5.3.1.1: Indoor and Outdoor Equipment, Materials, and Furnishing

Early care and education programs should make sure that equipment, materials, and furnishings, accessible to children both indoors and outdoors, are sturdy, in good condition, safe to use, and used only as intended by the manufacturer. The equipment, materials, and furnishings in the program should meet the safety recommendations of the U.S. Consumer Product Safety Commission and ASTM International.

Program leadership and staff should:

• Prevent children from accessing equipment, materials, and furnishings that are unsafe, such as items that
  • Are known to be hazardous (e.g., infant walkers, inclined sleepers, trampolines)
  • Are not developmentally appropriate for a child’s age or size (e.g., intended for older children)
  • Are raised above the ground or floor (e.g., playground platforms, step stools) and have neither guardrails nor protective barriers
  • Have sharp corners or points
  • Have openings that could entrap a child’s body parts (e.g., head or fingers)
  • Have small parts that may detach and be choking, breathing or swallowing hazards
  • Can pinch, sheer, or crush body parts
• Remove or make tip-over hazards secure, including
  • Unstable furnishings or unsecured equipment (e.g., bookshelves, dressers, televisions, indoor climbing equipment)
  • Playground equipment that is loosely anchored to the ground
• Remove tripping hazards (e.g., rugs, electrical extension cords).
• Remove strangulation hazards (e.g., cords, straps, strings), or make them secure or inaccessible to children.
• Remove or repair equipment, materials, and furnishings that are worn, damaged, or in poor condition, such as items with
  • Loose, rusty, or cracked parts
  • Rotted or split wood or plastic pieces that can cause splinters or other injuries
  • Protruding nails, bolts, or other components that could cause injury
  • Missing or damaged protective caps or plugs
  • Flaking paint or paint that may have lead or other hazardous materials
• Prevent children from playing with or on
  • Outdoor equipment, materials, and furnishings that are too hot or cold to use
  • Equipment that is spaced too closely together for safety
  • Climbing equipment or swings installed on surfaces that cannot absorb the impact of a fall
• Inspect newly acquired equipment and furnishings carefully to decide if they meet this standard before allowing children to use the items.
• Check that the U.S. Consumer Product Safety Commission (CPSC) for safety hazards has not recalled toys and equipment (see Standard 5.3.1.2: Product Recall Monitoring) by
  • Reading the CPSC recall list regularly, and/or subscribing to an email notification list from the CPSC.

RATIONALE

Young children in early care and education programs are at risk for unintentional injuries indoors and outdoors. Awareness of potential hazards and proper choice, use, and maintenance of equipment, materials, and furnishings can help prevent injuries. The CPSC collaborates with ASTM International, an international organization that develops and communicates technical standards, in determining safety and testing standards for many products for children.¹ This standard lists hazards often associated with injury and death by CPSC.^2,3,4

Equipment and furnishings that are not sturdy, safe, or in good condition may cause falls, trap a child’s head or limbs, or contribute to other injuries.^2,3,4 Regardless of their condition, some types of equipment are simply dangerous to use in early care and education programs (e.g., baby walkers, trampolines, inclined sleepers).^5.6 Others are dangerous when used in ways the manufacturer did not intend or when directions are not followed (e.g., not buckling safety belts, using infant bouncers or car seats for napping).^7,8 Although emergency department visits due to tip-overs of televisions and furniture declined in recent years, tip-overs are still an important risk for injury of children younger than 6.⁹

Playground equipment and materials have many potential hazards.¹⁰ More than a third of emergency visits for playground injuries involve pre-school children.¹¹ Falls from climbing structures cause the most serious injuries in early care and education programs.^11,12 However, knowing the surface temperature of outdoor playground equipment (metal and plastic) is also important to make sure children are playing safely. Staff should also pay attention to the temperature of other materials or furnishings (e.g., slides, steps, railings, metal picnic tables). Metal and other surfaces exposed to sun can quickly reach high temperatures that can burn a child’s skin in seconds.³ (See Burn Safety Awareness on Playgrounds, a CPSC factsheet about preventing thermal burns.¹³)

Young children’s intake of lead dust and particles from artificial turf, playground surfaces, and lead-based paint on older playground equipment and furnishings is very hazardous to their health and development.¹⁴ (See Standard 5.2.9.13: Testing for and Remediating Lead Hazards.. Directors and program staff need to pay attention to the safety and condition of new and existing equipment, materials, and furnishings to remove or fix potential hazards.

COMMENTS

For more information on specific requirements and safety considerations for many types of equipment, materials, and furnishings (e.g., infant equipment, playground surfaces, and inspections), see the Related Standards below. The CCHP Health and Safety Checklist,¹⁵ a CFOC-based resource from the California Childcare Health program, has sections on indoor and outdoor equipment and furnishings that may help programs assess hazards in this standard and related standards. Child care health consultants or other appropriately trained staff can help find resources to review the safety of equipment, materials, and furnishings in programs.

The National Program for Playground Safety (NPPS) at the University of Northern Iowa offers the Playground Safety Report Card.¹⁰ The tool is useful to assess the safety of playground equipment and what to correct or improve.¹⁰

For more information on lead hazards, visit the Environmental Protection Agency (EPA) Web page, Protect Your Family from Sources of Lead.¹⁶ Also see Standard 5.2.9.13: Testing for and Remediating Lead Hazards and Standard 5.2.9.15: Building Construction and Renovation Safety. Home-based early care and education programs may refer to The Lead-Safe Toolkit for Home-Based Child Care.¹⁷

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

3.1.4.1 Safe Sleep Practices and Sudden Unexpected Infant Death (SUID)/SIDS Risk Reduction
3.4.6.1 Strangulation Hazards
4.2.0.11 Ingestion of Substances that Do Not Provide Nutrition
4.5.0.2 Tableware and Feeding Utensils
5.1.1.4 Accessibility of Facility
5.1.3.5 Finger-Pinch Protection Devices
5.1.5.1 Balusters
5.1.5.4 Guards at Stairway Access Openings
5.1.6.6 Guardrails and Protective Barriers
5.2.9.13 Testing for and Remediating Lead Hazards
5.2.9.15 Construction and Remodeling
5.3.1.2 Product Recall Monitoring
5.3.1.3 Size of Furniture
5.3.1.5 Placement of Equipment and Furnishings
5.3.1.6 Floors, Walls, and Ceilings
5.3.1.8 High Chair Requirements
5.3.1.9 Carriage, Stroller, Gate, Enclosure, and Play Yard Requirements
5.3.1.10 Restrictive Infant Equipment Requirements
5.3.1.11 Exercise Equipment
5.3.1.12 Availability and Use of a Telephone or Wireless Communication Device
5.3.2.1 Therapeutic and Recreational Equipment
5.3.2.2 Special Adaptive Equipment
5.3.2.3 Storage for Adaptive Equipment
5.3.2.4 Orthotic and Prosthetic Devices
5.4.5.2 Cribs
5.4.5.3 Stackable Cribs
5.4.5.5 Bunk Beds
5.7.0.1 Maintenance of Exterior Surfaces
6.1.0.4 Elevated Play Areas
6.4.1.2 Inaccessibility of Toys or Objects to Children Under Three Years of Age
9.2.6.1 Policy on Use and Maintenance of Play Areas

REFERENCES

1. Earls A. The CPSC and ASTM Collaboration: the consensus process plays a growing role in ensuring child-safe products. Standardization News. 2011;January/February. Accessed May 2, 2022. https://sn.astm.org/?q=features/cpsc-and-astm-collaboration-jf11.html
   

2. U.S. Consumer Product Safety Commission. Toys & children products: injury statistics. National Electronic Injury Surveillance System (NEISS). U.S. Consumer Product Safety Commission Web site. Published December 13, 2021. Accessed April 18. 2022. https://www.cpsc.gov/Research--Statistics/Toys-and-Childrens-Products

3. U.S. Consumer Product Safety Commission. Public playground safety handbook. U.S. Consumer Product Safety Commission Web site. Published December 2015. Accessed April 18, 2022. https://www.cpsc.gov/s3fs-public/325.pdf

4. O’Brien C. Injuries and investigated deaths associated with playground equipment, 2001–2008. U.S. Consumer Product Safety Commission. Published October 29, 2009. Accessed April 18, 2022. https://www.cpsc.gov/s3fs-public/pdfs/playground.pdf

5. Sims A, Chounthirath T, Yang J, Hodges NL, Smith GA. Infant walker-related injuries in the United States. Pediatrics. 2018;142(4):e20174332. doi:10.1542/peds.2017-4332

6. Smith GA. Injuries to children in the United States related to trampolines, 1990-1995: a national epidemic. Pediatrics. 1998;101(3 Pt 1):406-412. doi:10.1542/peds.101.3.406

7. Liaw P, Moon RY, Han A, Colvin JD. Infant deaths in sitting devices. Pediatrics. 2019;144(1):e20182576. doi:10.1542/peds.2018-2576

8. Chaudhary S, Figueroa J, Shaikh S, et al. Pediatric falls ages 0-4: understanding demographics, mechanisms, and injury severities. Inj Epidemiol. 2018;5(Suppl 1):7. Published 2018 Apr 10. doi:10.1186/s40621-018-0147-x

9. Lu C, Badeti J, Mehan TJ, Zhu M, Smith GA. Furniture and television tip-over injuries to children treated in United States emergency departments. Inj Epidemiol. 2021;8(1):53. Published 2021 Aug 27. doi:10.1186/s40621-021-00346-6

10. National Program for Playground Safety. Safety Report Card. National Program for Playground Safety Web site. Published 2004. Accessed April 18, 2022. https://playgroundsafety.org/sites/default/files/2020-08/blank-report-card.pdf

11. Nabavizadeh B, Hakam N, Holler JT, et al. Epidemiology of child playground equipment-related injuries in the USA: emergency department visits, 1995-2019. J Paediatr Child Health. 2022;58(1):69-76. doi:10.1111/jpc.15644 

12. Hashikawa AN, Newton MF, Cunningham RM, Stevens MW. Unintentional injuries in child care centers in the United States: a systematic review. J Child Health Care. 2015;19(1):93-105. doi:10.1177/1367493513501020

13. Consumer Product Safety Commission. CPSC Fact Sheet: Burn Safety Awareness on Playgrounds. U.S. Consumer Product Safety Commission Publication 3200 042012. Published April 2012. Accessed May 2, 2022. https://www.cpsc.gov/s3fs-public/3200.pdf

14. Council on Environmental Health. Prevention of childhood lead toxicity. Pediatrics. 2016;138(1):e20161493. doi:10.1542/peds.2016-1493

15. California Childcare Health Program. CCHP health and safety checklist. University of California San Francisco Web site. Updated July 2020. Accessed April 18, 2022. https://cchp.ucsf.edu/content/cchp-health-and-safety-checklist

16. U.S. Environmental Protection Agency. Protect your family from sources of lead: soil, yards and playgrounds. U.S. Environmental Protection Agency Web site. Accessed April 18, 2022. https://www.epa.gov/lead/protect-your-family-sources-lead#soil

17. Children’s Environmental Health Network, National Center for Healthy Housing, and National Association for Family Child Care. Lead-safe toolkit for home-based child care. National Center for Health Housing Web site. Published 2019. Accessed April 18, 2022. https://nchh.org/tools-and-data/technical-assistance/protecting-children-from-lead-exposures-in-child-care/hbcc-toolkit/

NOTES

Standard was last updated on September 13, 2022.