Health and Safety in Child Care Settings: Resources for Early Childhood Educators

The Massachusetts Department of Public Health works closely with the Department of Early Education and Care to ensure the well-being of young children in Home-based and Center-based child care, Preschool, Out of School Time Care, and Funded Programs. This webpage serves as a portal for early childhood and out of school time educators on key health and safety resources and supports. It features resources specific to Massachusetts, along with those from leading national child health agencies and organizations, including the American Academy of Pediatrics and Head Start.

I. Cleaning and Infection Prevention

Hand hygiene

• About Hand Hygiene in Schools and Early Care and Education Settings | Centers for Disease Control and Prevention (CDC)
   Provides guidance on how and when to wash hands, use sanitizer, and supervise children.
• C is for CLEAN Resource Toolkit for Child Care Providers | American Cleaning Institute
  Offers guides, flyers, and checklists on cleaning, handwashing, and diapering. 

Cleaning and disinfection

• Selecting and Using Cleaning, Sanitizing, or Disinfecting Products | Head Start/ECLKC
  Explains the differences on how to clean, sanitize, and disinfect.   Includes tips on how to choose safe and effective products for child care settings. 
• Schedule for Cleaning, Sanitizing, and Disinfecting | Head Start/ECLKC
  Offers schedules on how often to clean surfaces in classrooms and childcare programs. 
• How to Clean and Disinfect Early Care and Education Settings | Centers for Disease Control (CDC)
  Outlines steps for cleaning and disinfecting, including for toys, linens, and play areas. 
• Clean Safe Guidelines for Early Education and Care | MA Department of Public Health 
  A free poster on how to safely use bleach when cleaning, sanitizing, and disinfecting. Available in multiple languages. 

Diapering and toileting

• Diapering in Child Care Settings (Poster) | Centers for Disease Control (CDC)
  A printable poster on how to change diapers and clean up safely to prevent illness.
• Toileting Independence for Preschoolers | Head Start/ECLKC
  A guide for supporting children’s toileting independence while maintaining hygiene and safety.

II. Infectious Disease and Illness Management

Illness management

• Common Illness in Young Children| American Academy of Pediatrics (AAP)
  Information on common childhood illnesses, including exclusion recommendations. Includes guidance on when to keep children home or let them stay in child care.

Infectious disease

• Norovirus: Diarrhea and Gastrointestinal Illness | MA Department of Public Health (DPH)
  Information about norovirus, a very contagious virus that causes vomiting and diarrhea.  Includes guidance on prevention, exclusion criteria, and how to report norovirus.
• Hand, Foot, and Mouth Disease | Centers for Disease Control (CDC)
  Information on hand, foot, and mouth disease (HFMD). Outlines the symptoms, prevention methods, and exclusion guidance for child care programs.
• Influenza: Flu information for school administrators and childcare professionals | MA Department of Public Health (DPH)
  Resources, guides, and checklists about flu for parents, schools, and child care settings.
• Influenza: Early Education and Care Influenza Resources | American Academy of Pediatrics (AAP)
  Guidance on flu prevention and communication tips for early educators and families.
• Influenza (Flu) in Early Childhood Programs | Head Start/ECLKC
  Guidance for preventing and managing flu outbreaks in early childhood education settings. 
• Respiratory Syncytial Virus (RSV) | MA Department of Public Health (DPH)
  Covers how respiratory syncytial virus (RSV) spreads, how to prevent it, and who can get the RSV vaccine. 
• Respiratory Syncytial Virus (RSV) | Information for Educators | Head Start/ECLKC
  Outlines RSV symptoms, prevention, and when children should stay home. Includes tips for educators on how to talk about RSV with families.
• RSV in Infants and Young Children | Centers for Disease Control (CDC)
  Tips for preventing RSV in infants and young children including vaccination information. 
• Protecting Against COVID-19 and Other Infections in Early Care Programs | Centers for Disease Control (CDC)
  Guidance for early educators on preventing respiratory illnesses in group care settings.
• Strep Throat | Centers for Disease Control (CDC)
  Guidance for identifying, managing, and preventing Group A strep infections. 
• Strep Throat | MA Department of Public Health (DPH)
  Information on the signs, symptoms, and treatment of strep throat and how to prevent it. 
• Pinkeye (Conjunctivitis) | American Academy of Pediatrics (HealthyChildren.org)
  Information about signs, symptoms, spread, and management of pinkeye. 

Insect protection and prevention

• Head Lice | MA Department of Public Health (DPH)
  State guidance on preventing and managing head lice in child care and schools.
• Head Lice in Early Childhood Programs | Head Start/ECLKC
  Provides information for educators on preventing and managing head lice in group care settings.
• Ticks | Prevention and Repellent | US Environmental Protection Agency (EPA)
  Information about safe bug repellants and prevention of ticks. 
• Ticks | MA Department of Public Health (DPH)
  Tick-borne disease information, factsheets, and prevention. 

Vaccination and immunization requirements

• Pediatric Immunization Schedule | American Academy of Pediatrics (AAP)
  Pediatric immunization schedule for children ages 18 years and younger.
• Easy-to-Read Child Immunization Schedule | American Academy of Pediatrics (HealthyChildren.org)
  Immunization schedule for children birth through age 6 years.
• Massachusetts School Immunization Requirements | MA Department of Public Health (DPH) 
  Lists all required immunizations and documents for child care and schools in Massachusetts. 
• Massachusetts Pediatric Vaccine Clinics | Massachusetts Medical Society
  Information on free vaccine clinics for children ages 19 and younger in Massachusetts. 
• Common questions about childhood immunizations | MA Department of Public Health (DPH) 
  Answers to common questions about childhood vaccines.
• Vaccines and Pregnancy & Vaccines for Your Child | Massachusetts Medical Society
  Answers to common questions about vaccines during pregnancy and childhood.

III. Injury Prevention and Wellness

Active supervision

Active Supervision | Head Start/ECLKC
Outlines six key strategies for active supervision, including positioning, scanning, counting, listening, setting up the environment, and anticipating children’s behavior. Materials include:

• Active Supervision Guide | Head Start
• Active Supervision Poster | Head Start/ECLKC

Car safety

Car Seat Safety | MA Department of Public Health (DPH)
Information on car seat installation, car seat laws, and where to have a car seat professionally installed.

Choking prevention

Choking Hazards | Centers for Disease Control (CDC)
Lists common choking hazards and offers prevention tips to ensure safe eating environments for infants and toddlers.

Choking Prevention for Babies and Children | American Academy of Pediatrics
Outlines common choking hazards (both food and household items), signs and symptoms of choking, and prevention strategies.

Burn prevention

Burn Prevention | Children’s Safety Network
Infographic with background on non-fatal burn injuries and prevention recommendations.

Playground and equipment safety

• Playground Safety | National Program for Playground Safety (NPPS)
  Covers the S.A.F.E. model—Supervision, Age-Appropriate Design, Fall Surfacing, and Equipment Maintenance—to reduce playground injuries. 
• Public Playground Safety Handbook (2025) | U.S. Consumer Product Safety Commission (CPSC)
  Latest national standards for playground design, surfacing, and maintenance to reduce injuries.
• Playground Safety Fact Sheet | MA Department of Public Health (DPH)
  Information about injury prevention and goals for playground safety.
  Playground safety tip sheet including information on concussions

Water safety

• Water Safety | MA Department of Public Health (DPH)
  Water safety resources, swim lessons, fact sheets, pool safety, and boating safety..
• Water Safety for Children with Autism | MA Department of Developmental Services (DDS)
  Information to prevent wandering and to improve water safety for children with autism spectrum disorder (ASD).

IV. Nutrition and Physical Activity

Nutrition education

• Nutrition and Breastfeeding | MA Department of Public Health
  Women, Infants, and Children Nutrition Program (WIC) educational materials on nutrition and breastfeeding for women, families, infants, and young children. 
• Team Nutrition | United States Department of Agriculture (USDA)/Food and Nutrition Service (FNS)
  Free multicultural nutrition materials, posters, and activities for early childhood classrooms.
• The Nutrition Source | Harvard T.H. Chan School of Public Health
  Evidence-based tips to support nutrition and physical activity for young children in the child care setting. 
• Go NAPSACC! | Nutrition and Physical Activity Self Assessment for Child Care
  Provides information for child care providers on healthy eating and physical activity habits in children. Includes breastfeeding friendly child care information.

Breast, bottle, and formula feeding

• Breastfeeding Information | MA Department of Public Health (DPH)
  Breastfeeding resources, including videos and fact sheets, donor milk guidelines, and WIC breastfeeding support and promotion services. 
• Supporting Breastfeeding Families in Early Care and Education Programs | Centers for Disease Control (CDC)
  Information about how to support breastfeeding families in ECE programs, as well as examples for breastfeeding policies and trainings.
• Breast Milk Storage and Preparation | Centers for Disease Control (CDC)
  Information about proper storage, thawing, and feeding expressed breastmilk. 
• Guide to Baby-Safe Bottles & Formula | Environmental Working Group
  Guide to baby-safe bottles and formula.

V. Oral Health

• Checklist for Child Care Staff: Best Practices for Good Oral Health | Head Start/ECLKC
  Checklist for child care staff to promote healthy brushing habits, monitor children’s oral hygiene, and encourage daily routines in early education settings.
• Oral Health Activities for the Classroom | American Dental Hygienists’ Association (ADHA)
  Oral health activities and lessons designed for early childhood educators to integrate into classroom routines.
• Cavity Free Kids Child Care Oral Health Curriculum | Head Start
  Oral health curriculum tailored for early care educators, including stories, songs, and activities. 
• Tooth Talk: Oral Health Guides & Resources for Young Children | University North Carolina 
  Videos, guidelines, and other resources for childcare providers and other professionals with information on improving young children’s dental health.
• Dental Hygienists in Early Childhood Communities: Tools & Resources | American Dental Health Association (ADHA)
  Toolkit supporting collaboration between hygienists and early educators to promote oral health and preventive care in early learning programs.
• Oral Health Disease Prevention Information | MA Department of Public Health (DPH)
  Information about community fluoridation and child oral health resources.
• Oral Health and Nutrition | Health Resources & Services Administration (HRSA)
  Information about healthy nutrition to support good oral health.

VI. Emergency Preparedness

• Emergency Preparedness Manual for Early Childhood Programs | Head Start/ECLKC
  Manual with templates for evacuation, shelter in place, reunification, and emergency drills.
• Disaster Planning, Training, and Communication Standards | Office of Child Care/Caring for Our Children 
  Outlines required emergency planning, training, and weather-related drill frequency for early care programs.
• Emergency Preparedness Materials | MA Department of Public Health (DPH)
  Checklist, basic kit information, and other resources to help prepare for an emergency.
• Emergency Preparedness in Child Care Programs | MA Department of Early Education and Care (EEC)
  EEC policy on emergency preparedness with additional resources and supports.

VII. Chronic Conditions and Special Health Needs

Special health care needs resources

• Division of Children and Youth with Special Health Needs (DCYSHN) | MA Department of Public Health (DPH)
  DCYSHN works with families, providers, and others to support children and youth with special health needs ages birth to 22 and their families. This includes children and youth with chronic medical, physical, developmental, behavioral, or emotional conditions.
• Community Support Line |MA Department of Public Health (DPH)
  A toll-free, statewide helpline that provides information, technical assistance, and resources for families with children and youth with special health needs and providers.
• Exceptional Lives
  An organization that provides resources for children with disabilities. Includes information on transition into school, family perspectives and stories about children with disabilities, and a Massachusetts resource hub.
• Federation for Children with Special Needs
  A Massachusetts organization that helps families, providers, child care educators, and students with information and programs related to children and young adults with disabilities and healthcare needs. 
• Children with Disabilities | Head Start/ECLKC 
  Guidance for early educators on supporting children with disabilities and promoting inclusive practices in early care and education programs. Includes resources on IDEA, individualized support plans, and collaboration with families and specialists.
• Administration of Medication |Office of Child Care/CFOC
  Explains how to safely administer medications in child care settings, including permissions and storage requirements.

Asthma

• Clean Air Asthma Toolkit & MA Asthma Action Partnership | MA Department of Public Health (DPH) & Health Resources in Action (HRiA)
  Guidance on maintaining an asthma-friendly healthy school environment, as well as training and supports. 
• Asthma Prevention Program | MA Department of Public Health (DPH)
  Provides resources, supports, and educational materials on asthma and prevention. 
• Healthy Environments and Asthma Management for Early Childhood and Out of School Time Educators​ | MA Department of Public Health (DPH) & MA Department of Early Education and Care (MA EEC)
  COMING SOON
• Asthma Education Guide | Head Start/ECLKC
  Asthma guide for educators which includes information on classroom triggers, response steps, and communication with families.
• Asthma Action Plan | American Academy of Pediatrics (HealthyChildren.org)
  Information for parents about what an asthma action plan is.
• Asthma Information and Facts | American Allergy and Asthma Foundation
  Flyers and videos about signs and symptoms of asthma, how to administer an inhaler/nebulizer, and creating an asthma/allergy free environment.

Diabetes

• Helping Students with Diabetes Succeed | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
  Guide for supporting children with diabetes in school or care settings, including collaboration tips for educators, nurses, and families.
• Diabetes basic information for parents | Centers for Disease Control (CDC)
  Three ways that parents can help manage their child’s type 1 diabetes. 
• Managing Diabetes at School | Centers for Disease Control (CDC)
  Basic diabetes management information (e.g., checking blood sugar, how to treat low blood sugar, making a diabetes checklist, and making a “hypo” box.)

Food allergy and anaphylaxis

• How to Manage Food Allergies in School & Childcare Settings | American Academy of Pediatrics (AAP)
  Guidance and resources on how to manage food allergies in school and child care settings. 
• Managing Food Allergies in Schools: Select Resources | Centers for Disease Control (CDC)
  List of key resources, including checklists, fact sheets, training materials, and reference documents, for program staff on managing food allergies in schools.
• Managing Your Child’s Food Allergies | Asthma and Allergy Foundation of America
  Free webinars by a pediatric allergist that discusses child food allergy and anaphylaxis symptoms, treatment, and prevention.   Registration is required to access to the webinars. 
• Informational Videos on Food Allergy, Asthma, Eczema | Kids With Food Allergies (KFA)
  Informational videos for community education on food allergies, eczema, and asthma. Includes recipes and food allergy free food lists. 
• Food Allergy Resources | Food Allergy Research and Education (FARE)
  Resources organized by audience and food allergen, including topics such as 504 health plan, recognizing and responding to food reactions, and avoiding cross-contact.
• Food Allergy Free Webinar | Food Allergy Research and Education (FARE)
  Free webinar on the basics of food allergies, including what food allergies are and aren’t, reaction signs and symptoms, the natural history of food allergies, routes of exposure, and related conditions.

Epilepsy and seizures

• Seizure First Aid Certification | Epilepsy Foundation
  Free course that provides information to increase the knowledge, skills, and confidence in recognizing seizures and safely administering seizure first aid. Participants who successfully complete the course will receive a two-year certification.
• Basic Seizure First Aid | Epilepsy Foundation
  Guide for babysitters and educators on basic seizure information and first aid.
• Seizure Rescue Therapies | Epilepsy Foundation
  Overview of type of seizure rescue medications for children. 
• Seizure Rescue Medications | Epilepsy Foundation
  Overview of types of medications that can be used as rescue treatments.
• Seizure Action Plan | Epilepsy Foundation
  Seizure Action Plan for healthcare specialist or primary care to complete.
• Seizure Action Plan | Child Neurology Foundation
  Seizure Action Plan for school and child care settings.
• Febrile Seizures | Epilepsy Foundation
  Information on guidance, treatment, and intervention for seizure safety in children with febrile seizures.

VIII. Environmental Health

Choosing Safe Places for Child Care Locations

Choose Safe Places for Early Education and Care | MA Department of Public Health (DPH)
This program works to prevent environmental exposures among children and staff in MA child care programs by helping providers choose safe locations through resources, education, and property screening. This website provides tools and resources to help child care providers learn about environmental health and DPH’s free services.

Environmental Assessment

• Healthy Child Care and Early Learning Facilities Self-Assessment | US Environmental Protection Agency (EPA)
  Self-assessment tool that helps early education programs identify and reduce environmental health risks related to indoor air quality, cleaning products, and ventilation.
• Property Questionnaire | MA Department of Public Health (DPH)
  Complete to request an environmental check of your child care facility or home. 

Air quality

• Outdoor Air Quality Resources for Child Care Programs | Child Care Aware of America
  Guidance and tools for managing outdoor activities based on local air-quality conditions; includes educational materials for program directors. 
• Air Quality Education for Teachers | AirNow/EPA
  Interactive resources, lesson plans, and real time air quality data to help teachers integrate environmental awareness into daily learning.
• Air Monitoring in Massachusetts | Massachusetts Department of Public Health (DPH) 
  Provides real-time state air quality information to help educators plan safe outdoor activities.

Lead exposure

• Protecting Children from Lead Exposures in Child Care (Toolkit) | National Center for Healthy Housing
  Toolkit for assessing and reducing lead exposure risks in child care environments.
• Childhood Lead Poisoning Prevention Program | MA Department of Public Health (DPH)
  The program helps prevent, screen, diagnose, and treat childhood lead poisoning. The program also works to eliminate sources of lead poisoning. 

Drinking water

• Lead and Drinking Water Safety | MA Department of Public Health (DPH)
  Information about de-leading and fact sheets about lead exposure in drinking water, multiple languages.
• Water-Smart | MA Department of Environmental Protection (DEP)
  Webpage shares information on how a facility can receive assistance to establish a lead and copper in drinking water program. 

Radon

Radon in Schools and Child Care Programs | MA Department of Public Health (DPH)
Information about radon exposure, testing, and mitigation, available in multiple languages.

Heat Safety

Heat Safety | MA Department of Public Health (DPH)
Information to help plan and manage extreme heat conditions.

IX. Safe Sleep

• Safe Sleep Information for Child Care Providers | MA Department of Public Health (DPH)
  Information on safe sleep for child care providers including EEC regulations, safe sleep checklist, and trainings. 
• Providing Care for Babies to Sleep Safely | Centers for Disease Control (CDC)
  Information for parents and caregivers to help reduce the risk of sleep-related infant deaths.
• Safe Sleep and Sudden Infant Death Syndrome (SUID) | American Academy of Pediatrics (AAP)
  Tools and resources to support the 2022 AAP Safe Sleep updated recommendations, including video and webinar.

X. Social, Emotional, and Mental Health

• Fostering Healthy Social & Emotional Development in Young Children: Tips for Early Childhood Teachers & Providers | U.S. Department of Education
  Strategies to support children’s social-emotional development across infancy, toddlerhood, and preschool years. Emphasizes creating nurturing environments, responsive relationships, self-regulation, and family engagement.
• Infant and Early Childhood Mental Health (Ages 0-5) for Professionals | MA Department of Mental Health (MA DMH)
  Information and resources pertaining to infant and early childhood mental health. 
• Pyramid Model Resource Library | The National Center for Pyramid Model Innovations (NCPMI)
  Trainings, webinars, technical assistance, and resources on the Pyramid Model. The Pyramid model is an evidence-based practice for promoting young children’s healthy social and emotional development.
• Head Start Heals | National Center on Health, Behavioral Health, and Safety
  A resource for programs to support the social and emotional and mental health of children and families. Includes videos resources.

XI. Other Professional Development for Early Educators

• Critical Competencies for Infant-Toddler Educators | ZERO TO THREE
  A suite of professional development services for early childhood educators to help build the essential knowledge and skills they need.
• StrongStart Online Professional Development System (PDS) | MA Department of Early Education and Care (EEC)
  Web-based "one stop center" for early educators and administrators that provides both self-paced and instructor-led training courses.
• Resources for Children & Families | Office of the Child Advocate (OCA)
  A guide to navigating the state agencies that provide services to children and families and links to helpful resources pages.