Evidence continues to mount that demonstrates the profound influence children’s earliest experiences have on later success. Nurturing and stimulating care given in the early years builds optimal brain architecture that allows children to maximize their potential for learning. Interventions in the first years of life are capable of altering the course of development and shift the odds for those at risk of poor outcomes toward more adaptive ones.

To meet the needs of our nation’s most vulnerable children and families, the early care and education programs administered by the Administration for Children and Families (ACF) are designed to both provide enriching early childhood experiences that promote the long-term success of children and assist low-income working parents with the cost of child care. In partnership with families, all early care and education programs should support children's needs and age-appropriate progress across domains of language and literacy development; cognition and general knowledge; approaches to learning; physical health and well-being and motor development, and social and emotional development that will improve readiness for kindergarten. Head Start, Early Head Start, pre-Kindergarten, and child care programs aim to support the ability of parents, teachers, child care providers and other community members to interact positively with children in stable and stimulating environments to help create a sturdy foundation for later school achievement, economic productivity, and responsible citizenship.

ACF strives to achieve the following goals in all early childhood programs:

• Build successful Early Learning and Development Systems across Early Head Start, Head Start, child care, and pre-Kindergarten.
• Promote high quality and accountable early learning and development programs for all children.
• Ensure an effective early childhood workforce.
• Improve the physical, developmental, mental health, and social well-being of children in early learning and development settings.
• Promote family engagement and support in a child’s development with the recognition that parents are their children's primary teachers and advocates.
• Build on the strengths and address the needs of culturally and linguistically diverse children and families.
• Improve the health and safety of early learning and development settings

While high quality early care and education settings can have significant developmental benefits and other positive long term effects for children well into their adult years, poor quality settings can result in unsafe environments that disregard children's basic physical and emotional needs leading to neglect, toxic stress, injury, or even death. As a result, it is not surprising that health and safety has been identified in multiple parent surveys as one of the most important factors to consider when evaluating child care options (Shlay, 2010). Health and safety practices provide the foundation on which states and communities build quality early care and education settings.

Licensing of center-based care and family child care homes is a process that establishes the minimum requirements necessary to protect the health and safety of children in care. State licensing requirements are regulatory requirements, including registration or certification requirements, established under State law necessary for a provider to legally operate and provide child care services.

From 2009 to 2011, more than half of states made changes to licensing regulations for center-based care and family child care homes. For example, states increased the pre-service training requirements for center directors, and increased the number of ongoing training hours for all center staff roles, as well as family child care providers. Specifically, 47 States require center staff and 37 States require family child care providers to complete first aid training. With respect to CPR, 46 States require training of center staff and 36 require it of family child care providers. More than half of States require center staff to complete training on child abuse and neglect (27 States) or the prevention of communicable diseases (25 States). The number of States requiring fingerprint checks of federal records and checks of sex offender registries has increased since 2007. All States that license centers and more than 85% that license family child care homes have requirements about the nutritional content of meals and snacks served to children. States have added requirements about fences for outdoor space, transportation, and emergency preparedness, and more States prohibit firearms in child care centers (Office of Child Care National Center on Child Care Quality Improvement and National Association for Regulatory Administration, 2013).

Great progress has been made in States to safeguard children in out of home care, yet more work must be done to ensure children can learn, play, and grow in settings that are safe and secure. States vary widely in the number and content of health and safety standards as well as the means by which they monitor compliance. Some early care and education programs may receive no monitoring while others receive multiple visits. Further, some programs who receive funding from multiple sources may receive repeated monitoring visits that evaluate programs against complicated, and sometimes conflicting, standards. While there are differences in health and safety requirements by funding stream (e.g. Head Start, Child Care Development Fund, Individuals with Disabilities Education Act, and Title I), early childhood program type (e.g. center-based, family child care homes) and length of time in care, there are basic standards that must be in place to protect children no matter what type of variation in program. Until now, there has been no federal guidance that supports States in creating basic, consistent health and safety standards across early care and education settings.

ACF is pleased to announce Caring for Our Children Basics: Health and Safety Foundations for Early Care and Education. Caring for our Children Basics represents the minimum health and safety standards experts believe should be in place where children are cared for outside of their homes. Caring for our Children Basics seeks to reduce the conflicts and redundancy found in program standards linked to multiple funding streams. Caring for our Children Basics should not be construed to represent all standards that should be present to achieve the highest quality of care and early learning. For example, the caregiver training requirements outlined in these standards are designed only to prevent harm to children, not to ensure their optimal development and learning.

Caring for our Children Basics is the result of work from both federal and non-federal experts and is founded on Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, Third Edition, created by the American Academy of Pediatrics; American Public Health Association; and National Resource Center for Health and Safety in Child Care and Early Education with funding from the Maternal and Child Health Bureau. The Office of Child Care, Office of Head Start, Office of the Deputy Assistant Secretary for Early Childhood, and the Maternal and Child Health Bureau were instrumental in this effort. Although use of Caring for our Children Basics is not federally required, the set of standards was posted for public comment in the Federal Register to provide ACF with practical guidance to aid in refinement and application. The standards, regulations, and guidance with which Caring for our Children Basics was produced are located at the end of this document.

Quality care can be achieved with consistent, basic health and safety practices in place. Though voluntary, ACF hopes Caring for Our Children Basics will be a helpful resource for states and other entities as they work to improve health and safety standards in both licensing and quality rating improvement systems (QRIS). As more states build their QRIS, it is hoped that Caring for Our Children Basics will support continuous quality improvement in programs as they move to higher levels of quality and improve the overall health and well-being of all children in out-of-home settings. In addition, ACF anticipates Caring for Our Children Basics will support efficiency and effectiveness of monitoring systems for early care and education settings. A common framework will assist the Nation in working towards and achieving a more consistent foundation for quality upon which families can rely.

Last Updated: June 3, 2024