Caring for Our Children (CFOC)

Chapter 6: Play Areas/Playgrounds and Transportation

6.3 Water Play Areas (Pools, Etc.)

6.3.1 Access to and Safety Around Bodies of Water

6.3.1.1: Enclosure of Bodies of Water

Content in the STANDARD was modified on 02/27/2020.

All water hazards, such as pools, swimming pools, stationary wading pools, ditches, fish ponds, and water retention or detention basins, should be enclosed with a permanent fence, wall, building wall, or combination thereof that is 4 to 6 feet in height or higher. The barrier must measure a distance of 3 feet horizontally from the swimming pool or body of water.1 The maximum vertical clearance (or gapping) allowed between the ground and the fence shall be 2 inches from surfaces that are not solid, such as grass or gravel, and measured on the side of the barrier that faces away from the vessel.1(p25)

Openings in the fence should be no greater than 3.5 inches.1 The fence should be constructed to discourage children and unwanted visitors from climbing and be kept in good repair. A house exterior wall can constitute one side of a fence if the wall has no openings capable of providing direct access to the pool (eg, doors, windows).

If the fence is made of horizontal and vertical members (like a typical wooden fence) and the distance between the tops of the horizontal parts of the fence is less than 45 inches, the horizontal parts should be on the swimming pool side of the fence.1(p26) The spacing of the vertical members and/or all mesh barriers should not exceed 1.75 inches.1(p26)

Exit and entrance points should have self-closing, positive latching gates with locking devices a minimum of 54 inches from the ground.1(p26–27)

If the facility has a water play area, the following requirements should be met:

  1. Water play areas should conform to all state and local health regulations.
  2. Water play areas should not include hidden or enclosed spaces.
  3. Spray areas and water-collecting areas should have a nonslip surface, such as asphalt.
  4. Water play areas, particularly those that have standing water, should not have sudden changes in depth of water.
  5. Drains, streams, waterspouts, and hydrants should not create strong suction effects or water-jet forces.
  6. All toys and other equipment used in and around the water play area should be made of sturdy plastic or metal (no glass should be permitted).
  7. Water play areas in which standing water is maintained for more than 24 hours should be treated according to Standard 6.3.4.1: Pool Water Quality and inspected for glass, trash, animal excrement, and other foreign material.

All areas must be visible to allow caregivers/teachers adequate active supervision of all children.2

RATIONALE

Fenced enclosures around swimming pools and spas provide an adequate barrier to prevent unwanted and unsupervised access.3 Drownings can occur in fresh water, often in home swimming pools within a few feet of safety and in the presence of a supervising adult.4 An effective fence is one that prevents a child from getting over, under, or through it and keeps the child from gaining access to the pool or body of water except when supervising adults are present. Fences are not childproof, but they provide a layer of protection for a child who strays from supervision. Fence heights are a matter of local ordinances with minimum heights being 5 feet.

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
6.2.5.1 Inspection of Indoor and Outdoor Play Areas and Equipment
6.2.5.2 Inspection of Play Area Surfacing
6.3.1.2 Accessibility to Above-Ground Pools
6.3.1.3 Sensors or Remote Monitors
6.3.1.7 Pool Safety Rules
6.3.4.1 Pool Water Quality
REFERENCES

  1. International Code Council, The Association of Pool & Spa Professionals. 2012 International Swimming Pool and Spa Code. Country Club Hills, IL: International Code Council; 2011. https://www.waterparks.org/docs/ISPSC-PV1.pdf. Accessed August 21, 2019

  2. US Department of Health and Human Services, Administration for Children and Families, Head Start Early Childhood Learning and Knowledge Center. Safety practices. Active supervision. https://eclkc.ohs.acf.hhs.gov/safety-practices/article/active-supervision. Updated January 29, 2019. Accessed August 21, 2019

  3. American Red Cross. Swimming and Water Safety. https://www.redcross.org/store/swimming-and-water-safety-manual-rev-04-14/651327.html?cgid=sp-lifeguarding-and-learn-to-swim. Accessed August 21, 2019

  4. Leavy JE, Crawford G, Leaversuch F, Nimmo L, McCausland K, Jancey J. A review of drowning prevention interventions for children and young people in high, low and middle income countries. J Community Health. 2016;41(2):424–441

NOTES

Content in the STANDARD was modified on 02/27/2020.

6.3.1.2: Accessibility to Above-Ground Pools


Above-ground pools should have non-climbable sidewalls that are at least four feet high or should be enclosed with an approved fence, as specified in Standard 6.3.1.1 (1,2). When the pool is not in use, steps should be removed from the pool or otherwise protected to ensure that they cannot be accessed.
RATIONALE
The U. S. Consumer Product Safety Commission (CPSC) has estimated that each year about 300 children under five-years-old drown in swimming pools (3).
COMMENTS
CPSC has published an illustrated guideline (Safety barrier guidelines for home pools) to explain barriers around and access to home swimming pools (3). The document is available online at http://www.cpsc.gov/cpscpub/pubs/pool.pdf.
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
6.3.1.1 Enclosure of Bodies of Water
REFERENCES
  1. ASTM International (ASTM). 2008. Standard guide for fences for residential outdoor swimming pools, hot tubs, and spas. ASTM F1908-08. West Conshohocken, PA: ASTM.
  2. ASTM International (ASTM). 2009. Standard guide for fences/barriers for public, commercial, and multi-family residential use outdoor play areas. ASTM F2049-09b. West Conshohocken, PA: ASTM.
  3. U. S. Consumer Product Safety Commission (CPSC). Safety barrier guidelines for home pools. Pub. no. 362. Washington, DC: CPSC. http://www.cpsc.gov/cpscpub/pubs/pool.pdf.

6.3.1.3: Sensors or Remote Monitors

Content in the STANDARD was modified on 02/27/2020.

Early care and education programs should consider installing additional safety features such as pool alarms, sensors, and/or remote monitors, not as a substitute for enclosures (ie, a fence) or active supervision but to ensure greater safety for all children enrolled.1,2

RATIONALE

Unintentional drowning is the leading cause of unintentional injury-related deaths in children 1 to 4 years of age.3 Enclosures around all water hazards, such as pools, swimming pools, stationary wading pools, ditches, fish ponds, and water retention or detention basins, as well as sensors, remote monitors, or alarms, can help early care and education centers avoid water-related injuries and death.

 

A temporary power outage negates the protection of sensors; therefore, they should not be used in lieu of proper enclosures. In addition, responses to an emergency are delayed if a remote monitor is used to replace active supervision. Active supervision is a strategy that requires early care and education programs to ensure no child is left alone or unsupervised.4

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
1.1.1.5 Ratios and Supervision for Swimming, Wading, and Water Play
2.2.0.1 Methods of Supervision of Children
2.2.0.4 Supervision Near Bodies of Water
REFERENCES

  1. Dellinger A, Gilchrist J. Leading causes of fatal and nonfatal unintentional injury for children and teens and the role of lifestyle clinicians. Am J Lifestyle Med. 2019;13(1):7–21

  2. Gromicko N. Pool alarms. International Association of Certified Home Inspectors website. https://www.nachi.org/pool-alarms.htm. Accessed August 21, 2019

  3. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Office of Statistics and Programming. 10 leading causes of injury death by age group. Highlighting unintentional injury deaths, United States—2005. https://www.cdc.gov/injury/images/lc-charts/10lc_unintentional_injury_2005b-a.pdf. Accessed August 21, 2019

  4. US Department of Health and Human Services, Administration for Children and Families, Head Start Early Childhood Learning and Knowledge Center. Safety practices. Active supervision. https://eclkc.ohs.acf.hhs.gov/safety-practices/article/active-supervision. Updated January 29, 2019. Accessed August 21, 2019

NOTES

Content in the STANDARD was modified on 02/27/2020.

6.3.1.4: Safety Covers for Swimming Pools


When not in use, in-ground and above-ground swimming pools should be covered with a safety cover that meets or exceeds the ASTM International (ASTM) standard “F1346-03: Standard performance specification for safety covers and labeling requirements for all covers for swimming pools, spas, and hot tubs” (2).
RATIONALE
Fatal injuries have occurred when water has collected on top of a secured pool cover. The depression caused by the water, coupled with the smoothness of the cover material, has proved to be a deadly trap for some children (1). The ASTM standard now defines a safety cover “as a barrier (intended to be completely removed before water use) for swimming pools, spas, hot tubs, or wading pools, attendant appurtenances and/or anchoring mechanisms which reduces--when properly labeled, installed, used and maintained in accordance with the manufacturer’s published instructions--the risk of drowning of children under five years of age, by inhibiting their access to the contained body of water, and by providing for the removal of any substantially hazardous level of collected surface water” (2).

Safety covers reduce the possibility of contamination by animals, birds, and insects.

COMMENTS
Facilities should check whether the manufacturers warrant their pool covers as meeting ASTM standards. See ASTM standard “F1346-03.” Some jurisdictions require four-sided fencing around swimming pools; the facility should follow the requirements of their jurisdiction. Best practice is four-sided fencing.
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
6.3.1.1 Enclosure of Bodies of Water
REFERENCES
  1. U.S. Consumer Product Safety Commission (CPSC). 2005. Guidelines for entrapment hazards: Making pools and spas safer. Washington, DC: CPSC. http://www.cdph.ca.gov/HealthInfo/injviosaf/Documents/DrowningEntrapmentHazards.pdf.
  2. ASTM International (ASTM). 2003. Standard performance specification for safety covers and labeling requirements for all covers for swimming pools, spas, and hot tubs. ASTM F1346-03. West Conshohocken, PA: ASTM.

6.3.1.5: Deck Surface


A swimming pool should be surrounded by at least a four-foot wide, nonskid surface in good repair, free of tears or breaks (1).
RATIONALE
This standard is to prevent slipping and injury of children and adults and to allow supervising caregivers/teachers to walk around all sides of the pool.
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
6.4.1.1 Pool Toys
REFERENCES
  1. ASTM International (ASTM). 2009. Standard practice for manufacture, construction, operation, and maintenance of aquatic play equipment. ASTM F2461-09. West Conshohocken, PA: ASTM.

6.3.1.6: Pool Drain Covers


All covers for the main drain and other suction ports of swimming and wading pools should be listed by a nationally recognized testing laboratory in accordance with ASME/ANSI standard “A112.19.8: Standard for Suction Fittings for Use in Swimming Pools, Wading Pools, Spas and Hot Tubs,” and should be used under conditions that do not exceed the approved maximum flow rate, be securely anchored using manufacturer-supplied parts installed per manufacturer’s specifications, be in good repair, and be replaced at intervals specified by manufacturer. Facilities with one outlet per pump, or multiple outlets per pump with less than thirty-six inches center-to-center distance for two outlets, must be equipped with a Safety Vacuum Release System (SVRS) meeting the ASME/ANSI standard “A112.19.17: Manufactured Safety Vacuum Release Systems for Residential and Commercial Swimming Pool, Spas, Hot Tub and Wading Pool Suction Systems” or ASTM International (ASTM) standard “F2387-04: Standard Specification for Manufactured SVRS for Swimming Pools, Spas, and Hot Tubs” standards, as required by the Virginia Graeme Baker Pool and Spa Safety Act, Section 1404(c)(1)(A)(I) (1,2).
RATIONALE
In some instances, children have drowned as a result of their body or hair being entrapped or seriously injured by sitting on drain grates (3). Drain covers mitigate the five types of entrapment: hair, body, limb, evisceration, and mechanical (jewelry). Use of flat- or flush-mount covers/grates is prohibited. Use of drain covers under conditions that exceed the maximum flow rate can pose a hazard for entrapment. When drain covers are broken or missing, the body can be entrapped. When a child is playing with an open drain (one with the cover missing), a child can be entrapped by inserting a hand or foot into the pipe and being trapped by the resulting suction. Hair entrapment typically involves females with long, fine hair who are underwater with the head near the suction inlet; they become entrapped when their hair sweeps into and around the cover, and not because of the strong suction forces. Use of a SVRS will not mitigate hair, limb, and mechanical entrapment.
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
REFERENCES
  1. American National Standards Institute (ANSI), American Society of Mechanical Engineers (ASME). 2007. Standard for suction fittings for use in swimming pools, wading pools, spas and hot tubs. ANSI/ASME A112.19.8. Washington, DC: ANSI.
  2. U.S. Congress. 2007. Virginia Graeme Baker Pool and Spa Safety Act. 15 USC 8001. http://www.cpsc.gov/businfo/vgb/
    pssa.pdf.
  3. U.S. Consumer Product Safety Commission (CPSC). 2005. Guidelines for entrapment hazards: Making pools and spas safer. Washington, DC: CPSC. http://www.cdph.ca.gov/HealthInfo/injviosaf/Documents/DrowningEntrapmentHazards.pdf.

6.3.1.7: Pool Safety Rules

Content in the STANDARD was modified on 02/27/2020.

Clear safety rules for the use of swimming and built-in wading pools should be posted in a visible location. Caregivers/teachers should understand and follow all pool safety rules at all times. Compliance should be assessed by interviewing caregivers/teachers to determine if they know the rules and by observing if the rules are followed.

Caregivers/teachers should use active supervision strategies to create a safe environment and prevent pool-related injuries or death to children enrolled.1

If the facility has a water play area, the following requirements should be met:

  1. Water play areas should conform to all state and local health regulations.
  2. Water play areas should not include hidden or enclosed spaces.
  3. Spray areas and water-collecting areas should have a nonslip surface, such as asphalt.
  4. Water play areas, particularly those that have standing water, should not have sudden changes in depth of water.
  5. Drains, streams, waterspouts, and hydrants should not create strong suction effects or water-jet forces.
  6. All toys and other equipment used in and around the water play area should be made of sturdy plastic or metal (no glass should be permitted).
  7. Water play areas in which standing water is maintained for more than 24 hours should be treated according to Standard 6.3.4.1: Pool Water Quality and inspected for glass, trash, animal excrement, and other foreign material.

The facility should develop and review an emergency plan, as specified in Standard 9.2.4.1: Written Plan and Training for Handling Urgent Medical Care or Threatening Incidents.

Early care and education programs should refer to state and local regulations for guidance and/or additional requirements for pool safety.

RATIONALE

Signage, visibly posted, that clearly communicates pool safety rules provides general guidelines for staying safe in and around water.2

COMMENTS

ADDITIONAL RESOURCES

Granofsky B, Leonardo J. How child drowning can be prevented. Children’s Safety Network website. https://www.childrenssafetynetwork.org/blog/how-child-drowning-can-be-preventeD. Published August 10, 2018. Accessed August 21, 2019

US Consumer Product Safety Commission. PoolSafely.gov. https://www.poolsafely.gov. Accessed August 20, 2019

US Consumer Product Safety Commission. In-home drowning information center. https://www.cpsc.gov/Safety-Education/Safety-Education-Centers/In-Home-Drowning-Safety-Information-Center. Accessed August 21, 2019

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
1.1.1.5 Ratios and Supervision for Swimming, Wading, and Water Play
2.2.0.4 Supervision Near Bodies of Water
2.2.0.5 Behavior Around a Pool
6.3.1.1 Enclosure of Bodies of Water
6.3.4.1 Pool Water Quality
6.3.5.3 Portable Wading Pools
9.2.4.1 Written Plan and Training for Handling Urgent Medical or Threatening Incidents
REFERENCES

  1. US Department of Health and Human Services, Administration for Children and Families, Head Start Early Childhood Learning and Knowledge Center. Safety practices. Active supervision. https://eclkc.ohs.acf.hhs.gov/safety-practices/article/active-supervision. Updated January 29, 2019. Accessed August 21, 2019

  2. American Red Cross. Swimming and Water Safety. https://www.redcross.org/store/swimming-and-water-safety-manual-rev-04-14/651327.html?cgid=sp-lifeguarding-and-learn-to-swim. Accessed August 21, 2019

NOTES

Content in the STANDARD was modified on 02/27/2020.

6.3.1.8: Supervision of Pool Pump


The adult in the pool should be aware of the location of the pump shut-off switch and be able to turn it off in case a child is caught in the drain. Unobstructed access should be provided to an electrical switch that controls the pump. This adult should also have immediate access to a working telephone located at the pool.
RATIONALE
The power of suction of a pool drain often requires that the pump be turned off before a child can be removed. The adult supervisor needs immediate access to the pump shut-off switch (1,2).
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
1.1.1.5 Ratios and Supervision for Swimming, Wading, and Water Play
6.3.1.6 Pool Drain Covers
REFERENCES
  1. National Fire Protection Association (NFPA). 2011. NFPA 70: National Electrical Code. 2011 ed. Quincy, MA: NFPA.
  2. U.S. Consumer Product Safety Commission (CPSC). 2005. Guidelines for entrapment hazards: Making pools and spas safer. Washington, DC: CPSC. http://www.cdph.ca.gov/HealthInfo/injviosaf/Documents/DrowningEntrapmentHazards.pdf.

6.3.2 Pool Equipment

6.3.2.1: Lifesaving Equipment


Each swimming pool more than six feet in width, length, or diameter should be provided with a ring buoy and rope, a rescue tube, or a throwing line and a shepherd’s hook that will not conduct electricity. This equipment should be long enough to reach the center of the pool from the edge of the pool, should be kept in good repair, and should be stored safely and conveniently for immediate access. Caregivers/teachers should be trained on the proper use of this equipment so that in emergencies, caregivers/teachers will use equipment appropriately. Children should be familiarized with the use of the equipment based on their developmental level.
RATIONALE
Drowning accounts for the highest rate of unintentional injury-related death in children one to four years of age; this lifesaving equipment is essential (1).
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
1.4.3.3 Cardiopulmonary Resuscitation Training for Swimming and Water Play
REFERENCES
  1. Safe Kids Worldwide. 2016. Keeping kids safe in and around water: Exploring misconceptions that lead to drowning. Washington, DC: Safe Kids Worldwide. https://www.safekids.org/research-report/keeping-kids-safe-and-around-water-exploring-misconceptions-lead-drowning. 

6.3.2.2: Lifeline in Pool


A lifeline (rope and float line) should be provided at the five-foot break in grade between the shallow and deep portions of the swimming pool.
RATIONALE
For children’s safety, the five-foot depth boundary should be known to caregivers/teachers assisting children in the pool (1).
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
6.3.2.1 Lifesaving Equipment
REFERENCES
  1. Association of Pool and Spa Professionals (APSA). 2014. Layers of protection to help protect pool, spa, and hot tub users, especially children under five years of age. Alexandria, VA: APSA. http://www.apsp.org/Portals/0/2016%20Website%20Changes/Safety%20Brochures/Layers%20of%20Protection
    %202015_1006.pdf    . 

6.3.2.3: Pool Equipment and Chemical Storage Rooms

Content in the STANDARD was modified on 02/27/2020.

Early care and education programs should use the following guidelines/best practices for storing pool equipment and pool-related chemicals.1 The design of storage rooms for pool equipment and chemicals should include the following features1:

  • Leakproof construction: Chemical storage areas should have a secondary containment mechanism that prevents chemical spills/leaks.
  • Ventilation: Ensure that the chemical storage room, pump room, and pool area are well ventilated. Follow local building codes and/or ASHRAE standards for proper ventilation and air handling for chemical storage areas and pump rooms.
  • Security: Secure the chemical storage area with a locking mechanism to keep out children and animals as well as to prevent any unwanted tampering with pool-related chemicals.
  • Safety: Store chemicals in original containers and according to the manufacturer’s label. Protect chemicals from extreme heat, heat sources, and flames. Practice good housekeeping, keeping storage areas free from rags, trash, debris, etc.
  • Related materials: Allow access to up-to-date Safety Data Sheets near the chemical storage area, pump room, and/or other locations that pool-related chemicals may be stored. Allow access to personal protective equipment, such as goggles and gloves, near the chemical storage area, pump room, and/or other locations that pool-related chemicals may be used or stored.

 

Caregivers/teachers should be trained in pool chemical safety and emergency response procedures to avoid chemical-related injuries or deaths.1

RATIONALE

Pool chemicals are kept in concentrated forms that are hazardous to children. Access to these hazards must be carefully controlled to avoid pool chemical-associated injuries or deaths.1

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
6.3.3.2 Construction, Maintenance, and Inspection of Pools
6.3.4.1 Pool Water Quality
REFERENCES

  1. Centers for Disease Control and Prevention. Healthy swimming. Pool chemical safety. https://www.cdc.gov/healthywater/swimming/aquatics-professionals/preventing-pool-chemical-events.html. Reviewed May 15, 2019. Accessed August 21, 2019

NOTES

Content in the STANDARD was modified on 02/27/2020.

6.3.3 Pool Maintenance

6.3.3.1: Pool Performance Requirements


Where applicable, swimming pools and built-in wading pool equipment and materials should meet the health effects and performance standards of the National Sanitation Foundation or equivalent standards as determined by the local regulatory health authority (1).
RATIONALE
Proper pool operation and maintenance minimizes injuries.
COMMENTS
The National Sanitation Foundation (NSF) standard “NSF/ANSI 50-2009: Equipment for Swimming Pools, Spas, Hot Tubs and other Recreational Water Facilities” provides evaluation criteria for materials, components, products, equipment, and systems for use at recreational water facilities.
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
REFERENCES
  1. National Sanitation Foundation International (NSF). 2009. Equipment for swimming pools, spas, hot tubs and other recreational water facilities. NSF/ANSI 50-2009. Ann Arbor, MI: NSF.

6.3.3.2: Construction, Maintenance, and Inspection of Pools


If swimming pools or built-in wading pools are on the premises and children use them, the pools should be constructed, maintained, and used in accordance with applicable state or local regulations and should be inspected by the health department to ensure compliance as legally required

When indoor pools are used, they should have adequate ventilation to reduce indoor air pollution.

RATIONALE
Data indicate inadequate ventilation is a source of air pollution experienced by children because of the containment of fumes from chemicals used to treat the water (1).

This standard is based on state and local regulations.

COMMENTS
In the United States, all pool codes are created, reviewed, and approved by state and/or local public health officials. As a result, there are no uniform national standards governing design, construction, operation, and maintenance of swimming pools and other treated recreational water venues (2).
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
REFERENCES
  1. Centers for Disease Control and Prevention. 2016. Chloramines and pool operation. http://www.cdc.gov/healthywater/swimming/pools/irritants-indoor-pool-air-quality.html.
  2. Centers for Disease Control and Prevention. 2016. The model aquatic health code (MAHC): An all-inclusive model public swimming pool and spa code. http://www.cdc.gov/mahc/. 

6.3.3.3: Electrical Safety for Pool Areas


Electrical equipment should be installed and inspected at and around the pool at intervals as required by the regulatory electrical inspector.

No electrical wires or electrical equipment should be located over or within ten feet of the pool area, except as permitted by the National Electrical Code.

RATIONALE
Safety equipment and proper location of electrical equipment prevents electrical hazards that could be life-threatening (1,2). Electrical wires and equipment can produce electrical shock or electrocution.
COMMENTS
For electrical safety, a ground-fault circuit-interrupter is mandatory. The National Electrical Code (NEC) code prohibits electrical installations closer than five feet from water and requires GFCI protection for all electrical equipment, including 240-volt equipment located five to ten feet from the water and for receptacles within a twenty-foot perimeter (1,2).

The National Electrical Code is available from the Institute of Electrical and Electronics Engineers (IEEE).

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
5.2.4.3 Ground-Fault Circuit-Interrupter for Outlets Near Water
REFERENCES
  1. National Fire Protection Association. 2011. NFPA 70: National Electrical Code. 2011 ed. Quincy, MA: NFPA.
  2. U.S. Consumer Product Safety Commission (CPSC). 2003. CPSC safety alert: Install ground-fault circuit-interrupter protection for pools, spas and hot tubs https://www.cpsc.gov/PageFiles/118868/5039.pdf.

6.3.3.4: Pool Water Temperature


Water temperatures should be maintained at no less than 82°F and no more than 88°F while the pool is in use.
RATIONALE
Because of their relatively larger surface area to body mass, young children can lose or gain body heat more easily than adults. Water temperature for swimming and wading should be warm enough to prevent excess loss of body heat and cool enough to prevent overheating.
COMMENTS
Learner pools in public swimming centers are usually at least two degrees warmer than the main pool.

Caregivers/teachers should be advised about the length of time infants should usually spend in the water and how to recognize when an infant is cold so that temperature control should not be problem (1). Signs that an infant is cold are that the infant has cold skin, becomes unhappy, has low energy or becomes less responsive.

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
REFERENCES
  1. Coleman, H., F. D. Finlay. 1995. When is it safe for babies to swim? Profess Care Mother Child 5:85-86.

6.3.4 Water Quality of Pools

6.3.4.1: Pool Water Quality


Water in swimming pools and built-in wading pools that children use should be maintained between pH 7.2 and pH 7.8. The water should be disinfected by available free chlorine between 1.0 ppm and 3.0 ppm, or bromine between 1.0 ppm and 6.0 ppm, or by an equivalent agent approved by the health department. The pool should be cleaned, and the chlorine or equivalent disinfectant level and pH level should be tested every two hours during periods of use.

Equipment should be available to test for and maintain a measurable residual disinfectant content in the water and to check the pH of the water. Water should be sampled and a bacteriological analysis conducted to determine absence of fecal coliforms (e.g., Escherichia coli, Pseudomonas aeruginosa, and Giardia intestinalis) at least monthly or at intervals required by the local health authority.

RATIONALE
This practice provides control of bacteria and algae and enhances the participants’ comfort and safety. Maintaining pH and disinfectant levels within the prescribed range suppresses bacterial growth to tolerable levels.

Bacteriologic water safety must be ensured to prevent the spread of disease via ingestion of pool water. The chemicals a pool needs to maintain the required standards differ from pool to pool – and day to day. Keeping records of the pool chemistry over time can help interpret its characteristics and aid in performing the correct task (1,3).

COMMENTS
If a stabilized chlorine compound is used, the pH should be maintained between 7.2 and 7.7, and the free available chlorine residual should be at least 1.50 ppm.

For further information, see the Model Aquatic Health Code from the Centers for Disease Control and Prevention (2).

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
REFERENCES
  1. Association of Pool and Spa Professionals (APSP), Recreational Water Quality Committee. 2009. Standard for water quality in public pools and spas. ANSI/APSP-11 2009. Alexandria, VA: APSP.
  2. Centers for Disease Control and Prevention. 2010. Model aquatic health code. http://www.cdc.gov/healthywater/swimming/pools/mahc/.
  3. American Chemistry Council, Chlorine Chemistry Division. Pool treatment 101: Introduction to chlorine sanitizing. http://www.americanchemistry.com/s_chlorine/sec_content.asp?CID=1167&DID=4529&CTYPEID=109/.

6.3.4.2: Chlorine Pucks


“Chlorine Pucks” must not be placed in skimmer baskets or placed anywhere in pools when children are present. If pucks are used, they must be dissolved before children enter the pool.
RATIONALE
Although this practice can keep chlorine disinfectant levels high, it can be dangerous because the “puck” is a concentrated form of chlorine and is very caustic. Curious children may take out a puck and handle it, causing serious skin irritations or burns (1). Contact with eyes can cause serious injury. Lung damage can occur if children inhale vapors, or children could ingest the poison.
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
REFERENCES
  1. U.S. Environmental Protection Agency. 2010. Swimming pool chemicals, chlorine. http://www.epa.gov/kidshometour/products/cjug.htm.

6.3.5 Other Water Play Areas

6.3.5.1: Hot Tubs, Spas, and Saunas


Children should not be permitted in hot tubs, spas, or saunas in child care. Areas should be secured to prevent any access by children.
RATIONALE
Any body of water, including hot tubs, pails, and toilets, presents a drowning risk to young children (1-3). Toddlers and infants are particularly susceptible to overheating.
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
6.3.1.1 Enclosure of Bodies of Water
6.3.1.4 Safety Covers for Swimming Pools
6.3.1.6 Pool Drain Covers
REFERENCES
  1. Gipson, K. 2008. Pool and spa submersion: Estimated injuries and reported fatalities, 2008 report. Atlanta: U.S. Consumer Product Safety Commission. http://www.cpsc.gov/LIBRARY/poolsub2008.pdf.
  2. U.S. Consumer Product Safety Commission (CPSC). 2009. CPSC warns of in-home drowning dangers with bathtubs, bath seats, buckets. Release #10-008. http://www.cpsc.gov/cpscpub/prerel/prhtml10/10008.html.
  3. American Academy of Pediatrics, Committee on Injury, Violence, and Poison Prevention. 2010. Policy statement: Prevention of drowning. Pediatrics 126:178-85.

6.3.5.2: Water in Containers


Bathtubs, buckets, diaper pails, and other open containers of water should be emptied immediately after use.
RATIONALE
In addition to home swimming and wading pools, young children drown in bathtubs and pails (4). Bathtub drownings are equally distributed in both sexes. Any body of water, including hot tubs, pails, and toilets, presents a drowning risk to young children (1,2,4,5).

From 2003-2005, eleven children under the age of five died from drowning in buckets or containers that were being used for cleaning (4). Of all buckets, the five-gallon size presents the greatest hazard to young children because of its tall straight sides and its weight with even just a small amount of liquid. It is nearly impossible for top-heavy infants and toddlers to free themselves when they fall into a five-gallon bucket head first (3).

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
REFERENCES
  1. U.S. Consumer Safety Commission (CPSC). How to plan for the unexpected: Preventing child drownings. Document #359. https://www.cpsc.gov/s3fs-public/359.pdf. 
  2. Rivera, F. P. 1999. Pediatric injury control in 1999: Where do we go from here? Pediatrics 103:883-88.
  3. U.S. Consumer Products Safety Commission (CPSC). In home danger: CPSC warns of children drowning in bathtubs, bath seats and buckets more than 400 deaths estimated over a five-year. period. 2012. https://www.cpsc.gov/Newsroom/News-Releases/2012/In-Home-Danger-CPSC-Warns-of-Children-Drowning-in-Bathtubs-Bath-Seats-and-Buckets-More-than-400-deaths-estimated-over-a-five-year-period/. 
  4. U.S. Consumer Products Safety Commission (CPSC). Submersions related to non-pool and non-spa products, 2009 report. 2010. https://www.cpsc.gov/s3fs-public/pdfs/nonpoolsub2009.pdf. 
  5. American Academy of Pediatrics, Committee on Injury, Violence, and Poison Prevention. 2010. Policy statement: Prevention of drowning. Pediatrics 126:178-85.

6.3.5.3: Portable Wading Pools


Portable wading pools should not be permitted.
RATIONALE
Small portable wading pools do not permit adequate control of sanitation and safety, and they promote transmission of infectious diseases (1,2).
COMMENTS
Sprinklers, hoses, or small individual water buckets are safe alternatives as a cooling or play activity, under close supervision.
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
REFERENCES
  1. Murph, J. R., S. D. Palmer, D. Glassy, eds. 2005. Health in child care: A manual for health professionals. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics.
  2. American Academy of Pediatrics, Committee on Injury, Violence, and Poison Prevention. 2010. Policy statement: Prevention of drowning. Pediatrics 126:178-85.