Caring for Our Children
National Health and Safety Performance Standards
Guidelines for Early Care and Education Programs
Caring for Our Children, (CFOC) is a collection of national standards that represent the best practices, based on evidence, expertise, and experience, for quality health and safety policies and practices for today's early care and education settings.
CFOC Online Standards Database
(Most up-to-date source)
Search the CFOC Online Standards Database by health and safety topic, search term, chapter, or standard number.
Suggested Citation for CFOC Standards Online Database:
Database
National Resource Center for Health and Safety in Child Care and Early Education. (n.d.). Caring for Our Children. Retrieved Month Day, Year, from https://nrckids.org
Standard
Standard Number, Title of Standard. (Year). Caring for Our Children, National Resource Center for Health and Safety in Child Care and Early Education. Retrieved Month Day, Year, from [standard URL]
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Updates to CFOC Standards
*NEW! Updates to CFOC Appendices!*
APPENDIX I: Recommendations for Preventative Pediatric Health Care
APPENDIX HH: Use Zones and Clearance Dimensions for Single-and Multi-Axis Swings
APPENDIX U: Safe Minimum Internal Temperature Chart for Cooking
APPENDIX E: Child Care Staff Health Assessment
APPENDIX DD: Child Injury Report Form
APPENDIX EE: Playground Safety Report Card
APPENDIX N: Protective Factors for Child Maltreatment
APPENDIX G: Recommended Childhood Immunization Schedule
APPENDIX H: Recommended Adult Immunization Schedule
APPENDIX F: Enrollment/Attendance/Symptoms Record
APPENDIX M: Recognizing Child Abuse and Neglect
APPENDIX A: Signs and Symptoms Chart
APPENDIX L: Cleaning Up Body Fluids
APPENDIX JJ: Breastfeeding/Chestfeeding Support in Early Care and Education Programs
APPENDIX I: Recommendations for Preventative Pediatric Health Care
APPENDIX W: Sample Food Service Cleaning Schedule
APPENDIX J: Selection and Use of a Cleaning, Sanitizing or Disinfecting Product
APPENDIX K: Routine Schedule for Cleaning, Sanitizing or Disinfecting
Complete Standard Revisions
September 2, 2025
Standard 1.4.1.1: Pre-service Training
June 23, 2025
Standard 2.2.0.4: Supervision Near Bodies of Water
Standard 7.4.0.4: Maintenance of Records on Incidents of Diarrhea
May 30, 2025
Standard 9.4.1.9: Records of Injury
Standard 9.4.1.10: Documentation of Notification for Serious Events
Standard 9.4.1.11: Injury, Incident, and Illness Reports Review
April 15, 2025
Standard 6.5.2.3: Supporting Positive Behavior During Transportation
April 11, 2025
Standard 3.4.4.4: Care for Children Who May Have Experienced Maltreatment
Standard 3.4.4.5: Program Layout to Reduce Risk of Child Maltreatment and Unintentional Injuries
Standard 10.3.5.3: Licensing Agency Child Maltreatment Training
April 8, 2025
Standard 5.2.4.2: Electrical Outlet Safety and Shock Prevention Covers
Standard 6.1.0.6: Location of Play Areas Near Bodies of Water
December 17, 2024
Standard 3.4.4.2: Immunity for Reporters of Child Maltreatment
Standard 3.4.4.3: Preventing and Identifying Shaken Baby Syndrome and Abusive Head Trauma
October 29, 2024
Standard 10.3.3.3: Licensing Agency Requirements for Reporting Suspected Child Maltreatment
Standard 10.3.3.4: Child Maltreatment Prevention Materials
October 17, 2024
Standard 2.2.0.6: Positive Behavior Support
Standard 2.2.0.9: Prohibited Staff Behaviors
September 25, 2024
Standard 5.4.5.1: Sleeping Equipment and Supplies
Standard 5.4.5.3: Stackable Cribs
September 24, 2024
Standard 3.1.4.3: Pacifier Use
July 31, 2024
Standard 2.2.0.1: Methods of Supervision of Children
Standard 3.4.2.1: Animals That Might Visit or Live in Programs
Standard 3.4.2.2: Contact with Prohibited Animals
Standard 3.4.2.3: Care for Animals
May 16, 2024
Standard 1.2.0.2: Background Screening
Standard 1.4.5.2: Child Maltreatment Education
Standard 3.4.4.1: Reporting Suspected Child Maltreatment
April 30, 2024
Standard 3.1.4.4: Scheduled Rest Periods and Sleep Arrangements
Standard 3.1.4.5: Access to Rest Areas for Unscheduled Naps
April 17, 2024
Standard 3.4.5.1: Sun Safety, Including Sunscreen
March 28, 2024
Standard 1.6.0.1: Child Care Health Consultants
March 8, 2024
Standard 3.2.2.5: Hand Sanitizers
January 24, 2024
Standard 7.2.0.1: Immunization Documentation of Children
Standard 9.2.3.10: Cleaning, Disinfecting, and Sanitizing Policies and Procedures
November 3, 2023
October 13, 2023
Standard 5.2.9.9: Reducing Exposure to Harmful Chemicals in Plastic
September 21, 2023
Standard 3.2.2.2: Handwashing Procedure
Standard 4.8.0.5: Handwashing Sink in Food Preparation Areas
Standard: 5.4.1.10: Handwashing Sinks
Standard 5.4.1.11: Handwashing Sinks Prohibited Uses
Standard 5.4.2.2: Handwashing Sinks for Diaper Changing Areas in Centers
Standard 5.4.2.3: Handwashing Sinks for Diaper Changing Areas in Homes
September 14, 2023
Standard 4.8.0.4: Food Preparation Sinks
June 16, 2023
Standard 4.9.0.11: Dishwashing in Centers
Standard 4.9.0.12: Dishwashing in Small and Large Family Child Care Homes
Standard 4.9.0.13: Method for Washing Dishes by Hand
April 12, 2023
Standard 5.2.6.10: Drinking Fountains
March 30, 2023
Standard 4.9.0.9: Cleaning Food Areas and Equipment
Standard 4.9.0.10: Cutting Boards
Standard 7.3.8.1: Attendance of Children with Respiratory Syncytial Virus Infection (RSV)
March 20, 2023
Standard 3.3.0.2: Cleaning and Sanitizing Toys
Standard 3.3.0.3: Cleaning and Sanitizing Objects Intended for the Mouth
Standard 3.3.0.4: Cleaning Individual Bedding
Standard 3.3.0.5: Cleaning Crib and Other Sleep Surfaces
February 9, 2023
Standard 4.3.1.2: Responsive Feeding of Infants by a Consistent Caregiver/Teacher
Standard 4.3.1.11: Introduction of Age-Appropriate Solid Foods to Infants
Standard 4.3.2.3: Encouraging Self-Feeding by Older Infants and Toddlers
January 31, 2023
Standard 5.2.9.1: Use and Storage of Toxic Substances
Standard 5.4.5.1: Sleeping Equipment and Supplies
Standard 6.2.4.2: Water Play Tables
January 3, 2023
Standard 5.6.0.4: Microfiber Cloths and Mops Used for Cleaning
December 20, 2022
Standard 2.3.1.2: Parent and Guardian Visits
Standard 5.4.1.7: Toilet Learning and Training Equipment
Standard 5.4.2.1: Diaper Changing Tables
Standard 5.2.7.5: Labeling, Cleaning, and Disposal of Waste and Diaper Containers
September 27, 2022
Standard 1.7.0.5: Stress Management for Staff
Standard 3.3.0.1: Routine Cleaning, Sanitizing, and Disinfecting
Standard 5.2.9.15: Construction and Remodeling
Standard 5.7.0.1: Maintenance of Exterior Surfaces
Standard 5.7.0.7: Structure Maintenance
Standard 7.2.0.2: Unimmunized/Underimmunized Children
Standard 9.4.1.13: Maintenance and Display of Inspection Reports
September 13, 2022
Standard 1.6.0.3: Infant and Early Childhood Mental Health Consultants
Standard 3.6.1.3: Guidelines for Taking Children’s Temperatures
Standard 5.3.1.1: Indoor and Outdoor Equipment, Materials, and Furnishing
Standard 7.4.0.3: Reporting Requirements for Diarrheal Infections
Standard 9.4.1.2: Maintenance of Records
July 05, 2022
CFOC Subchapter 7.1: Infections in Early Care and Education Programs
Standard 7.3.1.1: Exclusion for Group A Streptococcal (GAS) Infections
Standard 7.3.1.2: Informing Caregivers/Teachers of Group A Streptococcal (GAS) Infection
Standard 7.3.2.3: Reporting Requirements for Haemophilus Influenzae Type B Infections
Standard 7.3.7.2: Prophylactic Treatment for Pertussis (Whooping Cough)
Standard 7.3.7.3: Exclusion for Pertussis (Whooping Cough)
Standard 7.7.4.2: Exclusion of Children with Varicella-Zoster (Chickenpox) Virus
March 22, 2022
Standard 9.2.4.1: Written Plan and Training for Handling Urgent Medical or Threatening Incidents
Standard 9.2.4.5: Emergency and Evacuation Drills Policy
February 25, 2022
Standard 2.4.2.1: Health and Safety Education Topics for Staff
Standard 7.2.0.3: Immunization of Staff
Standard 7.3.3.1: Influenza Immunizations for Children and Staff
Standard 7.3.3.2: Influenza Control
Standard 7.3.3.3: Influenza Prevention Education
Standard 9.2.3.2: Policy Development for Care of Children and Staff Who Are Ill
Appendix B: Major Occupational Health Hazards
February 4, 2022
Standard 1.7.0.3: Staff Health Guidelines for Return to Work
Standard 1.7.0.4: On-Site Occupational Hazards
Standard 1.8.1.1: Basic Benefits for Staff
Standard 1.8.2.3: Staff Corrective Improvement Plan
Standard 1.8.2.5: Handling Official Complaints About Early Care and Education Staff
Standard 9.3.0.2: Written Human Resource Management Policies for Small Family Child Care Homes
April 27, 2021
Standard 5.1.1.2 Inspection of Buildings
Standard 5.1.1.6 Structurally Sound Facility
Standard 5.2.9.13 Testing for and Remediating Lead Hazards
Current CFOC Standard-based Resources
Other NRC Resources
- Special Collections
- *Nueva*Colecciones Especiales en Español
- A Parent's Guide to Choosing Safe and Healthy Child Care
- Licensing Toolkits
- Healthy Weight Checklists and Tipsheet
- Capítulo 5: Instalaciones, suministros, equipos y salud ambiental (CFOC Chapter 5 Spanish Translation)
Related External Resources
- California Health and Safety Checklist
- California Health and Safety User Manual
- Child Care Health Consultation: Skill Building Modules
Get CFOC 4 (Last updated June 2019)
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Copyright 2019
Please note: The 4th Edition of CFOC does not contain the most up to date information. Updates to CFOC are made on this website and users are encouraged to use the online version for current information.
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