARD 5.027 through STANDARD 5.041. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.040 water heating devices and temperatures allowed Facilities shall have water heating facilities that are connected to the water supply system as required by the regulatory authority. These facilities shall be capable of heating water to at least 120 degrees F and shall deliver hot water temperature at sinks used for handwashing, or at plumbing fixtures where the hot water will be in direct contact with children, at a temperature of at least 60 degrees F and not exceeding 120 degrees F. Scald-prevention devices, such as special faucets or thermostatically controlled valves, shall be permanently installed, if necessary, to provide this temperature of water at the faucet. Where a dishwasher is used, it shall have the capacity to heat water to at least 140 degrees F for the dishwasher (with scald preventing devices limiting water temperature at handwashing sinks to 120 degrees F). RATIONALE: Tap water burns comprise the leading cause of nonfatal burns (45, 46). Children under 5 years of age are the most frequent victims. Water heated to 130 degrees F takes only 30 seconds to burn the skin. If the water is heated to 120 degrees F, which is only 10 degrees F cooler, it takes 2 minutes to burn the skin (46). That extra 2 minutes could provide enough time to remove the child from the hot water source and avoid a burn. One study suggested that most child care providers do not know the temperature of their hot water (45). Another study indicated that lowering the temperature of water heaters to 120 degrees F proved satisfactory to consumers (46). Hot water for washing dishes is required to remove soil and sanitizing the dishes. COMMENTS: A simple and inexpensive method to ensure that hot water temperatures do not exceed 120 degrees F is to adjust the thermostat setting on the hot water heater, checking the temperature of the water the hot water heater produces, using a thermometer at the point of water delivery. Lowering the temperature of the hot water heater that supplies handwashing sinks will not interfere with the performance of laundry washing machines (since these work well with cold water detergents). However, if a dishwasher is used, a minimum hot water supply temperature of 140 degrees F is usually required by the dishwasher manufacturer, even if the dishwasher has its own booster heater. When providers purchase a dishwasher, the manufacturer's requirements should be followed. Anti-scald aerators designed to fit on the end of a modern bathroom and kitchen faucets, and anti-scald bathtub spouts, are also available at a reasonable cost. Only devices approved by the American National Standards Institute (ANSI) or the Canadian Standards Association (CSA) should be considered. A number of other scald-prevention devices are available on the market. Consult a plumbing contractor for details. Contact information for the ANSI and the CSA is located in Appendix BB. This standard ensures the availability of hot water to facilitate cleaning and sanitation. Hot water is needed to clean and sanitize food utensils adequately and sanitize laundry. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.041 humidifiers and dehumidifiers If humidifiers or dehumidifiers are used to maintain humidity, as specified in STANDARD 5.028, the facility shall follow the manufacturer's cleaning and maintenance instructions to avoid contamination by microorganisms and discharge of microorganisms and contaminants into the air. RATIONALE: Humidifiers or dehumidifiers may be required to meet American National Standards Institute (ANSI) and Association of Home Appliance Manufacturers (AHAM) Humidifier Standards and must not introduce additional hazards. Contact information for ANSI and AHAM is located in Appendix BB. COMMENTS: The benefits of humidifiers are uncertain. Improperly maintained humidifiers may become incubators of biological organisms and increase the risk of disease. Also, increased humidity enhances the survival of dust mites; and many children are allergic to dust mites. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home LIGHTING STANDARD 5.042 Levels of illumination Natural lighting shall be provided in rooms where children work and play for more than two hours at a time. Wherever possible, windows installed at child's eye level shall be provided to introduce natural lighting. All areas of the facility shall have glare-free natural and/or artificial lighting that provides adequate illumination and comfort for facility activities. The following guidelines shall be used for levels of illumination: a) Reading, painting, and other close work areas: 50 to 100 foot-candles on the work surface; b) Work and play areas: 30 to 50 foot-candles on the surface; c) Stairs, walkways, landings, driveways, entrances: at least 20 foot-candles on the surface; d) Sleeping, napping areas: no more than 5 footcandles during sleeping or napping. RATIONALE: These levels of illumination facilitate cleaning, reading, comfort, completion of projects, and safety (17). Too little light, too much glare and confusing shadows are commonly experienced lighting problems. Inadequate artificial lighting has been linked to eyestrain, to headache, and to non-specific symptoms of illness (5). Natural lighting is the most desirable lighting of all. Windows installed at children's eye level not only provide a source of natural light, they also provide a variety of perceptual experiences of sight, sound, and smell which may serve as learning activities for children and a focus for conversation. The visual stimulation provided by a window is important to a young child's development (5, 6). Natural lighting provided by sky lights exposes children to variations in light during the day that is less perceptually stimulating than eye level windows, but is still preferable to artificial lighting. A study on school performance shows that elementary school children seem to learn better in classrooms with substantial daylight and the opportunity for natural ventilation (76). COMMENTS: In rooms that are used for many purposes, providing the ability to turn on and off different banks of lights in a room, or installation of light dimmers, will allow caregivers to adjust lighting levels that are appropriate to the activities that are occurring in the room. Lighting levels should be reduced during nap times to promote resting or napping behavior in children. However, some degree of illumination must be allowed to ensure that staff can continue to observe children. See also STANDARD 5.160 for exclusion of window cords long enough to encircle a child's neck and STANDARD 5.115, Additional Indoor Requirements for School-age Children. For further information, contact the American National Standards Institute/Illuminating Engineers Society. Contact information is located in Appendix BB. Contact the lighting or home service department of the local electric utility company to have foot-candles measured. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.043 light fixtures including halogen lamps Light fixtures containing shielded or shatterproof bulbs shall be used in food preparation areas and all occupied areas. When portable halogen lamps are provided, they shall be installed securely to prevent them from tipping over, and a safety screen must be installed over the bulb. RATIONALE: Use of shielded or shatterproof bulbs prevents injury to people and contamination of food. Halogen lamps burn at a temperature of approximately 1200 degrees F and are a potential burn or fire hazard. Halogen lighting provides a more energy-efficient alternative to illuminate a room. Halogen bulbs are incorporated into freestanding lamps. Many of the older-style lamps do not have a protective screen to prevent children from touching the hot bulb or placing flammable materials on the bulb. Some portable lamps have a design that places the halogen bulb on the top of a tall pole. Although the base of these lamps is relatively heavy in weight, children can easily tip the lamps on their side and cause a potential fire hazard. COMMENTS: Halogen lamps are also incorporated into light fixtures that are mounted permanently on the ceiling or walls. The fixtures are usually placed out of the reach of children and, if properly installed, should not pose a safety hazard. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.044 High intensity discharge lamps, multi-vapor, and mercury lamps High intensity discharge lamps, multi-vapor, and mercury lamps shall not be used for lighting the interior of buildings unless provided with special bulbs that self-extinguish if the outer glass envelope is broken. RATIONALE: Multi-vapor and mercury lamps can be harmful when the outer bulb envelope is broken, causing serious skin burns and eye inflammation. COMMENTS: High intensity lamps are not appropriate for internal illumination of child care facilities since the level of lighting generated is generally too strong for the size of a typical room and/or generates too much glare. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.045 emergency lighting Emergency lighting approved by the local authority shall be provided in corridors, stairwells, and at building exits. Open flames shall not be provided as emergency lighting in child care facilities. RATIONALE: Provision of emergency lighting in corridors and stairwells enables safe passage to an emergency exit in the event of an electrical power outage. Open flames such as candles, flares, and lanterns are not safe. COMMENTS: In many places, daylight hours end while child care is still in session, especially in the fall and winter seasons. If electric power outages are frequent, consideration should be given to providing emergency lighting in each room that is accessible to children. In child care homes, battery-powered household emergency lights that insert into electrical wall outlets (to remain charged) may be sufficient, depending on the location of the electrical outlets in corridors, stairwells and near building exits. Although candles are sometimes recommended in emergency situations for portable lighting, a flashlight is the preferred type of portable emergency lighting in child care facilities. In some jurisdictions, fixed mounted emergency lighting may be required. Ask the local fire marshal for fire safety code requirements. TYPE OF FACILITY : Center; Large Family Child Care Home; Small Family Child Care Home NOISE STANDARD 5.046 noise levels Measures shall be taken in all rooms or areas accommodating children to maintain the decibel (db) level at or below 35 to 40 db for at least 80% of the time as measured by an acoustical engineer or, more practically, by the ability to be clearly heard and understood in a normal conversation without raising one's voice. These measures include acoustical ceiling, carpeting, wall covering, partitions, or draperies, or a combination thereof. RATIONALE: Excessive sound levels can be damaging to hearing, reduce effective communication, and reduce psychosocial well-being. The level of hearing loss commonly experienced by children with fluid in their middle ear space is 35 db. This level of hearing loss correlates with decreased understanding of language. By inference, this level of ambient noise may interfere with the ability of children to hear well enough to develop language normally. For those with normal hearing, the stressful effects of noise will, at a minimum, add to, and at a maximum, precipitate other stress factors present in the facility. Exposure to excessive levels of noise may have adverse physiologic effects, such as increasing blood pressure. In addition, uncontrolled noise will continually force the caregiver to speak at levels above those normally used for conversation and may increase the risk of throat irritation. This may be a particularly serious consequence when the caregiver's exposure to infectious agents is considered at the same time. While carpets can help reduce the level of noise, they can absorb moisture and serve as a place for microorganisms to grow. Consider using area rugs that can be taken up and washed often. COMMENTS: Noise should be measured according to the Code of Federal Regulations (CFR), Title 16, Section 1500.47. To obtain this publication, contact the Superintendent of Documents of the U.S. Government Printing Office. Contact information is located in Appendix BB. When there is new construction or renovation of a facility, consideration should be given to a design that will reduce noise from outside. Sound control measures should follow the pertinent American Society for Testing and Materials (ASTM) standards for noise, acoustics, and the like, as indicated below: E477-99 Standard Test Method for Measuring Acoustical and Air Flow Performance of Duct Liner Materials and Prefabricated Silencers E1042-92 Standard Classification of Acoustically Absorptive Materials Applied by Towel or Spray E1264-98 Standard Classification of Acoustical Ceiling Products E1124-97 Standard Test Method for Field Measurement of Sound Power Level by the Two-Surface Method E1007-97 Standard Test Method for Field Measurement of Tapping Machine Impact Sound Transmission in Floor-Ceiling Assemblies and Associated Structures E1050-98 Standard Test Method for Impedance and Absorption of Acoustical Materials using a Tube, Two Microphones, and a Digital Frequency Analysis System C384-98 Standard Test Method for Impedance and Absorption of Acoustical Materials by the Impedance Tube Method E1130-90 Standard Test Method for Objective Measurement of Speech Privacy in Open Offices using Articulation Index E1014-84 Standard Guide for Measurement of OutDoor A-Weighted Sound Levels E1041-85 Standard Test Method f or Evaluating Masking Sound in Open Offices E596-96 Standard Test Method for Laboratory Measurement of Noise Reduction of Sound-Isolating Enclosures For further information, contact the American Society for Testing and Materials. Contact information is located in Appendix BB.. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home ELECTRICAL FIXTURES AND OUTLETS STANDARD 5.047 electrical service Facilities shall be supplied with electric service. Outlets and fixtures shall be installed and connected to the source of electric energy in a manner that meets the National Electrical Code, as amended by local electrical codes (if any), and as certified by an electrical code inspector. RATIONALE: Proper installation of outlets and fixtures helps to prevent injury. COMMENTS: State or local electrical codes may apply. For further information, see the National Fire Protection Association's (NFPA) National Electrical Code and the NFPA-101 Life Safety Code from the National Fire Protection Association. Contact information for the NFPA is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.048 safety covers and shock protection devices for electrical outlets All electrical outlets accessible to children who are not yet of school-age shall have safety covers that are attached to the electrical receptacle by a screw or other means to prevent easy removal by a child. Outlet covers that a child can remove by extraction of a plug from the socket shall not be used. Unless screw-mounted outlet covers are installed to semi-permanently prevent access to the outlet or outlets are of the child-resistant ground-fault circuit-interrupter (GFCI) type, safety covers shall be used that are spring-loaded or have a comparable means to automatically prohibit access to electricity when a plug is removed from the outlet. All newly installed electrical outlets accessible to children shall be protected by GFCI shock protection devices or safety receptacles that require simultaneous contact with both prongs of a plug to access the electricity. RATIONALE: Preventing children from placing fingers or sticking objects into exposed electrical outlets will prevent electrical shock, electrical burns, and potential fires. Devastating oral injuries occur when young children insert a metal object into an outlet then try to use their teeth to extract the object. The combination of electricity and mouth moisture closes the circuit, leading to serious life-long injury. Young children can remove loose-fitting safety plugs and accidentally swallow them. Also, adults may fail to replace them after using the receptacle. Currently available receptacle-type GFCIs cost less than $10 each. GFCI receptacles significantly reduce the likelihood of injury but still permit a slight shock. New installations in areas accessible to children should be of the GFCI type. A slight shock may be fatal to a child with seizure disorder or heart problems, so even GFCI receptacles must be fitted with safety covers to prevent children from gaining access to the electricity. COMMENTS: One type of outlet cover replaces the outlet face plate with a plate that has a spring-loaded outlet cover, which will stay in place when the receptacle is not in use. For receptacles where the facility does not intend to unplug the appliance, a more permanent cap-type cover that screws into the outlet receptacle is available. Several effective and inexpensive outlet safety devices are available in home hardware and baby stores. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.049 Ground-fault circuit-interrupter for outlets near water All electrical outlets located within 6 feet of a sink or other water source must have a ground-fault circuit-interrupter (GFCI), which shall be tested at least once every 3 months using the test button located on the device. RATIONALE: This provision eliminates shock hazards. A slight shock may be fatal to a child with seizure disorder or heart problems. COMMENTS: Electrical receptacles of the type often found in bathrooms of new homes have a GFCI built into the receptacle. The GFCI does not necessarily have to be near the sink. An electrical receptacle can be protected by a special type of circuit breaker (which has a built-in ground-fault circuit-interrupter) in the electrical panel. See STANDARD 5.048, for details on outlet covers that prevent even a slight shock from GFCI outlets. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.050 location of electrical devices near water No electrical device or apparatus accessible to children shall be located so it could be plugged into an electrical outlet while a person is in contact with a water source, such as a sink, tub, shower area, or swimming/wading pool. RATIONALE: Contact with a water source while using an electrical device provides a path for electricity through the person who is using the device. This can lead to electrical injury. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.051 extension cords The use of extension cords shall be discouraged; however, when used, they shall bear the listing mark of a nationally recognized testing laboratory, such as UL, and shall not be placed through doorways, under carpeting, or across water-source areas. Electrical cords (extension and appliance) shall not be frayed or overloaded. RATIONALE: Electrical malfunction is a major cause of ignition of fatal house fires (14). The U.S. Consumer Product Safety Commission reports that in 1996 extension cords and other electric cords were the ignition sources of fires that caused 90 deaths and burn injuries of 320 persons (14). Extension cords should not be accessible to children, whether in use or when temporarily not in use but plugged in. There is risk of electric shock to a child who may poke a metal object into the extension cord socket. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.052 electrical cords Electrical cords shall be placed beyond children's reach. RATIONALE:. Injuries have occurred in child care when children pulled appliances such as tape players down on themselves by pulling on the cord. When children chew on an appliance cord, they can reach the wires and suffer severe disfiguring mouth injuries. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home FIRE WARNING SYSTEMS STANDARD 5.053 smoke detection systems In centers with new installations, a smoke detection system (such as hard-wired system detectors with control panel) shall be installed with placement of the smoke detectors in the following areas: a) Each story in front of doors to the stairway; b) Corridors of all floors; c) Lounges and recreation areas; d) Sleeping rooms. In large and small family child care homes, smoke alarms that receive their operating power from the building electrical system shall be installed. Battery-operated smoke alarms shall be permitted provided that the facility demonstrates to the fire inspector that testing, maintenance, and battery replacement programs ensure reliability of power to the smoke alarms and that retrofitting the facility to connect the smoke alarms to the electrical system would be costly and difficult to achieve. RATIONALE: Because of the large number of children at risk in a center, up-to-date smoke detection system technology is needed. In large and small family child care homes, single-station smoke alarms are acceptable. However, for all new building installations where access to enable necessary wiring is available, smoke alarms should be used that receive their power from the building's electrical system. The hard-wired smoke detectors should be interconnected so that occupants receive instantaneous alarms throughout the facility, not just in the room of origin. Batteries are not reliable enough; battery-operated smoke alarms should be accepted only where connecting smoke detectors to existing wiring would be too difficult and expensive as a retrofitted arrangement. COMMENTS: Some state and local building codes specify the installation and maintenance of smoke detectors and fire alarm systems. For specific information, see the NFPA-101 Life Safety Code and the NFPA 72 National Fire Alarm Code from the National Fire Protection Association and from the Building Officials and Code Administrators International (BOCA). Contact information is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.054 fire extinguishers Fire extinguisher(s) shall be installed and maintained. The fire extinguisher shall be of the A-B-C type. Size and number of fire extinguishers shall be determined after a survey by the fire marshal or by an insurance company fire loss prevention representative. Instructions for the use of the fire extinguisher shall be posted on or near the fire extinguisher. RATIONALE: All fire extinguishers are labeled, using standard symbols, for the classes of fires on which they can be used.  A red slash through any of the symbols tells you the extinguisher cannot be used on that class of fire.  Class A designates ordinary combustibles such as wood, cloth, and paper. Class B designates flammable liquids such as gasoline, oil, and oil-based paint. Class C designates energized electrical equipment, including wiring, fuse boxes, circuit breakers, machinery and appliances COMMENTS: Staff should be trained that the first priority is to remove the children from the facility safely and quickly. Fighting a fire is secondary to the safe exit of the children and staff. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home PLUMBING AND SANITARY FACILITIES CLEAN WATER AND PLUMBING STANDARD 5.055 water supply Every facility shall be supplied with piped running water under pressure, from a source approved by the Environmental Protection Agency (EPA) and/or the regulatory health authority, to provide an adequate water supply to every fixture connected to the water supply and drainage system. The water shall be sufficient in quantity and pressure to supply water for cooking, cleaning, drinking, toilets, and outside uses. When water is supplied by a well or other private source, it shall meet all applicable federal, state, and local public health standards and shall be approved by the regulatory health authority. Any facility not served by a public water supply shall keep on file documentation of approval of the water supply. RATIONALE: This standard ensures a water supply that is safe and does not spread disease or filth or contain dangerous substances. (18). COMMENTS: For more information on water supply standards, contact the local health authority or the EPA. Contact information is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.056 water handling and treatment equipment Newly installed water handling and treatment equipment shall meet applicable National Sanitation Foundation (NSF) standards and shall be inspected and approved by the local public health department or its designee. RATIONALE: Adherence to NSF standards will help ensure a safe water supply. State and local codes vary, but they generally protect against toxins or sewage entering the water supply. COMMENTS: Model codes are available from the NSF. Contact information for the NSF is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.057 cross-connections The facility shall have no cross-connections that could permit contamination of the potable water supply: a) Backflow preventers, vacuum breakers, or strategic air gaps shall be provided for all boiler units in which chemicals are used. Backflow preventers shall be tested annually; b) Vacuum breakers shall be installed on all threaded janitorial sink faucets and outdoor/indoor hose bibs; c) Nonsubmersible, antisiphon ballcocks shall be provided on all flush tank-type toilets. RATIONALE: Pressure differentials may allow contamination of drinking water if cross-connections or submerged inlets exist. Water must be protected from cross connections with possible sources of contamination. COMMENTS: Short hoses are often attached to the faucets of janitorial sinks (and laundry sinks) and often extend below the top edge of the basin. The ends of a hose in a janitorial sink and a garden hose attached to an outside hose bibs are often found in a pool of potentially contaminated water. If the water faucet is not completely closed, a loss of pressure in the water system could result in the contaminated water being drawn up the hose like dirt is drawn into a vacuum cleaner; thus contaminating the drinking water supply. Vacuum breakers may be installed as part of the plumbing fixture or are available to attach to the end of a faucet of hose bib. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.058 installation of pipes and plumbing fixtures Each gas pipe, water pipe, gas-burning fixture, plumbing fixture and apparatus, or any other similar fixture and all connections to water, sewer, or gas lines shall be installed and free from defects, leaks, and obstructions in accordance with the requirements of the state or local regulatory agency for buildings. RATIONALE: This standard prevents accidents and hazardous and unsanitary conditions. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home WATER TESTING STANDARD 5.059 testing of drinking water Drinking water shall be tested by the regulatory health authority no less than once a year for bacteriological quality and no less than once every 3 years for chemical quality. Testing shall be in compliance with procedures established by the National Sanitation Foundation (NSF), or equivalent. RATIONALE: This standard prevents the use of unsafe water supplies, whether well water or community-supplied water, the quality of which can vary from time to time. COMMENTS: Tests could include analyses for radon and gross alpha radiation. The need for these tests is still being researched, but it is recommended that they be done. If well water is used, water should also be tested for nitrates. For infants under 4 months, excessive exposure to nitrates is associated with the development of potentially fatal methemoglobinemia. For more information on water testing, contact the NSF. Contact information for the NSF is located in Appendix BB. TYPE OF FACILITY: Center STANDARD 5.060 handwashing sink using portable water supply When plumbing is unavailable to provide a handwashing sink, the facility shall provide a handwashing sink using a portable water supply and a sanitary catch system approved by a local public health department. A mechanism shall be in place to prevent children from gaining access to soiled water or more than one child from washing in the same water. RATIONALE: No barrier (gloves) or chemical substitute (sanitizer solutions) is as effective as running water. The point of handwashing is defeated if children can gain access to the soiled water. Hand sanitizers do not substitute for handwashing. COMMENTS: Some suppliers of portable toilets provide a variety of portable sinks. All require filling a container with a source of potable water that flows by gravity or by pumping action during use. All require emptying the catch container into a sanitary system. A large water container with a faucet can be combined with a catch container that is covered with a firmly attached grill to prevent children from getting into the contaminated water. Children must not wash in a communal basin because those who wash in the same water share contamination. Also, see Healthy Young Children available from the National Association for the Education of Young Children (NAEYC) for a diagram of an alternative to running water using a portable (bubbler) tank that has a sink tap and a cabinet. Contact information for the NAEYC is located in Appendix BB. For additional information on handwashing, see STANDARD 3.020 through STANDARD 5.126. See also Sinks, STANDARD 5.126 through STANDARD 5.128. For information on water temperature, see STANDARD 5.040. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.061 testing for lead levels in drinking water In both private and public drinking water supplies where interior or service piping or joint seals contain lead or other toxic materials, water shall be evaluated at the beginning of operation and at least every 2 years by the regulatory health authority to determine whether lead levels are safe. The samples shall consist of the first draw of water in the facility after at least a 6-hour lapse in use. RATIONALE: Drinking water must be safe for consumption. Exposure to toxic levels of lead can cause neurological, behavioral, and developmental problems. COMMENTS: Running the tap water for 30 to 60 seconds before using it for drinking and cooking will reduce the presence of lead in drinking water supplies where piping or joint seals contain lead. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.062 water test results All water test results shall be in written form and kept with other required reports and documents in one central location in the facility, ready for immediate viewing by regulatory personnel, or copies submitted as required by the local authority that regulates safe water. RATIONALE: Licensing staff should be easily able to determine compliance with regulatory requirements. Some regulatory authorities prefer to review copies of water test results available for inspection on site; others that do not provide on-site inspections may prefer to have the reports submitted to them. COMMENTS: See also Posting Documents, STANDARD 8.077. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.063 Emergency safe drinking water and bottled water Emergency safe drinking water shall be supplied during interruption of the regular approved water supply. Bottled water shall be certified as chemically and bacteriologically potable by the health department or its designee. RATIONALE: Children must have constant access to fresh, potable water if the regular approved supply of drinking water is temporarily interrupted. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home SEWAGE, GARBAGE AND PEST CONTROL STANDARD 5.064 sewage facilities Sewage facilities shall be provided and inspected in accordance with state and local regulations. Whenever a public sewer is available, the facility shall be connected to it. Where public sewers are not available, a septic tank system or other method approved by the local public health department shall be installed. Raw or treated wastes shall not be discharged on the surface of the ground. The wastewater or septic system drainage field shall not be located within the outdoor play area of a child care center licensed for 13 or more children, unless the drainage field has been designed by a sanitation engineer with the presence of an outdoor play area in mind and meets the approval of the local health authority. The exhaust vent from a wastewater or septic system and drainage field shall not be located within the children's outdoor play area. RATIONALE: Sewage must not be allowed to contaminate drinking water or ground water. It must be carried from the facility to a place where sanitary treatment equipment is available. Raw sewage is a health hazard and usually has an offensive odor. The weight of children or the combined weight of children and playground equipment may cause the drainage field to become compacted, resulting in failure of the system. Some structures are anchored in concrete, which adds weight. The legs of some equipment, such as swing sets, can puncture the surface of drainage fields. In areas where frequent rains are coupled with high water tables, poor drainage, and flooding, the surface of drainage fields often becomes contaminated with untreated sewage. COMMENTS: Whether the presence of an outdoor play area would adversely affect the operation of a wastewater or septic system will depend on the type of playground equipment and method of anchoring, the type of resilient surface placed beneath playground equipment to reduce injury from falls, the soil type where the field would be placed (some soils are more compactable than others), the type of ground cover present (a cover of good grass underlain by a good sandy layer is much better than packed clay or some impermeable or slowly impermeable surface layer), and the design of the drainage field itself. Consult with your local public health department. The national/international organization representing on-site wastewater/sewage interests is the National On-Site Wastewater Recycling Association, Inc. (NOWRA). Contact information is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.065 removal of garbage Garbage and rubbish shall be removed from rooms occupied by children, staff, parents, or volunteers on a daily basis and removed from the premises at least twice weekly or at other frequencies approved by the regulatory health authority. RATIONALE: This practice provides proper sanitation and protection of health, prevents infestations by rodents, insects, and other pests, and prevents odors and injuries. COMMENTS: Compliance can be tested by checking for evidence of infestation and odors. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.066 containment of garbage Garbage shall be kept in containers approved by the regulatory health authority. Such containers shall be constructed of durable metal or other types of material, designed and used so wild and domesticated animals and pests do not have access to the contents, and so they do not leak or absorb liquids. Waste containers shall be kept covered with tight-fitting lids or covers when stored. The facility shall have a sufficient number of waste and diaper containers to hold all of the garbage and diapers that accumulate between periods of removal from the premises. Plastic garbage bag liners shall be used in such containers. Exterior garbage containers shall be stored on an easily cleanable surface. Garbage areas shall be free of litter and waste that is not contained. Children shall not be allowed access to garbage, waste, and refuse storage areas. If a compactor is used, the surface shall be graded to a suitable drain, as approved by the regulatory health authority. RATIONALE: Containers for garbage attract animals and insects. When trash contains organic material, decomposition creates unpleasant odors. Therefore, child care facilities must choose and use garbage containers that control sanitation risks, pests, and offensive odors. Lining the containers with plastic bags reduces the contamination of the container itself and the need to wash the containers which hold a concomitant risk of spreading the contamination into the environment. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.067 containment of soiled diapers Soiled diapers shall be stored inside the facility in containers separate from other waste. Washable, plastic-lined, tightly covered receptacles, with a firmly fitting cover that does not require touching with contaminated hands or objects, shall be provided, within arm's reach of diaper changing tables, to store soiled diapers. The container for soiled diapers shall be designed to prevent the user from contaminating any exterior surfaces of the container or the user when inserting the soiled diaper. Soiled diapers do not have to be individually bagged before placing them in the container for soiled diapers. Soiled cloth diapers and soiled clothing that are to be sent home with a parent, however, shall be individually bagged. The following types of diaper containers shall not be used; a) Those that require the user's hand to push the diaper through a narrow opening; b) Those with exterior surfaces that must be touched with the hand; c) Those with exterior surfaces that are likely to be touched with the soiled diaper while the user is discarding the soiled diaper; d) Those that have lids with handles. Separate containers shall be used for disposable diapers, cloth diapers (if used), and soiled clothes and linens. All containers shall be inaccessible to children and shall be tall enough to prevent children reaching into the receptacle or from falling headfirst into containers. The containers shall be placed in an area that children cannot enter without close adult supervision. RATIONALE: Separate, plastic-lined waste receptacles that do not require touching with contaminated hands or objects and that children cannot access, enclose odors within, and prevent children from coming into contact with body fluids. Anything that increases handling increases potential for contamination. Step cans or other hands-free cans with tightly fitted lids provide protection against odor and hand contamination. Containers for soiled diapers should be of a type that prevents contamination of the exterior surfaces of the receptacle by touching during the diapering procedure. Separate bagging of each diaper increases the handling and therefore increases the risk of contamination. COMMENTS: Fecal material and urine should not be mixed with regular trash and garbage. Where possible, soiled disposable diapers should be disposed of as biological waste rather than in the local landfill. In some areas, recycling depots for disposable diapers may be available. The facility should not use the short, poorly made domestic step cans that require caregivers to use their hands to open the lids because the foot pedals don't work. Child care providers will find it worthwhile to invest in commercial-grade step cans of sufficient size to hold the number of soiled diapers the facility collects before someone can remove the contents to an outside trash receptacle. These are the types used by doctor's offices, hospitals, and restaurants. A variety of sizes and types are available from restaurant and medical wholesale suppliers. Other types of hands-free containers can be used as long as the user can place the soiled diaper into the receptacle without increasing contact of the user's hands and the exterior of the container with the soiled diaper. For additional information on waste that involves body fluids, diaper storage, and disposal, see STANDARD 3.026. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.068 labeling, cleaning and disposal of waste and diaper containers Each waste and diaper container shall be labeled to show its intended contents. These containers shall be cleaned daily to keep them free from build-up of soil and odor. Wastewater from these cleaning operations shall be disposed of by pouring it down a toilet or floor drain. Wastewater shall not be poured onto the ground, into handwashing sinks, laundry sinks, kitchen sinks, or bathtubs. RATIONALE: This standard prevents noxious odors and spread of disease. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.069 storage and disposal of infectious and toxic wastes Infectious and toxic wastes shall be stored separately from other wastes, and shall be disposed of in a manner approved by the regulatory health authority. RATIONALE: This practice provides for safe storage and disposal of infectious and toxic wastes. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.070 control of animal waste and pests Areas where children play shall be kept free of animal wastes, insects, infestation by rodents and other pests, and shall not provide shelter to pests. Whenever the regulatory agency determines that the presence of pests in the area constitutes a health hazard, the facility shall take the necessary actions to exclude, exterminate, or otherwise control such pests on its premises. All extensive extermination shall be provided by a licensed or certified pest control operator, and only after integrated pest management methods have been exhausted. RATIONALE: This standard reduces potential health hazards to children caused by the presence of pests. Before considering extensive extermination, other non-chemical pest management methods must be implemented. This will reduce unnecessary exposure of children to chemical pesticides. Uncovered sand is an invitation for a cat or other animal to defecate or urinate and, therefore, is a source for disease transmission (19). This standard also helps ensure pest control. Refer to STANDARD 5.070 through STANDARD 5.073, and STANDARD 5.202, for control of insects. COMMENTS: The rationale for this standard is one of several reasons why using sand as an impact-absorbing surface in playgrounds is not a good idea. It is almost impossible to cover such a surface. For additional information on sandboxes, see STANDARD 5.180. For additional information on pest control, see also Openings, on STANDARD 5.013 through STANDARD 5.019; and Insect Breeding Hazards, STANDARD 5.202. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.071 protection of openings from rodent entry Each foundation, floor, wall, ceiling, roof, window, exterior door, and basement and cellar hatchway shall be free from openings that would allow rodents to enter. Basement or cellar windows used, or intended to be used, for ventilation, and all other openings to a basement or cellar, shall not permit the entry of rodents. RATIONALE: This standard prevents access to the interior of the facility by rodents. Rodents can carry disease to humans. COMMENTS: Heavy-duty steel mesh screen (such as protective device) can be used to protect these entry points from access by rodents. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.072 protection of openings from flies and insects Openings to the outside shall be protected against the entrance of flies and other flying insects by: a) Outward-opening, self-closing doors; b) Closed windows; c) Screening; d) Air curtains; e) Other effective and approved means. RATIONALE: Minimizing the potential for flies and other flying insects from entering the child care environment will help prevent disease transmission, insect bites, and insect stings. House flies breed in excrement, garbage and other waste and have been implicated as mechanical vectors in the spread of disease. Some children can develop severe allergic reactions to insect bites and stings. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.073 type and use of pesticides and herbicides If pesticides are used, natural pesticides that are non-toxic to humans shall be given first consideration. If chemical pesticides are used, they shall be only those that are registered with the Environmental Protection Agency (EPA), of a type applied by a licensed exterminator, in a manner approved by the EPA. The facility shall have and consult a Material Safety Data Sheet (MSDS) for all toxic chemicals used, and shall be in compliance with the directions provided. General right-of-way pesticides or herbicides, sprayed in the community by others, shall be prohibited on the grounds of a child care facility. Pesticides shall be stored in their original containers and in a locked room or cabinet accessible only to authorized staff. No restricted-use pesticides shall be stored or used on the premises except by properly licensed persons. Banned pesticides shall not be used. Pesticides shall be applied in a manner that prevents skin contact and other exposure to children or staff members and minimizes odors in occupied areas. Notification shall be given to parents and staff before using pesticides, to determine if any child or staff member is sensitive to the product. A member of the child care staff shall directly observe the application to be sure that toxic chemicals applied on surfaces do not constitute a hazard to the children or staff. Pesticides shall be used in strict compliance with the instructions on the label or as otherwise directed or approved by the regulatory authority. No pesticide shall be applied while children are present. Following the use of pesticides, herbicides, fungicides, or other potentially toxic chemicals, the treated area shall be ventilated for the period re-commended on the product label or by a nationally certified regional poison control center before being reoccupied. Tests, recommended by a nationally certified regional poison control center, shall be taken to determine safe levels before reentering the facility. RATIONALE: Children must be protected from exposure to poisons. To prevent contamination and poisoning, child care staff must be sure that these chemicals are applied by individuals who are certified to do so. Direct observation of pesticide application by child care staff is essential to guide the exterminator away from surfaces that children can touch or mouth and to monitor for drifting of pesticides into these areas. The time of toxic risk exposure is a function of skin contact, the efficiency of the ventilating system, and the volatility of the toxic substance. The long-term effects of toxic substances are unknown. Spraying the grounds of a child care facility exposes children to toxic chemicals. COMMENTS: Manufacturers of pesticides usually provide product warnings that exposure to these chemicals can be poisonous. Material safety data sheets should be available from a licensed exterminator or the product manufacturer. Child care staff should ask to see the license of the exterminator and should be certain that the individual who applies the toxic chemicals has personally been trained and preferably, individually licensed. In some states only the owner of an extermination company is required to have this training, and he/she may then employ unskilled workers. Child care staff should ensure that the exterminator is familiar with the pesticide he/she is applying. Child care operators should contact their state pesticide office and request that their child care facility be added to the state pesticide sensitivity list. When a child care facility is placed on the state pesticide sensitivity list, the child care operator will be notified if there are plans for general pesticide application occurring near the child care facility. Child care staff and children who have developed sensitivity to pesticides can ask their physician to place them on a state pesticide sensitivity list. The state pesticide sensitivity list is made available to exterminators so that they are aware of people working or being cared for in a geographical area who have sensitivity to pesticides. For further information about pest control, contact the local health authority or the EPA. Contact information is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.074 testing for unsafe levels of toxic chemicals If the facility has been treated with a termiticide or any restricted or prohibited-use pesticide in the last 10 years, ambient measurements shall be taken and tested by an organization certified to make such tests according to Environmental Protection Agency (EPA) instructions to ensure that toxic chemicals are not present in unsafe levels. If the testing finds unsafe levels, children shall not be allowed to use these areas until effective corrective measures have been taken to achieve safe levels. RATIONALE: Many restricted or banned pesticides have residues that persist for many years. These residues can lead to toxic exposure of children. COMMENTS: Names of certified organizations that perform such tests can be obtained by contacting the regional office of the EPA. Contact information for the EPA is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home GENERAL FURNISHINGS AND EQUIPMENT REQUIREMENTS STANDARD 5.075 safety of equipment, materials and furnishings Equipment, materials, furnishings, and play areas shall be sturdy, safe, and in good repair and shall meet the recommendations of the U.S. Consumer Product Safety Commission (CPSC) for control of the following safety hazards: a) Openings that could entrap a child's head or limbs; b) Elevated surfaces that are inadequately guarded; c) Lack of specified surfacing and fall zones under and around climbable equipment; d) Mismatched size and design of equipment for the intended users; e) Insufficient spacing between equipment; f) Tripping hazards; g) Components that can pinch, sheer, or crush body tissues; h) Equipment that is known to be of a hazardous type (such as large animal swings); i) Sharp points or corners; j) Splinters; k) Protruding nails, bolts, or other components that could entangle clothing or snag skin; l) Loose, rusty parts; m) Hazardous small parts that may become detached during normal use or reasonably foreseeable abuse of the equipment and that present a choking, aspiration, or ingestion hazard to a child; n) Flaking paint; o) Paint that contains lead or other hazardous materials. RATIONALE: The hazards listed in this standard are those found by the U.S. Consumer Product Safety Commission (CPSC) to be most commonly associated with injury. COMMENTS: Equipment and furnishings that are not sturdy, safe, or in good repair, may cause falls, entrap a child's head or limbs, or contribute to other injuries. Disrepair may expose objects that are hazardous to children. Freedom from sharp points, corners, or edges shall be judged according to the Code of Federal Regulations, Title 16, Section 1500.48 , and Section 1500.49 . Freedom from small parts should be judged according to the Code of Federal Regulations, Title 16, Part 1501 . To obtain these publications, contact the Superintendent of Documents of the U.S. Government Printing Office. For assistance in interpreting the federal regulations, contact the U. S. Consumer Product Safety Commission (CPSC); the CPSC also has regional offices. Contact information for the Superintendent of Documents and the CPSC is located in Appendix BB. This standard is particularly important when equipment and furnishings are old and worn. Used equipment and furnishings should be closely inspected to determine whether they meet this standard before allowing them to be placed in a child care facility. If equipment and furnishings have deteriorated to a state of disrepair, where they are no longer sturdy or safe, they should be removed from all areas of a child care facility to which children have access. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.076 size of furniture Furniture shall be durable and child-sized or adapted for children's use. Tables shall be at waist height of the intended child-user and the child's feet shall be able to reach a firm surface while the child is seated. RATIONALE: Children cannot safely or comfortably use furnishings that are not sized for their use. When children eat or work at tables that are above the waist, they must reach up to get their food or do their work instead of bringing the food from a lower level to their mouth and having a comfortable arrangement when working to develop their fine-motor skills. When eating, this leads to scooping food into the mouth instead of eating more appropriately. When working, this leads to difficulty succeeding with hand-eye coordination. When children do not have a firm surface on which to rest their feet, they cannot reposition themselves easily if they slip down. This can lead to poor posture and increased risk of choking. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.077 surfaces of equipment, furniture, toys and play materials Equipment, furnishings, toys, and play materials shall have smooth, nonporous surfaces or washable fabric surfaces that are easy to clean and sanitize, or be disposable. RATIONALE: Few young children practice good hygiene. Messy play is developmentally appropriate in all age groups, and especially among very young children, the same group that is most susceptible to infectious disease. These factors lead to soiling and contamination of equipment, furnishings, toys, and play materials. To avoid transmission of disease within the group, these materials must be easy to clean and sanitize. COMMENTS: Toys that can be washed in a mechanical dishwasher that meets the standard for cleaning and sanitizing dishes can save labor, if the facility has a dishwasher. Otherwise, after the children have used them, these toys can be placed in a tub of soapy water to soak until the staff has time to scrub, rinse, and sanitize the surfaces of these items. Except for fabric surfaces, nonporous surfaces are best because porous surfaces can trap organic material and soil. Fabric surfaces that can be laundered provide the softness required in a developmentally appropriate environment for young children. If these fabrics are laundered when soiled, the facility can achieve cleanliness and sanitation. When a material cannot be recycled for safe and sanitary use, it should be discarded. TYPE OF FACILITY: Center; Large Family Child Care STANDARD 5.078 placement of equipment and furnishings Equipment and furnishings shall be placed to help prevent collisions and injuries while meeting the objectives of the curriculum and permitting freedom of movement by the children. RATIONALE: The placement of furnishings plays a significant role in the way space is used. If the staff places furnishings in such a way that they create large runways, children will run in this area. If the staff places furnishings that children can climb in locations where climbing is unsafe, this adds risk to the environment. Placement of furnishings should address the needs of the children for stimulation and development and at the same time help to prevent collisions and injury. COMMENTS: To prevent children from falling out of windows, the safest place for chairs and other furniture is away from windows. Chairs and other furnishings that children can easily climb should be kept away from cabinets and shelves to discourage children from climbing to a dangerous height or reaching for something hazardous. See STANDARD 5.014 for safety precautions for windows. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.079 Floors, walls, and ceilings Floors, walls, and ceilings shall be in good repair, and easy to clean when soiled. Only smooth, non porous surfaces shall be permitted in areas that are likely to be contaminated by body fluids or in areas used for activities involving food. Floors shall be free from cracks, bare concrete, dampness, splinters, sliding rugs, and uncovered telephone jacks or electrical outlets. Carpeting shall be clean, in good repair, nonflammable, and nontoxic. RATIONALE: Messy play and activities that lead to soiling of floors and walls is developmentally appropriate in all age groups, but especially among very young children, the same group that is most susceptible to infectious disease. These factors lead to soiling and contamination of floors and walls. A smooth, non porous surface is easier to clean and sanitize and therefore, helps prevent the spread of communicable diseases. To avoid transmission of disease within the group, and to maintain an environment that supports learning cleanliness as a value, all surfaces should be kept clean. Cracked or porous floors cannot be kept clean and sanitary. Dampness promotes the growth of mold. Sliding rugs and uncovered telephone jacks or electrical outlets in floors are tripping hazards. Damaged floors, walls or ceilings can expose underlying hazardous structural elements and materials. Surface materials must not pose health, safety, or fire hazards. COMMENTS: Carpeted floors are not smooth, and therefore, carpeting is not consistent with this standard, except for area carpets for activities that do not involve food or contact with body fluids. Many family child care homes and indoor playrooms of centers use wall-to-wall carpeting on the floor. Although carpeted floors may be more comfortable to walk and play on, smooth floor surfaces provide a better environment for children with allergies. Washable rugs can be placed on smooth floor surfaces. By using friction backings or underlayment, removable and washable carpeting can be used on smooth floor surfaces safely. When facilities use carpeting or sound-absorbing materials on walls and ceilings, these materials must not be used in areas where contamination with body fluids or food is likely, because they are difficult to clean. Thus, carpeted walls should not be present around the diaper change areas, in toilet rooms, in food preparation areas, or where food is served. Also, facilities should exercise caution when using carpeting in child care areas because the fibers, adhesive, and formaldehyde associated with the presence of carpeting can pose health problems. Obtain ASTM D2859-96 Standard Test Method for Flammability of Finished Textile Floor Covering Materials, for flammability of finished materials from American Society for Testing and Materials (ASTM). Contact information for the ASTM is located in Appendix BB. Ask the local fire marshal for fire safety code requirements. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.080 facility arrangements to minimize back injuries The child care setting shall be organized to reduce the risk of back injuries for adults provided that such measures do not pose hazards for children or affect the implementation of developmentally appropriate practice. Furnishings and equipment shall enable caregivers to hold and comfort children and enable their activities while minimizing the need for bending and for lifting and carrying heavy children and objects. Caregivers shall not routinely be required to use child-sized chairs, tables, or desks. RATIONALE: Back strain can arise from adult use of child-sized furniture. Analysis of worker compensation claims shows that employees in the service industries, including child care, have an injury rate as great as or greater than that of workers employed in factories. Back injuries are the leading type of injury (20). Appropriate design of work activities and training of workers can prevent most back injuries. The principles to support these recommendations (see Comments) are standard principles of ergonomics, in which jobs and workplaces are designed to eliminate biomechanical hazards. In a statewide (Wisconsin) survey of health status, behaviors and concerns, 446 randomly selected early childhood professionals, directors, center teachers, and family providers, reported dramatic changes in frequency of backache and fatigue symptoms since working in child care (21). COMMENTS: Some approaches to reduce risk are: Adult-height changing tables; Small, stable stepladders, stairs, and similar equipment to enable children to climb to the changing table or other places to which they would otherwise be lifted, without creating a fall hazard; Convenient equipment for moving children, reducing the necessity of carrying them; Adult furniture that eliminates awkward sitting or working positions in all areas where adults work. This standard is not intended to interfere with child adult interactions or to create hazards for children. Modifications can be made in the environment to minimize hazards and injuries for both children and adults. Adult furniture has to be available at least for break times, staff meetings, etc. See also Staff Health, STANDARD 1.045 through STANDARD 1.049. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.081 high chair requirements High chairs, if used, shall have a wide base and if equipped with a tray, shall have a passive means to prevent a child from slipping down and becoming entrapped between the tray and seat. High chairs shall also be equipped with a safety strap to prevent a child from climbing out of the chair. High chairs shall be labeled or warranted by the manufacturer in documents provided at the time of purchase or verified thereafter by the manufacturer as meeting the American Society for Testing Materials ( ASTM ) Standard F404-99a Consumer Safety Specification for High Chairs . RATIONALE: This standard is to help prevent falls. ASTM Standard F404-99a Consumer Safety Specifications for High Chairs covers: Sharp edges Locking devices Drop tests of the tray Disengagement of the tray Load and stability of the chair Protection from coil springs and scissoring Maximum size of holes Restraining system tests Labeling Instructional literature COMMENTS: The Juvenile Products Manufacturers Association (JPMA) has a testing and certification program for highchairs, play yards, carriages, strollers, walkers, gates, and expandable enclosures. When purchasing such equipment, consumers can look for labeling that certifies that these products meet the standards. Contact information for the ASTM and JPMA is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.082 carriage, stroller, gate, enclosure, and play yard requirements Each carriage, stroller, gate, enclosure, and play yard used shall meet the corresponding American Society for Testing and Materials (ASTM) standard and shall be so labeled on the equipment. · Carriages/strollers: ASTM F833-00 Standard Consumer Safety Performance Specification for Carriages and Strollers · Gates/enclosures: ASTM F1004-00 Consumer Safety Specification for Expansion Gates and Expandable Enclosures · Play yards: ASTM F406-99 Consumer Safety Specification for Play Yards RATIONALE: The presence of a certification seal placed on Juvenile Products Manufacturers Association (JPMA) products ensures that the product is in compliance with the requirements of the current safety standard for that product at the time of manufacture. ASTM standards are, by congressional act, accepted as federal safety standards. COMMENTS: For more information, contact the JPMA or the ASTM. Contact information is located in Appendix BB. TYPE OF FACILITY: Center; Large Family Child Care Home; Small Family Child Care Home STANDARD 5.083 baby walkers Baby walkers that the child can move across the floor shall not be used in any type of child care facility. RATIONALE: The environment of a child staying at child care facility is different than that of a child living in his/her own home. In general, more children are present and caregivers cannot provide one-to-one supervision to a child using a baby walker. Baby walkers are dangerous toys because they move children around too fast and to hazardous areas, such as stairs. The upright position also brings children close to objects that they can pull down onto themselves. Many injuries, some fatal, have been associated with baby walkers. Parents and caregivers report that children who are not yet able to pull or hold themselves upright seem to enjoy using walkers. Nevertheless, there is no evidence that baby walkers are beneficial to children. A study of twins found that the twin not using the walker walked slightly earlier than the sibling using the walker (22). Baby walkers used with high-risk infants and young children with cerebral palsy promoted undesirable reflexes and did not enable the child to develop normally (22). Recent evidence indicates that stationary devices may also pose a problem by delaying motor development. In one small study, children who used walkers sat, crawled, and walked later than those who did not use walkers. The effect seemed to last for as long as ten months after the initial use of a walker (26). Baby walkers are the cause of more injuries than any other baby product. Each year, an estimated 21,300 children under 15 months of age were treated in U.S. hospital emergency rooms for injuries related to baby walkers. The majority of the injuries resulted from falls down stairs. A small number of injuries resulted from tipovers, burns, and other injuries from bumping into or climbing on a walker. Because of increased mobility , a child in an baby walker is at high