Safety in a family childcare setting involves eliminating potential hazards to provide a safe, but not too restrictive, environment. Injury prevention strategies include careful supervision of children and age-appropriate precautions and instruction. Infants and toddlers should not have access to toys that are less than 1/4 inches in diameter. Instructions for emergencies should be clearly defined and posted. Caregivers should conduct monthly fire drills to practice children to a safe location as quickly as possible, and should have operable fire extinguishers and smoke detectors in place and know how to use them. Electrical outlets accessible to children should be covered with childproof covers. Shock stops (safety plugs) should be installed on all unused outlets.

Family childcare providers should be aware that infant walkers that move across the floor are the cause of more injuries than any other baby product and should not be used. Healthy infants should be put into bed on their backs to reduce the risk of Sudden Infant Death Syndrome (SIDS). Also, children have been strangled when their shoulders or necks have been caught between the slats of a crib or between the mattress and crib side. Therefore, cribs should have slats spaced no more than 2 3/8 inches apart, and a mattress that allows no more than two fingers to fit between it and the crib side. Cribs should not be used with the drop side down, as children may fall out.

Family childcare providers also can:

• Check toys and other materials available to children to make sure they do not pose a choking hazard and are developmentally appropriate, in good repair, and nontoxic.
• Invite someone from the local fire department to share information on fire prevention and safety.
• Post emergency numbers and keep a copy of every child’s enrollment form near the phone/and or door; teach children how to dial 911.
• Identify a neighbor who can assist in case of an emergency.
• Check indoor and outdoor play areas for potential hazards every day before allowing children to play.
• Take appropriate safety measures when transporting children; use an appropriately installed child safety seat or seat belt for each passenger in compliance with local and state regulations.
  Refer to national health and safety guidelines and standards for family and other childcare programs.

Childcare guidelines can be obtained in Caring for Our Children; National Health and Safety Performance Standards, Guidelines for Out-of-Home Child Care Programs, by calling the American Academy of Pediatrics, 800-433-9016. The text can be found on the National Resource Center for Health and Safety in Child Care website: nrc.uchsc.edu.