**HEALTH PLAN**

**FOR**

**(Name of Your Head Start Center)**

**HEAD START CENTER**

**HEALTH PLAN**

**FOR**

**HEAD START CENTERS**

The following are ( [name of your program/center )]{.underline} health
care policies and

procedures that make up our Health Plan. The Head Start Center is
committed to

the health, safety and wellness of the children, families and community.

**TABLE OF CONTENTS**

I. Administration Plan

> A. Imminent Health Hazard
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 1
>
> B. Environmental Health Survey and Evaluation
> Policy\...\...\...\...\...\...\...\...\...\...\...\..... 3
>
> C. Administrative Authority
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 4
>
> D. Staff Ratio
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 5
>
> E. Plan Review
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 7

II\. Health Promotion and Protection Plan

> A. Health Services Advisory Committee
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 8
>
> B. Parental/Community Health and Safety Concerns
> Policy\...\...\...\...\...\...\...\...\...\...\... 9
>
> C. Health Records
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 11
>
> D. Immunization
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 14
>
> E. Health Screening
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 17
>
> F. Medication Handling. Storage and Administration
> Policy\...\...\...\...\...\...\...\...\...\.... 20
>
> G. Daily Health Assessment
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 24
>
> H. Incident Log
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 25
>
> I. Exclusion/Re-Admission
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 27
>
> J. Tobacco Use
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 31
>
> K. Animal
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 32
>
> L. Physical, Emotional, Sexual Abuse
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 34
>
> M. Health Education
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 36
>
> N. Infectious Disease Control
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 40
>
> O. Sanitation and Disinfection
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 51
>
> P. Infections Disease Outbreak
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 55

III\. Sanitary Facilities Plan

> A. Water
> Supply\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 57
>
> B. Liquid Waste Disposal
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 59
>
> C. Solid Waste Disposal
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 60

IV\. Vector Control Plan

> A. Vector Control
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 61
>
> B. Pesticide Use/Documentation
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 63

V. Safety and Emergency Plan

> A. General Safety
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 64
>
> B. Fire Safety
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 66
>
> C. Toxic Substances
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 70
>
> D. Playground Safety
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 72
>
> E. Toy Safety
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 74
>
> F. Injury Prevention
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 75
>
> G. Transportation Safety
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 77

VI\. Emergency Plan

> A. Emergency
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 81
>
> B. Emergency Contact
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 84
>
> C. Emergency Evacuation
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 86
>
> D. Bus and Transportation Emergency
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 89
>
> E. Medical Emergency
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 91
>
> F. Industrial Emergency
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 95
>
> G. Weather Emergency
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 96
>
> H. Violent Behavior Emergency
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 97
>
> I. Bomb Threat
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\....
> 98
>
> J. Missing Child
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 99

VII\. Physical Environmental Facility Plan

> A. Handicapped Accessibility
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 101
>
> B. Heating, Air Conditioning, Ventilation
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 102
>
> C. Electrical System
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 105
>
> D. Plumbing
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 106
>
> E. Lighting
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 107

VIII\. Food Service and Sanitation Policy

> A. Food Service
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...
> 108
>
> B. Infant Food Service
> Policy\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\...\.....
> 109

**I. ADMINISTRATION PLAN**

The Administration Plan for the Head Start Program sets forth and
establishes administrative policies and procedures to ensure the safe
and healthy operation of the Head Start Program for the children,
visitors, employees and community.

**I.A Imminent Health Hazard Policy**

1\. **POLICY**: It is the policy of the Head Start Center that the Head
Start Program Director, the Center Administrator and the Head Start
Center staff will take what ever steps are necessary to prevent the
creation of an imminent health hazard and to protect the children, staff
and community from any imminent health hazards that may occur.

2\. **PROCEDURE**: In order to reduce the effect of an imminent health
hazard, as described in Section 3-101.2 of the AIPB Head Start
Environmental Health Standard, the following actions will be taken:

a\. If the Health Advisor or AIPB identify an imminent health hazard,
the Center Administrator will:

> \(1\) Follow the recommendations to eliminate of the health hazard or
> reduce the risk of exposure to the health hazard, which could include
> evacuation of the Center.
>
> \(2\) Coordinate actions necessary to permanently eliminate the health
> hazard to the satisfaction of the Health Advisor
>
> \(3\) Prepare a written request to the Head Start Director requesting
> that the Center be allowed to reopen. The request will include what
> the imminent health hazard was, what was done to eliminate the hazard
> or reduce the risk of exposure to the hazard, and a copy of the
> written recommendation by the Health Advisor to open the Center or
> written declaration that the health hazard has been eliminated.

b\. If the Head Start Center staff or visitors identify an imminent
health hazard, the Center Administrator will:

> \(1\) The Center Administrator will determine if the situation is an
> emergency and if evacuation of the Center is necessary. If evacuation
> is necessary, then the Emergency Evacuation Procedures presented in
> Section VI.C of this Plan will implemented.
>
> \(2\) For non-emergency imminent health hazards, the Center
> Administrator will:
>
> \(a\) The Center Administrator will take steps to eliminate the
> imminent health hazard or to limit exposure to the imminent health
> hazard immediately.
>
> \(b\) Call the Head Start Director at [(phone number)]{.underline}
> immediately of the situation and what actions are planned.
>
> \(c\) Call the Health Advisor at [(phone number)]{.underline}
> immediately of the situation and what actions are planned and request
> technical assistance.
>
> \(d\) Follow the recommendations to eliminate of the health hazard or
> reduce the risk of exposure to the health hazard as provided by the
> Health Advisor.
>
> \(e\) Coordinate actions necessary to permanently eliminate the health
> hazard to the satisfaction of the Health Advisor.

**I.B Environmental Health Survey and Evaluation Policy**

1\. **POLICY:** The Head Start Center staff encourage environmental
health surveys of the Center to ensure the health and safety of the
children, staff and visitors and will work with the Health Advisor, the
Health Services Advisory Committee and the Parent Advisory Committee (or
whatever your committee is called) to correct problems identified at the
Center.

2\. **PROCEDURE:** In order to ensure that a comprehensive environmental
health survey is conducted annually, the following actions will be
taken.

> a\. The Center Administrator will contact the Health Advisor in
> September of each year to schedule the environmental health survey of
> the Head Start Center.
>
> b\. The Center Administrator will make sure all policies and
> procedures, plans, and reports needed for the survey are complete and
> ready for inspection.
>
> c\. The Center Administrator, or their designee, will be present
> during the survey to respond to questions and provide information to
> the Health Advisor.
>
> d\. The Center Administrator will review the survey report and
> schedule a meeting with the Health Advisor if necessary to clarify any
> information contained in the report.
>
> e\. Within one month of receiving the survey report, the Center
> Administrator will prepare a Compliance Plan and Schedule to correct
> items noted in the survey report.
>
> f\. The Center Administrator will share the survey report and the
> Compliance Plan and Schedule with the Parent Advisory Committee for
> the Center at the next regularly scheduled meeting after the survey
> report is received and will provide periodic progress reports on
> corrections.

**I.C Administrative Authority Policy**

1\. **POLICY**: The [(Name of Tribe or Head Start Grantee)]{.underline}
Head Start Director will ensure the efficient and practical operation of
the Head Start Center by granting administrative authority for the
day-to-day operation of the Center.

2\. **PROCEDURE**: In order to ensure effective and efficient day-to-day
operation of the Head Start Centers, the following actions will be
taken:

> a\. The [(Name of Tribe or Head Start Grantee)]{.underline} grants
> administrative authority for the day-to-day operation of the Head
> Start Center to [(name of person)]{.underline} Center Administrator.
> These authorities are granted to the Center Administrator in order to
> enhance and protect the health and safety of the children, staff and
> visitors at the Head Start Center.
>
> b\. The Center Administrator will post a list of delegated authority
> for the Head Start Center on [(location where posted)]{.underline}
> indicating who is in charge when the Center Administrator is absent.

**I.D Staff Ratio Policy**

1\. **POLICY:** The Head Start Center will not leave children unattended
or supervised and will maintain required staff to student ratios to
protect the health and safety of the children at the Center.

2\. **PROCEDURE:** In order to comply with the staff to student ratios
presented in the Head Start Performance Standards, Sections 1306.32 and
1304.52(g)(4) and also with the more stringent requirements of the local
fire code, the following actions will be taken:

> a\. The following staff to student ratios will be maintained at the
> Head Start Center during all hours of operation:
>
> \(1\) Early Head Start, Children 0-36 months.
>
> \(a\) There is one Teacher for every 3 children ages birth to 24
> months.
>
> \(b\) There is one Teacher for every 4 children 24 months to 36
> months.
>
> \(c\) The group's size will be limited to 7 children
>
> \(2\) Head Start: Children 3 years to 5 years.
>
> \(a\) There will be a minimum of 2 adult staff persons on duty at all
> times.
>
> \(b\) There will be a staff to student ration maintained at the Center
> for children 3 to 5 years of age as follows:
>
>  1 adult staff member per 7 children age 3-4 years
>
>  1 adult staff member per 8 children ages 5 years or older.
>
> \(3\) These staffing ratios will be maintained at the Center and on
> the bus during transportation of children.
>
> \(4\) Staff Absences: There are occasions when, due to illness or
> unforeseen circumstances, the number of staff available to provide
> services may temporarily less then required. In these instances the
> following procedures will apply:
>
> \(a\) If an Early Head Start Teacher does not report to work or must
> leave work during the day, and a substitute teacher can not be found,
> a Head Start staff member will be shifted to provide service only to
> the Early Head Start children. This shift will be allowed for a
> maximum of two working days, after which the Early Head Start will
> reduce enrollment to comply with the staff to student ratios.
>
> \(b\) Both staff members who provide service to a group of 7 Early
> Head Start children will be a paid Teacher.
>
> \(c\) If both Teachers required for a group of 7 Early Head Start
> children are gone, this will constitute and emergency situation and
> the Center Administrator will implement the emergency contact
> procedures for the Early Head Start children only and cancel Early
> Head Start classes.
>
> \(d\) If a Head Start staff member does not report to work, must leave
> work during the day or is shifted to cover the Early Head Start
> services, and a substitute Teacher can not be found, a regular
> volunteer for the Center will provide services to the Head Start
> children. This shift will be allowed for a maximum of two working
> days, after which the Head Start will reduce enrollment to comply with
> the staff to student ratios.
>
> \(e\) At least one of the staff providing service to a group 14 Head
> Start children ages 3-4 years or a group of 16 children ages 5 years
> or older must be a paid Teacher. If this cannot be maintained then the
> Center Director will declare an emergency situation and will implement
> the emergency contact procedures for the Head Start children and will
> cancel classes.
>
> \(4\) Staff Shortages: There are occasions when, due to long term
> illness, resignations or other unforeseen circumstances, the number of
> staff available to provide services will be less then required for
> more then two days. In these instances the following procedures will
> apply:
>
> \(a\) The Center Administrator will notify the Head Start Director
> immediately of the staffing shortage and determine if any Head Start
> Administrative staff, home based staff, or other identified qualified
> substitutes can assist until the shortage can be resolved.
>
> \(b\) The Center Administrator will provide orientation to all
> substitutes and volunteers within the first week of hire or presence
> at the Center. Substitutes and volunteers will be under the
> supervision of one of the regular Head Start staff at all times.
>
> \(c\) If the staff shortage cannot be resolved through the use of
> substitute staff, then the Center Director will reduce the enrollment
> of the Early Head Start or Head Start Programs, or both, until
> adequate staff can be hired.

**I.E** **Plan Review Policy**

1\. **POLICY**: The Head Start Center will work with the Health Advisor
to ensure that renovated and new facilities are designed to protect the
health and safety of the children, staff and visitors.

2\. **PROCEDURE:** In order to reduce and eliminate unnecessary delays
and expenses associated with a renovation, construction or move in to a
new facility, the following actions will be taken:

> a\. New Facilities: The Center Administrator will notify the Health
> Advisor in writing of any proposals to construct a new Head Start
> facility, including the name and phone number of a contact person to
> arrange for the review of plans for the new facility.
>
> b\. Renovations to Existing Centers: The Center Administrator will
> notify the Health Advisor in writing of any plans to renovate the
> existing facility, including the name and phone number of a contact
> person to arrange for the review of the renovation plans.
>
> c\. Occupying an Existing Facility: The Center Administrator will ask
> the Health Advisor to conduct a site visit of any facility that the
> Head Start Program intends to occupy for use as a Head Start Center.
> Prior to occupying any facility, the Head Start Program will have
> approval from the Health Advisor.

**II. Health Promotion and Protection Plan**

**II.A Health Services Advisory Committee Policy**

1\. **POLICY:** The Head Start Center will participate in and utilize
the expertise of the [(name of the HSAC)]{.underline} Health Services
Advisory Committee (HSAC) for health and safety issues.

2\. **PROCEDURE**: In order to utilize the valuable and important source
of health and safety information available from the Health Service
Advisory Committee, the following actions will be taken:

> a\. The [(name of the HSAC)]{.underline} Health Services Advisor
> Committee provides service for the Head Start Center. The Head Start
> Center is represented on the Health Services Advisory Committee by the
> Center Administrator.
>
> b\. The Health Services Advisory Committee will review all health and
> safety policies and procedures and provide guidance on such issues as
> immunization schedules for staff.
>
> c\. The Health Services Advisory Committee meets [(frequency that the
> HSAC meets)]{.underline} . Prior to the meeting, the Center
> Administrator will ask the staff for any issues or concerns they would
> like presented to the HSAC.
>
> d\. The Center Administrator will provide a verbal report to the staff
> on topics covered during the HSAC meeting and make available copies of
> minutes from the meeting to the staff.

**II.B Parental/Community Health and Safety Concerns Policy**

1\. **POLICY**: The Head Start Center staff will encourage and provide
opportunities for the Head Start parents/guardians to be involved to the
fullest extent in the Head Start Center Program.

2\. **PROCEDURE:** In order to ensure parental participation in Head
Start Program activities the following actions will be taken:

> a\. Parents/guardians will be made to feel welcome at the Center at
> all times and will be treated with dignity and respect at all times.
>
> b\. The Center Administrator will respond quickly and confidentially
> to the needs and concerns of parents/guardians regarding their
> children, their families and the Head Start Program.
>
> c\. The Center Administrator will make available to parent/guardian
> fact sheets and information on health and safety issues and the Head
> Start Centers health and safety policies and procedures.
>
> d\. Parents/guardians will choose to participate in Head Start
> activities without fear of endangering their child's right to be in
> the Program.
>
> e\. Parents/guardians may review their child's records on request at
> any time during the year.
>
> f\. Non-confidential reports on injury trends, inspections reports,
> compliance to standards and regulations and other similar information
> will be made available to parent/guardian on request.
>
> g\. Parents/guardians will be encouraged to:
>
> \(1\) Participate in the process of making decisions about the nature
> and operation of the Head Start Program by electing and serving as
> representatives in decision-making groups. The Center Administrator
> will provide to the parents/guardians at the time of their child's
> enrollment, information on the various decision making groups, what
> groups they can automatically participate in, and how they can be
> elected to other decision making groups.
>
> \(2\) Participate in classrooms as paid employees, volunteers or
> observers.
>
> \(3\) Present ideas for activities to the Center Administrator for
> themselves and Head Start Children.
>
> \(4\) Work with their children in cooperation with the Head Start
> staff.

**II.C Health Records Policy**

1\. **POLICY:** It is the policy of the Head Start Center that only
those records required by the AIPB, the Tribe or the local State will be
maintained in order to meet the health, mental and social needs of the
children in our care. These health records will be developed in
conjunction with the parent/guardian and health care professionals and
will be maintained on site in a confidential manner.

2\. **PROCEDURES:** In order to enhance and protect the health and
safety of the children, their families, and the staff, and to maintain
health information in a professional and confidential manner, the
following actions will be taken:

> a\. Required Records: Certain health information about each child is
> required by the Head Start Performance Standards, State child care
> regulations, or Tribal child care regulations. We ask for the
> following information in our registration packet:
>
> \(1\) Pre-admission enrollment information will be collected at the
> time of admission on [(name of form)]{.underline} .
>
> \(2\) Medical Records
>
> \(a\) Child's medical history (Form , name or number of form)
>
> \(b\) Child's developmental history, (Form , name or number of form)
>
> \(c\) Child's screening results (Form , name or number of form)
>
> \(d\) Child's medical and dental examination data (Form , name or
> number of form)
>
> \(e\) Immunization Certificate
>
> \(f\) Report from health care professional's determination on schedule
> of age appropriate prevention and primary care. (Form , name or number
> of form)
>
> \(g\) Schedule of well child care and treatment plan. (Form , name or
> number of form)
>
> \(h\) Parent permission for health screening and developmental
> testing, or the parent\'s written refusal for their child\'s receiving
> health screening and developmental testing. (Form , name or number of
> form)
>
> \(3\) The Center Staff will review the forms with the parent/guardian
> at admission and explain what the health information is for and how it
> will be maintained in a confidential manner. A fact sheet will be
> provided to the parent/guardian on how this information will be used
> by the Center.
>
> \(4\) The Center Administrator will update medical information forms
> with new information on the following schedule:
>
> \(a\) quarterly for children less than one year of age,
>
> \(b\) semi-annually for children 1-2 years of age, and
>
> \(c\) yearly for children over two years of age.
>
> b\. Confidentiality of Records:
>
> \(1\) Under all circumstances, confidentiality about the child's
> medical condition and the family's status shall be preserved unless
> such information is released at the written request of the
> parent/guardian. Tribal or State laws and regulations apply to the
> release of confidential information in cases where abuse or neglect is
> a concern.
>
> \(2\) When custody has been awarded to only one parent, access to
> records shall be limited to the custodial parent only.
>
> \(3\) Each child's records shall be copied for the child's
> parent/guardian on request.
>
> \(4\) Head Start Center staff shall not disclose or discuss personal
> information regarding children and their relatives with any
> unauthorized person.
>
> \(5\) The Center Administrator will consult with the Head Start Health
> Coordinator and decide who among the staff may have access to
> confidential information and may have confidential information
> discussed with them. Confidential information shall only be seen and
> discussed with staff that need the information in order to provide
> service.
>
> \(6\) During enrollment of a child, the staff shall ask the parent to
> identify the child's health care providers and to provide written
> consent to enable the staff to establish communication with those
> providers, if necessary.
>
> \(7\) Each person gaining access to confidential records must complete
> the Records Access Form attached to the cover of each record.
>
> \(8\) Written releases must be obtained from the child's parent or
> legal guardian prior to forwarding information or the child's records
> to other service providers using Form (Name or number of form), unless
> release of the information to authorized health agencies is required
> by State, Tribal or federal laws.
>
> \(9\) Staff health records are confidential and are maintained by the
> Head Start Director. Permission from the staff member for review or
> release of staff health information must be obtained prior to
> forwarding information to other service providers using Form (Name or
> number of form), unless release of the information to authorized
> health agencies is required by State, Tribal or Federal laws. The Head
> Start Director will consult with the Head Start Health Coordinator and
> decide who among the staff need access to confidential health
> information on other staff members, before a request for disclosure of
> such information is made.

**II.D Immunization Policy**

1\. **POLICY:** To protect all children in our care and our staff, the
Head Start Center follows the immunizations and schedules for children
and staff established by the Health Services Advisory Committee and
shall not be less then the immunizations and schedule recommended by the
Centers for Disease Control and Prevention (CDC), Advisory Committee on
Immunization Practices (AIPC).

2\. **PROCEDURES:** In order to comply with State and Tribal laws and to
ensure the health of the children, staff and community, the following
actions will be taken:

> a\. Child Immunization:
>
> \(1\) Certificate of Immunization:
>
> \(a\) Parent/guardian must provided at the time of enrollment a
> Certificate of Immunization signed and issued by a health care
> professional that indicates the current immunization status of the
> child.
>
> \(b\) We keep on file the Certificate of Immunization status provided
> by the parent during enrollment. When a child leaves our care, the
> Certificate is returned to the parent.
>
> \(c\) The Center Administrator will review the Certificate of
> Immunization with the parent/guardian and discuss any problems or
> missing immunizations.
>
> \(2\) We allow three months for parent/guardian to obtain the required
> immunizations from the date of admission to the center. The Center
> Administrator will send a written reminder to the parent/guardian
> every 30 days.
>
> \(3\) A child whose immunizations are not kept up-to-date shall be
> dismissed after three written reminders to parent/guardian over a
> 3-month period.
>
> \(4\) A child can be accepted into care without immunization when the
> parent/guardian provide a signed statement stating:
>
> \(a\) They oppose their child being immunized due to religious,
> philosophical or personal grounds or;
>
> \(b\) Immunizations are medically unsafe or unnecessary for their
> child. In this instance the child's health care provider must describe
> the medical reason why it is not safe and sign a statement advising
> against immunization.(Form Name or number of form)
>
> \(5\) Children who are not immunized will not be accepted for care
> during a disease outbreak for diseases that can be prevented by
> immunization. This is for the un-immunized child's protection and to
> reduce the spread of the disease. Examples are a measles or mumps
> outbreak.
>
> \(6\) The following immunization schedule will be followed:(use
> schedule established by your HSAC, local State or Tribe). For children
> younger than seven years of age and not immunized at infancy, we will
> follow the recommendations of the HSAC.

  --------------------------------- -------------------------------------
  Schedule of Immunizations for     
  Infants and Children              

  [Age]{.underline}                 [Vaccine(s)\*]{.underline}

  2 months                          DTP-1, OPV-1or IPV-1, HbCV-1

  4 months                          DTP-2, OPV/IPV-2, HbCV-2

  6 months                          DTP-3, HbCV-3

  15 months                         MMR-1, HbCV-4

  15-18 months                      DTP-4, OPV/IPV-3,

  4-6 years                         DTP-5, OPV/IPV-4

  4-16 years                        MMR-2
  --------------------------------- -------------------------------------

> \* DTP = diphtheria and tetanus toxoids with pertussis vaccine; OPV =
> oral poliovirus vaccine containing attenuated poliovirus types 1, 2
> and 3; IPV = inactivated poliovirus containing killed type 1, 2 and 3;
> MMR = attenuated measles, mumps and rubella viruses in a combined
> vaccine, HbCV = H. Influenza type b conjugated vaccines.
>
> b\. Staff Immunization: The staff shall have the same immunization
> status as required for the children. Proof of immunization status
> shall be maintained as part of the confidential medical record.
>
> \(1\) As established by the HSAC, the immunization status of the staff
> shall be determined by:
>
> \(a\) Certificates of Immunization; or
>
> \(b\) Certified immune by a health care professional through
> serological testing; or
>
> \(c\) Age indicating presumed immunity to certain diseases.
>
> \(2\) All staff shall have completed a primary series for tetanus and
> diphtheria, and shall receive boosters every 10 years.

**II.E Health Screening Policy**

1\. **POLICY:** The Head Start Center, in collaboration with the
parent/guardian and health care professionals will determine and promote
the medical, dental and mental health needs of the children and staff
and will assist families in developing links with ongoing sources of
continuing and accessible health care.

2\. **PROCEDURE:** In order to identify health problems and improve the
provision of health care for the children and the staff, the following
actions will be taken:

> a\. Determining Health Status: In collaboration with parent/guardian,
> during the enrollment (or admission) process, and within the first 30
> calendar days of entry, the Center Administrator will:
>
> \(1\) Inform the parent/guardian of what the health status information
> is for, how it will be maintained, and why some information will be
> shared with the Head Start Program staff to provide adequate service.
>
> \(2\) Determine if the child has ongoing source of continuous,
> accessible health care.
>
> \(3\) Ask the parent/guardian the child has any health or safety needs
> that the Head Start Program may need to address.
>
> \(4\) Ensure there is a Health Status Medical Report [(name and number
> of the form)]{.underline} completed and signed by the child's health
> care provider or completed by the health care professional that
> conducts the Head Start Centers health screening.
>
> \(5\) Obtain the health care professional's determination if the child
> is up-to-date on the schedule of age appropriate prevention and
> primary health care, which includes medical, dental and mental health.
> The schedule is established by the Early and Periodic Screening and
> Diagnosis and Treatment (EPSDT) Program of the Medicaid agency of
> State.
>
> \(6\) Schedule of Well-Child Care and Treatment Plan:
>
> \(a\) The Center Administrator will develop a Treatment Plan in
> collaboration with the parent/guardian and health care provider based
> on the child's age appropriate schedule of well child care. The
> Treatment Plan will document what immunizations or examinations should
> be carried out to become up-to-date or to stay current with the
> schedule.
>
> \(b\) For children who are not up-to-date on their age appropriate
> schedule of well child care, the Center Administrator will provide to
> the parent/guardian a schedule of health care needs. The Center
> Administrator will collaborate with the parent/guardian and health
> care providers for the children, to ensure the needed immunizations
> and examinations are received.
>
> \(c\) For children who are up-to-date with their age appropriate
> schedule of well child care, the Center Administrator will provide to
> the parent/guardian the schedule for continuing with the well child
> care.
>
> \(d\) The Center Administrator will meet with the parent/guardian
> regularly to determine if examinations or treatments have taken place,
> and will update the child's records accordingly.
>
> \(5\) Health screening will be conducted for a child only with a
> signed Health Screening Consent Form [(or whatever form name
> used)]{.underline} signed by the parent/guardian.
>
> \(6\) If a parent/guardian refuses to give authorization for health
> services, the parent/guardian must provide their refusal in writing
> using the Health Screening Consent Form.
>
> \(7\) The Center Administrator will provide to the parent/guardian
> fact sheets on all health screening and related health activities that
> will occur at the center. The fact sheets will explain what health
> screening will be done, what they are intended to determine, and how
> the results will be used.
>
> \(8\) The results of all health screening will be provided to the
> parent/guardian for each of their children. The results will include a
> summary of the health care providers interpretation of the screening
> results and any recommendations for further testing. The Center
> Administrator will offer to schedule a meeting with the
> parent/guardian to discuss the screening results.
>
> b\. Screening for Developmental, Sensory and Behavioral Health
>
> \(1\) Linguistically and age appropriate screening shall be conducted
> for each child within 45 days of entry with parental permission. The
> screening devices used at this Center have been approved by the Health
> Services Advisory Committee and include:
>
> \(a\) (What ever tools your Center uses).
>
> \(b\)
>
> \(2\) The results of developmental, sensory and behavioral screening
> will be reviewed by a certified or qualified mental health specialist
> or child development specialist. The mental health specialist or child
> development specialist available for consultation with the Head Start
> Center is (name , phone number .
>
> \(3\) If the parent/guardian, developmental consultant, staff or other
> health care provider, believe additional testing may be required for a
> child based on the screening results, then the Center Administrator
> will assist the parent/guardian in arranging for the additional
> testing.
>
> \(4\) The Center Administrator will provide to the parent/guardian
> fact sheets on all developmental and behavioral screening activities
> that will occur at the center. The fact sheets will explain what
> developmental and behavioral screening will be done, what the
> screening is intended to determine, and how the screening results will
> be used.
>
> \(5\) The results of all developmental and behavioral screening will
> be provided to the parent/guardian for each of their children. The
> results will include a summary of the interpretation of the screening
> results by the developmental consultant and any further testing that
> may be indicated. The Center Administrator will offer to schedule a
> meeting with the parent/guardian to discuss the screening results.
>
> c\. Staff Health Screening: All staff will have a health appraisal
> (Form Name or number of form) completed within the 3 months prior to
> employment. For staff hired during the school year, the health
> appraisal will be completed within the first month of employment.

**II.F Medication Handling, Storage and Administration Policy**

1\. **POLICY:** The Head Start Center designated staff will properly
store and administer medication, following the written authorization of
the child's parent/guardian or physician to safe guard the health of the
children, staff and families.

2\. **PROCEDURE:** In order to ensure the safe handling, storage and
administration of medicines to the children, the following actions will
be taken:

> a\. The Head Start staff and the parent must complete the [Medication
> Administration Plan (or other name or number of the
> form)]{.underline}**,** that specifies the conditions for the
> administration of prescription and non-prescription medication and the
> parent's consent for administration of medications to their child. A
> child\'s medication will be sent home when it is no longer needed.
>
> b\. The Center Administrator will arrange for the training of staff
> members on the administration, handling and storage of medications in
> the week prior to children starting school. This annual training is
> provided by [(name and title and organization/agency of health care
> provider that provided the training)]{.underline} , on [(date of
> training)]{.underline} .
>
> c\. The Center Administrator or designated staff member who have been
> properly trained, is responsible for administering medications and
> keeping documentation of the date and time the medication was given on
> the Daily Medication Record Form [(or what ever the name of the form
> )]{.underline} .
>
> d\. When the parent/guardian of a child needing medication during
> school will give the medication to the Center Administrator. The
> Center Administrator will take the medication from the parent/guardian
> and:
>
> \(1\) Ensure there is a Medication Administration Plan signed by the
> parent for the child and that the medication to be administered is in
> compliance with the Medication Administration Plan.
>
> \(2\) Ensure there is a prescription by a health care provider, if
> required;
>
> \(3\) Complete the Medication Labeling Checklist Form [(other name or
> number of form)]{.underline} to determine if all the information
> required on the label is provided on medication brought to the center
> by parent/guardian.
>
> e\. The Center Administrator will record any medications given during
> the day on the Daily Medication Administration Form (or whatever form
> you use) for each child taking medication. These forms will be
> maintained in the child\'s medical record.
>
> f\. The Center Administrator will review with the staff any potential
> reactions that a child may have to a medication. The staff will
> observe the child for any adverse reactions to the medication and
> record any observed adverse reactions on the Medication Administration
> Form. Adverse reactions could include:
>
> \(1\) Signs of being tired, or sleepy
>
> \(2\) Moodiness
>
> \(3\) Aggressiveness
>
> \(4\) Physical reactions such as rashes, swelling, or breathing
> difficulty
>
> g\. Prescription Medications:
>
> \(1\) Prescription medications will be administered to children only
> with signed parental consent. The medication must be in the original
> container from the pharmacy and properly labeled (see Section
> II.F.2.d(3) of this Plan).
>
> \(2\) The parent/guardian must provide information on any adverse
> reactions that may be associated with use of the prescription
> medication as provided by the health care provider or the pharmacy.
> The parent/guardian should be encouraged to give the first dose of the
> medication at home and observe the child for any adverse reactions.
>
> h\. Non-Prescription Medications (over the counter drugs):
>
> \(1\) Examples of non-prescription medication include:
>
> \(a\) Antihistamines,
>
> \(b\) Non aspirin fever reducers/pain relievers,
>
> \(c\) Non-narcotic cough suppressants,
>
> \(d\) Decongestants,
>
> \(e\) Anti-itching ointments/locations intended to relieve itching,
>
> \(f\) Diaper ointments, intended for use with \"diaper rash\"
>
> \(g\) Sunscreen
>
> \(h\) Vitamins
>
> \(i\) Anti-diarrheal medications
>
> \(2\) We will only give a child a non-prescription medication when the
> medication is in its original container and the parental consent form
> includes the dose and frequency for the child. The medication must be
> age-appropriate.
>
> \(3\) Non-prescription medications will be administered to children
> only with signed parental consent. The medication must be in the
> original container and properly labeled (see Section II.F.2.d(3) of
> this Plan).
>
> j\. Storage of medication:
>
> \(1\) We store medications so they are inaccessible to children, under
> lock and key and at the proper temperature when at the center or if
> medications must be taken on field trips. The following storage
> procedures are used:
>
> \(a\) All medications are stored with child-proof caps and in locked
> cabinets that is location inaccessible to children. The medical
> storage cabinet is located [(provide location of cabinet)]{.underline}
> .
>
> \(b\) **Internal** medications are stored separate from **external**
> medications.
>
> [Internal]{.underline} medications are stored ( [)]{.underline}. give
> location(s) where stored
>
> [External]{.underline} medications are stored ( [)]{.underline}. give
> locations(s) where stored
>
> \(c\) All medications are stored at the proper temperature
> (refrigerated or non-refrigerated).

(d) Refrigerated medications will be stored in leak-proof lock boxes and
    in such a

> manner as to not contaminate food and to not be contaminated by food.
>
> \(e\) Medications shall not be used after the expiration date.
>
> \(f\) Medications that must be transported for field trips or other
> activities will be transported in a lock box and at the proper
> temperature using an ice chest [(or other device for maintaining
> temperature)]{.underline} .

**II.G Daily Health Assessment Policy**

1\. **POLICY:** The Head Start Center shall conduct daily health
assessments of children in a manner that is comfortable to the children
to determine the health of the child and any recent illness in the child
or injuries to the child.

2\. **PROCEDURE:** In order to identify conditions that may require
medical attention and to protect the health of the children, staff and
families, the following actions will be taken:

> a\. The Head Start Center staff will receive annual training from
> [(name and organization/agency of health care provider)]{.underline}
> on conducting a health assessment.
>
> b\. The Daily Attendance Sheet will include a column that indicates if
> the daily health assessment was conducted. A mark of (indicate type of
> mark, such as OK) will indicate that no problems were observed. A mark
> of (indicate type of mark, such as FORM) indicates that an Illness
> Incident Report was completed and has been placed in the child's
> health record. This form records data for the entire group of children
> for a [(weekly or monthly)]{.underline} period and helps identify
> patterns of illness for an individual child or the group in a center.
>
> c\. The staff shall observe the children throughout the day for any of
> the following that may indicate a health concern:
>
> \(1\) Changes in behavior or appearance from those observed during the
> previous day's attendance.
>
> \(2\) Skin rashes, itch skin, or itchy scalp.
>
> \(3\) Increase in body temperature, determined by taking the child's
> temperature, if there is a change in the child's behavior or
> appearance.
>
> \(4\) Complaints of pain or if not feeling well.
>
> d\. If any of the above conditions are noted, the staff will inform
> the Center Administrator. The Center Administrator will talk with the
> child and discuss the observations with the parent.
>
> e\. The Daily Attendance Sheets will be reviewed weekly by the Center
> Administrator to identify any illness or injury trends among the
> students.

**II.H Incident Log Policy**

1\. **POLICY:** The Head Start Center shall maintain an incident log of
illness and injuries to promote the health and safety of the children
and staff, to identify disease outbreaks and determine injury trends,
and implement effective interventions.

2\. **PROCEDURE:** In order to document how injuries and illnesses
occurred, what was done for the child as a result of an injury or
illness, and what steps were taken to protect health, the following
actions will be taken:

> a\. Illness
>
> \(1\) The Illness Incident Form [(or what ever name or number of
> form)]{.underline} will be completed for any child who is identified
> as ill during the daily health assessment or during the day when
> symptoms appear.
>
> \(2\) When a more serious illness occurs that requires first aid or
> medical attention to a child or adult, the Center Administrator will
> treat the illness as a Medical Emergency and follow the procedures
> presented in Section VI.E of this Plan.
>
> \(3\) The parent/guardian will be notified immediately of an illness
> that requires professional medical attention. The staff will document
> this notification of parent/guardian on the Illness Incident Form.
>
> \(4\) The Illness Incident Report shall be completed in triplicate. A
> copy of the report will be distributed as follows:
>
> \(a\) One copy shall be given to the child's parent or legal guardian
> or discussed with the parent when they pick the child up from the
> center (or the ill adult).
>
> \(b\) One copy shall be kept in the child or staff's medical file.
>
> \(c\) One copy shall be kept in a chronologically filed illness log.
>
> \(5\) The completed Illness Incident Form will be maintained in the
> child's health record for [(number of years or months)]{.underline} .
> The Illness Incident Form will be made available to health care
> professionals and the Health Advisor for review and analysis only with
> parental permission.
>
> \(6\) The Center Administrator will prepare a summary report of all
> illnesses observed quarterly for review by the Head Start Health
> Coordinator, the Health Services Advisory Committee and the Health
> Advisor. This report will not identify children but will identify
> disease trends.
>
> b\. Injury Incident
>
> \(1\) When an injury occurs in the Head Start Center to a child or
> adult, the Center Administrator will complete the Injury Incident
> Report Form [(or whatever name or number of form you use
> )]{.underline} . The completed injury report forms shall be made
> available to the Health Advisor and other appropriate health agencies
> for review and analysis only with parental permission.
>
> \(2\) The Injury Incident Report shall be completed in triplicate. A
> copy of the report will be distributed as follows:
>
> \(a\) One copy shall be given to the child's parent or legal guardian
> or discussed with the parent when they pick the child up from the
> center (or the injured adult).
>
> \(b\) One copy shall be kept in the child or staff's medical file.
>
> \(c\) One copy shall in a chronologically filed injury log.
>
> \(3\) When a more serious injury occurs that requires first aid or
> medical attention to a child or adult, the Center Administrator will
> treat the injury as a Medical Emergency and follow the procedures
> presented in Section VI.E of this Plan.
>
> \(4\) The parent/guardian will be notified immediately of an injury
> that requires professional medical attention. The staff will document
> this notification of parent/guardian on the Injury Incident Form.

**II.I Exclusion/Re-Admission Policy**

1\. **POLICY:** The Head Start Center shall not deny admission to or
send home any child because of illness unless the child is unable to
actively participate in program activities, they expose other children
and staff to illness or they are at risk for being exposed to other
illnesses when their resistance is low.

2\. **PROCEDURE:** In order to ensure that children and staff are not
unnecessarily excluded from Head Start activities and to protect the
health of the children and staff, the following actions will be taken:

> a\. Children Exclusion and Re-Admission
>
> \(1\) The Head Start Center will not deny admission nor exclude any
> enrolled child from program participation for long-term period solely
> on the basis of his or her health care needs or medication
> requirements unless keeping a child in care poses a significant risk
> to the health or safety of the child or other children, staff or
> visitors and the risk cannot be eliminated or reduced to acceptable
> levels through reasonable modifications in procedures, policies or
> staffing. Long-term exclusion of a child can only be approved by the
> Head Start Director after consultation with the child's
> parent/guardian, health care provider and the Head Start Health
> Coordinator.
>
> \(2\) The following are conditions of short-term exclusion from and
> for re-admission to the Head Start Center:
>
> \(a\) Fever of 101^0^ F axillary (under arm) or higher
> **[AND]{.underline}** who also have one or more of he following:
>
> 1\) diarrhea
>
> 2\) earache
>
> 3\) sore throat
>
> 4\) rash
>
> 5\) show signs of irritability or confusion
>
> \(b\) Symptoms and signs of possible severe illness such as lethargy,
> uncontrolled coughing, irritability, persistent crying, difficulty
> breathing, or wheezing, until medical evaluation allows inclusion.
>
> \(c\) Vomiting, on 2 or more occasions within a 24-hour period, until
> the vomiting resolves, or a health care provider determines the
> illness to be non-communicable, and the child is not in danger of
> dehydration.
>
> \(d\) Diarrhea, that is, increased number of stools, increased stool
> water or decreased form that is not contained by a diaper.
>
> \(e\) Mouth sores with drooling, unless a health care provider or
> health official determines the condition is noninfectious.
>
> \(f\) Rash with fever or behavior change until a health care provider
> determines that these symptoms do not indicate a communicable disease.
>
> \(g\) Eye discharge or pinkeye. Children can be readmitted after:
>
> 1\) medical diagnosis to rule out bacterial infection, or
>
> 2\) 24 hours on antibiotic treatment
>
> \(h\) Tuberculosis, until a health care provider or health official
> states that the child can attend.
>
> \(i\) Impetigo, until 24 hours after treatment has been initiated.
>
> \(j\) Strep throat or other streptococcal infection, until 24 hours
> after initial antibiotic treatment and the cessation of fever.
>
> \(k\) Chicken pox, until 6 days after onset of rash or until all sores
> have dried and crusted, or with permission by their health care
> provider.
>
> \(l\) Pertussis (Whooping Cough), until 5 days of appropriate
> antibiotic treatment to prevent and infection have been completed.
>
> (m)Mumps, until 9 days after onset of parotid gland swelling.
>
> \(n\) Hepatitis-a virus, until 1 week after onset of illness or as
> directed by the health department when passive immunoprophylaxis has
> been administered to appropriate children and staff.
>
> \(o\) Measles, until 6 days after onset of rash.
>
> \(p\) Rubella, until 6 days after onset of rash.
>
> \(q\) Shingles (herpes zoster), exclusion only on recommendation of
> child's health care provider. Clothing or a dressing shall cover sores
> until the sores have crusted.
>
> \(r\) Children with open oozing sores, which cannot be covered, will
> not be allowed to be at the center until:
>
> 1\) 24 hours after starting antibiotic treatment, or
>
> 2\) sores are properly covered (e.g. bandage/clothing, staff-gloves),
> or
>
> 3\) sores have healed.
>
> \(s\) Lice, scabies or other infestations, until 24 hours after
> treatment has been initiated.
>
> \(3\) If a child must be sent home because of an illness, the staff
> will place the child in quiet isolation and attend to their needs to
> the extent that this attention does not compromise the care of the
> other children. The isolation area/room for the Center is located
> [(location of isolation area or room)]{.underline} .
>
> \(4\) a child with uncontrolled diarrhea or vomiting shall be provided
> separate care in the isolation area, apart from other children until
> the child's parent arrives to remove the child from the Center.
>
> \(5\) If the Center Administrator has concerns about a child\'s
> ability to safely return to the Center, we reserve the right to
> request a note from the child\'s health care provider.
>
> \(6\) When a child is excluded from attending our child care center
> the staff will note this in the Illness Incident Report or Injury
> Incident Report (refer to Section II.H of this Plan).
>
> b\. Staff Exclusion:
>
> \(1\) Staff members should be excluded for the following reasons:
>
> \(a\) Chicken pox, until 6 days after the onset of the rash or until
> all sores have dried and crusted over.
>
> \(b\) Shingles (herpes zoster), exclusion only on recommendation of
> child's health care provider. Clothing or a dressing shall cover sores
> until the sores have crusted.
>
> \(c\) Rash with fever or joint pain until diagnosed not to be measles
> or rubella.
>
> \(d\) Measles or Rubella until 5 days after rash onset.
>
> \(e\) Vomiting, 2 or more occasions within a 24-hour period, until the
> vomiting resolves or is determined to be due to a non-communicable
> condition.
>
> \(f\) Diarrheal illness. Three or more episodes of diarrhea during
> previous 24 hours, until diarrhea resolves.
>
> \(g\) Hepatitis-a virus, until 1 week after onset of illness or as
> directed by the health department when passive immunoprophylaxis has
> been administered to appropriate children and staff.
>
> \(h\) Tuberculosis, until a health care provider or health official
> states that the child can attend.
>
> \(i\) Impetigo, until 24 hours after treatment has been initiated.
>
> \(j\) Strep throat or other streptococcal infection, until 24 hours
> after initial antibiotic treatment and the cessation of fever.
>
> \(k\) Pertussis (Whooping Cough), until 5 days of appropriate
> antibiotic treatment to prevent and infection have been completed.
>
> \(l\) Mumps, until 9 days after onset of parotid gland swelling.
>
> c\. Non-Exclusion Conditions: Certain conditions do not constitute a
> reason for denying admission to, or sending a child home from child
> care, unless the child is determined by the Health Advisor to
> contribute to transmission of the illness at the facility. Exclusion
> of children for any of the following conditions will be decided by the
> Head Start Director with consultation of the child's parent/guardian
> and the child's health care provider

.

> \(1\) Presence of germs in urine or feces in the absence of illness.
>
> \(2\) Nonpurulent conjunctivitis.
>
> \(3\) Cytolomegalo virus (CMV) infection.
>
> \(4\) Hepatitis-B virus carrier state and have no behavioral or
> medical risk factors.
>
> \(5\) HIV infection and have no behavioral or medical risk factors.

**II.J Tobacco Use Policy**

1\. **POLICY:** The Head Start Center, in compliance with the Head Start
Performance Standard (45 CFR 1304.53(a)(8), prohibits the use of all
forms of tobacco in all spaces used by the program, in the evening as
well as the day, including classrooms, staff offices, kitchens,
hallways, outdoor play areas and vehicles used for transporting
children.

2\. **PROCEDURES:** In order to protect the children from adverse health
effects from tobacco and to promote good health behaviors to the
children, the following actions will be taken:

> a\. Parent/guardian will be informed upon enrollment of their child of
> the tobacco use policy and that it will be strictly enforced.
>
> b\. Tobacco use by Head Start parent/guardian and staff will be
> prohibited during any Head Start activity, both at the center and away
> from the center. This includes field trips, socialization activities,
> meeting, home visits, and other Head Start activities.
>
> c\. Any staff member or parent who notices a violation of this policy
> may request the violator to extinguish all smoking materials or
> dispose of other forms of tobacco that may be in use, immediately, and
> may inform him/her of the tobacco use policy.
>
> d\. NO SMOKING signs will be posted throughout the Head Start
> building to inform all staff, parent/guardian and visitors that
> smoking is prohibited in the Center.
>
> **OPTIONAL: Some Head Start may ask for religious teaching for their
> children or practice religious beliefs that may include the burning of
> tobacco in pipes or other devices as part of the religious ceremony.
> The following statement allows the use of tobacco smoke for religious
> purposes only with parental permission.**
>
> e\. The use of tobacco smoke or mountain smoke for religious reasons
> shall be strictly restricted to bonafide religious practices and must
> be approved by the Center Administrator. Only children, with written
> parental consent may be present when the tobacco is used.

**II.K Animal Policy**

1\. **POLICY:** Any pet or animal present at the Head Start Center,
indoors or outdoors will be in good health, show no evidence of carrying
any disease and be a friendly companion for the children.

2\. **PROCEDURES:** In order to ensure that pets and animals kept at the
Center do not pose a significant risk to the health and safety of the
children or staff, the following actions will be taken:

> a\. The Center Administrator will obtain written approval of the
> Health Advisor for any animals, wild or domestic, that will be kept at
> the Center.
>
> b\. There shall be no ferrets, turtles, psittacine birds (birds of the
> parrot family), or any wild or dangerous animals kept at the center.
>
> c\. Potentially very aggressive animals shall not be in the center.
>
> d\. The Center Administrator will maintain all vaccination records for
> all dogs or cats kept at the Center. Any dogs or cats shall be
> maintained on a flea, tick, and worm control program that is approved
> by the Health Advisor.
>
> e\. At the Head Start Center, we have approval from the Health Advisor
> to keep the following animals: [(list all animals kept at your
> Center)]{.underline} . Specific procedures for their feed, care and
> maintenance are as follows:
>
> \(1\) Dog: (include name, age, sex, weight, breed of dog (if known),
> spayed or neutered, vaccination requirements, amount of feed required
> per day, amount of water required per day, responsible person for
> feeding and watering the dog, instructions for care of the animal,
> maintenance of the animal pen and other information on the local 4-H
> clubs may be able to offer written instructions for the care and
> maintenance of many animals, otherwise consult with a veterinarian).
>
> \(2\) Repeat same basic information for any dogs, cats, birds, fish or
> other animals approved for your Center.
>
> f\. Animal cages will be of an approved type with removable bottoms
> and will be kept clean and sanitary.
>
> g\. The living quarters of animals shall be enclosed and kept clean of
> waste to reduce the risk of human contact with the waste.
>
> h\. Animal litter boxes shall not be located in areas accessible to
> children.
>
> i\. All animal litter must be immediately removed from children's
> areas and be disposed of properly. For outdoor animals, staff will be
> assigned cleaning duties of litter on the duty chart (Name or number
> of duty assignment form).
>
> j\. Staff will always be present when children are exposed to domestic
> animals. Children shall be instructed on safe procedures to follow
> when in close proximity to animals (local veterinarians may be able to
> provide safety procedures for most animals).

**II.L Physical, Emotional, Sexual Abuse Policy**

1\. **POLICY:** The Head Start Center will through training and
supervision ensure that abuse of children is identified, whether inside
or outside the Center, and dealt with in an appropriate manner as
required by [(State or Tribal Laws)]{.underline} .

> **Head Start Programs are required to comply with their State or
> Tribal law with regards to reporting child abuse, even if the State or
> Tribal Law are less stringent then the Head Start Performance
> Standards. The Head Start Personnel should review and incorporate the
> Head Start Performance Standards, Section 1301.31, Appendix a before
> completing this section**.

2\. **PROCEDURES:** In order to ensure that children are protected from
abuse and neglect, the following actions will be taken:

> a\. Any staff member who suspects that a child may be being abused
> will report these suspicions and the reasons for their suspicions to
> the Center Administrator immediately. The Center Administrator will
> notify the Head Start Director and confer with the Head Start Health
> Coordinator on any suspected child abuse.
>
> b\. The Center Administrator will report suspected child abuse to the
> [(child protective services, department of social services, Tribal
> police or whatever agency is required by your Tribe or
> State)]{.underline} .
>
> c\. The Center Administrator will approach individuals suspected of
> abuse or neglect, when appropriate and if so doing will not present a
> danger to the Center Administrator, to convey concerns and inform the
> individual that a report to the appropriate authority is being
> submitted.
>
> d\. The Head Start Center staff will receive annual inservice training
> on child abuse from [(person or agency that will provide the
> training)]{.underline} . The training will include:
>
> \(1\) The four types of child abuse (emotional abuse, neglect,
> physical abuse, sexual).
>
> \(2\) The signs and symptoms a child may show that indicate possible
> abuse.
>
> \(3\) Reporting requirements.
>
> \(4\) Methods for staff members to reduce stress associated with child
> care.
>
> \(5\) The signs and symptoms of sexually transmitted disease (STD).
>
> e\. Staff will not be discharged or otherwise disciplined in any way
> solely on the basis of reporting suspected child abuse, unless it is
> proven that the report was malicious.
>
> f\. The name of the person reporting the suspected child abuse and the
> records concerning suspected child abuse are confidential and will be
> maintained in a confidential manner.
>
> g\. The Head Start Center Program is not the primary instrument for
> treatment of abuse or neglect, nor will the Program staff undertake
> treatment on their own.

**II.M Health Education Policy**

1\. **POLICY:** The Head Start Center will promote good physical,
mental, oral and social health and safety through demonstration,
modeling healthy behavior, educational materials and presentations for
the children and their parent/guardian. The health education program is
part of the Head Start curriculum.

2\. **PROCEDURES:** In order to provide basic knowledge to the children,
parent/guardian and staff on health and safety issues and improve the
health of our community, the following actions will be taken:

> a\. Health Education for Children
>
> \(1\) Health education will be integrated daily in the program of
> activities. Health education for children will include: (The subjects
> covered by your program will probably different but these are some
> recommended in the Caring For Our Children on page 338. You need to
> list those subjects that will be taught in your Head Start).
>
> \(a\) Body awareness
>
> \(b\) Families and cultural heritage
>
> \(c\) Personal/Social skills
>
> \(d\) Expression of feelings
>
> \(e\) Injury prevention
>
> \(f\) Motor vehicle safety
>
> \(g\) Hygiene
>
> \(h\) Playground safety
>
> \(i\) etc.
>
> \(2\) Center staff will talk to the children about healthful behaviors
> while carrying out routine daily activities. Activities shall be
> accompanied by words of encouragement and praise for achievement.
>
> \(3\) All health education activities shall be geared to the
> developmental age of the child and shall take into account individual
> personalities and interests.
>
> \(4\) The center shall use age-appropriate health education materials
> in children's projects that, when taken home, will help educate the
> parent/guardian and other children at home.
>
> b\. Health Education for Parent/guardian
>
> \(1\) Parent/guardian shall be given opportunities to observe staff
> modeling of healthy behavior and child development activities, and
> have the opportunity to ask questions and comment on the effectiveness
> of these activities with regards to their child.
>
> \(2\) The Head Start Center will schedule a health education open
> house for parent/guardian once each (month or quarter or
> semi-annually) designed to meet the unique characteristics of the
> enrolled family. The topics of the open house will be provided to the
> parent/guardian prior to the open house.
>
> \(3\) The Head Start Center will distribute a health news letter once
> per (month or quarter or semi-annually).
>
> \(4\) The Center Administrator will ensure that the health education
> plan for parent/guardian meets the needs of individual families and
> family conditions. Written pamphlets and information will be provided
> to the parent/guardian in the following areas:
>
> \(a\) Safety (home, vehicular, bicycle, playground, etc.)
>
> \(b\) Oral health promotion and disease prevention
>
> \(c\) Value of wellness care (exercise, nutrition, avoidance of
> substance abuse)
>
> \(d\) Child development
>
> \(e\) Parental health
>
> \(f\) Prevention and management of infectious disease (handwashing,
> diapering, etc.)
>
> \(g\) Child behavior (normal and problem behavior)
>
> \(h\) Handling emergencies/first aid
>
> \(i\) Child advocacy skills
>
> \(j\) Special needs.
>
> c\. Health Education for Staff:
>
> \(1\) The Center Administrator will schedule at least 12 hours of
> training during the school year for the Head Start Center staff in the
> areas of health and safety issues.
>
> \(2\) The Center Administrator will provide orientation to all new
> staff and volunteers with in the first week of their employment or
> presence at the Center. The staff will be able to demonstrate
> knowledge of the following:
>
> \(a\) The names and ages of the children that they will be responsible
> for and the children\'s specific developmental needs.
>
> \(b\) Any special adaptations to the facility for children with
> special needs.
>
> \(c\) Any special health or nutrition needs of the children under the
> new staff\'s supervision.
>
> \(d\) The planned program of activities at the facilities.
>
> \(e\) Routines and transitions
>
> \(f\) Accepted methods of discipline.
>
> \(g\) Occupational health hazards for the staff.
>
> \(h\) Emergency health and safety procedures.
>
> \(i\) Review of the Health and Safety Plan and the Health and Safety
> Policies and Procedures.
>
> \(3\) The Center Administrator will work with new staff to ensure that
> within the first 3 months at the Center, the new staff will receive
> further orientation on the Health and Safety Plan and be able to
> demonstrate key elements of the Plan to include:
>
> \(a\) Recognition of symptoms of illness and correct use of the
> Illness Incident Report and Daily Incident Log.
>
> \(b\) Exclusion and Re-admission procedures.
>
> \(c\) Cleaning, sanitation and disinfection procedures.
>
> \(d\) Medication Administration procedures.
>
> \(e\) Procedures for notifying parent/guardian of illness and injury
> events.
>
> \(f\) Procedures for performing and documenting the Daily Health
> Assessment.

**II.N Infectious Disease Control Policy**

1\. **POLICY:** The Head Start Center will reduce the spread of
communicable diseases among the children and staff through proper
hygiene, housekeeping and infection control practices.

2\. **PROCEDURE:** In order to reduce the spread of communicable
diseases in the Head Start Center, the following actions will be taken:

> a\. Reportable Diseases

(1) The following illnesses are reported to the local State Health
    Department by physicians.

> The Center Administrator will call the Health Advisor or the local
> Health Department for information when a child or staff member has
> contracted any of these illnesses. a list of these diseases will be
> provided to the parent/guardian upon enrollment of their child. The
> parent/guardian shall be asked to notify the Center Administrator if
> their child is diagnosed with any of these illnesses: (check with your
> local health department to determine the list of reportable diseases
> in your area)

+--------------------------+------------------+-----------------------+
| Acquired Immune          | Kawasaki         | Salmonellosis         |
| Deficiency Syndrome      | Syndrome         |                       |
| (AIDS)                   |                  | Rubella (German or 3  |
|                          | Listeriosis      | day measles)          |
| Campylobacteriosis       |                  |                       |
| (Campy) Diphtheria       | Meningitis       | Shigellosis           |
|                          |                  |                       |
| E. Coli 0157: H 7        | Mumps            | Rubeola (10 day       |
|                          |                  | measles)              |
| Giardiasis               | Per              |                       |
|                          | tussis([Whooping | Tuberculosis (TB)     |
| Hemophilus Influenza     | Co               |                       |
| Type B (HIB)Hepatitis    | ugh]{.underline} | Tetanus               |
|                          |                  |                       |
|                          | poliomyelitis    | Yersiniosis           |
|                          | (Polio)          |                       |
|                          |                  | Typhoid Fever         |
|                          | Rheumatic Fever  |                       |
|                          |                  |                       |
|                          | Reyes Syndrome   |                       |
+--------------------------+------------------+-----------------------+

> \(2\) Communicable or contagious diseases are caused by germs and are
> easily spread from one person to another. Germs can be spread in many
> ways. Common methods of germ spread are:
>
> a\) Direct contact with human waste (stools, urine)
>
> b\) Contact with body fluids (drool, blood, nose and eye discharges,
> and vomitus)
>
> c\) Direct skin-to-skin contact
>
> d\) Indirect contact with inanimate objects (drinking glasses, toys,
> bedding, etc.)
>
> e\) Mice or other rodents, files, mosquitoes or other insects
> (vectors) capable of spreading a disease.
>
> \(3\) The Center Administrator will notify the Health Advisor within
> 24 hours if any child is diagnosed with any of these illnesses. The
> Health Advisors telephone number is:
>
> \(4\) The Center Administrator after consultation with the Health
> Advisor, shall follow the recommendations of the Health Advisor
> regarding notification of parent/guardian of children who attend the
> facility about exposure of their child to a communicable disease. When
> notification is recommended, the Center Administrator shall notify the
> parent/guardian in writing and shall include the following
> information:
>
> a\) The disease to which the child was exposed, and whether this is
> one case or part of an outbreak.
>
> b\) Signs and symptoms of the disease that the parent should watch for
> in the child.
>
> c\) How the disease is spread.
>
> d\) The incubation period of the disease (when they might see symptoms
> appear).
>
> e\) How long the disease can be spread.
>
> f\) Disease prevention measures recommended by the Health Advisor.
>
> g\) What control measures have been implemented at the center.
>
> b\. Exposure Control Plan:
>
> The purpose of this exposure control plan is to eliminate or minimize
> employee and volunteer exposure to blood or certain other body fluids.
> This plan meets or exceeds the Administration for Children and
> Families (ACF) Occupational Health Standards for Bloodborne Pathogens
> (ACYF-IM-93-21).
>
> \(1\) Procedures for Preventing Risk:
>
> \(a\) Employee Exposure Determination: Anyone at the Head Start Center
> (teachers, volunteers, bus drivers, cooks) may conceivably have to
> administer first aid in an emergency situation. This may include
> cleaning of blood or blood-containing body fluids and tissue
> discharges. The incidental nature of these circumstances establish
> first aid and cleaning as collateral duties of all Head Start staff.
>
> \(b\) All staff, volunteers and children shall wash their hands after
> exposure to blood or blood-containing body fluids and tissue
> discharges as specified in the Handwashing procedures, Section
> II.N.2(c), of this Plan.
>
> \(c\) Staff and volunteers shall avoid contact with blood or
> blood-containing body fluids and tissue discharges. Gloves shall be
> worn if there is potential contact with blood or blood-containing body
> fluids and tissue discharges.
>
> \(d\) Evaluation of Exposure to Bloodborne Pathogens: Incidents of
> exposure to blood, tissue and body fluids visibly contaminated with
> blood must be reported to the (Health Coordinator or Head Start
> Director) by the Center Administrator before the end of the work shift
> during which the incident occurred. Any Head Start staff, volunteers
> or children exposed to blood/blood contaminated materials shall be
> referred to [(the local Tribal or IHS hospital)]{.underline} or other
> appropriate medical services for evaluation and disposition within 24
> hours after exposure.
>
> \(e\) The Center Administrator will complete an Exposure Report Form
> for any activities by the staff, children or visitors that may have
> resulted in an exposure to body fluids. The completed forms shall be
> attached to a summary of all incidents or events that required first
> aid. The Exposure Report Form shall include
>
> 1\) Names of all people involved in providing first aid or in cleanup
> activities, description of the injury or illness event, and the date
> and time of the exposure.
>
> 2\) This report shall be maintained in the (Health Coordinator's or
> Head Start Director's) office and be readily available for review by
> the Health Advisor or OSHA.
>
> \(2\) Personal Protective Equipment
>
> \(a\) Latex gloves shall be worn if there is contact with blood or
> blood -containing body fluids or tissues.
>
> \(b\) Gloves shall be available in the center first aid kit and the
> bus first aid kit, in each classroom and in the office.
>
> \(c\) Teachers and volunteers must carry one pair of gloves on the
> playground.
>
> \(d\) Teachers, bus drivers and volunteers must carry one pair of
> gloves on field trips.
>
> \(e\) Disposable gloves are not to be washed or reused after use.
>
> \(f\) Disposable gloves shall be changed as soon as practical when
> they become contaminated and as soon as feasible when they become torn
> or punctured.
>
> \(g\) Utility rubber gloves used for cleaning shall be washed and
> disinfected after use and disposed of when they become cracked,
> peeling or their ability to act as a barrier is otherwise compromised.

(2) Procedures for Cleaning: Universal Precautions: Staff shall follow
    universal precautions

> as presented below:
>
> \(a\) Spills of body fluids include blood, urine, stools (feces) drool
> (saliva), vomit, drainage from sores/rashes (pus) shall be cleaned up
> immediately as follows:
>
> 1\) For spills of vomitus, urine and feces, on floors, walls,
> bathrooms, tabletops, toys, kitchen countertops, and diaper changing
> tables shall be cleaned and disinfected with 1/4 cup chlorine bleach
> mixed into a gallon of water.
>
> 2\) For spills of blood or blood-containing body fluids and drainage
> from sores/rashes (pus) the area shall be cleaned and disinfected
> using a proper disinfecting agent (e.g. 1/4 cup bleach to a gallon of
> water). Gloves shall be used when cleaning blood or blood-containing
> body fluids and drainage from sores/rashes (pus).
>
> 3\) Mops used for cleaning up body fluids shall be cleaned, rinsed in
> disinfection solution (e.g. 1/4 cup bleach to a gallon of water), and
> then wrung as dry as possible and hung to dry. Any brushes, brooms,
> dustpans, mops, etc. used to clean-up body fluids will be soaked in
> the disinfecting solution, and rinsed thoroughly. Equipment used for
> cleaning is stored safely out of children\'s reach.
>
> 4\) All disposable cleaning materials used to clean up body fluids
> will be put in a plastic bag, secured with a tie and placed in a
> covered waste container.
>
> 5\) Any open cuts or sore on children or staff will be kept covered.
> Depending on the type of wound, a covering may be a bandage, or
> clothing, or gloves.

6)  Whenever a child or staff comes into contact with any body fluids
    the body

> area will be washed immediately with soap and warm water and dried
> with disposable paper towels.
>
> 7\) Children\'s clothes soiled with body fluids will be put into a
> plastic bag and sent home with the child\'s parent for laundering. a
> change of clothing will be available for children in care.
>
> 8\) All clothing soiled with body fluids will be changed. Staff in
> regular contact with body fluids (e.g. changing diapers) are provided
> an apron to protect street clothing. Staff working with infants or
> toddlers are advised to have a fresh change of clothes at the center.
> All soiled laundry will be kept safely out of reach of children and
> will be laundered daily.
>
> 9\) Hands are always to be washed after handling soiled laundry or
> equipment.
>
> \(4\) Post Exposure and Hepatitis B Vaccinations:
>
> \(a\) All medical evaluations and procedures, including the
> Hepatitis-B vaccine and vaccination series and post-exposure follow-up
> shall be:
>
> 1\) Made available at no cost to the staff, volunteer or child. All
> expenses incurred shall be the responsibility of the Head Start
> Program after other funding sources such as private insurance,
> Medicaid, IHS, are exhausted.
>
> 2\) Made available at a reasonable time and place and performed by or
> under the supervision of a licensed physician.
>
> 3\) Provided according to the latest recommendations of the U. S.
> Public Health Service.
>
> 4\) Documented by the health agency or by the private physicians
> according to their protocol.
>
> 5\) All Hepatitis B laboratory tests shall be conducted by an
> accredited laboratory at no cost to the employee, volunteer or child.

6)  If a routine booster of Hepatitis-B vaccine is recommended by the
    U.S. Public

> Health Service at a future date, the Head Start Program will make
> available the booster.
>
> 7\) Any employee or volunteer who declines the Hepatitis-B vaccination
> offered shall sign the (OSHA or other equivalent form) required waiver
> form.
>
> \(5\) Training and Communication of Hazards
>
> \(a\) All staff and volunteers shall be trained annually on exposure
> to bloodborne pathogens. This training shall include:
>
> 1\) Explanation of the laws and regulations
>
> 2\) Information on bloodborne diseases and methods of transmission.
>
> 3\) Components of the Head Start Exposure Control Plan
>
> 4\) Safety and prevention guidelines
>
> 5\) Exposure reporting
>
> \(b\) This training shall be provided during working hours, within the
> first month of employment for initial assignments.
>
> \(c\) This training shall be provided annually for all staff.
>
> \(d\) This training shall be provided if a staff member changes
> assignments within the Head Start Center and their new assignments
> increases their risk for exposure.
>
> \(e\) Copies of the exposure control plan shall be provided to each
> staff member and volunteer upon initial assignment and to
> parent/guardian upon enrollment of their child.
>
> c\. Handwashing and Hygiene
>
> Handwashing is the single best way to reduce or stop the spread of
> bacteria (germs) that cause a child to be ill, e.g. diarrhea. A
> continuous supply of handwashing soap and disposable paper towels (or
> other approved drying device) will be provided at each lavatory and
> handwashing sink. Our staff washes their hands and teaches or helps
> children to wash their hands according to:
>
> \(1\) Staff wash their hands:
>
> \(a\) Upon arrival at the child care center.
>
> \(b\) Before handling foods, cooking activities, or serving food.
>
> \(c\) Before and after eating meals or snacks.
>
> \(d\) After toileting self, the children or diaper changing
>
> \(e\) After handling or coming in contact with body fluid or items
> contaminated with body fluids, such as blood, drool, vomit, urine,
> stools (feces) or discharges from the eyes or nose.
>
> \(f\) After coming in from outside play time.
>
> \(g\) After handling pets or other animals.
>
> \(h\) Before and after administering medications.
>
> \(2\) Children will be directed or assisted in washing their hands:
>
> \(a\) Upon arrival at the Head Start Center.
>
> \(b\) Before meals or cooking activities.
>
> \(c\) After toileting.
>
> \(d\) After outdoor play.
>
> \(e\) After coming in contact with body fluids.
>
> \(f\) After handling pets or other animals.
>
> \(3\) Handwashing by both children and staff will be done by the
> following method:
>
> \(a\) Soap, warm water and individual towels are available for staff
> and children
>
> \(b\) Turn on water and adjust temperature.
>
> \(c\) Wet hands and apply a liberal amount of soap.
>
> \(d\) Rub hands in wringing motion from wrists to fingertips for a
> period of not less than 10 seconds.
>
> \(e\) Rinse hands thoroughly
>
> \(f\) Dry hands, using an individual towel.
>
> \(g\) Use hand-drying towel to turn off water faucet(s).
>
> d\. Personal Use Items
>
> Personal use items include soft, non-washable toys used by
> infants/toddlers, individual cloth towels, washcloths, combs, hair
> brushes, toothbrushes, blankets and pillows or other items capable of
> transmitting communicable diseases and ectoparasites.
>
> \(1\) Combs, hair brushes, toothbrushes, pacifiers, personal clothing,
> bedding and towels shall never be shared and shall be labeled with the
> child's name.
>
> \(2\) Separate storage shall be provided for each child's and staff
> member's personal use items and clothing.
>
> \(3\) Bedding shall be labeled with the child's name and stored
> separately for each child.
>
> \(4\) Coat hooks shall be spaced so coats will not touch each other
> (in lieu of coat hooks, which can pose an injury problem, individual
> cubicles or lockers, can be provided for storage of children's
> clothing and personal use items).
>
> \(5\) Toothbrushes shall be stored: ( in an approved manner so
> that: 1. The brushes air dry; 2. The brush heads are at least two
> inches apart; 3. The toothbrushes don't drip on each other; and 4. The
> brush heads don't touch any other surface).
>
> \(6\) Soft, nonwashable toys in the infant/toddler areas shall be
> limited to personal use articles that are not shared between children.
>
> \(7\) Children's personal items, such as individual cloth towels,
> washcloths, combs, and hairbrushes shall be returned home for cleaning
> and disinfection at least weekly. (If a center has the capability, the
> personal use items can be cleaned and disinfected by the staff weekly.
> A cleaning schedule and procedure for personal use items would need to
> be developed).
>
> e\. Toy Use
>
> \(1\) Toys that are placed in children's mouths, or are otherwise
> contaminated by body secretions or excretions, shall be set aside to
> be cleaned with water and detergent, disinfected ( 1/4 cup chlorine to
> a gallon of water), and rinsed with clean water before handling by
> another child. Machine washable cloth toys can be used and shall be
> machine-washed when contaminated.
>
> \(2\) All frequently touched toys in rooms in which infants and
> toddlers are cared for shall be cleaned and disinfected daily and when
> soiled.
>
> \(3\) Toys in rooms in which older, non-diapered children are cared
> for shall be cleaned and disinfected weekly and when soiled.
>
> \(4\) Toys and equipment provided at the Head Start Center shall be
> cleaned and disinfected weekly and be maintained in good repair to
> allow adequate cleaning and disinfection.
>
> \(5\) The staff shall be assigned to clean and disinfect play
> equipment and toys. Staff assignments for the inspection of the play
> equipment and toys will be established on the (Weekly or monthly
> cleaning and duties schedule).
>
> f\. Diaper Changing
>
> \(1\) Diapers worn by children shall be able to contain urine and
> stool and minimize fecal contamination of the children, staff,
> environmental surfaces, and objects in the Head Start Center.
>
> \(2\) The use of modern disposable paper diapers are associated with
> less fecal contamination of the Head Start environment. Therefore it
> is the policy of the Head Start Center that reusable cloth diapers not
> be allowed in the facility. Disposable diapers are provided for the
> children by (the parent/guardian or by the Center).
>
> \(3\) On a diapered child's arrival at the Center, their assigned
> teacher will check for wetness or feces.
>
> \(4\) The assigned staff will check their diapered children's diapers
> for wetness or feces at least hourly or when the child indicates
> discomfort or exhibits behavior that suggests a soiled or wet diaper.
> The child shall be changed promptly when found to be wet or soiled.
>
> \(5\) The following diaper changing procedures are posted in the
> diaper changing area and consist of the following:
>
> \(a\) Wash hands (refer to Section II.N2(c) of this Plan).
>
> \(b\) Gather necessary materials, i.e., clean diaper, wipes, clean
> clothing if needed.
>
> \(c\) Put-on disposable gloves (not required)
>
> \(d\) Place single use cover on table (if part of Center\'s practice)
>
> \(e\) Child is gently placed on the approved diaper-changing table.
> Soiled diaper is removed and deposited in a plastic lined and foot-
> pedal type covered waste receptacle (foot peddle type is best).
>
> \(f\) The child\'s diaper (peri-anal) area is cleaned from front to
> back with a clean, damp wipe, for each stroke.
>
> \(g\) Wash hands (refer to Section II.N2(c) of this Plan).
>
> \(h\) Topical cream/ointment/lotion is applied only when parent\'s
> written request has been received by the infant room staff. This
> parental permission shall be kept in the child's medical record (refer
> to Section II.F.2.h (3))
>
> \(i\) Put on clean disposable diaper and clean clothing if the child's
> clothing are soiled.
>
> \(j\) Child\'s hands are washed. Infant or child can now return to
> other children.
>
> \(k\) Single-use table cover is put in covered waste receptacle (if
> using single-use cover is part of Center\'s practice).
>
> \(l\) Disinfect diaper-changing table using 1/4-cup chlorine bleach to
> a gallon of water.
>
> \(m\) Remove and dispose of gloves, if used.
>
> \(n\) Wash hands.
>
> \(7\) Children shall be diapered only on the approved diaper-changing
> table and on no other surface.
>
> \(8\) Diaper changing tables shall be kept in good repair and shall be
> cleaned and disinfected after each use. The tables shall be cleaned to
> remove visible soil, followed by wiping with an approved disinfectant
> (1/4 cup chlorine bleach in a gallon of water). Disposable,
> nonabsorbent paper table covers (are/are not) used at this center. (if
> used at the center the covers must be approved by the Health Advisor
> prior to use).
>
> \(9\) Soiled diapers shall be stored in containers separate from other
> waste and labeled with SOILED DIAPERS (or whatever labeling your
> center wants). The washable containers are provided with plastic,
> disposable linings and are located within arms reach of each changing
> table. The soiled diaper containers are kept tightly covered when not
> in use.
>
> \(10\) Diaper containers shall be cleaned and sanitized at least
> weekly or when ever the there is a build up of soil or odor. The Early
> Head Start teachers will share the duties for cleaning and
> disinfecting the soiled diaper containers (or the facility
> administrator can schedule cleaning duties that includes cleaning the
> soiled diaper containers).
>
> \(11\) Soiled diaper containers shall be emptied at least daily or as
> often as necessary to prevent the accumulation of soiled diapers in
> the container.

**II.O Sanitation and Disinfection Policy**

1\. **POLICY:** The Head Start center staff will conduct housekeeping
activities to maintain our facility in a clean and sanitary manner to
reduce the transmission of infectious and communicable diseases.

2\. **PROCEDURE:** In order to reduce the spread of disease through
adequate and effective cleaning and disinfection, the following actions
will be taken:

> a\. Cleaning Chemicals and Equipment: The Head Start center will use
> only chemicals that do not pose a significant risk to the children,
> staff or visitors at the center and will only use and maintain
> housekeeping equipment that is necessary for cleaning and disinfecting
> our facility.
>
> \(1\) The Head Start Center does not use disinfection agents with
> Phenol or Quaternary Ammonium compounds. These agents require extra
> time to rinse off surfaces and remove any harmful residues. At our
> Center we choose to use only chlorine bleach solutions for
> disinfecting surfaces. The solutions are mixed according to the table
> below.

+----------------+---------------------+--------------+---------------+
| Use to Clean   | Amount of Bleach    | Amount of    | Temperature   |
|                |                     | Water        | of Water      |
| (sanitize):    |                     |              |               |
+----------------+---------------------+--------------+---------------+
| All surfaces,  | 1 tablespoon        | 1 quart      | minimum       |
|                |                     |              | 70^0^F        |
| e.g. where     | 1/4 cup             | 1 gallon     |               |
| children eat,  |                     |              |               |
| diapering      | Same concentration, |              |               |
| areas, hard    | as above, just      |              |               |
| surface toys   | makes more          |              |               |
|                | disinfectant        |              |               |
+----------------+---------------------+--------------+---------------+
| Dishes,        | 1 teaspoon          | 1 gallon     | minimum       |
| utensils,      |                     |              | 70^0^F        |
| pans, etc.     |                     |              |               |
+----------------+---------------------+--------------+---------------+

> \(2\) Each day, the staff will do the following:
>
> \(a\) Mix and fill all clean spray bottles to be used with
> disinfection solution
>
> \(b\) Label each bottle with the date
>
> \(c\) Empty all spray bottles filled at the end of each day
>
> \(3\) If other cleaning chemicals are used, such as glass cleaners or
> floor cleaners, the manufacturers recommendations for use of these
> cleaners will be followed.
>
> \(4\) The cleaning schedule is posted . The center administrator
> develops the cleaning schedule and assignments monthly and ensures
> that the cleaning schedule is followed.
>
> \(5\) Housekeeping equipment:
>
> \(a\) Brooms, dust pans, sponges
>
> \(b\) Heavy duty utility gloves designated for cleaning and
> disinfection will not be used for any other purpose.
>
> \(c\) Mops with mop buckets
>
> \(d\) Spray bottles for disinfectant
>
> \(e\) Disposable paper towels
>
> \(6\) Cleaning Chemical Storage: Cleaning chemicals will be stored in
> their original container and stored in the [(where chemicals are
> stored)]{.underline} , which is inaccessible to children.
>
> \(7\) Cleaning Equipment Storage: Brooms, dustpans, mops, vacuum
> cleaners, spray bottles and other cleaning supplies shall be stored in
> the [(where equipment is stored)]{.underline} , in an orderly manner.
> Mops will be hung on mop racks to facilitate drying.
>
> b\. Cleaning and disinfection of handwashing sinks, toilets and potty
> chairs:
>
> \(1\) Toilet rooms, flush toilets, potty chairs and handwashing sinks
> will be cleaned and disinfected at least daily and when obviously
> soiled.
>
> \(2\) Potty chairs will be emptied in toilets, cleaned and disinfected
> after each use and stored in the toilet room on a hard, easily
> cleanable surface.
>
> \(3\) Utility gloves used for cleaning and disinfecting will be used
> for each cleaning and will not be used for other cleaning purposes.
>
> \(4\) Disposable towels used for cleaning will be removed to outside
> garbage immediately after cleaning.
>
> \(5\) Chemical air fresheners will not be used. Toilet room odors will
> be controlled by adequate ventilation and disinfection.
>
> c\. Cleaning and Disinfection of Diaper Changing Area:
>
> \(1\) Diaper changing tables will be cleaned and disinfected after
> each use.
>
> \(2\) Hard floors in the diaper changing area will be cleaned and
> disinfected daily.
>
> \(3\) Carpeted floors will be vacuumed daily and steam cleaned
> monthly.
>
> d\. Cleaning and Disinfection of Floors
>
> \(1\) Floors and carpets will be maintained in good repair.
>
> \(2\) Hard floors will be swept and mopped with a disinfection
> solution at least daily and when soiled.
>
> \(3\) Carpeted floors will be maintained free from visible soil.
> Carpeted areas will be vacuumed daily and shampooed at least every
> quarter or as often as necessary to remain free of visible soil that
> can be removed by shampooing. Carpets will be cleaned when children
> are not present.
>
> \(4\) Carpeted floors and all rugs will be spot cleaned, shampooed or
> steam cleaned whenever body fluids contaminate the surfaces.
>
> \(5\) Large throw rugs that cannot be laundered will be vacuumed at
> least daily and shampooed at least quarterly.
>
> \(6\) Small rugs that can be laundered will be shaken or vacuumed at
> least daily and laundered at least weekly or when soiled.
>
> d\. Cleaning and Disinfection of Toys and Play Equipment: Toys will be
> cleaned at a frequency as specified in Section II.N.2(e) of this Plan.
>
> \(1\) Plastic and other hard surface toys are washed in soap and water
> and dipped in a disinfectant solution for a minimum of 1 minute and
> allowed to air dry. Toys, which cannot be easily dipped, are sprayed
> with a disinfectant solution. The solution is allowed to stay on the
> item for 1 full minute before being dried.
>
> \(2\) Toys, including plastic toys that look like food, that are
> placed in a child's mouth, or otherwise contaminated by body
> secretions or excretions will be set aside to be cleaned and
> disinfected before being used by another child.
>
> \(3\) Cloth toys are washed weekly or when contaminated by body fluids
> in the washing machine at a water temperature of 150^o^F. Cloth toys
> are machine dried.
>
> e\. Cleaning and Disinfection of Pet and Animal Pens and Areas: The
> Head Start Center has the following pets or animals approved for the
> center[:]{.underline} . The following cleaning and disinfection
> schedules have been established.
>
> (These schedules are dependent on the types of animals present at the
> center. In general, animal waste should be removed at least daily,
> which includes litter boxes. Large animal waste, such as dogs, should
> be removed immediately. Litter boxes should be inaccessible to
> children. Cages and pens should be completely cleaned and disinfected
> at least weekly. For more information on cleaning and disinfection of
> your specific type of animal contact your local veterinarian, county
> extension office or a local 4-H club.)

**II.P Infections Disease Outbreak Policy**

1\. **POLICY:** The Head Start Center will work cooperatively with the
parent/guardian, Health Advisor and local health departments to control
and limit the spread of infectious diseases during an outbreak in the
community or in the center.

2\. **PROCEDURES:** In order to control the spread and impact of an
infectious disease outbreak that occurs, the following actions will be
taken:

> a\. Parent/guardian will be informed of the need to notify the center
> within 24 hours after their child has developed a known or suspected
> communicable disease, or if a member of the immediate household has a
> communicable disease.
>
> b\. The center shall provide to the parent/guardian a list of
> reportable diseases as provided by the State or local health
> department. If any child has a confirmed or suspected case of any
> disease on the reportable disease list, then the Center Administrator
> shall notify the Health Advisor at [(phone number)]{.underline} and
> the Head Start Health Coordinator at [(phone number)]{.underline}
> within 24 hours of being notified.
>
> c\. In cooperation with the Health Advisor and the local Tribal, IHS
> or other health department, parent/guardian of other children who
> attend the center shall be informed in writing by the Center
> Administrator that their child may have been exposed at the center to
> the following diseases or conditions:
>
>  Neisseria Meningitides
>
>  Pertussis
>
>  Streptococcal infections/Scarlet fever
>
>  Chicken Pox
>
>  Head lice/Scabies
>
>  *Giardia lamblia* diarrhea
>
>  Salmonella diarrhea
>
>  Shigella diarrhea
>
>  Hepatitis-a
>
>  Haemophilus Influenzae type B.
>
> d\. In the event of a know or suspected communicable disease outbreak
> the Center Administrator will take the following steps:
>
> \(1\) Notify the Health Advisor at [(phone number)]{.underline} or the
> local health department at [(phone number)]{.underline} .
>
> \(2\) Notify the Head Start Health Coordinator at [(phone
> number)]{.underline} .
>
> \(3\) Follow the recommendations of the Health Advisor for control of
> the outbreak.
>
> \(4\) Request from the Health Advisor written handouts on the disease
> to distribute to the parent/guardian. The name and phone number of the
> Health Advisor should be on the handout to facilitate questions from
> parent/guardian or health care providers.
>
> \(5\) Provide a written notification to the parent/guardian of the
> outbreak that includes:
>
> a\) The disease to which the child was exposed.
>
> b\) Signs and symptoms of the disease that the parent should watch for
> in the child.
>
> c\) How the disease is spread.
>
> d\) The incubation period of the disease (when they might see symptoms
> appear).
>
> e\) How long the disease can be spread.
>
> f\) Disease prevention measures recommended by the Health Advisor.
>
> g\) What disease control measures have been implemented at the center.

**III. SANITARY FACILITIES PLAN**

**III.A Water Supply Policy**

1\. **POLICY:** The Head Start Center will provide adequate amounts of
clean, potable water for cooking, cleaning, handwashing, drinking,
toilets and outside activities.

2\. **PROCEDURES:** **IF YOUR CENTER IS ON a COMMUNITY WATER SYSTEM
THEN:** The Head Start Center is provided with piped running water under
pressure from an approved source. The Head Start Center is provided
water from (Name of community water system), which is operated by (name
of system operator). The water system is inspected by (name of local
OEHE office, Tribal Office or state agency that inspects the water
system for compliance to the Safe Drinking Water Act).

> **IF YOUR CENTER IS ON AN INDIVIDUAL WATER SYSTEM THEN:** The Head
> Start Center is provided with piped running water under pressure from
> a source approved by the Health Advisor on (date of approval by Health
> Advisor). The water source for the Head Start Center is from an
> individual well (describe water supply or source). This water supply
> is owned by (owner of the source) and is operated and maintained by
> (name of person, program or agency responsible for the operation and
> maintenance of the system). The water system is inspected annually by
> (name of program or agency that inspects the water system).
>
> Water samples on the Head Start Center water system for bacterial
> water quality are collected (every three years or whatever is required
> by the Health Advisor or the Tribal or State programs) as required by
> the Health Advisor and the federal Safe Drinking Water Act. Copies of
> bacterial water sample results are maintained on file at the center
> for a period of (number of years) years.
>
> Water samples on the Head Start Center water system for chemical water
> quality are collected (monthly, quarterly, whatever is required by the
> Health Advisor or the Tribal or State programs) as required by the
> Health Advisor. Copies of chemical water sample results are maintained
> on file at the Center for a period of years.
>
> Based on the inspections and the bacterial and chemical water quality
> sample results the Head Start Center water supply is considered
> satisfactory for use.
>
> In order to provide adequate water to provide a positive educational
> experience and to ensure the health of the children, the following
> actions will be taken:
>
> a\. Repairs or maintenance activity and all water system equipment
> currently in the Center, or that may be installed in the Center, will
> have no cross connections to the water system that could result in
> contamination of the water supply.
>
> b\. Disruption of the water supply for a period of more then two hours
> will be considered an imminent health hazard and the procedures
> presented in Section I.A of this Plan will be implemented.

**III.B Liquid Waste Disposal Policy**

1\. **POLICY:** The Head Start Center liquid waste is disposed of in a
sanitary manner to promote and protect the health of the children and
their families, the staff and the community.

2\. **PROCEDURE:** **IF YOUR CENTER IS ON a COMMUNITY SEWER SYSTEM
THEN:**

> The Head Start Center is connected to the (name of community sewer
> system), which is operated by (name of system operator). The sewer
> system is inspected by (name of local health department or state
> agency that inspects the sewer system).
>
> **IF YOUR CENTER IS ON AN INDIVIDUAL SEWER SYSTEM THEN:** The Head
> Start Center liquid waste is disposed of in an individual sewer system
> approved by the Health Advisor on (date of approval by Health
> Advisor). The sewer system is (describe sewer system, e.g. 1000 gallon
> septic tank system connected to a subsurface drainfield). As-built
> drawings for the sewer system are on file at the Center. The Center
> Administrator (or other designated staff member) makes arrangements to
> have the septic tank pumped to remove solids (annually or every two
> years or what ever the frequency of pumping is as recommended by the
> Health Advisor)
>
> This individual sewer disposal system is owned by (owner of the
> source) and is operated and maintained by (name of person, program or
> agency responsible for the operation and maintenance of the system).
> The sewer system is inspected annually as part of the annual
> inspection by the Health Advisor (or name of program or agency that
> inspects the sewer system).

**III.C Solid Waste Disposal Policy**

1\. **POLICY:** The Head Start Center collects and disposes of solid
waste in a manner that provides proper sanitation and prevents insect
and rodent infestations.

2\. **PROCEDURES:** In order to ensure that solid waste generated at the
Head Start Center is adequately collected and disposed, the following
actions will be taken:

> a\. Garbage generated by the Head Start Center is removed from the
> center daily. The staff remove the plastic liners from each garbage
> container and deposit them in a large plastic bag. The large plastic
> bag is deposited in the outdoor containers at least twice weekly (or
> as often as needed to prevent the accumulation of garbage in the
> Center).
>
> b\. Garbage containers are lined with disposable plastic garbage bags,
> leak proof, and labeled with the name of the classroom. Office or
> location where the container belongs.
>
> c\. The outside garbage storage area is located [(number of feet or
> yards, approximately)]{.underline} from the outside play area.

**IV. VECTOR CONTROL PLAN**

**IV.A Vector Control** **Policy**

1\. **POLICY:** The Head Start Center will maintain the facility to
reduce the potential for and eliminate any rodent or insect infestations
to safeguard the health and safety of the children, staff and visitors.

2\. **PROCEDURE:** In order to prevent vector borne diseases, infectious
diseases and problems with venomous insects, the following actions will
be taken:

> a\. The following potential vector borne diseases are common to our
> area according to the Health Advisor: [(list vector borne diseases
> common to your area).]{.underline}
>
> \(1\) Hantavirus:
>
> \(2\) Plague
>
> b\. The following venomous insects are found in our area according to
> the Health Advisor: [(list venomous insects common to your
> area)]{.underline} .
>
> \(1\) Black Widow Spiders
>
> \(2\) Brown Recluse Spiders
>
> \(3\) Scorpions
>
> \(4\) etc.
>
> c\. All outer openings in the foundation, walls, ceiling, roof,
> windows and exterior doors shall be sealed to prevent the entrance of
> insects and rodents.
>
> d\. All gaps and openings around pipes and conduits will be sealed on
> the interior side of the Center.
>
> e\. Windows used for ventilation are equipped with screening that is
> in good repair. (If other types of flying insect control devices are
> used, such as air curtains, then list these devices) Outer doors to
> the Center are equipped with properly adjusted self-closing devices.
>
> f\. When the Health Advisor declares that there is a rodent or insect
> infestation at the Center, the Center Administrator will ensure all
> recommendations provided by the Health Advisor are followed.
>
> g\. The staff will clean any spider webs identified inside the
> building daily.
>
> h\. Playground equipment will be inspected weekly to identify a spider
> nests or other insect breeding sites and eliminate them.

**IV.B Pesticide Use/Documentation Policy**

1\. **POLICY:** The Head Start Center will allow the use of chemical
pesticides only when necessary and in a manner that will not harm the
health of the children, staff and visitors.

2\. **PROCEDURES:** In order to prevent any health related problems for
the children, staff or visitors that could result from the use of
chemical pesticides, the following actions will be taken:

> a\. All extensive pesticide application will be conducted by a
> licensed (or certified) pesticide applicator contractor and shall be
> applied only when the children are not present at the Center.
> Pesticide application services are provided to the Head Start Center
> by [(name, location and phone number of pesticide
> contractor)]{.underline} . This contractor is licensed through the
> State of [(name of State)]{.underline} .
>
> b\. The staff may apply commercial, over-the-counter pesticides at the
> Center only with the approval of the Center Administrator and only
> when the children are not present.
>
> c\. Only U.S. Environmental Protection Agency approved pesticides can
> be applied at the Center.
>
> d\. The licensed pesticide contractor will provide a list of all
> pesticides that will be applied at the Center, including information
> on the type of pesticide used, the common and chemical name of the
> pesticides used, the purpose for applying the pesticide, how the
> pesticides should be applied, and any warnings or special precautions
> that the staff should be aware of for the pesticide used.
>
> e\. Pesticides will not be applied while the children are present at
> the Center. The Center Administrator (or their designee) will be
> present and observe the application of pesticides by the pesticide
> applicator.
>
> f\. The Center Administrator will document the used of pesticides at
> the center on the Pesticide Use log [(or whatever name of form
> used)]{.underline} . The log will contain the date and time of
> application, the pesticide applied, who applied the pesticide and the
> purpose for application.

**V. SAFETY AND INJURY PREVENTION PLAN**

**V.A General Safety Policy**

1\. **POLICY:** The Head Start Center will ensure that children in our
care are released only to people authorized by the custodial parent or
guardian, and only into a situation where the health and safety of the
child is not placed in jeopardy.

2\. **PROCEDURES:** In order to ensure that access to children is
limited only to authorized persons, the following actions will be taken:

> a\. The Center Administrator will ensure that children are not
> released to any person not authorized by the custodial parent or
> guardian. The Center Administrator will take the following actions:
>
> \(1\) Maintain a list of the names, addresses, and telephone numbers
> of persons authorized to take the child from the Center.
>
> \(2\) Require the custodial parent to provide written legal
> documentation of custody.
>
> \(3\) Allow telephone authorization to take a child from the Center
> only with prior written permission of the custodial parent.
>
> b\. Any child that is dropped off at the Center will be signed in by
> the parent/guardian using the Daily Sign-In/Sign-Out Sheet [(or
> whatever your form is called)]{.underline} .
>
> c\. a child will not be released to any person in an obvious state of
> intoxication. In the event that a parent, guardian or other authorized
> person arrives to pick-up a child in a state of apparent intoxication,
> the Center Administrator will:
>
> \(1\) Take the intoxicated person into the office or other location
> isolated from the children and informs the person that they cannot
> release the child to the person.
>
> \(2\) If the person becomes agitated or violent, the Center
> Administrator will implement the Emergency Procedures in Section VI.H
> of this Plan.
>
> \(a\) If the Center Administrator can not locate any authorized person
> on the Emergency Contact list for the child, then the [(department of
> social services, child protective services, police or whatever your
> Tribe or State requires)]{.underline} will be called to take custody
> of the child.
>
> \(b\) The Center Administrator will talk with the custodial
> parent/guardian about any event involving an intoxicated person
> arriving to take their child.
>
> \(c\) In the event an intoxicated custodial parent/guardian arrives to
> take their child, the Center Administrator will discuss with the Head
> Start Director and Head Start Health Coordinator the situation, and
> discuss appropriate actions that should be taken to ensure the safety
> of the child.
>
> \(3\) In the event that a non-custodial parent attempts to take a
> child from the Center without the consent of the custodial parent, the
> Center Administrator will explain that the child cannot be released to
> them. If the non-custodial parent becomes angry or violent, the Center
> Administrator will implement Section VI.H of this Plan if necessary.

**V.B Fire Safety Policy**

1\. **POLICY:** The Head Start Center will reduce the risk of fires
through proper training and equipment to eliminate harm to the children
and staff and reduce damage to the Center.

2\. **PROCEDURES:** In order to prevent the occurrence of a fire and to
ensure the health and safety of the children, staff and visitors in the
event of a fire, the following actions will be taken:

> a\. Fire Protection
>
> \(1\) Highly flammable chemicals and materials will not be kept in the
> Head Start Center. All flammable chemicals will be stored [(where they
> will be stored, outside the Center)]{.underline} .
>
> \(2\) The Center Administrator will inspect the center monthly to
> ensure less then 25 percent of wall areas are covered with combustible
> materials, such as paper.
>
> \(3\) Monthly fire safety inspections will be conducted on the center
> using the Monthly Fire Safety Inspection Check List [(or whatever your
> form is called)]{.underline} .
>
> \(4\) a fire that cannot be immediately extinguished by the Center
> staff will be considered an imminent health hazard and the Center will
> be evacuated in accordance with Section VI.C of this Plan. The Center
> Administrator will follow the procedures for an imminent health hazard
> as described in Section I.A of this Plan.
>
> \(5\) The Center Administrator will notify the Head Start Director,
> the Health Advisor and the local fire department in writing within 24
> hours of any fire emergency that involved the Head Start Center. The
> notification will include what the fire emergency was, the date and
> time of the emergency, the actions taken by the staff, any injuries
> that occurred and the damage to the facility.
>
> \(6\) The staff will receive annual inservice training on the fire
> safety policies and procedures, the use of fire extinguisher, and the
> safe evacuation of children. This inservice training will be
> documented in the staff training files including the date, names of
> staff members trained, who conducted the training and what information
> was covered in the training.
>
> \(7\) The Center Administrator will develop a fire plan for the center
> that will be posted [(give locations where the fire plan will be
> posted)]{.underline} . The fire plan includes the routes of evacuation
> from various areas of the Center, the location of fire extinguisher,
> the location of smoke detectors, and the location of the outside
> assembly point.
>
> b\. Fire Detection
>
> \(1\) The Center Administrator will ensure that an adequate number of
> functional smoke detectors are provided and located as required in the
> Environmental Health Standards and as recommended by the Health
> Advisor. The locations of the smoke detectors are indicated on the
> fire plan for the center.
>
> \(2\) The Center Administrator will change the batteries for all
> battery operated smoke detectors during the first week of classes.
>
> \(3\) The Center Administrator will replace batteries immediately for
> battery operated smoke detectors that emit and audible chirp
> indicator that the batteries are low.
>
> \(4\) The Center Administrator will check the operation of the smoke
> detector monthly, by pushing the test button on the detector.
>
> c\. Fire Suppression and Evacuation
>
> \(1\) Fire Emergency: The closest responding fire station to the
> Center is located [(number of miles)]{.underline} from the Center with
> an average response time of [(number of minutes for
> response)]{.underline} .
>
> \(2\) The primary responsibility for the Head Start Center staff is
> for the safe evacuation of children and not to extinguish fires. If a
> fire can be extinguished quickly and safely, then a staff member will
> extinguish the fire while the other staff is evacuating the children.
>
> \(3\) Fire extinguishers in the Center are ABC-Type and are located
> [(give location of all fire extinguishers in the Center)]{.underline}
> . The locations of the fire extinguishers are indicated on the fire
> plan for the Center.
>
> \(4\) Fire extinguisher will be inspected as follows:
>
> \(a\) Fire extinguishers are serviced annually and tagged by [(name
> and location of service contractor)]{.underline} , a qualified fire
> extinguisher service contractor.
>
> \(b\) Fire extinguisher will be inspected monthly using the Monthly
> Fire Safety Inspection Check List [(or whatever your form is
> called)]{.underline} by the Center Administrator. The Center
> Administrator will carry out manufacturer's recommended routine
> maintenance activities.
>
> \(c\) If a fire extinguisher is used, it will be taken out of service
> until inspected and recharged by a qualified fire extinguisher service
> contractor.
>
> \(5\) The sprinkler system, or other type of extinguisher system, in
> the kitchen (if the building is sprinkled then leave off in the
> kitchen) will be inspected annually by [(name of certified or
> qualified fire safety equipment contractor)]{.underline} .
>
> \(6\) The children will be taught the stop-drop-n-roll technique for
> putting out clothing fires. This will be practiced by the children at
> least once per quarter.
>
> \(7\) The Center Administrator will ensure that all emergency exits
> are unobstructed and not locked, chained or otherwise made un-usable.
>
> \(8\) All emergency exits will be clearly labeled with large EXIT
> signs. (If your Center operates after dark, that is one hour after
> sunset or before sunrise, then you must have illuminated fire exit
> signs and develop procedures to test the illuminated signs).
>
> \(9\) The fire evacuation plan for the center will be posted near the
> each exit and will include the routes of evacuation from rooms and the
> location of the assembly point outside the building. The assembly
> point for the Head Start Center is [(location of assembly
> point)]{.underline} . Evacuation of the Center in the event of a fire
> will follow the emergency evacuation plan presented in Section VI.C of
> this Plan.
>
> \(10\) Fire drills at the Head Start Center will be conducted as
> follows:
>
> \(a\) Fire drills are conducted at least one time per month, with two
> drills conducted the first two weeks of school.
>
> \(b\) All children at the Center, including infants and toddlers, will
> participate in fire drills.
>
> \(c\) Fire drills will be conducted following the emergency evacuation
> procedures presented in Section VI.C of this Plan.
>
> \(d\) The cook will observe the fire drill for the orderly evacuation
> of the center, including the time to evacuate the center to the
> designated assembly point.
>
> \(11\) Fire drills for the Head Start Center bus will be conducted as
> follows:
>
> \(a\) Fire drills are conducted on the transportation vehicle one time
> per month with two drills conducted the first two weeks of school.
> Fire drills will be conducted at locations and in a manner that will
> not place the children at risk of injury due to motor vehicle traffic
> or other hazards.
>
> \(b\) The bus driver will observe the fire drill for the safe and
> orderly evacuation of the bus, including the time it takes to evacuate
> the bus to a safe distance.
>
> \(12\) Fire Drills for the Center and the bus will be documented on
> the Fire Drill Report Form [(or whatever your form is
> called)]{.underline} , and will include the following information:
>
> \(a\) Date the drill is conducted
>
> \(b\) Time the drill is conducted
>
> \(c\) Number of children participating.
>
> \(d\) Number of staff participating
>
> \(e\) Time to evacuate the center to the designated assembly point
> outside the center.
>
> \(f\) Comments on the fire drill, including how orderly evacuation
> preceded, any hazards identified by the staff during the drill, any
> problems or delays noted during the drill.
>
> \(13\) Fire Drill Report Forms will be maintained on file at the
> Center for a period of three (3) years [(or whatever length of time is
> required by the Tribe or State)]{.underline} .

**V.C Toxic Substances Policy**

1\. **POLICY:** The Head Start Center will operate a safe and hazard
free environment.

2\. **PROCEDURES:** In order to eliminate or reduce toxic substances
used at the Center and to limit access to any toxic substances that must
be used, the following actions will be taken:

> a\. Hazardous and Toxic Chemicals
>
> \(1\) Toxic chemicals include cleaning chemicals, detergents, some art
> materials, duplicating fluids, other office chemicals, pesticides,
> aerosol cans, health and beauty aids, poisons and other toxic
> substances. These substances that are required for use at the center
> will be stored [(location where toxic chemicals will be
> stored)]{.underline} , which is inaccessible to children.
>
> \(2\) The Center Administrator will develop a list of all cleaning
> chemicals, detergents, office chemicals, pesticides poisons and other
> chemicals that will be used at the Center. The Center Administrator
> will substitute non-toxic chemicals for the toxic chemicals whenever
> possible. The list of approved chemicals for the Head Start Center
> will be kept on file at the Center and will be posted [(location where
> list is posted)]{.underline} .
>
> \(3\) Toxic chemicals whose original label has come off or is damaged
> in a way that prevents complete identification of the contents will be
> properly disposed of according to the instructions on the label or the
> Material Safety Data Sheet (MSDS) for that chemical.
>
> \(4\) During employee orientation the Center Administrator will
> provide each employee with information on the toxic chemicals used at
> the Center. Any Material Safety Data Sheets for chemicals at the
> Center will be provided to and reviewed with the employees during
> orientation.
>
> \(5\) The Head Start Center will use only non-toxic art materials. At
> the beginning of each school year the Center Administrator will
> inspect all art materials to ensure they are labeled as non-toxic.
>
> b\. Hazardous Materials:
>
> \(1\) The Head Start Center was constructed in [(year of
> construction)]{.underline} . **[If your Center was constructed before
> 1978]{.underline}** a lead based paint inspection was conducted in
> [(year of inspection)]{.underline} by [(name and location of certified
> lead based paint inspector)]{.underline} . The Center [does/does
> not]{.underline} contain any painted surface, inside or outside the
> Center, with lead (Pb) above 1mg/cm^2^.
>
> \(2\) The Center Administrator will ensure that all new paint applied
> to either the inside or outside of the Center, including playground
> equipment, does not contain hazardous quantities of lead (Pb)
> exceeding 0.06 percent Pb (the label on paint will usually indicate
> the lead content as PbO~2~ or PbO~4~).
>
> \(3\) The Center Administrator will maintain a listing of all
> hazardous building materials at the center including lead based paint,
> formaldehyde, and asbestos.
>
> \(4\) The Head Start Center was tested for the presence of radon gas
> in [(year testing conducted)]{.underline} and hazardous levels of
> radon [were/were not]{.underline} found. (Talk with your Health
> Advisor about radon testing in your area is conducted). (If elevated
> levels of 4pci/l radon are found or associated with your Head Start
> Center, then include the abatement plan developed and implemented)
>
> \(5\) The Head Start Center was inspected for the presence of asbestos
> in [(year inspection conducted)]{.underline} and the Center was free
> of asbestos containing materials **[OR]{.underline}** and the Center
> does contain asbestos containing materials. An Asbestos Management
> Plan has been developed for the Head Start Center and is on file at
> the Center. (Talk with your Health Advisor about asbestos management
> plans and what needs to be included in these plans)
>
> \(6\) The Center Administrator will maintain all sampling results,
> assessment reports and abatement plans for any hazardous materials at
> the center. Any hazardous material identified at the Center will have
> an abatement plan developed and approved by the Health Advisor.
>
> \(7\) Information on hazardous substances present at the Center,
> including MSDS sheets will be shared with all new employees during
> their orientation.
>
> \(8\) Fact sheets on lead based paint, asbestos, radon and other
> hazardous materials will be provided to parent/guardian by all Centers
> to help parents understand hazardous materials they may have at their
> homes.
>
> \(9\) The Center Administrator will maintain a list of all plants in
> the Center and will check with the local poison control center to
> determine if any are poisonous. Any plant that is poisonous or has
> parts that are poisonous will be hung in a manner inaccessible to
> children [(or not allowed in the Center)]{.underline}.

**V.D Playground Safety Policy**

1\. **POLICY:** The Head Start Center will provide and maintain a safe
outdoor play area that is properly designed, and age and developmentally
appropriate to prevent injuries to the children.

2\. **PROCEDURES:** In order to provide a safe outside play area, the
following actions will be taken:

> a\. Playground Equipment and Grounds
>
> \(1\) a list of all playground equipment provided at the Head Start
> Center will be developed and updated annually by the Center
> Administrator. The list of all playground equipment, and what
> agegroups can use the equipment, will be maintained on file at the
> Center.
>
> \(2\) The Center Administrator will ensure that all playground
> equipment is age and developmentally appropriate based on the
> manufacturers labeling of the equipment.
>
> \(3\) The playground layout and design, equipment, type and depth of
> fill material, and equipment construction and design were inspected
> and approved by the Health Advisor on [(date of inspection and
> approval)]{.underline} .
>
> \(4\) Any modifications to the playground design, layout or equipment
> will be approved by the Health Advisor before modification.
>
> \(5\) The children will be supervised by at least two staff members
> while on the playground.
>
> \(6\) The Center Administrator will develop a set of playground safety
> rules based on the equipment manufacture's recommendations and general
> safety considerations. These rules will be reviewed with the staff and
> will be posted [(location where rules will be posted)]{.underline} .
>
> \(7\) The playground safety rules will be reviewed with the children
> on the first day of class and before the children use the playground.
> The playground staff will remind children of the safety rules while
> the children are at play.
>
> b\. Playground Inspections:
>
> \(1\) The playground will be inspected daily prior to use by the
> children by using the Daily Playground Inspection Form [(or whatever
> your form is called)]{.underline} . The Center Administrator will
> ensure that any problems identified during the daily inspection are
> corrected immediately or the equipment or area of the playground
> restricted from use until the problem or hazard is corrected.
>
> \(a\) The Daily Playground Inspection Reports will be reviewed monthly
> by the center staff during the staff meetings to identify recurring
> problems and develop methods or ways to prevent the recurrence of
> these problems.
>
> \(b\) The Daily Playground Inspection Reports will be maintained on
> file at the center for one year (or longer if required by Tribal or
> State laws).
>
> \(2\) The staff will notify the Center Administrator of any equipment
> or playground hazards noted by the children or the supervisory staff.
> These hazards will be noted on the Daily Playground Inspection Form
> for that day. The staff will correct any problems that can be
> corrected immediately before the children enter the playground.
>
> \(3\) The playground equipment will be inspected monthly by the Center
> Administrator using the Playground Equipment Checklist [(or whatever
> your form is called)]{.underline} . Any equipment hazards identified
> will be corrected immediately or the equipment will be taken out of
> service until the problem can be corrected.
>
> \(a\) The monthly Playground Equipment Checklists will be reviewed
> annually by the center staff to identify recurring hazards with
> specific types or brands of equipment, and develop methods to prevent
> the recurrence of these hazards.
>
> \(b\) The monthly Playground Equipment Checklist will be maintained on
> file at the center for three years (or longer if required by Tribal or
> State laws).
>
> \(4\) Playground equipment that cannot be repaired or made safe will
> be removed from the playground area as soon as possible.

**V.E Toy Safety Policy**

1\. **POLICY:** The Head Start Center will provide only toys that are
safe and age appropriate, and will maintain all toys in a safe condition
for use by the children.

2\. **PROCEDURE:** In order to ensure that all toys are safe and age
appropriate and are properly maintained and stored, the following
actions will be taken

> a\. Before each school year begins, the Center Administrator will
> inspect all toys in the Center to ensure:
>
> \(1\) Toys for children under the age of three (3) years do not have
> removable parts, and are not smaller then 1 inches in diameter and
> less then 2 inches long.
>
> \(2\) Toys for children over the age of three (3) years and under the
> age of four (4) years are not smaller then 1 inches in diameter, and
> do not have removable parts smaller then 1 inches in diameter.
>
> \(3\) Toys are free of sharp points and sharp edges.
>
> \(4\) No projectile type toys are allowed.
>
> \(5\) Scissors and other educational tools will have rounded ends and
> be free of sharp edges.
>
> \(6\) Stuffed animals and other soft toys will not have detachable
> eyes or other loose parts.
>
> \(7\) Any toys that are damaged or not age appropriate will be
> discarded in the garbage.
>
> b\. Balloons will not be used at the Head Start Center.
>
> c\. The children will not have access to plastic bags or Styrofoam
> objects at the Center.
>
> d\. The staff will remove any toy that they believe because of design
> or deterioration is not safe for the children to play with, and will
> inform the Center Administrator of what toys are being removed from
> play.
>
> e\. The Center Administrator will provide to the parent/guardian
> information sheets on toy safety and the need to use age-appropriate
> toys at home.
>
> f\. Toys are stored in a safe, orderly fashion to reduce clutter and
> maximum use of the floor space.

**V.F Injury Prevention Policy**

1\. **POLICY:** The Head Start Center will prevent the occurrence of
injuries and reduce the severity of those injuries that may occur
through education, providing and maintaining a safe environment, and
providing adequate supervision of the children.

2\. **PROCEDURE:** In order to prevent injuries by encouraging safe
behavior, eliminating hazards, and protecting children and staff from
hazards that cannot be eliminated, the following actions will be taken:

> a\. Training and education of staff, children and parent/guardian.
>
> \(1\) Staff will model safe behavior, including wearing seat belts and
> using age appropriate children restraints in their private vehicles.
>
> \(2\) When an unsafe action by a child is observed by the staff, the
> staff talks with the child in a positive manner about the unsafe
> action as soon as possible.
>
> \(3\) Staff will provide injury prevention training and information to
> the children in the following topics: (your Head Start Center and
> health coordinator should consult with your Health Advisor to develop
> the list appropriate to your Center).
>
> \(a\) Seat belt use and child restraint use.
>
> \(b\) Pedestrian Safety
>
> \(c\) Playground Safety
>
> \(d\) Fire Safety/Burn Safety
>
> \(e\) Bicycle Safety
>
> \(f\) Firearm Safety
>
> \(g\) Poison Prevention
>
> b\. Injury Monitoring and Trend Analysis
>
> \(1\) The Center Administrator will review each Injury Incident Report
> (refer to Section II.H.2.b of this Plan) for each injury that occurs
> at the Center to determine if a modification to equipment, the
> grounds, or other environmental modification would reduce the chance
> for a repeat of the injury. The Center Administrator will make note on
> the Injury Incident Report of what actions were taken or will be taken
> to eliminate the conditions or hazards that contributed to the injury.
>
> \(2\) The Center Administrator will review the Injury Incident Log
> (refer to Section II.H.2b of this Plan) to identify injury trends
> among the students and staff. Trends identified will be presented to
> the Parent Advisor Committee, the Health Coordinator, and the Health
> Advisor for review and comment. The Center Administrator will develop
> a plan to correct any problems that contribute to the injuries and
> will implement this plan prior to the beginning of the next school
> year.

**V.G Transportation Safety Policy**

1\. **POLICY:** The Head Start Center will provide for the safe
transportation of children to and from the Head Start Center and during
other Head Start Program events.

2\. **PROCEDURE:** In order to reduce the hazards associated with
transporting children, the following actions will be taken:

> The transportation vehicle for the Head Start Center is a [(make, year
> and model of bus)]{.underline} , that is owned and operated by the
> [(name of Tribe and Department or name of school that own\'s the bus
> used by the Center)]{.underline} . This vehicle [is (is
> not)]{.underline} equipped with safety belts. The maximum capacity of
> this vehicle is [(number of passengers that can ride on the
> bus)]{.underline} .
>
> a\. Driver and Vehicle
>
> \(1\) The Head Start Center bus is licensed in [(the State, Tribe or
> Government)]{.underline} .
>
> \(2\) The Bus Driver has a [(type of driver's license that qualifies
> driver for the bus) issued]{.underline} by [(the state or jurisdiction
> that issued the license)]{.underline} .
>
> \(3\) The bus is equipped with:
>
> \(a\) a first aid kit that is secured and stored out of reach of the
> children
>
> \(b\) Emergency contact information for each child that rides on the
> bus.
>
> \(c\) a radio or cellular phone that can be used at any point along
> the normal bus route.
>
> \(d\) Road Emergency Equipment: Flares, tire chains, flashlight, that
> are properly stored and secured.
>
> \(e\) a tire jack, tire-changing tools that are properly stored and
> secured.
>
> \(f\) a spare tire that is properly stored and secured.
>
> \(g\) a fire extinguisher that is properly stored and secured.
>
> \(h\) The vehicle is air conditioned and is cooled to maintain a
> maximum inside air temperature of 75 degrees Fahrenheit or lower.
>
> \(h\) The bus is provided with a heater that can maintain a minimum
> inside temperature of 50 degrees Fahrenheit or higher.
>
> \(4\) In the event of an emergency, a backup bus is available from
> [(describe where the backup vehicle will be dispatched
> from)]{.underline} by calling [(provide number of person or
> organization you would call to get the backup vehicle
> dispatched)]{.underline} .
>
> \(5\) The Bus Driver is responsible for:
>
> \(a\) The safe operation of the vehicle.
>
> \(b\) Picking up and dropping off children in safe locations.
>
> \(c\) Ensuring it is safe for the children to exit the bus.
>
> \(d\) Ensuring that all rules of conduct are followed on the bus.
>
> \(e\) Not listening to loud music or using earphones while operating
> the bus.
>
> \(f\) Inspection of the bus daily using the Daily Bus Inspection Form
> [(or whatever your form or check sheet is called)]{.underline} .
>
> \(g\) Inspection of the bus weekly using the Weekly Bus Inspection
> Form [(or whatever your form or check sheet is called)]{.underline} .
>
> \(h\) Ensure that the owner's routine maintenance schedule for the bus
> established by the owner is followed.
>
> \(i\) Cleaning the inside and outside of the vehicle, including
> washing seats and seat backs with soap and water solution each week or
> when soiled.
>
> \(j\) Receiving training on transportation, including defensive
> driving, proper use of child safety seats and safe transportation of
> wheel chair bound children, etc.
>
> \(6\) The Teacher [(or Teachers Aide or other adult accompanying the
> children) is]{.underline} responsible for:
>
> \(a\) the conduct of children on the bus.
>
> \(b\) ensuring that all children are properly restrained on the bus.
>
> \(c\) ensuring that an adult is home when children are dropped off.
>
> \(d\) receiving training on transportation including emergency
> evacuation procedures, rules of conduct on the bus, entry and exiting
> the bus and the use of safety belts, wheel chair restraints and child
> safety seats.
>
> b\. Transporting children:
>
> \(1\) The staff to student ratios will be maintained as described in
> Section I.D of this Plan.
>
> \(2\) The Center Administrator and the Bus Driver have established
> rules for riding on the bus. These rules include the following: (list
> bus rules)
>
> \(a\)
>
> \(b\)
>
> \(3\) The rules for riding on the Center bus are provided to the
> parent/guardian at the time of enrollment of their child and discussed
> with the child on the first day of class attendance. The bus safety
> rules will be discussed each quarter with the children.
>
> \(4\) Pick Up Procedures: The bus driver, with concurrence of the
> Center Administrator will establish the pick up locations for each
> child.
>
> \(a\) Children will be picked up only at off-street (off-road)
> locations that are protected from traffic. Children will not be picked
> up at a location where they must cross traffic.
>
> \(b\) The Teacher on the bus will assist with loading of the children,
> including making sure children are properly secured in seat belts or
> child safety seats before the bus moves from the pick up point.
>
> \(c\) The Center Administrator will notify the parent/guardian in
> writing where their child will be picked up and the approximate time
> the child will be picked up. The parent/guardian are responsible for
> supervision of their children until the children are loaded on the
> bus.
>
> \(3\) Drop Off Procedures:
>
> \(a\) In most cases, children will be dropped off where they were
> picked up.
>
> \(b\) The Teacher on the bus will supervise exiting of children and
> ensure that a parent/guardian is home or there to pickup the child. No
> child will be dropped off if the parent/guardian is not there to
> assume supervision of the child.
>
> \(c\) If there is no one home or there to pick up the child, the child
> will be returned to the Center and Emergency Contact procedures
> presented in Section VI.B of this Plan will be implemented.
>
> \(d\) The Teacher will ensure that all children are clear of the path
> of the bus after they have exited the bus and before the bus begins
> moving.
>
> \(4\) All infants and toddlers transported on the bus will be properly
> secured in properly installed child safety seats.
>
> \(5\) Wheel Chairs: When a child in a wheel chair is transported on
> the bus, the Center Administrator will ensure:
>
> \(a\) The staff and Bus Driver have received training on the
> transportation of special needs children, including children in wheel
> chairs from [(provide the name and organization)]{.underline} .
>
> \(b\) The Bus Driver will secure the wheel chairs on the bus using 4
> tie-downs.
>
> \(c\) The Teacher will ensure that the child in the wheel chair is
> secured in the chair using the wheel chair safety belts, including any
> required chest straps.
>
> \(6\) Non-Bus: The Center Administrator must approve the use of any
> vehicle, other then the standard bus, for transportation of children
> to Center sponsored outings or as a part of the Head Start Center
> activities.
>
> \(a\) Seat belt use or child restraint use is required.
>
> \(b\) a child will not be transported in any vehicle other then the
> Center bus for field trips or other activities outside the Center
> without written parental permission.
>
> \(c\) The same staff to student ratio, established in Section I.D of
> this Plan, will be followed for non-bus transportation of children.

**VI. EMERGENCY PLAN**

**VI.A Emergency Policy**

1\. **POLICY:** The Head Start Center will ensure that the children and
staff are safe and secure while at the center during natural or man-made
emergencies or while on travel away from the center.

2\. **PROCEDURE:** In order to reduce the risk to children and staff and
ensure proper medical care is provided during an emergency event, the
following actions will be taken:

> (The exact procedures needed are dependent to a large extent on the
> types of emergencies that occur in your area. The Health Advisor and
> local emergency response programs should be able to help with
> developing specific procedures for emergencies common to your area.)
>
> a\. The following types of emergencies could occur in the Head Start
> Center region: (include only those emergencies that are considered a
> possibility in your region)
>
> \(1\) Medical Emergencies
>
> \(2\) Bus and Transportation Emergencies
>
> \(3\) Industrial Accidents
>
> \(4\) Weather Emergencies
>
> \(5\) Death of a Child or Staff Member
>
> \(6\) Lost or Missing Children
>
> \(7\) Hostage Situations
>
> \(8\) Bus Jacking
>
> b\. Responsibilities:
>
> \(1\) The Center Administrator:
>
> \(a\) Has the direct authority for the classroom, staff and visitors
> at the Center. The decision to implement the emergency plan is the
> Center Administrator's, or their designee.
>
> \(b\) The Center Administrator is the principal decision maker for the
> Head Start Center.
>
> \(c\) For any emergency situation, the Center Administrator is the
> principal spokesperson for the Head Start Center.
>
> \(d\) In the event that either children or staff are injured, the
> Center Director will implement the Medical Emergency Procedures found
> in Section VI.E of this Plan.
>
> \(e\) The Center Administrator will determine if it is safe to
> re-enter the building after evacuation based on the recommendations of
> emergency response personnel.
>
> \(f\) The Center Administrator will prepare a written report on any
> emergency event to include when and where the event occurred, what the
> emergency was, what actions were taken to safeguard the children and
> staff, any emergency response and who responded, any injuries that
> occurred, the severity and to whom (specific names, ages and
> injuries), actions that will prevent reoccurrence of the emergency.
>
> \(2\) Teachers Aide
>
> \(a\) The [Teachers Aide (or specific group Teacher, must be
> identified by title or name)]{.underline} will collect and carry the
> Emergency Contact Information file and the Daily Attendance Log if
> evacuation of the Center is required.
>
> \(b\) The [Teachers Aide (or specific group Teacher, must be
> identified by title or name)]{.underline} will assemble all children
> and adults inside the Center and notify Center Administrator if any
> are missing.
>
> \(c\) The Teachers Aide will supervise the children once outside the
> Center at the safe assembly point.
>
> \(d\) The Teachers Aide will, if properly trained, administer
> emergency first aid.
>
> \(3\) Cook
>
> \(a\) The Cook will, upon direction from the Center Administrator,
> call 911\" [(or whatever number to reach emergency response personnel
> in your area)]{.underline} .
>
> \(b\) The Cook will assist with the evacuation and supervision of
> children once they have evacuated the Center.
>
> \(c\) The Cook will, if properly trained, administer emergency first
> aid
>
> \(4\) Bus Driver: For Center based emergencies:
>
> \(a\) The Bus Driver will assist with locating any missing children.
>
> \(b\) The Bus Driver, with the approval of the Center Administrator,
> may extinguish fires.

**VI.B** **Emergency Contact Policy**

1\. POLICY: The Head Start Center will ensure that the
parent\'s/guardian\'s of children can be contacted and kept informed in
the event of an emergency.

2\. PROCEDURES: In order to keep parent/guardian informed on the health
of their children and to help a child involved in an emergency
situation, the following actions will be taken:

> a\. Emergency contact information for each child shall be maintained
> in and Emergency Contact File that accompanies the children on any
> outings or field trips. Emergency contact information for each child
> is recorded on the Emergency Contact Information Form [(or whatever
> your Form is called)]{.underline} and includes:
>
> \(1\) Names and telephone numbers (both home and work) of the
> parent/guardian or legal guardians.
>
> \(2\) Names and telephone numbers (both home and work) of parent or
> contact persons to whom the child may be released, if the
> parent/guardian is unavailable.
>
> \(3\) Name, address and telephone number of the child's usual source
> of medical and dental care.
>
> \(4\) Information on the child's health insurance, including the name
> of the insurance carrier, identification number, and the subscriber's
> name.
>
> \(5\) Special conditions, disabilities, allergies, or medical and
> dental information, such as date of the latest DPT immunization.
>
> \(6\) Parent's or guardian's written consent, in case emergency care
> is needed.
>
> b\. In the event of an illness, injury, emergency situation or other
> event where immediate contact of the parent/guardian is necessary, the
> Center Administrator will:
>
> \(1\) Call the parent/guardian using the Emergency Contact Information
> provided by the parent. The Center Administrator will calmly and
> clearly explain to the parent what has occurred and how their child
> was involved, the severity of injury or illness, what first aid or
> care has been provided by the staff, and what further medical care has
> been required. The parent needs to know where their child is, how sick
> or injured is their child, how and when their child became sick or
> injured and what is needed of the parent/guardian.
>
> \(2\) In the event the parent/guardian cannot be located, the Center
> Administrator will contact the other people authorized by the parent
> on the Emergency Contact List. The person taking custody of the child
> will sign the child out using the Daily Sign-In/Sign-Out Sheet.
>
> \(3\) If neither the parent/guardian nor any of the emergency contacts
> can be located, the Center Administrator will contact the [(department
> of social services, child protective services, police or whatever
> agency of the Tribe or State is appropriate)]{.underline} .
>
> \(4\) In the event that Emergency Contact procedures are implemented,
> the Center Administrator will complete the Injury Incident or Illness
> Incident Report form, which ever is appropriate, and include who was
> contacted, the time of the contact and who finally did pick up the
> child.

**VI.C Emergency Evacuation Policy**

1\. **POLICY:** The Head Start Center staff will ensure any emergency
evacuation of the Center is conducted in a calm, safe and efficient
manner to avoid any injury or adverse effect to the children and staff.

2\. **PROCEDURES:** These emergency evacuation procedures apply to
emergency evacuation of the Center only. Emergency evacuation procedures
for Bus and Transportation emergencies are presented in Section VI.D of
this Plan. In order to ensure the safe and orderly evacuation of the
Center by infants and toddlers, special needs children and other
children and staff, the following actions will be taken:

> **(**The emergency evacuation plan for your center is generally
> referred to as the fire evacuation plan, but there are other
> emergencies when evacuation of the Center may be necessary. The
> evacuation plan for each Center will differ based on the number of
> staff, the number of classes or groups of children and the building
> arrangement. You must adapt the evacuation plan specific to the needs
> of your Center, including provisions for special needs children and
> infants and toddlers. You are encouraged to work with you Health
> Advisor to help you develop and emergency evacuation policy and
> procedures for your Center that meets yours needs. The following
> examples are based on a Center with a Teacher who is also the Center
> Administrator, a Teachers Aide, and Early Head Start Teacher and
> Teachers Aid, a Bus Driver and a Cook.)
>
> a\. Emergency Evacuation: In the event that emergency evacuation of
> the Center is required the Center Administrator will implement the
> following emergency evacuation procedures:
>
> \(1\) The Center Administrator will sound the fire alarm indicating
> that evacuation of the Center is necessary.
>
> \(2\) When the fire alarm is sounded, the Cook will call 911\" [(or
> emergency services number in your area)]{.underline} . Information to
> be related to the emergency services personnel should include:
>
>  The name of the Head Start Center
>
>  That the Center is being evacuated
>
>  The physical location of the Head Start Center, including directions
> how to get to the Center if necessary.
>
>  The nature and extent of the emergency (i.e. fire, chemical spill,
> violent visitor, etc.)
>
>  How many people are at the Head Start Center.
>
>  Caller name and the telephone number the caller is calling from.
>
>  Any specific information requested to assist with the response.
>
> \(3\) When the fire alarm is sounded, the Teacher\'s Aide (or each
> group teacher) will make sure all of their children are accounted for
> and will verify this using the daily attendance sheet. The Teacher's
> Aid will place any special needs children in evacuation wheel chairs
> or strollers.
>
> \(4\) The Teacher's Aid will lead the children from the classroom and
> the Center to the designated safe assembly location. The safe assembly
> location is [(provide safe assembly location)]{.underline} . The
> Teacher's Aid will, if necessary take charge of any wheel chairs or
> evacuation strollers and push the wheelchair/stroller in front of the
> group.
>
> \(5\) If any children are not accounted for, the Teacher's Aide will
> immediately notify the Center Administrator before evacuating the
> other children. The children will then be evacuated from the Center.
> The Center Administrator and Bus Driver will inspect each room of the
> Center to locate the missing children. Once located, the Center
> Administrator will lead the children from the Center.
>
> \(6\) The Cook will follow the students out of the Center. If
> necessary, the Cook will assist with the evacuation of additional
> special needs children and push their wheelchair/stroller behind the
> group.
>
> \(7\) The Early-Head Start Teacher and Teacher's Aid will place
> infants and toddlers in evacuation strollers (or cribs) provided and
> will evacuate all of the infants and toddlers at once. In no
> circumstances will any infants or toddlers be left unattended during
> an evacuation.
>
> \(8\) The Center Administrator will be the last person out of the
> building and will ensure that all children and staff have safely
> evacuated the Center. Once outside, the Center Administrator will
> verify, based on the daily attendance sheets, that all of the children
> have been evacuated.
>
> \(9\) The Center Administrator will decide if the children and staff
> should be moved to a refuge building, especially in bad weather. The
> emergency evacuation refuge building is the [(name of the
> building)]{.underline} , which is located [(provide the location of
> the building)]{.underline} .
>
> \(10\) The Center Administrator will wait for emergency assistance to
> arrive. The Center Administrator will make the decision to initiate
> the Emergency Contact Procedures to have children picked up by their
> parent/guardian.
>
> \(11\) The Center will not be re-entered unless cleared by the
> emergency response personnel and approved by the Center Administrator.
>
> \(12\) The Center Administrator will prepare a letter to the
> parent's/guardian's of children explain the date and time of the
> evacuation, the reason for the evacuation, what steps have been taken
> to prevent the emergency in the future and any information that
> parent/guardian may want to explain to their children.
>
> \(13\) The Center Administrator will prepare a report to the Head
> Start Director, with a copy to the Health Advisor on any emergency
> evacuation required at the Center. The report will include the date
> and time of the evacuation, the reason for the evacuation, the number
> of children and staff involved, any injuries involved, if Emergency
> Contact procedures were implemented and any long term effects of the
> emergency.

**VI.D Bus and Transportation Emergencies Policy**

1\. **POLICY:** The Head Start Center will ensure that the children and
staff are safe and secure during emergencies that may occur on the bus.

2\. **PROCEDURES:** In order to ensure the safe and orderly evacuation
of the bus by infants and toddlers, special needs children and other
children and staff, the following actions will be taken:

> a\. The Bus Driver is the primary decision maker for emergencies that
> occur on the bus away from the Center. In the event the bus driver is
> incapacitated, then the Teacher/Teacher's Aide [(staff member on the
> bus with the children)]{.underline} , will be the primary decision
> maker. Emergency contact information for each child will be maintained
> on the bus at all times.
>
> \(1\) Evacuation
>
> \(a\) The staff member on the bus will lead the children from the bus
> and to a safe location at least 50 feet from the bus. The children
> will be lead away from the bus and away from the road as quickly as
> possible, without running.
>
> \(b\) The bus driver will follow the children from the bus and ensure
> that all the children have evacuated the bus.
>
> \(2\) Motor Vehicle Accident/Stalled Bus
>
> \(a\) The children will not be evacuated from the bus unless there is
> a fire or there is a significant risk of further injury due to other
> vehicles crashing into the bus or other life-threatening situation.
>
> \(b\) The Teacher/Teacher's Aide [(staff member on the bus with the
> children)]{.underline} , will inspect each child for injuries, calm
> the children on the bus and administer first aid, if necessary. The
> children will not be left alone on the bus for any period of time.
>
> \(c\) If the Teacher's Aide is incapacitated, the bus driver will
> inspect the children for injuries, calm the children and administer
> first aid, if necessary.
>
> \(d\) The Bus Driver will use the two-way radio or cellular phone to
> call for emergency assistance. If the communication device is not
> operational, the bus driver will try to get someone passing by to call
> for emergency assistance.
>
> \(e\) If the Bus Driver is incapacitated then the Teacher's Aide will
> call for emergency assistance or get someone else to call for
> emergency assistance.
>
> \(f\) The Bus Driver will inspect the bus to ensure it is safe and
> resting in a secure location. If the placement of emergency flares is
> necessary, then the Bus Driver will place the emergency flares. When
> the bus is secure, the Bus Driver will assist the Teacher's Aide in
> administering first aid and in calming the children.
>
> \(g\) The Bus Driver will call for the emergency back-up vehicle to
> transport the children. The backup bus is available from [(describe
> where the backup vehicle will be dispatched from)]{.underline} by
> calling [(provide number of person or organization you would call to
> get the backup vehicle dispatched)]{.underline} .
>
> \(h\) The Teacher's Aide will be the spokesperson for the children
> when emergency assistance arrives.
>
> \(i\) The Teacher's Aide will take the Emergency Contact Information
> File with the children to hospital.
>
> \(j\) The Bus Driver will remain with the bus.
>
> \(3\) Bus Jacking
>
> \(a\) The Bus Driver will comply with the demands of the bus jacker.
>
> \(b\) The Teacher will keep the children calm and in their seats.
>
> \(c\) If allowed to leave the bus, the Teacher will lead the children
> from the bus and the Bus Driver will follow behind the children.

**VI.E Medical Emergencies Policy**

1\. **POLICY:** The Head Start Center staff will provide, to the best of
their ability, emergency first aid to the children and staff until
emergency medical personnel can continue treatment.

2\. **PROCEDURES:** In order to ensure that a medical emergency is
handled promptly, effectively and appropriately, the following actions
will be taken:

> a\. Emergency medical procedures for choking, stopping bleeding and
> head injuries (and whatever else your HSAC wants posted) are posted
> [(give location where procedures are posted)]{.underline} .
>
> b\. All of the staff at the Center have received training in emergency
> first aid, infant CPR, and CPR.
>
> c\. The Center Administrator will ensure, to the extent necessary for
> the staff to provide care, that the Center staff are made aware of the
> medical needs of special needs children.
>
> d\. When an immediate response is required, the following emergency
> procedures will be used:
>
> \(1\) A staff member trained in First Aid or CPR shall provide
> appropriate emergency care to the person or persons.
>
> \(2\) If directed by the Center Administrator, the Cook (other
> designated person) will call 911\" (other appropriate emergency
> number if your area is not served by 911\") to contact the Emergency
> Medical System and will provide the following information:
>
> \(a\) Name of caller
>
> \(b\) Name of Center
>
> \(c\) Nature of the emergency
>
> \(d\) Telephone number of the Center or where they are calling from
>
> \(e\) Address of the Center
>
> \(f\) Directions to the Center
>
> \(g\) Exact location of injured person or persons
>
> \(h\) Condition of person injured
>
> \(i\) Emergency medical care being given.
>
> The person making the call will stay on the line until Emergency
> Medical System personnel arrive.
>
> \(3\) Emergency transportation for necessary medical care will be
> determined by the Emergency Medical System operator or the
> parent/guardian. In the event center staff must transport an injured
> child or staff member, the center bus [(or other vehicle)]{.underline}
> will transport the injured person to the nearest emergency medical
> facility. The Teacher for the child's group will go with the child and
> remain with the child until the parent/guardian arrive.
>
> \(4\) The Center Administrator [(or other designated staff
> member)]{.underline} will implement the Emergency Contact Procedures.
>
> \(5\) Emergency phone numbers will be posted near each of the phones
> at the Center and be included with the Emergency Contacts Information
> File for taking on field trips and outings. The following phone
> numbers will be included:
>
> NUMBER FOR FIRE: [(Write number of fire department)]{.underline}
>
> NUMBER FOR POLICE: [(Write number of police department)]{.underline}
>
> NUMBER FOR EMERGENCY MEDICAL: [(Write number)]{.underline}
>
> NUMBER FOR LOCAL HEALTH DEPT.: [(Write number)]{.underline}
>
> e\. At least one staff member with current training, in
> age-appropriate Cardio-Pulmonary Resuscitation (CPR) and First Aid,
> shall be present at the Center at all times and be present on all
> field trips. The Center Administrator is responsible for assuring our
> first aid kit(s) are fully stocked in accordance with the AIPB,
> Environmental Health Standard, Section 5-102.29.
>
> f\. When we go on field trips ( [(staff title)]{.underline} ) is
> responsible for taking the first aid kit.
>
> g\. The following conditions will also be treated as medical
> emergencies:
>
> \(1\) An infant under the 4 months of age has an axillary temperature
> of 100 degrees Fahrenheit or higher or a rectal temperature of 101
> degrees Fahrenheit or higher.
>
> \(2\) A child over 4 months of age has a temperature of 105 degrees
> Fahrenheit or higher.
>
> \(3\) An infant under 4 months of age has forceful vomiting (more than
> once) after eating.
>
> \(4\) Any child looks or acts very ill or seems to be getting worse
> quickly.
>
> \(5\) Any child has neck pain when the head is moved or touched.
>
> \(6\) Any child has a stiff neck or severe headache.
>
> \(7\) Any child has a seizure for the first time.
>
> \(8\) Any child acts unusually confused.
>
> \(9\) Any child has unequally sized pupils (black centers of the
> eyes).
>
> \(10\) Any child has a blood-red or purple rash made up of
> pinhead-sized spots or bruises that are not associated with an injury.
>
> \(11\) Any child has a rash of hives or welts that appear quickly.
>
> \(12\) Any child breathes so fast or hard that he or she cannot play,
> talk, cry or drink.
>
> \(13\) Any child has a severe stomachache without vomiting or diarrhea
> after a recent injury, blow to the abdomen or hard fall.
>
> \(14\) Any child has stools that are black or have blood mixed through
> them.
>
> \(15\) Any child has not urinated in more than 8 hours, and the mouth
> and tongue look dry.
>
> \(16\) Any child has continuous clear drainage from the nose after a
> hard blow to the head.
>
> h\. The Center Administrator will document medical emergencies on the
> appropriate Illness Incident or Injury Incident Report forms as
> presented in Section II.H of this Plan.
>
> i\. Death of a Child
>
> \(1\) If a child dies while at the facility:
>
> \(a\) The Center Administrator will immediately notify the emergency
> medical personnel
>
> \(b\) The Center Administrator will immediately notify the child's
> parent/guardian.
>
> \(c\) The Center Administrator will notify the Head Start Director.
>
> \(d\) Provide age appropriate information to the parent/guardian of
> the other children.
>
> \(e\) Provide appropriate grief and other support information to the
> parent/guardian of the deceased child.
>
> \(f\) Arrange for student and staff grief counseling.
>
> \(2\) If a child dies while not at the Center, the Center
> Administrator will
>
> \(a\) Provide age appropriate information to the parent/guardian of
> the other children.
>
> \(b\) Provide appropriate grief and other support information to the
> parent/guardian of the deceased child.
>
> \(c\) Arrange for student and staff grief counseling.

**VI.F Industrial Emergency Policy**

1\. **POLICY:** The Head Start Center will reduce the effect of any
industrial accidents through the location of the Center and proper
response to any industrial accident that may occur.

2\. **PROCEDURES:** In order to reduce the impact of any industrial
accidents that may occur in nearby industries or on the roads or
railroad tracks near the Head Start Center, the following actions will
be taken:

> a\. The Center Administrator will identify any
> industrial/manufacturing facilities within close proximity to the
> Center and determine what potential risks to the Center exist.
>
> b\. When an industrial accident occurs, the Center Administrator call
> 911\" [(or emergency services number in your area)]{.underline} , to
> report the accident and obtain guidance on the risk from the hazard to
> the children, staff and Center.
>
> c\. Evacuation of the Center will be done only when recommended by
> emergency services personnel, or, if the Center Administrator
> determines that there is reasonable risk to the health and safety of
> the children.
>
> d\. If evacuation of the local area is required by the emergency
> services agency, the Center Administrator will notify the emergency
> services agency if additional transportation will be needed to
> evacuate the children to a safe location.
>
> e\. The Center Administrator will implement the Emergency Contact
> Procedures in Section VI.B of this Plan, if the Center is evacuated to
> notify parent/guardian of the emergency and where their children
> should be picked up.

**VI.G Weather Emergency Policy**

1\. **POLICY:** The Head Start Center staff will reduce the health and
safety risk associated with adverse weather conditions to the children
and staff.

2.  **PROCEDURES:** In order to reduce the impact of adverse weather
    conditions, including floods,

> blizzards, extreme cold, extreme heat, tornados, hurricanes, icy
> roads, muddy roads and other conditions that can impact the safety of
> children, the following actions will be taken:.
>
> (Your Center will need to develop policies for specific types of
> weather emergencies that occur in your area. Some types of emergencies
> that plans should be developed for include tornados, blizzards and
> others. The primary concern in a weather emergency is to protect the
> safety of the children and to take no action that would increase the
> children's risk for injury. Consult with your Health Advisor and local
> emergency services programs to help develop specific procedures.)
>
> a\. If the [(name of local school) announces]{.underline} over local
> radio stations that their classes have been canceled due to weather
> conditions, the Head Start Center classes will also be canceled.
>
> b\. The Center Administrator will make the determination if Head Start
> Center classes will be canceled for a given day due to weather
> conditions. The Center Administrator will notify [(name of local radio
> station that provides service to your area)]{.underline} at FM/AM
> [(frequency number) that]{.underline} classes are canceled for the
> day.
>
> c\. If adverse weather conditions develop during the day that cause
> early closure of the Center or prevent the bus from transporting the
> children, the Center Administrator will implement the Emergency
> Contact Procedures in Section VI.B in this Plan, to have the children
> picked up.
>
> d\. If adverse weather conditions occur and delay normal bus runs, the
> Center Administrator will notify parent/guardian of the delay, the
> reason for the delay and how much of a delay is expected.

**VI.H Violent Behavior Emergency Policy**

1\. **POLICY:** The Head Start Center staff will protect the children
and staff from violent acts, and minimize the impact on the children and
staff due to any violent acts that may occur. Violence at our Head Start
Center will not be tolerated.

2\. **PROCEDURES:** In order to prevent violent acts and to minimize the
impact of any violent acts on the children, the following actions will
be taken.

> (This is another one where you will need to consult with local law
> enforcement personnel and perhaps local schools and your Head Start
> Health Coordinator to determine the proper procedures. The main point
> is to isolate the children from the violent person.
>
> a\. In the event that a visitor, staff member or parent becomes
> violent, the Center Administrator or their designee, will take charge
> of the situation.
>
> b\. The Center Administrator will attempt to calm the person and move
> them away from the children (do not take them into the office if this
> is the location of the only phone in the Center).
>
> c\. The Teacher's Aide will quietly and calmly move children away from
> the area of the confrontation.
>
> d\. If possible, the Center Administrator will direct the Teacher's
> Aid to take the children outside to the playground.
>
> e\. If violence appears imminent or has happened, the Center
> Administrator will direct the Cook [(or Bus Driver, or other
> Teacher)]{.underline} , to close the office door. This is the signal
> to call 911\" for law enforcement assistance. The Cook will remain in
> the office with the door closed.
>
> f\. The Bus Driver will leave the building to get additional help to
> the Center. The Bus Driver will return to the Center and be ready to
> assist the Center Administrator if necessary.

**VI.I Bomb Threat Policy**

1\. **POLICY:** The Head Start Center staff will evacuate the children
and staff immediately in the event of a bomb threat.

2\. **PROCEDURES:** In order to help prevent bomb threats and to
evacuate the children in the event of a bomb threat, the following
actions will be taken:

> a\. If a bomb threat is received at the Center, the person receiving
> the call will ask the caller:

 where the bomb is located

 why the bomb has been placed.

> The person should listen for background noise, and try to determine
> the age and sex of the caller.
>
> b\. The person who receives the call will notify the Center
> Administrator immediately.
>
> c\. The Center Administrator will implement the Emergency Evacuation
> procedures presented in Section VI.C of this Plan.
>
> d\. The Center Administrator will allow re-entry of the building only
> after the Center has been cleared by the emergency response personnel.
>
> e\. If re-entry of the building is delayed, the Center Administrator
> will determine if the Emergency Contact in Section VI.B of this Plan
> will be initiated.

**VI.J Missing Child Policy**

1\. **POLICY:** The Head Start Center staff will provide continuous
supervision of children in our care and, if a child should turn up
missing, the staff will take what ever steps are necessary to locate the
child.

2\. **PROCEDURES:** In order to locate a missing child and ensure the
safety of the other children, the following actions will be taken:

> a\. If a child is missing from the Center:
>
> \(1\) The Teacher or other staff will immediately notify the Center
> Administrator.
>
> \(2\) The Center Administrator will confirm from the daily
> sign-in/sign-out sheets that the child was at the Center that day and
> has not been picked up.
>
> \(3\) The Center Administrator will initiate a search within the
> Center.
>
> \(4\) The Bus Driver and Cook will initiate a search of the grounds
> outside the Center.
>
> \(5\) If the child is not located inside the Center or on the
> immediate grounds, the Center Administrator will notify the child's
> parent/guardian that the child is missing and will call the local law
> enforcement at [(phone number of local police)]{.underline} , to
> report a missing child.
>
> b\. If a child is missing during an outing away from the Center:
>
> \(1\) The Teacher or other staff will immediately notify the Center
> Administrator.
>
> \(2\) The Center Administrator will confirm from the daily
> sign-in/sign-out sheets that the child was on the outing.
>
> \(3\) The Teacher's Aid will ensure that all of the other children are
> kept in one location or area.
>
> \(4\) If in a building, the Center Administrator will immediately
> notify the building manager that a child is missing and request
> immediate assistance to locate the child.
>
> \(5\) The Center Administrator and the Bus Driver will initiate a
> search of the building and the immediate grounds to locate the child.
>
> \(6\) If the child is not located inside the building or on the
> immediate grounds of the building, the Center Administrator will
> notify the child's parent/guardian that the child is missing and will
> call the local law enforcement at [(phone number of local
> police)]{.underline} , to report a missing child.

**VII. PHYSICAL ENVIRONMENT FACILITY PLAN**

**VII.A Handicapped Accessibility Policy**

1\. **POLICY:** The Head Start Center will comply with the appropriate
requirements for handicapped accessibility.

2\. **PROCEDURES**: In order to ensure full participation of children
with special needs, the following actions will be taken:

> a\. The Center Administrator will ensure that all necessary
> handicapped accessibility requirements are provided as recommended by
> the Health Advisor.
>
> b\. The Center Administrator will ensure that any ramps, railings,
> wheel chair accessible toilets, sinks and drinking fountains can be
> effectively used by special needs children and then modifications to
> the design, height and position of these fixtures will be modified if
> necessary to facilitate their use by the special needs child.
>
> c\. Adequate space is available for therapy needs of special needs
> children. The therapy area for the Head Start Center is located
> [(provide location of area or room designated for the provision of
> therapy)]{.underline} .
>
> d\. The Center Administrator will ensure that the movement or
> re-arrangement of furniture and equipment in the classroom and outdoor
> play area is kept to a minimum for children with visual or hearing
> impairments.

**VII.B Heating, Air Conditioning, Ventilation Policy**

1\. **POLICY:** All rooms used by children at the Head Start Center
shall be heated, cooled and ventilated to maintain the required
temperatures, humidity and air exchange and to avoid the accumulation of
objectionable odors and harmful fumes.

2\. **PROCEDURES:** In order to provide appropriate indoor environment
and protect the health and safety of the children and staff, the
following actions will be taken:

> a\. The air temperature inside the Center will be maintained between
> 65 F to 75F during the winter months and between 68F. to 82F
> during the summer months. Relative humidity will be maintained between
> 30 to 70 percent.
>
> b\. The Center Administrator will schedule the annual inspection of
> the heating, ventilation, and air conditioning system within 30 days
> of beginning classes with [the name of a heating/air conditioning
> contractor and their location]{.underline} . These inspections are
> required by the Head Start Performance Standards.
>
> c\. Heating: Heating for the Head Start Center is provided heat by a
> [type of heating system, (gas, electric, heating oil, hot water or
> boiler, wood stove, coal stove, etc.)]{.underline} . The system was
> installed in [date system installed]{.underline} . Copies of the
> manufacturers operating instructions are maintained in the mechanical
> room [(or where ever you keep your operating information)]{.underline}
> . Emergency repair or maintenance of the heating system can be
> provided by [the name of a heating/air conditioning contractor and
> their location, and phone number]{.underline} .
>
> **Depending on the type of heating system in use specific procedures
> for the operation and maintenance of this system will need to be
> developed. This should include inspection of the system at the
> beginning of the school year, protecting children from hot surfaces,
> ventilation requirements for flame-burning units, filter changing and
> cleaning requirements, wood stove safety, etc. Work with the Health
> Advisor to develop policies and procedures specific to your heating
> system**.
>
> \(1\) Portable open-flame and kerosene space heaters will not be used.
> Portable gas stoves will not be used at the Center.
>
> \(2\) Electric space heaters will be used only in the event of an
> emergency. The electric space heaters are UL-approved and will be
> placed so they are inaccessible to children and placed at least 3 feet
> from curtains, papers and furniture. The electric space heaters are
> provided with a protective cover to prevent injuries.
>
> \(3\) Hot surfaces above 110F will be made inaccessible to children.
> There are no hot surfaces accessible to the children.
> **[OR]{.underline}** The following hot surfaces above 110F have been
> identified and are protected in the following ways:
>
>  (List any hot surfaces and how they are protected or made
> inaccessible to the children)
>
> \(4\) The heating system is inspected annually by [(name and location
> of heating system contractor or other qualified
> inspector)]{.underline} .
>
> \(5\) If the heating system is unable to maintain the air temperature
> in the Center above 65F, for one day of classes, then the Center
> should be closed until the heating system is repaired.
>
> \(6\) If the temperature in the Center drops below 60F, then the
> Center Administrator will declare an Imminent Health Hazard and close
> the school until the heating system can be repaired.
>
> d\. Cooling: Cooling for the Center is provided by [type of cooling
> system used (air conditioner, swamp coolers, electrical fans,
> etc.)]{.underline} . The cooling system was installed in [(date system
> installed)]{.underline} . Copies of the manufacturers operating
> instructions are maintained in [(where ever you keep your operating
> information)]{.underline} . Emergency repair or maintenance of the
> cooling system can be provided by [the name of a heating/air
> conditioning contractor and their location, and phone
> number]{.underline} .
>
> \(1\) Air cooling is provided free of drafts on the children.
>
> \(2\) The air cooling system will be inspected at the beginning of
> each school year.
>
> \(3\) The air-cooling system is maintained and cleaned in accordance
> with the manufacturer's requirements.
>
> \(4\) If the cooling system is unable to maintain the air temperature
> in the Center below 82F, for one day of classes, then the Center
> should be closed until the cooling system is repaired.
>
> \(5\) If the air temperature in the Center goes above 87F, then the
> Center Administrator will declare an imminent health hazard and close
> the school until the cooling system can be repaired.
>
> e\. Ventilation: Ventilation for the Head Start Center is provided by
> natural and mechanical means to ensure a minimum ventilation rate of
> 10 complete air changes per hour. Mechanical ventilation is provided
> in the toilet rooms, janitor's closet [(or where ever mechanical
> ventilation is provided).]{.underline} Copies of the manufacturers
> operating instructions are maintained in [(where ever you keep your
> operating information)]{.underline} . Emergency repair or maintenance
> of the ventilation system can be provided by [the name of a
> heating/air conditioning contractor and their location, and phone
> number.]{.underline}
>
> \(1\) Windows used for natural ventilation are equipped with draft
> deflectors.
>
> \(2\) Electrical fans are [(**either** mounted high on the
> wall/ceiling **or** guarded to limit the size of the openings, front
> and back, to less than  inch) depending on what type of fan used at
> your Center]{.underline}.
>
> \(3\) The ventilation system is inspected annually by [(the name of a
> ventilation system service contractor and their location, and phone
> number).]{.underline}
>
> \(4\) The ventilation system is cleaned in accordance with the
> manufacture's requirements.

**VII.C Electrical System Policy**

1\. **POLICY:** The Head Start Center provided with properly installed
and maintained electrical service to facilitate operation of the Center
and to prevent illness and injury.

2\. **PROCEDURES:** The electrical power is provided by the [(name and
location of electrical power company)]{.underline} .

> In order to provide safe electrical service for the Center, the
> following actions will be taken:
>
> a\. The Center Administrator will ensure that any major repairs or
> alterations to the Center's electrical system are provided by a
> licensed electrician and in accordance with the National Electric Code
> (NFPA-70) [(or the local code used in your area)]{.underline} .
>
> b\. The Center Administrator will provide electrical outlet safety
> plugs (shock stops) for all unused electrical outlets not equipped
> with protective covers. The Center Administrator will inspect all
> electrical outlets in the Center at least monthly to ensure outlet
> safety plugs are in place. The Center staff will re-insert outlet
> safety plugs when done using an electrical outlet.
>
> c\. The Center Administrator will ensure that any electrical outlet,
> fixture or equipment that is identified as faulty is not used until
> inspected and repaired by a licensed electrician.
>
> d\. At the beginning of the school year, the Center Administrator will
> inspect all electrical appliances to ensure they are UL-approved, that
> the cords are not frayed or damaged and that the electrical cords are
> placed out of easy reach by the children. Any appliance found to have
> damaged electrical cords will be taken out of service immediately.
>
> e\. Extension electrical cords will be used only with the Center
> Administrator's approval and only for short time periods. The
> extension cords will not be placed under carpets or across water
> sources.

**VII.D Plumbing Policy**

1\. **POLICY:** The Head Start Center plumbing system for water, waste
water, and gas are installed and maintained free of defects, leaks and
obstructions.

2\. **PROCEDURES:** In order to provide safe and adequate plumbing, the
following actions will be taken:

> a\. The Center Administrator will ensure that any repairs or new
> installations of gas pipe, water pipe, gas burning fixtures, and
> plumbing fixtures and installations to the water or sewer or gas lines
> are done by a qualified plumbing contractor and meet the requirements
> of the Uniform Plumbing Code [(or your local plumbing
> code)]{.underline} or the National Fuel Gas Code (NFPA 54) [(or your
> local fuel gas code)]{.underline} .
>
> b\. Hot water for the Center is provided by a [(number of
> gallons)]{.underline} , gas fired (or electrical, solar powered) water
> heater. The water heater is properly installed in the water supply
> system and all drain lines and connections are in compliance with the
> Uniform Plumbing Code. The hot water temperature is tested in the
> children's lavatories [(frequency of testing, monthly, quarterly,
> annually)]{.underline} and is maintained at or below 120 Fahrenheit.
>
> c\. Drinking water for the children is provided by (dispensed from
> drinking fountains or by single-service cups) and is accessible to
> children while indoors or outdoors.
>
> d\. The Head Start Center water system has been tested for the
> presence of lead in the drinking water as recommended by the U.S.
> Environmental Protection Agency. The Center water is satisfactory for
> use. The Center Administrator maintains water-sampling results. (If
> your Center has not been inspected, then contact your Health Advisor
> for assistance.)
>
> e\. There will be no cross-connections that could permit contamination
> of the potable water supply.
>
> f\. All gas piping will be repaired by a licensed plumber or qualified
> gas plumbing repair contractor.

**VII.E Lighting Policy**

1\. **POLICY:** The Head Start Center will provide adequate lighting to
promote health and well being of the children and staff and to
facilitate safe activities and facilitate cleaning.

2\. **PROCEDURES:** In order to provide adequate lighting, the following
actions will be taken:

> a\. The Center Administrator has an emergency flashlight located in
> [(location of the flashlight)]{.underline} .
>
> b\. The following levels of illumination are provided on various
> surfaces:
>
> \(1\) Reading, painting, other close work areas: 50 -100 foot
> candles on the work surface
>
> \(2\) Working and play areas: 30-50 foot candles on surfaces
>
> \(3\) Sleeping and napping area: no more then 5-foot candles during
> sleeping/napping.
>
> c\. Glare free lighting is provided in all areas of the Center.
>
> d\. Lighting in the food preparation area will be at the level and
> shielded as required in the local food sanitation code.

**VIII. FOOD SERVICE PLAN**

**VIII.A General Food Sanitation Policy**

1\. **POLICY:** The Head Start Center will provide nutritious meals
prepared and served in a sanitary manner.

2\. **PROCEDURES:** Food sanitation surveys of the Head Start Center are
conducted by the Health Advisor using the [(cite the food sanitation
standards or code that the Center must comply with)]{.underline} .

> In order to ensure food provided at the Center is prepared and served
> in a sanitary manner, the following actions will be taken:
>
> a\. The Center Administrator will ensure that all of the Head Start
> Center staff follows good food sanitation practices while preparing,
> serving and handling food and food equipment.
>
> b\. The Teachers and staff of the Head Start Center will eat with the
> children and encourage family style meals.
>
> c\. The Center Administrator will ensure that while participating in
> family style meals, the children will not engage in food preparation
> of others or any activities that poses a risk of food contamination.
>
> d\. The Center Administrator will coordinate with the Health Advisor
> for the provision of food handlers training for the Head Start Center
> staff. The food handlers training should be provided within 3 months
> of the Center beginning annual operation.
>
> e\. The Center Administrator will provide basic food handling
> requirements to all new employees within 30 days of their employment
> at the Center. This training does not take the place of the food
> handlers training provided by the Health Advisor.

**VIII.B Infant Food Sanitation Policy**

1\. **POLICY:** The Head Start Center will feed infants only nutritious
and healthy food items that are stored and served in a sanitary manner.

2\. **PROCEDURES:** In order to ensure that infants are fed only healthy
foods that have been properly stored and that are served in a sanitary
manner, the following actions will be taken:

> a\. General Feeding
>
> \(1\) When parent/guardian provide infant foods, we ask the food be
> labeled with the child\'s name and dated.
>
> \(2\) No egg whites or honey will be given to infants less than 12
> months of age.
>
> \(3\) Before preparing formula or food, staff washes their hands and
> clean and disinfect preparation surfaces. a separate food preparation
> sink is provided, away from diaper changing/hand washing area.
>
> \(4\) We do not heat formula, breastmilk or baby food in a microwave
> oven because there is the possibility of a bottle exploding, or part
> of the liquid could get much hotter then other portions (called \"hot
> spots\"), which could result in burning a child\'s mouth. Microwaving
> also destroys the essential components in breastmilk.
>
> \(5\) a note from the child\'s health care provider will be required
> if an infant is to be on a limited food/formula intake, diluted
> formula, Pedialyte, or any type of elimination (allergy) diet.
>
> \(6\) Children will not be allowed to walk around with bottles.
>
> b\. Infants: Breastfeeding/Formula
>
> \(1\) Infants will be fed when they are hungry unless the
> parent/guardian specify, in writing, differently.
>
> \(2\) The staff will not overfeed infants. When feeding an infant we
> watch for cues to know when the infant has had enough. These cues
> include: infant no longer sucking on nipple, lengthy pauses or turning
> head away from the bottle.
>
> \(3\) The Head Start Center Program encourages the use of breastmilk
> for nursing infants. Breastmilk and formula are labeled with:
>
>  child\'s name
>
>  today\'s date
>
>  time of preparation
>
> \(4\) All breast milk and formula is refrigerated after mixing,
> feeding or immediately upon arrival at the center.
>
> \(5\) No medication will be added to breastmilk or formula.
>
> \(6\) Powdered formula in cans will be dated when opened and stored in
> a cool, dark place. If within one month after opening the powdered
> formula is not completely used, then the remaining powder will be
> discarded or sent home. This is done due to the number of times
> formula is opened, touched, etc. in a Head Start setting.
>
> \(7\) Bottles prepared at the center will be mixed as needed.
>
> \(8\) Used bottles and warmed, unused formula will be discarded 1 hour
> after preparation to prevent bacterial growth. Unconsumed portions of
> formula will not be re-heated for re-use. All unused prepared formula
> will be discarded at the end of each day.
>
> \(9\) Frozen breastmilk will be thawed overnight in a refrigerator and
> warmed in lukewarm water, just prior to feeding. Frozen breastmilk
> which has been stored for more than 3 months or that is not dated will
> not be accepted or will be discarded. Thawed breastmilk will be
> refrigerated and used within 3 hours. Thawed breastmilk will not be
> refrozen.
>
> \(10\) Bottles, nipples and other eating utensils cleaned at the
> Center will be washed with soap and water and boiled for 5 minutes or
> washed in a dishwater with water temperature of 150^0^F.
>
> \(11\) Infants will be held when being fed, until they are able to
> hold a bottle or drink from a cup. Bottles will not be propped while
> infant's sleep or are going to sleep.
>
> c\. Transitioning Foods:
>
> \(1\) Solids are discouraged before 4-6 months of age without health
> care provider consent, due to increased food allergy risks.
>
> \(2\) Chopped safe table foods are encouraged after 10 months of age.
>
> \(3\) Cups and spoons are encouraged around 9-10 months of age.
>
> \(4\) Whole milk is not recommended for children under 12 months of
> age. Whole milk is encouraged for children aged 12 months through 23
> months. Parent/guardian requesting 2% milk must do so in writing.
>
> \(5\) Bottle feeding will be discouraged after 18 months of age.

REVIEW AND APPROVAL

Our Head Start Program\'s Health Plan has been reviewed by the Health
Services Advisory Committee, the Head Start Program Health Coordinator,
and the Health Advisor.

Chairperson, Health Services Advisory Committee Date

Head Start Health Coordinator Date

Health Advisor Date

The Health Plan has been approved by the Parent Policy Committee:

Chairperson, Parent Policy Committee Date

( The center\'s actual policy needs to have the signature of Dr., RN, or
PA)

Original Date: Signed By:

Review Date: Signed By:

Review Date: Signed By: