Assessing Indiana's Health and Safety in early care and education programs: identifying areas for improvement

The objective of this study is to describe the key National Health and Safety Standards (NHS) met in early care and education (ECE) programs in Indiana and to establish reliability for the Indiana Health and Safety Checklist. The Indiana Health and Safety Checklist, modified from the California Childcare Health Program's Health and Safety Checklist, includes 87 items and 11 subscales. It was completed in 2 h by trained child care health consultants in 82 ECE programs to assess the number of key NHS met. The 82 ECE programs met the majority of NHS items. Thirteen items were not met in more than 50% of the programs. The items with the lowest compliance were emergency food supplies, children's hand washing, special health care plans, cleaning and sanitizing counters, and impact surfaces under playground equipment. The Indiana Health and Safety Checklist had moderate internal reliability for 6 of the 9 subscales analyzed. ECE programs strive to provide high quality care and the programs met the majority of NHS on the checklist. The Checklist is a reliable instrument that helped identify health and safety gaps and thus, identified the targeted interventions for child care health consultation.