Advice To Users

The intended users of the standards include all who care for young children in early care and education settings and who work toward the goal of ensuring that all children from day one have the opportunity to grow and develop appropriately, to thrive in healthy and safe environments, and to develop healthy and safe behaviors that will last a lifetime.

All of the standards are attainable. Some may have already been attained in individual settings; others can be implemented over time. For example, any organization that funds early care and education should, in our opinion, adopt these standards as funding requirements and should set a payment rate that covers the cost of meeting them.

Recommended Use


We have defined many terms in the Glossary. Some of these are so important to the user that we are emphasizing them here as well.

Types of Requirements:

A standard is a statement that defines a goal of practice. It differs from a recommendation or a guideline in that it carries greater incentive for universal compliance. It differs from a regulation in that compliance is not necessarily required for legal operation. It usually is legitimized or validated based on scientific or epidemiological data, or when this evidence is lacking, it represents the widely agreed upon, state-of-the-art, high-quality level of practice.

The agency, program, or health practitioner that does not meet the standard may incur disapproval or sanction from within or without the organization. Thus, a standard is the strongest criterion for practice set by a health organization or association. For example, many manufacturers advertise that their products meet ASTM standards as evidence to the consumer of safety, while those products that cannot meet the standards are sold without such labeling to undiscerning purchasers.

A guideline is a statement of advice or instruction pertaining to practice. It originates in an organization with acknowledged professional standing. Although it may be unsolicited, a guideline often is developed in response to a stated request or perceived need for such advice or instruction. For example, the American Academy of Pediatrics (AAP) has a guideline for the elements necessary to make the diagnosis of Attention-Deficit/Hyperactivity Disorder.

A regulation takes a previous standard or guideline and makes it a requirement for legal operation. A regulation originates in an agency with either governmental or official authority and has the power of law. Such authority is usually accompanied by an enforcement activity. Examples of regulations are: State regulations pertaining to child:staff ratios in a licensed child care center, and immunizations required to enter an early care and education program. The components of the regulation will vary by topic addressed as well as by area of jurisdiction (e.g., municipality or state). Because a regulation prescribes a practice that every agency or program must comply with, it usually is the minimum or the floor below which no agency or program should operate.

Types of Facilities:

Child care offers developmentally appropriate care and education for young children who receive care in out-of-home settings (not their own home). Several types of facilities are covered by the general definition of child care and education. Although there are generally understood definitions for child care facilities, states vary greatly in their legal definitions, and some overlap and confusion of terms still exists in defining child care facilities. Although the needs of children do not differ from one setting to another, the declared intent of different types of facilities may differ. Facilities that operate part-day, in the evening, during the traditional work day and work week, or during a specific part of the year may call themselves by different names. These standards recognize that while children's needs do not differ in any of these settings, the way children's needs are met may differ by whether the facility is in a residence or a non-residence and whether the child is expected to have a longer or only a very short-term arrangement for care.

For definitions of other special types of child care - drop-in, school-age, for the mildly ill - see Standard Uniform Categories and Definitions.

The standards are to guide all the types of programs listed above.

Age Groups:

Although we recognize that designated age groups and developmental levels must be used flexibly to meet the needs of individual children, many of the standards are applicable to specific age and developmental categories. The following categories are used in Caring for Our Children.

AgeFunctional Definition (By Developmental Level)
InfantBirth-12 monthsBirth to ambulation
Toddler13-35 monthsAmbulation to accomplishment of self-care routines such as use of the toilet
Pre-schooler36-59 monthsFrom achievement of self-care routines to entry into regular school
School-Age Child5-12 yearsEntry into regular school, including kindergarten through 6th grade

Format and Language

Each standard unit has at least three components: the Standard itself, the Rationale, and the applicable Type of Facility. Most standards also have a Comment section, a Related Standards section and a References section. The reader will find the scientific reference and/or epidemiological evidence for the standard in the rationale section of each standard. The Rationale explains the intent of and the need for the standard. Where no scientific evidence for a standard is available, the standard is based on the best available professional consensus. If such a professional consensus has been published, that reference is cited. The Rationale both justifies the standard and serves as an educational tool. The Comments section includes other explanatory information relevant to the standard, such as applicability of the standard and, in some cases, suggested ways to measure compliance with the standard. Although this document reflects the best information available at the time of publication, as was the case with the first and second editions, this third edition will need updating from time to time to reflect changes in knowledge affecting early care and education.

Caring for Our Children is available at no cost online at It is also available in print format for a fee from the American Academy of Pediatrics (AAP) and the American Public Health Association (APHA).

Standards have been written to be measurable and enforceable. Measurability is important for performance standards in a contractual relationship between a provider of service and a funding source. Concrete and specific language helps caregivers/teachers and facilities put the standards into practice. Where a standard is difficult to measure, we have provided guidance to make the requirement as specific as possible. Some standards required more technical terminology (e.g., certain infectious diseases, plumbing and heating terminology). We encourage readers to seek interpretation by appropriate specialists when needed. Where feasible, we have written the standards to be understood by readers from a wide variety of backgrounds.

The Steering Committee agreed to consistent use of the terms below to convey broader concepts instead of using a multitude of different terms.

Relationship of the Standards to Laws, Ordinances, and Regulations

The members of the technical panels could not annotate the standards to address local laws, ordinances, and regulations. Many of these legal requirements have a different intent from that addressed by the standards. Users of this document should check legal requirements that may apply to facilities in particular locales.

In general, child care is regulated by at least three different legal entities or jurisdictions. The first is the building code jurisdiction. Building inspectors enforce building codes to protect life and property in all buildings, not just child care facilities. Some of the standards should be written into state or local building codes, rather than into the licensing requirements.

The second major legal entity that regulates child care is the health system. A number of different codes are intended to prevent the spread of disease in restaurants, hospitals, and other institutions where hazards and risky practices might exist. Many of these health codes are not specific to child care; however, specific provisions for child care might be found in a health code. Some of the provisions in the standards might be appropriate for incorporation into a health code.

The third legal jurisdiction applied to child care is child care licensing. Usually, before a child care operator receives a license, the operator must obtain approvals from health and building safety authorities. Sometimes a standard is not included as a child care licensing requirement because it is covered in another code. Sometimes, however, it is not covered in any code. Since children need full protection, the issues addressed in this document should be addressed in some aspect of public policy, and consistently addressed within a community. In an effective regulatory system, different inspectors do not try to regulate the same thing. Advocates should decide which codes to review in making sure that these standards are addressed appropriately in their regulatory systems. Although the licensing requirements are most usually affected, it may be more appropriate to revise the health or building codes to include certain standards, and it may be necessary to negotiate conflicts among applicable codes.

The National Standards are for reference purposes only and should not be used as a substitute for medical or legal consultation, nor be used to authorize actions beyond a person's licensing, training, or ability.