Caring for Our Children (CFOC)

Chapter 1: Staffing

1.5 Substitutes

1.5.0 Orientation of Substitutes

Content in the STANDARD was modified on 5/22/2018

The director of any center or large family child care home and the small family child care home caregiver/teacher should provide orientation training to newly hired substitutes, including a review of all the program’s policies and procedures (see sample that follows). This training should include the opportunity for an evaluation and a repeat demonstration of the training lesson. Orientation should be documented in all child care settings. Substitutes should have background screenings.

All substitutes should be oriented to, and demonstrate competence in, the tasks for which they will be responsible.

On the first day a substitute caregiver/teacher should be oriented on the following topics:

  1. Safe infant sleep practices
    1. The practice of putting infants down to sleep positioned on their backs and on a firm surface, along with all safe infant sleep practices, to reduce the risk of sudden infant death syndrome (SIDS), as well as general nap time routines and healthy sleep hygiene for all ages.
  2. Any emergency medical procedure or medication needs of the children
  3. Access to the list of authorized individuals for releasing children
  4. Any special dietary needs of the children


During the first week of employment, all substitute caregivers/teachers should be oriented to, and should demonstrate competence in, at least the following items:

  1. The names of the children for whom the caregiver/teacher will be responsible and their specific developmental and special health care needs
  2. The planned program of activities at the facility
  3. Routines and transitions
  4. Acceptable methods of discipline
  5. Meal patterns and safe food-handling policies of the facility (Special attention should be given to life-threatening food allergies.)
  6. Emergency health and safety procedures
  7. General health policies and procedures as appropriate for the ages of the children cared for, including, but not limited to

               1. Hand hygiene techniques, including indications for hand hygiene

               2. Diapering technique, if care is provided to children in diapers, including appropriate diaper disposal and diaper changing techniques and use and wearing of gloves

               3. Preventing shaken baby syndrome/abusive head trauma

               4. Strategies for coping with crying, fussing, or distraught infants and children

               5. Early brain development and its vulnerabilities

               6. Other injury prevention and safety, including the role of a mandatory child abuse reporter to report any suspected abuse/neglect

               7. Correct food preparation and storage techniques, if employee prepares food

               8. Proper handling and storage of human (breast) milk, when applicable, and formula preparation, if formula is handled

               9. Bottle preparation, including guidelines for human milk and formula, if care is provided to infants or children with bottles

               10. Proper use of gloves in compliance with Occupational Safety and Health Administration blood-borne pathogen regulations

      h. Emergency plans and practices


On employment, substitutes should be able to carry out the duties assigned to them.


Because facilities and the children enrolled in them vary, orientation programs for new substitutes can be most productive. Because of frequent staff turnover, comprehensive orientation programs are critical to protecting the health and safety of children and new staff (1,2).  Most SIDS deaths in child care occur on the first day of care or within the first week due to unaccustomed prone (on stomach) sleeping. Unaccustomed prone sleeping increases the risk of SIDS 18 times (3). 


Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Background Screening Discipline Measures Handling Physical Aggression, Biting, and Hitting Preventing Expulsions, Suspensions, and Other Limitations in Services Prohibited Caregiver/Teacher Behaviors Scheduled Rest Periods and Sleep Arrangements Type of Diapers Worn Situations that Require Hand Hygiene Handwashing Procedure Assisting Children with Hand Hygiene Training and Monitoring for Hand Hygiene Hand Sanitizers Prevention of Exposure to Blood and Body Fluids Medical Emergency Procedures Use of Fire Extinguishers Response to Fire and Burns General Requirements for Toilet and Handwashing Areas Location of Toilets and Privacy Issues Ability to Open Toilet Room Doors Preventing Entry to Toilet Rooms by Infants and Toddlers Chemical Toilets Ratios of Toilets, Urinals, and Hand Sinks to Children Toilet Learning and Training Equipment Cleaning and Disinfecting Toileting Equipment Waste Receptacles in the Child Care Facility and in Child Care Facility Toilet Room(s) Sleeping Equipment and Supplies Cribs Stackable Cribs Futons Bunk Beds Exchange of Information at Transitions Food and Nutrition Service Policies and Plans Infant Feeding Policy Written Plan and Training for Handling Urgent Medical or Threatening Incidents Review of Written Plan for Urgent Care and Threatening Incidents Records of Nutrition Service
Appendix D: Gloving
  1. Landry SH, Zucker TA, Taylor HB, et al. Enhancing early child care quality and learning for toddlers at risk: the responsive early childhood program. Dev Psychol. 2014;50(2):526–541

  2. Ellenbogen S, Klein B, Wekerle C. Early childhood education as a resilience intervention for maltreated children. Early Child Dev Care. 2014;184:1364–1377
  3. Ball HL, Volpe LE. Sudden infant death syndrome (SIDS) risk reduction and infant sleep location—moving the discussion forward. Soc Sci Med. 2013;79:84–91


Content in the STANDARD was modified on 5/22/2018