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The first edition of Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs (CFOC) was published in 1992. Professionals in the fields of early education and health quickly embraced the standards as effective tools to improve health and safety in early education and child care programs. The 981 standards in CFOC, 1st edition provided a comprehensive blueprint for quality. After the publication of the standards, some users asked the experts to identify a subset of the standards linked to the most serious risks so that they could begin their use of CFOC with this subset as a priority. In 1997, the National Resource Center for Health and Safety in Child Care published the 1st edition of Stepping Stones to Using Caring for Our Children as a companion document. The selected standards were those most likely to prevent frequent or severe disease, disability and death (morbidity and mortality) in child care settings. Subsequently, many public and private organizations such as state child care, health, and resource and referral agencies, as well as a variety of professionals who work in child care settings, parents, and advocacy groups have used Stepping Stones to target limited resources to these priority standards.
Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs was revised extensively from 1997-2001. The Maternal and Child Health Bureau (MCHB) funded the revision process that involved updating, consolidating and adding standards as appropriate. The resulting document contains 659 standards. The American Academy of Pediatrics (AAP), the American Public Health Association (APHA), and the National Resource Center for Health and Safety in Child Care (NRC) jointly published CFOC, 2nd Edition in 2002. To reflect the many changes/additions to CFOC, 2nd Edition content, NRC worked with the Steering Committee for CFOC, 2nd Edition to implement a process for revising Stepping Stones that was completed in 2003. Using the same criteria to select standards for the 2nd edition as for the first edition of Stepping Stones, 233 standards in CFOC, 2nd Edition were identified as having the greatest impact on reducing frequent or severe disease, disability and death (morbidity and mortality) in early education and child care settings.
Field-based informants were interviewed to identify significant problems in health and safety practice that are covered in CFOC, but were not included in Stepping Stones, 1st Edition;
Fifty-five experts from 10 technical subject areas (experts who had developed the content for CFOC, 2nd Edition) rated the risk of harm to children and child care staff for noncompliance with specific standards. The experts reviewed the standards they had developed that were in the 1st edition of Stepping Stones and those that had been identified by field-based informants;
Users of Stepping Stones, 1st Edition were surveyed on methods to enhance the format and usability of Stepping Stones, 2nd Edition; and
National organizations, representing providers, parents, child care advocates, health professionals, safety specialists, early childhood educators, regulators, and federal, military, and state agencies that promote and implement quality and safety in the field of early education and child care, were asked for feedback on the standards and enhancements in the format suggested by the previous steps.
The NRC enabled discussions to establish among the participants wherever possible and the Steering Committee decided which arguments for changes for the 2nd edition were persuasive. The significant content and format changes and additions for this new edition of Stepping Stones are:
Addition of new standards on sleep position of infants related to SIDS studies; oral health requirements; outdoor play temperature conditions; training on standard precautions; handling and feeding of human milk; care of children with asthma and with food allergies; availability of water in daily program activities and for supply in disasters; installation of safety devices to reduce risks of finger pinching;
Integration of standards throughout the document that are relevant to children with special needs, as well as to all children, to promote inclusion;
Our sincere appreciation goes to all of our colleagues who willingly gave their time and expertise to the development of this resource. Please see Acknowledgements on page v and a listing of all contributors on page 147 and Advice to Users on page x for more information on intended audiences and uses. We hope this latest offering provides the support and assistance needed to improve the health and safety of children in early education and child care settings.
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Stepping Stones, 2nd Edition Copyright 2003 http://nrckids.org 1-800-598-5437 info@nrckids.org |
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