Caring for Our Children (CFOC)

Chapter 3: Health Promotion and Protection

3.4 Health Protection in Child Care

3.4.4 Child Abuse and Neglect Facility Layout to Reduce Risk of Child Abuse and Neglect

Content in the STANDARD was modified on 08/28/2018

All caregivers/teachers have a responsibility to supervise children at all times. The physical layout of child care facilities should be arranged to allow for a high level of visibility in all areas used by children, including diaper changing stations and toileting areas, while upholding children’s right to privacy. All areas should be within view by at least 1 adult in addition to the primary caregiver/teacher at all times.

For center-based programs, rooms should be designed so that there are windows to the hallways to keep classroom activities visible, or it should be ensured that inside doors to activity areas remain open during hours of operation. Home-based programs should ensure that activities are conducted in 1 or 2 primary rooms that are dedicated to child care programming. These arrangements reduce the risk of child abuse and neglect and the likelihood of extended periods in isolation for individual caregivers/teachers with children, especially in areas where children may be partially undressed or in the nude. For small family child care home caregivers/teachers, a plan should be intentionally made for how to ensure the most active supervision possible.

Caregivers/teachers should be educated and trained in child abuse prevention and remain aware of potential risks of abuse and neglect of a child when in care. Other facility staff should periodically walk into child care rooms to monitor/prevent potential instances of child abuse and neglect. Family home caregivers/teachers should not allow other adults in the household to be alone with children at any time.




Despite the fact that most child abuse and neglect occur inside the home, children may also experience abuse by caregivers/teachers while in out-of-home care (1). While upholding a child’s right to privacy, centers can take action to prevent child abuse and neglect from occurring. For instance, the presence of multiple caregivers greatly reduces the risk of serious abusive injury. Child maltreatment tends to occur in privacy and isolation, especially in toileting areas and during diaper changing (2).


Small family child care homes will need to be creative to ensure active supervision at all times, even when the children are toileting. This may include group potty time for toddlers or creating a very small play area in the hall outside the bathroom to which all the small children can be moved when each one in is the bathroom.

Additional information on preventing child abuse in out-of-home care can be found at:

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Toilet Learning/Training Methods of Supervision of Children Diaper Changing Procedure Procedure for Changing Children’s Soiled Underwear, Disposable Training Pants and Clothing Situations that Require Hand Hygiene 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)
  1. American Academy of Pediatrics. Child abuse and neglect. Web site. Updated April 13, 2018. Accessed June 26, 2018

  2. United States Department of Agriculture, National Institute of Food and Agriculture. Cooperative Extension. Creating safe and appropriate diapering, toileting, and hand washing areas in child care. Published October 2, 2015. Accessed June 26, 2018


Content in the STANDARD was modified on 08/28/2018