Health, Safety, and Nutrition HSAN July 1, 2016

Health, Safety, and Nutrition HSAN July 1, 2016

Health, Safety, and Nutrition HSAN July 1, 2016 Icons Several icons are used throughout this course as a visual reference. This icon represents a new topic in the text. This is a visual cue for you to answer any questions about the previous section before moving along to the next one. This icon is used to identify an exercise that involves in-class practices and feedback. This icon is used to identify a specially designed activity that requires active class participation. This icon is used to identify a section that is accompanied by a video.

Health, Safety, and Nutrition 2 Icons This icon is used to identify a key point in the material. This icon is used to identify an online resource. You will need a computer with an internet connection to view these resources. This icon is used to identify an exercise that involves a role-playing scenario. This icon is used to identify an activity that requires you to reflect on the information taught in the course by asking you a question. The answers to these questions will require you to think about your role as a child care professional and may influence your actions. Health, Safety, and Nutrition

3 Health, Safety and Nutrition Module 1: A Healthy Environment Health, Safety, and Nutrition 4 Module Goal and Learning Objectives Goal Participants will be able to identify and discuss the elements of a healthy environment. Learning Objectives After successfully completing this module, you will be able to:

Identify the characteristics of a healthy environment Describe the characteristics of a healthy child Identify communicable diseases Describe methods of preventing the spread of communicable disease Explain the process of communicable disease control Identify proper hygiene practices for children and caregivers Identify safe food handling, preparation, and storage practices Describe the proper method of administering medication and documenting the use of medication in a program PG 1 Health, Safety, and Nutrition 5 Activity: Spreading Germs

Health, Safety, and Nutrition 6 Activity: Important Terms

Health Appetite Impermeable Surface Safety Hazards Nutrition Sanitize Immunizations Clean Disinfect Vaccine Communicable Disease Evacuation Plan Isolation Area

Health, Safety, and Nutrition 7 What are the Qualities of a Healthy Environment? Characteristics of a healthy environment that promote good health practices include: Clean work and play areas Proper Hygiene practices Implementation and routine practice of a written health policy How do you know if your program has a written policy? Why should policies be written? PG 2

Health, Safety, and Nutrition 8 Key Point Establishing and following a written policy is an effective way of maintaining a safe and healthy child care program. PG 2 Health, Safety, and Nutrition 9

What are the Qualities of a Healthy Child? How are each of the senses used to observe a child? Why is it important to use more than one sense at a time to observe warning signs? PG 3 Health, Safety, and Nutrition 10 Appetite

Can eat a substantial amount of food at times Will consume a variety of foods Is interested in eating Appears content after meals and snacks PG 3 Health, Safety, and Nutrition 11 Appearance

Has clear, bright eyes Has clear skin Has well-developed muscles Gains steadily in height and body weight PG 3 Health, Safety, and Nutrition 12 Activity

Has plenty of energy Is alert Sleeps soundly Has few aches and pains PG 3 Health, Safety, and Nutrition 13 Key Point The three As of a healthy child

are: Appetite, Appearance and Activity. PG 3 Health, Safety, and Nutrition 14 Activity: Draw a Healthy or Sick Child Draw a healthy or sick child in the space provided. List the healthy or unhealthy characteristics, along with some visual indicators of the childs condition, next to your drawing. PG 5

Health, Safety, and Nutrition 15 Daily Health Checks Daily health checks are a good way of preventing, identifying, and controlling illness in a child care environment. PG 6 Health, Safety, and Nutrition 16 Daily Health Checks

Behavior General mood (unusually quiet, irritable, drowsy, or restless) Unusual behavior Activity level Breathing difficulties (labored) Severe coughing or sneezing Hoarseness

PG 6 Physical Skin color (flushed or pale, dry or clammy, hot) Unusual spots, rashes Swelling or bruises Sores Discharge from nose,

ears, eyes Eyes red, irritated, sensitive to light Health, Safety, and Nutrition 17 Daily Health Checks What other signs have you observed in children as part of a daily health check? Fever (over 101oF, taken orally) Vomiting (all, or even part, of food consumed recently) Bowel movement changes (changes in color, odor, frequency) Pain (screaming, crying, head-rolling) Skin Marks (rashes, bruises)

PG 7 Health, Safety, and Nutrition 18 Key Point Daily health checks are essential for ensuring the health of children in care. PG 7 Health, Safety, and Nutrition

19 Determining if a Child Has a Fever You should take a childs temperature when the child is displaying symptoms such as: Warm or hot to the touch We know a child has a Sweating more than usual fever by taking the child Flushed appearance s temperature Sleepiness under the arm and Unusual breathing getting a reading of

100oF or Poor appetite under the tongue and May be more thirsty than usual getting a reading of 101oF. PG 8 Health, Safety, and Nutrition 20 If You Could Just Help Me Out This Once PG 9

Health, Safety, and Nutrition 21 Responding to an Illness Watch the child closely, apply first aid/CPR as needed, and be ready to discuss your observations with parents and/or paramedics. Your observations should be documented. Isolate the child until parents and/or paramedics arrive. Call the parents, and if necessary, suggest to the parents that the child needs medical attention. Call 9-1-1. PG 10

Health, Safety, and Nutrition 22 Dehydration Watch for the following signs: Dry to very dry mouth Little to no tears when crying Less active than usual, or very fussy Infant will wet less than 6 diapers a day, a child will make fewer trips to the restroom than he normally does PG 11 Health, Safety, and Nutrition

23 Dehydration If dehydration is severe, the following will occur: Eyes are sunken Hands and feet are cool and blotchy Pulse may seem weak and fast Child will not urinate for hours PG 11 Health, Safety, and Nutrition 24 Dehydration The steps to prevent dehydration are dependent on

the childs symptoms, and can include: For mild diarrhea, do not give milk; it has a high concentration of minerals and salt which could be dangerous to a child with diarrhea. For vomiting, stop giving solid food, and give water at 30 to 60 minute intervals. For both diarrhea and vomiting, stop the childs normal diet and give electrolytes. Do not give a child sports drinks or any other similar drink made for adults. PG 11 Health, Safety, and Nutrition 25

Heat Exhaustion Heat exhaustion can occur when someone is exposed to high temperatures and strenuous physical activity. 1. The childs emergency contact should be notified. 2. Lay the person down in a cool and quiet place, with feet raised a little bit. 3. Loosen any tight clothing. 4. Supply water or sports drinks to drink. 5. Use other cooling measures, such as towels soaked in cool water as compresses. 6. If signs of symptoms worsen or do not improve within an hour, seek medical attention. Seek immediate medical attention if the persons body temperature reaches 104 degrees or higher. PG 12 Health, Safety, and Nutrition

26 Heat Stroke Heres what to do if you observe these conditions: 1. Anyone who has heat stroke should receive medical attention. If you suspect heatstroke, call 9-1-1. While waiting for emergency Medical Services (EMS) to arrive: 2. 3. 4. 5.

Remove clothing and wrap the person in a cold wet sheet, or sponge with cold or tepid water. Fan the person by hand, with an electric fan, or with a hairdryer set to cold. When his or her temperature drops to 101oFahrenheit, place the person in the recovery position. Cover the person with a dry sheet and continue to fan. If his or her temperature rises again, repeat the cooling procedure. A caregiver should know the signs of illness in children and be prepared to take appropriate action. PG 12 Health, Safety, and Nutrition

27 Key Point It is important to recognize and respond appropriately to signs of illness in the children in your care, both for their well-being and for the prevention of illness and disease within your program PG 12 Health, Safety, and Nutrition 28

Bacteria, Viruses, Fungi, and Parasites Bacteria are small organisms seen with an ordinary microscope. Viruses are smaller than bacteria and only grow in living cells. Fungi grow best in warm, moist places. Parasites are organisms that live on or in animals and people, and benefit by deriving nutrients at the expense of the host. PG 14 Health, Safety, and Nutrition 29 Key Point

As a child care provider, it is important to know the difference between the four types of germs: bacteria, viruses, fungi, and parasites. PG 14 Health, Safety, and Nutrition 30 Transmission of Communicable Diseases Respiratory Fecal/Oral

Direct contact Blood borne PG 15 Health, Safety, and Nutrition 31 Key Point As a child care provider, it is important to understand the four ways illnesses and diseases are transmitted in order to minimize the spread of communicable diseases. PG 15

Health, Safety, and Nutrition 32 Activity: Communicable Illness Charades Health, Safety, and Nutrition 33 Pink Eye Health, Safety, and Nutrition 34

Head Lice Health, Safety, and Nutrition 35 Ring Worm Health, Safety, and Nutrition 36 Common Cold Health, Safety, and Nutrition

37 Chicken Pox Health, Safety, and Nutrition 38 Serious Communicable Diseases Haemophilus Influenzae type B, or Hib Hepatitis B Hepatitis C HIV PG 16-17 Health, Safety, and Nutrition

39 Chicken Pox Slight fever Fine blisters, first on scalp, then on face and body PG 18 Health, Safety, and Nutrition 40 Common Cold Runny nose Watery eyes

Chills Malaise (ill feeling) Usually no fever Lethargic (sluggish) PG 18 Health, Safety, and Nutrition 41 Influenza (Flu) (Review the information on the Centers for Disease Control and Prevention (CDC) website (www.cdc.gov) regarding flu pandemic in child care.) High fever Chills

Headache Sore throat Muscle pain Sneezing Can develop chest pain and cough PG 18 Health, Safety, and Nutrition 42 Diarrhea-Related Disease

Loose or watery stools Nausea Vomiting Stomachache Headache Fever PG 19 Health, Safety, and Nutrition 43 Conjunctivitis

(Eye Infection; Pink eye) Red eye or eyes Discharge from one or both eyes Crusted lid or lids PG 19 Health, Safety, and Nutrition 44 Giardiasis Parasite found in the stools Diarrhea, bloating, abdominal cramps Weight loss and weakness PG 19

Health, Safety, and Nutrition 45 Allergic Reactions/ Anaphylaxis Rashes Swelling of Throat Difficulty breathing PG 19 Health, Safety, and Nutrition 46

RSV (Respiratory Synctial Virus) Wheezing and cough Blue color around lips Rapid breathing PG 19 Health, Safety, and Nutrition 47 Lice Itchy scalp Nits (eggs) Small, red bumps or sores from scratching

PG 20 Health, Safety, and Nutrition 48 Key Point Responding in a correct and timely manner when a child displays a symptom or symptoms of a communicable disease is an excellent way of preventing communicable diseases in a child care program. PG 20

Health, Safety, and Nutrition 49 Isolation

Severe coughing Difficult or rapid breathing Stiff neck Diarrhea Temperature 101 degrees Fahrenheit or over Conjunctivitis (Red eyelids or eyeballs and drainage) Exposed or open skin lesions Unusually dark urine Gray or white stool Yellowish skin or eyes Isolation still requires direct supervision. PG 21 Health, Safety, and Nutrition 50

Immunization Immunization is another essential factor in preventing the spread of disease among children and caregivers. Children who are attending child care programs are especially in need of receiving all recommended vaccines on time and must provide documentation of those vaccinations. In Florida, all children who are enrolled in a child care program must provide documentation of current immunizations. It is possible to admit children who do not have current immunizations into care when certain conditions are met. PG 21 Health, Safety, and Nutrition

51 Key Point Remember, there are religious and philosophical objections to immunization, but there must be proper documentation for each child on record at the child care program. PG 21 Health, Safety, and Nutrition 52

Activity: Calculating Immunizations Kathy is 24 months old Flu (Influenza) yearly; If she is in a high-risk group she would also need: Pneumococcal Polysaccharide Vaccine (PPSV); Hepatitis A (HepA); and Meningococcal Timmy is 18 months old Hepatitus B (HepB); Diphtheria, Tetanus, and Pertussis or (DTaP); Inactivated Poliovirus (IPV); Flu (Influenza) yearly; and Hepatitis A (HepA) Heather is 15 months old Hepatitus B (HepB); Diphtheria, Tetanus, and Pertussis or (DTaP); Haemophilus influenza type b (Hib); Pneumococcal Conjugate (PCV13); Inactivated Poliovirus (IPV); Flu (Influenza) yearly; Measles, Mumps, and Rubella or (MMR); Varicella; and Hepatitis A (HepA)

PG 22 Health, Safety, and Nutrition 53 Activity: Calculating Immunizations Jennifer is 4 months old May receive at this time Rotavirus; Diphtheria, Tetanus, and Acellular Pertussis (DTaP); Haemophilus influenza type b (Hib); Pneumococcal Conjugate (PCV13); Inactivated Poliovirus (IPV) Brian is 4 years old Flu (Influenza) yearly; may also receive Diphtheria, Tetanus, and Pertussis or (DTaP); Inactivated Poliovirus (IPV); Measles,

Mumps, and Rubella or (MMR); and Varicella; if he is in a highrisk group, he would also need: Hepatitis A (HepA); Pneumococcal Polysaccharide Vaccine (PPSV); and Meningococcal PG 22 Health, Safety, and Nutrition 54 Best Practices for Avoiding Contamination Wear gloves. Throw disposable gloves away after one use. Do not get any bodily fluid in your eyes, nose, or mouth; or near an open sore. Clean and disinfect any surfaces and non-disposable

cleaning equipment, such as mops, that contact a bodily fluid. A common and inexpensive disinfectant can be made by mixing cup of bleach and 1 gallon of water. Discard fluid and fluid-contaminated materials in a tightly secured plastic bag. PG 23 Health, Safety, and Nutrition 55 Best Practices for Avoiding Contamination Wash your hands in accordance with CDC guidelines after cleaning up bodily fluids. Change diapers on non-porous surfaces. Do not share personal hygiene items, such as

toothbrushes, dental floss, or rinsing cups. Use disposable sheaths on thermometers. Wash contaminated linens and clothing separately from other laundry. Use cup of bleach in the wash load. Place childrens contaminated items or clothes in a tightly sealed plastic bag to be taken home and washed. PG 23 Health, Safety, and Nutrition 56 Best Practices for Avoiding Contamination Do not allow babies and toddlers to share teething toys. Sanitize these items after each use.

Teach children not to pick off scabs or bandages. Cover and treat open wounds on both children and caregivers. PG 23 Health, Safety, and Nutrition 57 Key Point Caregivers should use Standard Precautions to avoid contact with blood and bodily fluids, and remove children from any area where exposure to communicable diseases is

possible. PG 23 Health, Safety, and Nutrition 58 Changing a Glove 1. 2. 3. 4. Grasp the palm of the glove. Pull the glove off toward fingers, turning it inside out. Throw the glove into a plastic bag that can be sealed.

Run your ungloved index finger under the remaining glove cuff. 5. Pull the glove off, turning it inside out. 6. Put the soiled glove in the plastic bag. PG 24 Health, Safety, and Nutrition 59 Changing a Diaper 1. 2. 3. 4. 5.

6. 7. 8. 9. Get organized. Carry the baby to the changing table. Clean the childs diapering area. Remove the soiled diaper (and clothing if soiled) without contaminating any surface. Put on a clean diaper. Clean the babys hands. Clean and disinfect the diaper area. Wash your hands. Use a daily journal to document diaper changes. PG 24

Health, Safety, and Nutrition 60 1. 2. 3. 4. 5. 6. 7. Handwashing Wet your hands with clean, running water and apply soap to your hands. Rub your hands together to make a lather.

Scrub the backs of your hands, between fingers, under nails, and under jewelry. Continue scrubbing for at least 20 seconds (sing Happy Birthday two times). Rinse your hands well under running water. Dry your hands using a clean towel. Discard the used disposable towel in the trash can lined with a fluid-resistant (plastic) bag. 8. Retrieve a new, clean disposable towel. 9. Turn the faucet off using the towel as a barrier between your hands and the faucet handle. 10. Discard the used disposable towel in a trash can lined with a fluid-resistant (plastic) bag. PG 24 Health, Safety, and Nutrition 61

Key Point Proper personal hygiene is the most effective way of preventing the spread of germs and diseases in a child care setting. PG 24 Health, Safety, and Nutrition 62 The Right Response During small group time, you notice Charles is having difficulty breathing and is wheezing. What

should you do? Assume this could be life threatening. Call 9-1-1 and Charles parents. PG 25 Health, Safety, and Nutrition 63 The Right Response At the dramatic play center, you notice Chelsea scratching the back of her head vigorously. What should you do? Check for lice, scabies, and/or rash. If there are lice, send Chelsea home with information. Sanitize the dress-up clothes, carpet, stuffed animals,

and all other cloth items. PG 25 Health, Safety, and Nutrition 64 The Right Response While at the sensory table, Chancie sneezes into the water. What should you do? Ask Chancie to blow her nose and wash her hands. Change the water at the sensory table. Sanitize during the water change. Make sure all children wash their hands before and after using the sensory table.

PG 25 Health, Safety, and Nutrition 65 The Right Response Later in the day, the snack center is set up as a green grocery. Children come with a little straw basket to select crunchy vegetables for snack time. Chancie is shopping. She nibbles a few vegetables, but then complains of a stomachache. What should you do? Monitor Chancie closely. She may be sick; or she may dislike the raw vegetables, and this mornings sneeze was only coincidental.

PG 25 Health, Safety, and Nutrition 66 The Right Response In the free-art center, Chu-lin is helping a teaching assistant mix dry tempura powder. Suddenly, her face becomes red and she begins to cough. What should you do? This was a trick question. Do not mix dry tempura paint or dry papier-mch in the presence of young children. There are other hazards that may occur during art projects, such as accidental ingestion; allergic reactions; and accidents such as slips, falls, cuts, etc. If this situation does occur, call Poison Control.

PG 26 Health, Safety, and Nutrition 67 The Right Response After playing in an outdoor learning center, you notice blister-like sores on Chakas arm. What should you do? Understand that this might be the sign of a communicable illness or disease. Call the parents and suggest they seek prompt medical attention. Isolate the child until the parents arrive. Chaka should be seen by a doctor.

Document your observations. PG 26 Health, Safety, and Nutrition 68 The Right Response Charlotte ate very little at lunch today; now she has her head on a table and is complaining of a stomachache. What should you do? Watch her closely and be ready to react to further signs of illness. Notify and discuss the signs with her parents. If she is unable to participate in normal activities, she should be sent home.

PG 26 Health, Safety, and Nutrition 69 The Right Response Chico is difficult to awaken after a long nap. He is warm to the touch, and then vomits as you lead him to the bathroom. What should you do? Understand that these might be the signs of a communicable illness or disease. Call the parents and suggest they seek prompt medical attention. Isolate the child until the parents arrive. Chico should be seen by a doctor.

PG 26 Health, Safety, and Nutrition 70 The Role of Sanitation in Preventing Illnesses The process of cleaning, sanitizing, and disinfecting areas and items that children are most likely to have close contact with will reduce their potential exposure to germs. Think about some items that should be cleaned, sanitized, and/or disinfected as often as possible.

Toys Crib rails Restrooms Diapering areas Drinking fountains Computer keyboard and mouse Hands-on learning items Books Health, Safety, and Nutrition PG 27

71 Food Safety Food must be in sound condition, free from spoilage and contamination. Food preparation areas, and food equipment and table ware must be properly maintained and sanitary. Staff members must properly handle and prepare food. Food must be maintained at proper temperatures. PG 28 Health, Safety, and Nutrition

72 Special Requirements and Prohibited Foods Meat, poultry, fish, dairy products, and processed foods shall have been inspected under the United States Department of Agriculture (USDA) requirements No raw milk or unpasteurized juice may be served without the written consent of the parent or legal guardian No home-canned food may be served No home-grown eggs may be served No recalled food products may be served All raw fruits and vegetables shall be washed thoroughly before being served or cooked PG 28 Health, Safety, and Nutrition

73 Preparation and Serving Areas Clean food contact surfaces, cutting boards, dishes, utensils, and counter tops with hot soapy water after preparing each food item and before you go on to the next item. Use smooth, nonabsorbent food contact surfaces that do not harbor bacteria. Food equipment and tableware must be properly cleaned by pre-rinsing or scraping, washing, rinsing, sanitizing, and air drying. Infant bottles and sippy cups provided by a facility must be washed and sanitized between each use. PG 28

Health, Safety, and Nutrition 74 Food Handling Wash hands thoroughly Wear proper head covering and disposable gloves Examine purchased/delivered food Maintain a Food Acceptance Log Separate food items to avoid cross contamination Thaw food safely Wash fruits and vegetables before serving or cooking PG 28 Health, Safety, and Nutrition

75 Food Temperatures: Cooked Foods Food Minimum Internal Temperature Fruits, Vegetables, Grains, and Legumes 135 0F Roasts (Fresh Beef, Pork, and Lamb) 145 0F (with a 3 minute rest time)

Fish 145 0F Eggs Cook until yolk and whites are firm Egg Dishes 160 0F Ground meats (Beef, Pork and Lamb) and fresh Ham (raw) 160 0F

Poultry - whole, parts, or ground 165 0F Leftovers 165 0F Foods cooked in microwave 165 0F Sauces, Gravy, Soups, and Casseroles 165 0F PG 29

Health, Safety, and Nutrition 76 Food Temperatures: Refrigerated Food Category Salads Food Refrigerator Egg, chicken, ham, 3 to 5 days tuna & macaroni salads

Hot dogs opened package 1 week unopened package 2 weeks Luncheon opened package or 3 to 5 days meat deli sliced unopened package 2 weeks Bacon & Bacon 7 days Sausage Sausage, raw 1 to 2 days from chicken, turkey, pork, beef Hamburger & Hamburger, ground 1 to 2 days Other Ground beef, turkey, veal,

Meats pork, lamb, & mixtures of them PG 29 Category Fresh Beef, Veal, Lamb & Pork Food Steaks Chops Roasts Fresh Poultry Chicken or

turkey, whole Chicken or turkey, pieces Soups & Stews Vegetable or meat added Leftovers Cooked meat or poultry Chicken nuggets or patties Pizza Health, Safety, and Nutrition Refrigerator 3 to 5 days

3 to 5 days 3 to 5 days 1 to 2 days 1 to 2 days 3 to 4 days 3 to 4 days 3 to 4 days 3 to 4 days 77 Food Temperature: Frozen Foods Food Item Months

Bacon and Sausage 1 to 2 Months Casseroles 2 to 3 Months Frozen Dinner and Entrees 3 to 4 Months Ham, Hot Dogs, and Lunchmeats 1 to 2 Months Meat (Uncooked)

4 to 12 Months Meat (Uncooked Ground) 3 to 4 Months Meat (Cooked) 2 to 3 Months Poultry (Cooked) 4 Months Soups and Stews

2 to 3 Months PG 29 Health, Safety, and Nutrition 78 Key Point Safe and sanitary food practices help keep a child care program free of germs and diseases, and include using clean utensils and equipment; applying correct storage and cooking techniques; employing

clean, healthy workers; and practicing safe foodhandling procedures. PG 29 Health, Safety, and Nutrition 79 Activity: Five Best and Five Worst Food Handling Practices Considering the information you have just learned and your own experiences, create a list of five best and five worst food-handling practices PG 30

Health, Safety, and Nutrition 80 Administering Medication Accept medications Store medications Administer medications, and Document medications What should caregivers pay attention to while administering medication?

Why is it important to ensure that caregivers administer medication properly? PG 31 Health, Safety, and Nutrition 81 Key Point It is important to note that programs have the right to decide whether or not to administer medication. Deciding whether or not to administer medication is a major responsibility of the caregiver.

PG 31 Health, Safety, and Nutrition 82 Conclusion You have achieved this modules learning objectives if you can: Identify the characteristics of a healthy environment Describe the characteristics of a healthy child Identify communicable diseases Describe methods of preventing the spread of communicable disease Explain the process of communicable disease control Identify proper hygiene practices for children and caregivers Identify safe food handling, preparation, and storage practices

Describe the proper method of administering medication and documenting the use of medication in a program PG 32 Health, Safety, and Nutrition 83 Health, Safety and Nutrition Module 2: A Safe Environment Health, Safety, and Nutrition 84 Module Goal and Learning

Objectives Goal Participants will be able to identify and discuss the need for a safe environment. Learning Objectives After successfully completing this module, you will be able to: Identify processes to plan for, establish, and maintain a safe child care environment Identify procedures for reporting accidents and incidents Explain methods used to prevent potential safety and fire hazards Explain procedures used in case of emergency Explain procedures for using car seats and other methods of restraining a child in a vehicle PG 33 Health, Safety, and Nutrition

85 Elements of a Safe Environment The characteristics of a safe child care environment are: Potential hazards are kept at a minimum, or are completely avoided The surroundings are neat and orderly The children are constantly supervised Caregivers have knowledge of, and practice, safety policies and procedures A safety hazard is anything in the environment that can be dangerous to a childs health or welfare. PG 34

Health, Safety, and Nutrition 86 Activity: Safety Hazard Hunt Health, Safety, and Nutrition 87 Poisoning Follow these poison control prevention practices to ensure that children are not exposed to poisonous materials, unclean items, or unsafe food-handling practices: Keep all chemicals out of the reach of children Follow safe food handling and storage guidelines Follow the directions for dosage found on the medicine

packages label Teach children not to put unfamiliar items in their mouths Keep emergency phone numbers by the phone PG 35 Health, Safety, and Nutrition 88 Key Point No person is immune to poisoning and small children are especially at risk.

PG 35 Health, Safety, and Nutrition 89 Activity: Poison Hazards by Season Each season has potential poisons that may not be present at other times of the year, and we need to be alert to those, as well as to ones that are present yearround. Think about some of the poisons and hazards that tend to occur during each season. Spring and Summer Fall and Winter Winter Holidays PG 35-36

Health, Safety, and Nutrition 90 Activity: Look a-Likes Hazardous Item Medicine Powdered cleanser Lamp oil or rubbing alcohol Pine cleaner Motor oil Shaving cream Alcoholic beverages and mouthwash Dishwashing liquids Hazardous sprays/pesticides

Rodent Killing Pellets PG 36 What It Looks Like to a Child Candy Powdered sugar or grated cheese Bottled water Apple juice Honey Whipped cream Juice drinks Sports drinks Hairspray Hard Candy Health, Safety, and Nutrition

91 Accidents and Injuries It is very important to document any accident involving or injury received by children in your care. PG 37 Health, Safety, and Nutrition 92

Key Point It is important to complete the accident and injury report form as soon as possible, and to accurately reflect what occurred, while keeping the names of children involved confidential. PG 37 Health, Safety, and Nutrition 93 Activity: Accident and Injury Report Form On September 18th, at Happy Mornings Preschool, 4year-old Johnny fell off a tricycle on the playground right

after lunch (1:00 p.m.). He skinned his knee, which you cleaned with soap and water. While applying a bandage, you asked your co-workers if anyone saw the accident. Brenda, another caregiver, said she saw Johnny fall, called the parents immediately, and notified the director of the child care center. PG 37 Health, Safety, and Nutrition 94 Accidents and Injuries Crib Safety Toy Safety

PG 37-38 Health, Safety, and Nutrition 95 Infant Safety While we are studying crib safety, it is a good time to talk about SIDS, or Sudden Infant Death Syndrome. SIDS is not a cause of death, but rather a classification for a manner of death. Does anyone know the memory aid that helps us to remember how to place a baby in a sleeping position? PG 38 Health, Safety, and Nutrition

96 Back to Sleep PG 38 Health, Safety, and Nutrition 97 Support for Injured Children Always be honest, but positive. Using positive words and non-verbal behaviors will help the child remain calm. Do not tell the child that something will not hurt if it will or if you do not know if it will or not. Remain calm. Being prepared for emergencies will help you

achieve this. After the incident is over, and you are out of the childs sight, you may (or may not) fall apart. Allow yourself to have a natural reaction to what you have just witnessed. Treat the child as a person. Do not ignore the injury or the childs feelings. PG 39 Health, Safety, and Nutrition 98 Support for Injured Children Encourage the child to express his or her feelings. It is normal to cry when frightened or injured. Do not tell him not to cry or shame him for doing so. Allow the child to have as much control as possible. For

example, ask, Do you want to look at it? and Would you like me to stay here with you? Let the child hold a brown cloth over an area that is bleeding. (A brown cloth will not show blood.) PG 39 Health, Safety, and Nutrition 99 Support for Injured Children Encourage the child to talk or think about something pleasant. Talk about a favorite pet or activity, sing songs, or tell stories. Explain unfamiliar procedures and equipment step-bystep. Children react better when they understand what is going on. (Adults do too!) Do not ignore the presence

of scary people or things. Do not say, That? Oh, thats nothing. Ignore it. PG 39 Health, Safety, and Nutrition 100 Support for Injured Children Determine the advantages and disadvantages of your presence during treatment. Often, medical staff can do a quicker and more thorough job if you leave the room. Ask the child what her preference is, and ask staff if you can accommodate that wish. If you leave the room, do not take all of your belongings, so the child will know youre coming back. Tell the child where you will wait. Console her right after treatment.

Bring a favorite toy or blanket to the emergency room. Tell the child that doctors and nurses help people and take care of them when they are sick or hurt. PG 39 Health, Safety, and Nutrition 101 Support for Injured Children Take an emergency bag with you to the hospital that contains paper, crayons, story books, small toys, and similar items. Watch your language! Be alert to what you say and how you say it. If you say, We are going to sew up the cut on your arm, the child may imagine the sewing machine he/she

sees at home. Instead, say, The doctor is going to fix your cut and you are going to feel better after he does that. Avoid all medical terms. Say, Let me help you to hold still, not We are going to hold you down. PG 39 Health, Safety, and Nutrition 102 Support for Injured Children Talk to the child at eye level. Children are empowered when they look at and talk to adults at an eye-to-eye level. Do not stand over an injured child to talk to him/her. After treatment, the child may have a possible regression in behavior. He/she may be suddenly sucking his/her

thumb and wetting his/her bed; he/she may develop a fear of strangers or become aggressive. Recommend a psychological service if the behavior is hurting himself/herself or other people, or if it is prolonged. PG 40 Health, Safety, and Nutrition 103 Support for Injured Children After treatment, encourage the child to role-play and talk about how he/she feels. This will bring about closure and help you, the caregiver, become aware of any issues the child might have. Consider using the experience in a learning center activity so that any

children who witnessed the accident or injury can have closure as well. PG 40 Health, Safety, and Nutrition 104 Key Point A childs response to an injury or accidents depends on the adults and others around him/her. PG 40

Health, Safety, and Nutrition 105 Activity: Safety Checklist for Child Care Settings Locate the Safety Checklist for Child Care Settings in the appendix. Complete the checklist for your child care program. Discuss these items with your child care program director and fellow child care professionals to try to find ways of improving safety conditions in your center. PG 41 Health, Safety, and Nutrition

106 Preventing Injuries and Accidents What are some of the roles a caregiver plays in injury prevention? Careful, constant supervision Maintaining a neat and orderly environment Having an established daily routine that children are familiar with, so that they know what to expect Establish a clear set of rules and behaviors so that children know what is expected of them and which behaviors are unacceptable Teaching children safe behaviors Providing age-appropriate and skill-level-appropriate toys and games Having a person on the premises at all times who knows first aid and/ or CPR

PG 41 Health, Safety, and Nutrition 107 Key Point Every caregiver has important roles to play in injury prevention, and it is their responsibility to secure a safe environment for the children in their care. PG 41 Health, Safety, and Nutrition

108 Safe Talk As a child care professional, one of your daily priorities should be to help children learn safe behaviors; another should be to encourage them to exhibit these behaviors in an effortless manner. Ways to Accomplish a Safe Environment Example Encourage children to engage in activities and Everyone, remember to stay where I can see you play where they can be seen. on the playground.

PG Remind children about the classroom rules and why they were established. Walk slowly and safely in the classroom. We use walking feet inside so you do not get hurt. Help children understand the importance of cleaning up after activities, and keeping walkways and traffic areas clear. Remember to be safe. We need to pick up our toys from the floor and put them on the shelf where they belong, so our friends are safe.

Provide children with age-appropriate and skill-level-appropriate materials and supplies. Here are your safety scissors. It is best for us to use these so we can cut our paper during art time. Remind children what they are supposed to be After we clean up our art supplies, we are going doing and what they can expect to have to eat lunch. Who would like to play on the playground after lunch? Health, Safety, and Nutrition happen 42 next.

109 Activity: Safe Talk Scenario 1: Dante is standing on his tiptoes on a chair, trying to reach a toy on a high shelf. Scenario 2: Bobby, Nikki, and Juan are playing in the sandbox. Bobby is throwing sand at the other two children. Scenario 3: An overexcited Ali is running back and forth between two learning centers. PG 42 Health, Safety, and Nutrition 110 Activity: What Can You See?

Playgrounds Near Electrical Outlets Restrooms Playpens PG 42-43 Health, Safety, and Nutrition 111 Safety Hazard Sharp corners or objects Rusted or decrepit equipment Loose-fitting bolts holding equipment together Suggested Remedy Remove or cover

Remove equipment and replace Remove equipment or repair Access to vehicular traffic Unfenced area Constant supervision must be maintained Fence the area in accordance with 65C-20 and 65C-22 Fence the area in accordance with 65C-20 and 65C-22 Retention pond, ditch, or swale nearby Fence the area in accordance with 65C-20 and 65C-22 Swimming Pool and Hot Tubs Large tree blocking caregivers view

Ensure safety equipment is installed, such as drain covers, barriers, and alarms Ensure there is a certified lifeguard present or provide one person with a certified lifeguard certificate or equivalent Caregiver moves around to provide constant supervision Lack of sufficient ground cover/resilient surfacing Provide a safe fall zone under equipment Unused electrical outlets Children have toys near outlets Use safety plugs Constant supervision must be maintained to keep children from sticking toy parts into outlets; move the toys

Too many cords in one outlet Hot water faucets Relocate some of the equipment Lower the water temperature; paint hot water faucet red and let children know what it means; see, Tap Water Scalds in the appendix Child can lock himself in the bathroom Wet floor Cabinets contain cleaning materials Install a lock that opens from outside Clean up all spills immediately Install safety latches on cabinets or move the cleaning materials to a locked closet or cabinet

Childproofing Your Environment Small toys Rips and tears in playpen pad Sharp objects in or near playpen Health, Allow nothing smaller than 1 inches Replace it Safety, Remove and Nutrition the objects or replace the playpen 112

Emergency Preparedness Plan Responding appropriately to accidents, injuries, and incidents are some of the main responsibilities of an effective child care professional. Your child care program must have written plans and procedures for evacuating the facility, establishing a shelterin-place, and a lockdown procedure. PG 44 Health, Safety, and Nutrition 113 Key Point Caregivers should familiarize themselves with their child care

programs written policies regarding the evacuation, shelter-in-place, and lockdown procedures. PG 44 Health, Safety, and Nutrition 114 Key Point When creating any written emergency response plan, there should be a designated position assigned to each task that is required for effective execution

of the plan. PG 44 Health, Safety, and Nutrition 115 Emergency Procedures Evacuation Procedure Shelter-in-Place Procedure Lockdown Procedure PG 45-46 Health, Safety, and Nutrition

116 Key Point Florida Law requires children to be secured by either a federallyapproved child restraint seat or safety belt, and child care professionals should know the requirements for both the child care program and for sharing with families. PG 47 Health, Safety, and Nutrition 117

Child Passenger Safety Children must never be left in a vehicle unsupervised. There are four primary aspects to remember when installing a car seat: The location, where the seat is placed inside the vehicle The direction the car seat is facing inside the vehicle The seat belt path; whether or not the belts are correctly threaded through the seats slots Tightness; how firmly the seat is held in place PG 47 Health, Safety, and Nutrition 118 Conclusion

You have achieved this modules learning objectives if you can: Identify processes to plan for, establish, and maintain a safe child care environment Identify procedures for reporting accidents and incidents Explain methods used to prevent potential safety and fire hazards Explain procedures used in case of emergency Explain procedures for using car seats and other methods of restraining a child in a vehicle PG 49 Health, Safety, and Nutrition 119

Health, Safety and Nutrition Module 3: Children and Nutrition Health, Safety, and Nutrition 120 Module Goal and Learning Objectives Goal Participants will identify the need for and understand guidelines related to proper nutrition for all children. Learning Objectives After successfully completing this module, you will be able to: Identify the nutritional needs of all children Describe how to plan nutritious meals and snacks Explain the proper role of the caregiver during mealtimes

Identify foods that are potentially dangerous for young children Describe procedures for helping a choking child PG 50 Health, Safety, and Nutrition 121 Physical Development and Nutrition Nutrition is the process of nourishing or being nourished by the foods we eat and how our bodies use them. The food needs of infants, babies and children are essential for their growth and development. Food experiences also have an impact on: Social skills or behaviors during meal times Motor skills or dexterity in handling utensils and foods

And more, as we will see in this module. PG 51 Health, Safety, and Nutrition 122 Key Point Each age group has specific nutritional needs that must be met in order to supply essential resources their bodies must have to grow and develop. PG 51

Health, Safety, and Nutrition 123 Physical Development and Nutrition When we discuss childrens developmental skills related to eating, we consider three things: Mouth patterns Hand and body skills Feeding skills or abilities PG 51 Health, Safety, and Nutrition

124 Health, Safety, and Nutrition 125 Breast Milk and Feeding Infants and Toddlers Breast Milk Feeding Infants and Toddlers PG 53 Health, Safety, and Nutrition 126

Key Point A very important feeding practice is to always hold and interact with infants while you feed themyou should NEVER prop a bottle. PG 53 Health, Safety, and Nutrition 127 Key Point When the right foods are

introduced at the right time, nutritional needs are met, and skills develop properly. PG 54 Health, Safety, and Nutrition 128 MyPlate www.choosemyplate.gov PG 55 Health, Safety, and Nutrition

129 Meal and Snack Planning Offer different foods from day to day, and encourage children to choose from a variety of foods. Serve food in small portions during scheduled meals and snacks. Choose healthy snacks. This will help children get the nutrients they need as part of their daily requirements. Make smart beverage choices. Water, fat-free or low-fat milk, and small amounts of 100% fruit juices are good examples. PG 56 Health, Safety, and Nutrition

130 Daily Food Plan for Preschoolers Nutritional snacks and meals should be planned around guidelines established by the United States Department of Agriculture. Calories are a measure of the energy a food or beverage provides. USDA Sample Meal Patterns SuperTracker PG 56 Health, Safety, and Nutrition 131

Key Point The amount of exercise an individual gets per day has an effect on the amount of calories recommended by the USDA. Individuals who are more physically active should be allowed a higher caloric intake, as described by the USDAs MyPlate charts. Health, Safety, and Nutrition 132 Written Menus and Food Sensitivities

Creating a written menu well in advance of preparing and serving meals and snacks provides several benefits for caregivers. By communicating with parents about the foods they are serving at home and the new types of foods they are introducing, caregivers can ensure that children are receiving foods they enjoy, as well as avoiding any complications from potential food allergies. PG 56 Health, Safety, and Nutrition 133 Food Allergies

Food allergies affect 4-6% of children in the United States. A food allergy occurs when the body has a physical reaction to a specific food. Reactions to these foods can range from minor to severe. Over 90% of food allergies are associated with eight types of food. It is also important to educate all of the staff, children, and families about food allergies As part of the emergency plans, the child care program should have a plan to handle food allergies. Health, Safety, and Nutrition 134 Key Point

A written menu, especially when provided to parents well in advance, offers many benefits for children, caregivers, and parents. PG 57 Health, Safety, and Nutrition 135 Key Point Knowing the foods that children like and dislike allows you to ensure that they will enjoy a diet

that is healthy and balanced while under your care. PG 57 Health, Safety, and Nutrition 136 Key Point It is critical for child care programs to be prepared to handle food allergies. PG 57

Health, Safety, and Nutrition 137 Activity: Icky! Yummy! Think about your experiences with children and create a list of foods that they typically enjoy or dislike. Write these foods in your participants guide. Think about ways to introduce healthy foods to children that they may think they dislike in order to encourage healthy eating practices. PG 57 Health, Safety, and Nutrition 138

Activity: Menu Evaluation Using the information you just learned about meal planning, you will be asked to evaluate a menu for a typical child. PG 57-58 Health, Safety, and Nutrition 139 The Roles of the Adults and Children at Mealtime It is the adults responsibility to make certain that mealtimes are enjoyable, stress-free occasions, during which children can learn and practice important social skills. Based on your own experience, can you think of any other equipment that is used for children with special needs at

mealtime? Children also have the opportunity to learn important responsibilities at mealtimes. PG 59 Health, Safety, and Nutrition 140 Key Point Remember, since tooth brushing has the potential to expose caregivers to bodily fluids, Universal Precautions should be used during tooth brushing activities.

PG 60 Health, Safety, and Nutrition 141 Key Point Remind children not to swallow toothpaste. Call the Florida Poison Control Center immediately if they swallow an excessive amount. PG 60 Health, Safety, and Nutrition

142 Inappropriate Foods There are some foods that are inappropriate for children due to their size, shape, and/or texture. Have you ever seen a situation when a parent put a dangerous food in a childs lunch? How did you handle the situation? PG 61 Health, Safety, and Nutrition 143 Key Point

When helping a choking child, it is as important to know what not to do as it is to know what to do. PG 62 Health, Safety, and Nutrition 144 Choking Prevention

Make sure children eat slowly. Provide a calm, relaxed eating environment. Encourage them to sit quietly in their places. Remind them to chew food well before swallowing and to eat small bites. Teach them not to talk with their mouth full, because they could inhale it into their airway that way. PG 63 Health, Safety, and Nutrition 145 Choking Prevention Grind up tough foods. Cut food into small pieces or thin strips.

Cut round foods, such as hot dogs, into strips rather than slice them into round pieces. Remove all bones from fish, chicken, and meat. Cook food until it is soft. Take out seeds and pits from fruits. PG 63 Health, Safety, and Nutrition 146 Key Point Never serve foods that could potentially pose a choking hazard.

Health, Safety, and Nutrition 147 Conclusion You have achieved this modules learning objectives if you can: Identify the nutritional needs of all children Describe how to plan nutritious meals and snacks Explain the proper role of the caregiver during mealtimes Identify foods that are potentially dangerous for young children Describe procedures for helping a choking child PG 64

Health, Safety, and Nutrition 148

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