About Us

National Resource Center for Health and

Safety in Child Care and Early Education

Since 1995, the National Resource Center for Health and Safety in Child Care and Early Education (NRC) has maintained and continues to develop national health and safety standards for early care and education settings, as compiled in Caring for Our Children: National Health and Safety Standards; Guidelines for Early Care and Education Programs (CFOC).

With each edition of CFOC, the NRC has developed standard-based resources. Current resources may be seen in the CFOC Tab. (Retired resources may be seen below)


Caring for Our Children CoverCFOC was published in 1992 by the American Public Health Association (APHA) and the American Academy of Pediatrics (AAP), working with the National Center for Education in Maternal and Child Health at Georgetown University. In 1995 the NRC was established at the University of Colorado, College of Nursing under the direction of Dr. Marilyn J. Krajicek, who has since led CFOC revisions. CFOC, 2nd Edition was published in 2002, and CFOC, 3rd Edition in 2011, with our publishing partners AAP, APHA, and MCHB. NRC subsequently created numerous standards-based resources to promote health and safety in child care and early education. In 2012, the NRC created a searchable CFOC3 standards database for the Early Care and Education (ECE) community to access the most up to date content.

Healthy Weight

Preventing Obesity CoverA collection of standards promoting healthy weight, Preventing Childhood Obesity in Early Care and Education Programs (PCO), was published in 2010, and updated in 2012 as PCO2. Participants in a 2010 National Healthy Weight Advisory Committee Meeting prioritized PCO healthy weight practices that would have the most impact upon childhood obesity. In 2010, the NRC compared all states’ child care licensing regulations to these healthy weight practices, as reported in Achieving a State of Healthy Weight, ASHW. MCHB funded yearly ASHW updates through 2014. The Centers for Disease Control and Prevention (CDC) subsequently funded ASHW updates from 2015 to date.


NRC Support

The Maternal and Child Health Bureau (MCHB) funded the NRC at the University of Colorado from 1995 to 2015 to: update CFOC standards, develop standard-based collections, maintain a centralized access point for states' childcare licensing regulations, and assess those regulations for support of obesity prevention.

In 2015, the American Academy of Pediatrics (AAP) was awarded a grant to establish the National Center on Early Childhood Health and Wellness (NCECHW), a collaborative effort of the Office of Head Start, Office of Child Care (OCC), and MCHB. AAP awarded a contract to the NRC to continue updating the standards and the CFOC3 database.

Retired NRC Resources

Caring for Our Children, 2nd Edition: The second edition of CFOC standards was published in 2002.

Healthy Kids, Healthy Care: The adaptation of Caring for Our Children, 2nd Edition, was published in 2006 for parents/guardians in English and Spanish.

CFOC2 Special Collections (retired upon publication of CFOC3):

  • Child Care Health Consultants
  • Children with Special Health Care Needs
  • Emergency/Disaster Preparedness for Child Care Programs
  • Medication Administration
  • Reducing the Risk of Sudden Infant Death Syndrome (SIDS)

Stepping Stones: The first edition of Stepping Stones consisted of selected standards from the Caring for Our Children, 2nd Edition, most likely to prevent adverse outcomes in early care and education.

  • Stepping Stones to Using Caring for Our Children, 2nd Edition, Compliance/Comparison Checklist

Toolkit for Integrating Healthy Physical and Mental Development in Early Learning Guidelines: This was an instrument to strengthen health and safety in early learning guidelines, published in 2008.

Parent’s Checklist for Good Dental Health Practices in Child Care

A Parents’ Guide to Choosing Safe and Healthy Child Care: The 1st edition of this checklist was based upon the 13 Indicators of Quality Child Care: Research Update, by Richard Fiene, PhD.