JGV 210

Health, Safety and

Nutrition
Week 3
Theme 2
The Health Policy

JGV 210: University of Pretoria

Learning outcomes
• Understand how the various components of the
health policy work together to maintain the health
and safety of the children and staff in an Early
Childhood Development (ECD) site
• Implement the different components of the health
policy in the ECD situation
 Introduction
• An ECD institution has the responsibility to ensure that a
safe environment for the children and staff is provided
• The rationale for the development and implementation of an
ECD health policy is to make sure that all the necessary
health and safety aspects are addressed in order to:
– Provide a safe and hygienic environment for an ECD
centre
– Promote healthy practices for the child, his family and
ECD practitioners at an ECD centre
 Components of a health policy
• Establish sections and subsections in A4 lever arch file
REMEMBER:
• Information will be affected by changes in:
– Current health
– Welfare and educational legislation
– Local customs and health beliefs
– Environment (of centre: rural / urban)
– Health resources and expertise available
THEREFORE:
• Revise and update regularly!
 1. Maintenance of indoor and outdoor
standards
• Ensure that ECD centre meets legislation and/or
guidelines regarding minimum space, design and
maintenance requirements
• Be familiar with Guidelines for Early Childhood
Development Centres (May 2006: Department of Social
Development)
• FILE: Attach current inspection reports
2. Admission policy
• From a health perspective, 3 aspects need to be considered
1. Adherence to Inclusion (DoE)
2. The following forms are completed by parent/guardian:
– Application/enrolment form
– History of child development and health
– Emergency contact information
– Consent forms
3. The following forms and records are kept:
– Attendance records
– Incident reports
– Parental and practitioner communication
– Immunisation records
– Medication records
– Any relevant assessment, health screening, therapy etc
– Information about chronic diseases
– Reports on interviews and discussions
 3.1 Water for drinking and food
preparation
• Water that does not come from municipal supply should be
made safe before it is used for:
– drinking
– preparing food
– washing eating utensils
• Sufficient water for emergency purposes should be stored
 3.2 Hand-washing policy
• Most important way of preventing disease
• Staff, volunteers and children should wash their hands:
– When arriving at school
– Before preparing food, bottles or feeding
– After changing a nappy or visiting the toilet
– After touching bodily fluids
– Before and after cleaning injuries or sores
– Before and after giving any medication
– After touching pets or other animals
– After outdoor play or whenever visibly dirty
– After doing any cleaning
– After removing gloves
 3.3 Glove policy
• Disposable gloves need to be available in
the following situations:
– For any contact with blood- or blood-stained bodily fluids
– When changing a child with diarrhoea, blood in stools or
oozing nappy rash
– When contact with blood is likely
– When cleaning surfaces have been contaminated with
blood
– When cleaning an area that is grossly contaminated with
bodily fluids
– When using cleaning materials that can damage skin
– When a staff member has open lesions on his/her hands
 3.4 Nappy changing
• A special area must be provided which is not close to any
areas where food is prepared or kept
• The surface should be waterproof, kept clean and have no
cracks or tears in it
• A nappy changing routine should be established where:
– The caregiver disinfects the area after use,
– Disposes of nappies hygienically
– Washes both her and
babies' hands after
 3.5 Toileting
• Children under 5 years or those that require assistance
should be accompanied by a supervised adult
• Child-sized toilet (or adapted adult-sized toilets) must be
provided
• Toilets/potties must be thoroughly cleaned and disinfected
in between toilet routines or whenever necessary
• Potties may only be used in the toilet area
• Sufficient toilet paper, soap and paper towels
should be available and within reach
 3.6 Non-sharing of personal items
• Staff and children should not share items like towels, face
cloths, toothbrushes or linen
• Each person must have his or her own items which are
clearly marked and regularly cleaned
 3.7 Cleaning routine for ECD centre
• Thorough cleaning of surfaces to reduce germs
• Cleaning duties must be allocated
• It is important to know who is responsible for cleaning and
how this should be done
• Care should be taken when using dangerous or poisonous
chemicals
• When surfaces are soiled by bodily fluids or infectious
material, they should first be cleaned with soap and water
to remove organic matter and then
disinfected
 3.8 Toys
• Toys which are ‘mouthed’ by children should be thoroughly
washed, disinfected and allowed to air dry
• This should be done every afternoon
• Toys that are not ‘mouthed’ should be cleaned regularly with
soap and water
• This should be done at least every 1 to 2 weeks
 3.9 Pets
• Any pets should be in good health, shows no signs of illness
and have a friendly disposition towards children
• Information regarding type of pet and restrictions of
keeping certain pets should be obtained
• Pet living areas should be kept clean, and waste should be
disposed
• Children must wash their hands after handling pets
• Teachers should be aware of children with
pet allergies, and parents should be made
aware of which pets are kept
 3.10 Plants
• All plants (indoor and outdoor) should be non-toxic
• Staff should remind the children that plants should not be
tasted, eaten or used in play
• Plant materials used for art or teaching purposes should be
non-poisonous
• In case of an emergency, the contact numbers of the
Poison Information Centre should be available and current
 3.11 Exposure to blood or blood-stained
or potentially infected body fluids
• Everyone at the ECD site should know how to deal with any
spills and all the materials needed to clean up should be
available

UNIVERSAL PRECAUTIONS FOR USE IN SCHOOLS

• All blood, blood products and blood-stained bodily fluids must be regarded
as potentially infectious. NB: This does not apply to faeces, nasal secretions,
sputum, sweat, tears, urine and vomitus unless they contain visible blood.
• Everybody must use every possible method to prevent direct contact with
blood or blood contaminated fluids (e.g., By using gloves or waterproof
plastic bags).
• Injuries on the hands of adults and children should be covered by
waterproof plasters.
• Thorough hand washing must be done after the gloves are removed or after
any accidental blood contact.
 3.12 Disposal of contaminated items
• It should be arranged for daily removal with local authority
if disposable nappies are used
• All indoor dustbins should have lids and should be lined with
plastic bags
 3.13 Pest control
• NEVER done when children are present and should be
arranged for holiday periods or weekends
 4.1 Provision for insurance for staff,
children, building and equipment
• Maintenance of sufficient insurance for:
– the replacement of equipment,
– the building, and
– accidental injury to children or staff
• Advice from a reputable insurance broker
 4.2 Criteria for safe selection of toys
and play materials
• Toys should be developmentally appropriate for the children using
them
• Baby toys should not be smaller than 5mm in diameter to prevent
choking
• All toys should be made from non-toxic material
• No toys should have sharp edges or splinters. Wooden toys should be
sanded smoothly
• Excessively noisy toys should be avoided as they can damage hearing
• No projectile, battery operated or mechanical toys, which are
dangerous to young children, should be allowed
• Toys should be durable and easy to clean
• Toys should have no dangerous, small removable parts
• Hinged toys should be designed so they do not crush fingers
• Soft toys should be securely stitched and seams regularly checked
• Pulling toys should have strings or cords no longer than 25cm to
prevent strangulation
• Paint used on toys should be lead free
 4.3 Safe positioning and maintenance
of equipment
a) Climbing equipment:
• Not too high (safe height is child’s height)
• Not placed close to a perimeter or fence
• Securely anchored in the ground and
• Metal equipment should be placed in the shade
• Have an impact-absorbing surface (loose sand) should be under
equipment (depth of at least 50cm)
b) Slides:
• Securely anchored in the ground
• Have built-up sides
• Have a long run off area at the base which is parallel to the
ground
• Have a guard rail at the ladder (rungs should be evenly spaced)
 4.3 Safe positioning and maintenance
of equipment cont.
c) Swings:
• Securely anchored in the ground
• Have back support for children under 6 years
• Have drainage holes on tyre swings
• Have a visual and physical barrier to prevent children from running in
front of it whilst moving
• Have sand or a rubber mat under for protection
d) Sandpit:
• Placed in the shade or have a roof for sun protection
• A wide outer ledge to prevent sand being lost
• Sand depth should be at least 40cm and should have suitable drainage
• Washed and sterilised river sand and replaced when contaminated
• Regularly disinfected with coarse salt and dug over to expose it to sun
• Covered at night to prevent contamination by animal faeces
 4.3 Safe positioning and maintenance
of equipment cont.
e) Water tables:
• Emptied or covered when not in use
• Supervised by an adult
• Plastic aprons should be provided to protect
clothing
• Children with injuries to their hands should not be allowed to play
in communal water containers
f) Wheeled toys:
• a separate smooth area should be provided
• All moving parts should be oiled often

• All of the above should be checked regularly for wear and tear
 4.4 Provision for children with special
needs
• Ramps and wide doorways are provided if wheelchair access is
necessary
 4.5 Rules for the safe use of equipment
• Constantly enforced
a) Climbing equipment:
• Children should not be allowed on climbing equipment if it is wet or
slippery
• They must hold on with both hands and not be carrying/holding
anything
• No wearing of gloves, long scarves, loose clothes, sandals or hard-
soled shoes
• Only a few children at one time
• No pushing or fighting
b) Slides:
• One at a time sitting up and facing forward
• Use the ladder
• Should not hold the sides when sliding
• Move away from the bottom when they are finished sliding
4.5 Rules for the safe use of equipment
cont.
c) Swings:
• One at a time
• No standing and holding with both hands
• Only climb off when the swing has stopped
• Only adults allowed to push swings
d) Sandpit:
• No food or breakable items
• No throwing sand
e) Wheeled toys:
• No loose clothing
• No bumping or speeding
• Used in demarcated area
 4.6 Regular safety checks
• Ensure that the children are protected at all times against hazards
from electricity, sharp objects, choking, poisoning, drowning and
burns
• A roster should be drawn up and should specify the following:
– Who will check the toys and equipment for safety
– How often safety checks will be done
– What procedure will be followed when broken toys or faulty
equipment is identified
 4.6 Safety checklist
• The best method is to develop a safety checklist to be used on a
monthly basis for every area
• Make provision for:
– Area
– Aspect being checked
– When the check was done
– By whom the check was done
– Any problems found
– What was done about the problem
– When the repair was done
 4.7 Review of injury/incident reports
• Whenever injury/incident occurs, 3 copies of an injury report
should be completed
1. For parents
2. For child’s file
3. For safety file (to be reviewed to identify and correct problems)

SEE Incident Report Form on pg 245 (pg 215 Marotz)

Meier, C & Marias, P. 2008. Education Management in Early
Childhood Development. Van Schaik. Pretoria
 4.8 Protecting children from
environmental health hazards
• Most NB is sun damage
• Protect children by:
– Limiting the time children spend outside during the hottest
part of the day (11h00 – 15h00)
– Provide adequate shading (trees, shade-net or umbrellas)
– Ensure that children wear sunscreen,
protective clothing and hats when
playing outdoors
 5. Supervision
• Children must be supervised within sight and hearing at all times
• To do this, one should ensure the following:
• Appropriate adult:child ratio
– 1:4/6 (babies)
– 1:6/8 (toddlers)
– 1:15 (3 years)
– 1:20/25 (4-6 years)
• Adequate supervision during outdoor play
– Roster of what area, when and who will supervise
• Adequate supervision during outings
• 1:5 (over the age of 4)
 6. Child health services
• What routine health services are provided in the community?
• Obtain written parental permission BEFORE making use of any of
these services
• Immunisation is parent’s responsibility
 7.1 Exclusion of ill children
• Children should stay at home if illness:
– poses a significant risk to others
– prevents them from participating in normal activities
– requires more care from staff than they are able to provide
 7.2 Managing children who become
sick while at the ECD centre
• Inform the parent/guardian
• Written record must be made (symptoms and treatment in
agreement with parent)
• The child should rest in a quiet place until they are fetched
• If you suspect infectious illness, separate child from the group
• No sick child should be left alone
 8. Medication policy
• When parents send medicine to school,
ensure the following:
– Medicine must be personally handed to the teacher by the
parent
– It must be prescribed by a medical doctor
– It must be supplied in a container with a chemist’s label
giving clear instructions regarding dosage, administration, the
child’s first and last name, the prescribing doctors name, the
date of the prescription, the expiry date of the medication
and any special storage instructions
– Parents must fill in and sign the medication book, giving full
details of the above
• In addition, decide who will administer the medication and
where it will be stored
 9. Emergency plan
• Develop an emergency plan in case of an unforeseen event
including:
• Contact numbers of emergency services
• Emergency contact numbers for staff and children
• Qualified staff who are able to give first-aid treatment
• First-aid kit
 9. Disaster plan
• Evacuation plan which is known by all staff
• List of contact numbers of emergency services
• Knowing who is responsible for contacting emergency services
• Practicing evacuation procedures regularly (drills)
• Familiarising all staff with various tasks that are required
• Knowing which children are absent each day
• Having a list of children with health conditions which require
specific care
• Having at least 2/3 exits
 10. Outings and transportation
• Ensure the following:
• Vehicles are safely maintained
• Proper seat restraints
• The driver is reliable and has a valid license
• The vehicle and accident insurance is up-to-date
• The route and destination have been planned for safety
• The safety procedures for arrival/departure have been planned
• That there are adequate staff:child ratios for transportation
supervision
• That the procedure for coping with health and emergencies is
planned
• That any child going on the outing has a signed permission form
from parents/guardians
 11. Food preparation
• Necessary facilities and equipment for:
– Safe storage
– Preparation
– Serving
• All surfaces, appliances, furniture and equipment
must be cleaned regularly
 12. Staff health policies
• Current SA labour legislation (sick leave, maternity leave etc)
– Train all new staff in applicable health procedures such as:
– Hygiene techniques
– Food-handling and food preparation techniques
– Recognition of illness
– Handling of special needs of individuals
– Appropriate first aid
 13. Health policy review
• Copies of the current policy should be available to staff and
parents
• New parents/staff should sign that they have read, understood
and agreed to abide by the policy
• The policy should be regularly reviewed by health professionals
 14.1 Maintenance of parking area
• Ideal to have undercover parking for staff and safe, ample
parking for parents and visitors
• The surface should be paved, tarred or cemented
• Any breaking or holes in surface must be repaired
• Area must be checked for sharp objects, broken glass etc
• Parking spaces (a little wider than usual to accommodate children
getting into and out of cars) should be demarcated
 14.2 Maintenance of the fence
• A wire or palisade fence is preferable
• Fences are a safety measure and should be inspected day-to-day
• Should be painted regularly to stay free from rust and look neat
• The bell and locks should be in perfect working order
• Change the locks or passwords every now and then
 14.3 Maintenance of the garden
• Forms part of the learning environment and should be maintained
• Trees and shrubs should be checked for protruding branches
• Pests should be controlled using organic measures
• Poisons and fertilisers should be used when children are not there
 14.4 Maintenance of swings, jungle
gyms and sandpits
• Must be maintained and kept clean at all times
• Ropes, chains, screws, connections and beams checked everyday
• Fall areas checked everyday
• Painted with lead-free paint
 14.5 Maintenance of the building
• Check the following:
• Roof (leaks or broken tiles)
• Interior walls (clean or paint)
• Tiles (replace loose or broken ones)
• Carpets (spots or stains cleaned)
• Toilets (check for leaking or blocked)
• Taps (repair drips)
• Dustbins (disinfect daily)
• Tables and chairs (clean and paint)
• Sinks and wash basins (check blockages and disinfect)
• Windows (replace cracked panes and install safety glass in sliding doors)
• Electric wires, plugs, appliances
• Door locks (check for tampering)
• Pest control (twice a year)
• Mattresses and blankets (replace or clean)
• Kitchen (check appliances)
• Light bulbs (relace blown ones)
• Damp (repair)
• Doors (fix squeaking, sticking, handles)
• Walls (fix holes)
• Gutters (clean regularly)
• Sprinkler (check sprayers)