Private Organization Accreditation

Lutheran Social Services of New England is a high-performing nonprofit organization. LSS is a powerful difference maker and go-to resource, driving ourselves to constantly anticipate futures that are different from the past. For 140 years, LSS has been caring for people in need in New England.


Catholic Charities, Diocese of Covington

Wm. R. (Bill) Jones, ACSW, MDiv, Chief Executive Officer

Catholic Charities in Covington has been COA accredited since 1996. Though the time spent in completing the self study and hosting the site visit can sometimes feel sometimes daunting, the rewards far outweigh the effort. In our agency, the self-study is a group process that involves every member of the staff from the CEO to the building maintenance staff.
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Early Childhood Education facilitates appropriate child development and ensures the health and safety of children in care.

CA-ECE 4: Health and Safety

The organization promotes and protects the health and safety of children and staff.

Note: Please see Facility Observation Checklist - Private, Public, Canadian for additional assistance with this standard.

Research Note: The research identifies health promotion as a key indicator of quality and a strong predictor of positive outcomes.

Rating Indicators
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice standards.
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted, however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations (CA-HR 6.02) and training (CA-TS 2.03); or
  • Active client participation occurs to a considerable extent.
Practice requires significant improvement, as noted in the ratings for the Practice standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • A number of client records are missing important information  or
  • Client participation is inconsistent; or
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing; or  
  • Two or more Fundamental Practice Standards received a rating of 3 or 4.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Cleaning and sanitation procedures
    • Bottle handling procedures
    • Infant sleep procedures to reduce risk of SIDS
    • Diaper changing procedures
    • Hand washing procedures
    • Child abuse and neglect reporting procedures
    • Procedures for reporting, responding to and recording health problems and accidents
    • Health policy/procedures provided to parents
    • Sample menus for meals and snacks
    • Agreement with a health facility or qualified medical professional
    • Documentation of professional installation, maintenance, and annual inspection of playground equipment
    • Documentation of monthly playground maintenance inspections
    • Copies of manufactures instructions for all playground equipment
    • Smoking policy
    • Interview:
      1. Program director
      2. Relevant staff
    • Review teaching staff files for:
      1. Documentation of health screening
      2. CPR and First Aid certification
    • Review children’s health records
    • Observe facility

  • FP
    CA-ECE 4.01

    A health record is maintained for each child that includes:

    1. verification of up-to-date, preventative screenings;
    2. evidence of up-to-date immunizations as required by applicable law or regulation;
    3. emergency contact information that is kept current and updated at least once a year;
    4. written parental authorization for emergency care;
    5. information about and consent forms related to relevant health information and needs, including medication permission forms, if applicable, updated at least annually; and
    6. information about and consent/authorization forms related to special needs, if applicable, updated at least annually.

    Interpretation: Emergency contact information includes the names of the family physician, clinic, or hospital to be used in emergencies.

  • FP
    CA-ECE 4.02

    All parents receive a written health policy and procedures that address:

    1. the process for determining whether or not the organization can handle a child’s specific health needs;
    2. attendance guidelines for sick children, including separation from other children; and
    3. procedures for notifying parents that their child may have been exposed to an infectious disease.

  • FP
    CA-ECE 4.03

    Child health problems and accidents, including changes in appearance or behaviour, are promptly recorded and reported to parents and administration, and follow-up is conducted as needed.

  • FP
    CA-ECE 4.04

    Procedures for regularly cleaning and sanitizing the classroom limit the spread of infection and include:

    1. daily cleaning of the facility;
    2. disinfecting bedding, beds, cots, cribs, and mats at least once a week and between use by different children;
    3. disinfecting toys and other materials at least weekly and immediately after use if items are placed in the child’s mouth; and
    4. the availability of properly labeled disinfectants, which are securely stored away from children at all times.

  • FP
    CA-ECE 4.05

    To limit the spread of infection, diaper changing areas:

    1. are separate from food preparation areas;
    2. have a posted copy of diaper changing procedures;
    3. utilize changing tables made of non-porous material; and
    4. include covered, plastic-lined, hands-free cans for the disposal of used diapers.

  • FP
    CA-ECE 4.06

    Diapering procedures meet nationally recognized guidelines for sanitary diapering practices, and include:

    1. that children are never to be left unattended on changing tables and that one hand must be on the child at all times;
    2. proper disposal of diapers and other contaminated items;
    3. proper use of gloves when they are offered to teaching staff;
    4. steps for gathering materials ahead of time;
    5. relevant hand-washing requirements; and
    6. steps for disinfecting the area after each use.

    Research Note: The 2nd Edition of Caring for Our Children, which is a joint partnership of the American Academy of Pediatrics, the American Public Health Association, and the National Resource Centre for Health and Safety in Child Care, offers detailed diaper changing procedures that organizations may find useful when developing their own diapering practices.

  • FP
    CA-ECE 4.07

    Hand washing areas are designed to promote safety and limit the spread of infection including:

    1. separating hand-washing sinks from food preparation sinks;
    2. installing shatter-proof mirrors;
    3. making hand washing sinks easily accessible to all children; and
    4. having liquid soap and sanitary methods for drying off hands available.

    Interpretation: Sanitary methods for drying off hands include disposable paper towels or electric dryers that turn on and off automatically.

  • FP
    CA-ECE 4.08

    Hand washing policies and procedures meet nationally recognized guidelines for hand washing and include:

    1. under what situations hands must be washed;
    2. requirements for water temperature, soap use, and time spent scrubbing and rinsing; and
    3. procedures for turning off water that reduce the risk of recontamination.

    Research Note: The 2nd Edition of Caring for Our Children, which is a joint partnership of the American Academy of Pediatrics, the American Public Health Association, and the National Resource Centre for Health and Safety in Child Care, has hand washing procedures that organizations may find useful when developing their own hand washing practices.

  • CA-ECE 4.09

    Teaching staff promote good health habits by: 

    1. modelling and providing developmentally-appropriate instruction on health and hygiene practices;
    2. serving nutritious meals and snacks; and
    3. providing opportunities for active play.

    Interpretation: Examples of health and hygiene practices include, but are not limited to:

    1. washing hands before and after eating;
    2. washing hands after using the bathroom;
    3. covering the nose and mouth when sneezing or coughing; and
    4. regular tooth brushing.

    Interpretation: Active play for infants may include “tummy time,” allowing infants to develop the muscles of their back and neck.

    Research Note: Research has shown that healthy eating habits and active lifestyles are established in infancy.

  • FP
    CA-ECE 4.10

    Children are protected from injuries, accidents, and illnesses through practices that ensure teaching staff: 

    1. follow universal precautions as well as diapering, hand washing, and sanitation procedures;
    2. notify parents in case of emergencies or when safety issues arise;
    3. are trained on emergency response procedures;
    4. train children in a developmentally and age-approrpiate manner on how to respond in case of emergency;
    5. identify and report suspected child abuse and neglect to prescribed authorities;
    6. have access to a telephone, emergency transportation, emergency numbers and first aid supplies both on- and off-site;
    7. are informed about children in their care with special medical needs or allergies; and
    8. are healthy and capable of performing the essential functions of the job with reasonable accommodation.

    Interpretation: While an annual physical examination is preferred, teaching staff may receive a general health screening performed by a qualified medical practitioner, provided the screening addresses communicable diseases, including tuberculosis when required by relevant health authorities.

  • FP
    CA-ECE 4.11

    The organization ensures that staff are available to respond in a medical emergency by guaranteeing:

    1. each classroom has at least one person present with current pediatric First Aid certification;
    2. one person with current Cardiopulmonary Resuscitation (CPR) certification is on site at all times the program is in operation; and
    3. individuals with First Aid and CPR certification are present on field trips away from the facility.

    Interpretation: First Aid and CPR certification must be kept up-to-date according to the guidelines established by the certification body.

  • CA-ECE 4.12

    A health facility or qualified medical professional is available to provide:

    1. medical consultation to the organization and parents;
    2. a review of children’s health needs; and
    3. a review of the organization’s health and safety practices.

    Interpretation: The intent of this standard is not to require that organizations pay for this service, but to ensure they have access to medical professionals as needed. Some organizations, particularly those that serve a higher risk population, might have medical professionals on staff; others will develop formal or informal relationships with medical professionals outside the organization to receive assistance when special health needs arise.

    Research Note: The literature identifies physical health as one predictor of future academic success. As such, organizations should consider each child’s physical health and well-being when making program decisions.

    Research Note: The literature identifies physical health as one predictor of future academic success. As such, organizations should consider each child’s physical health and well-being when making program decisions.

  • FP
    CA-ECE 4.13

    Bottles of breast milk and formula are:

    1. labeled with the child’s full name and the date that it was brought in;
    2. brought in daily and stored in a refrigerator upon arrival;
    3. discarded if the bottle is not finished in one feeding; and
    4. warmed in water and never in a microwave oven.

    Interpretation: Breast milk or formula should not stored overnight by the child care centre. Bottles that are unused at the end of the day should be sent home with the parent.

    NA The organization does not provide infant care.

  • FP
    CA-ECE 4.14

    Teaching staff take necessary precautions to reduce the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related infant deaths, including:

    1. placing infants on their backs for sleep unless otherwise instructed by the child’s doctor;
    2. placing infants on a firm sleep surface such as a safety-approved crib mattress with fitted sheet;
    3. removing soft materials or objects such as pillows, loose bedding, bumper pads, or toys from sleep areas;
    4. ensuring sleep spaces are free of strangulation hazards such as dangling cords, electric wires, and window-covering cords; and
    5. keeping the room at a comfortable temperature and dressing infants in appropriately for the environment. 

    Research Note: The Back to Sleep Campaign® reduces the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related causes of infant death by educating caregivers on safe sleep practices, and is a good resource for organizations looking for more information on SIDS prevention. The National Institute of Child Health and Human Development directs and maintains the Safe to Sleep campaign® in collaboration with the American Academy of Pediatrics, the Centers for Disease Control and Prevention, the Consumer Product Safety Commission, First Candle, and the Maternal and Child Health Bureau. 

    NA The organization does not provide infant care.

  • FP
    CA-ECE 4.15

    A safe environment is maintained through proper selection and maintenance of play equipment, including:

    1. indoor and outdoor playground equipment that meets national safety standards;
    2. installing equipment on an appropriate amount of impact absorbing surfaces;
    3. conducting daily inspections of playground equipment and the surrounding area;
    4. monthly maintenance inspections of playground equipment according to manufacturer’s instructions; and
    5. annual inspections of the play equipment by an appropriately certified individual.

    Interpretation: The amount of the impact absorbing surface will vary given the material used and the height of the playground equipment. Organizations should refer to industry standards and the manufacturer’s instructions for more detailed guidance on the proper depth of impact absorbing surfaces.

    Interpretation: The daily inspection of the playground should focus on the immediate identification of potentially hazardous conditions such as standing water, broken glass, or damage to the play equipment. Monthly maintenance inspections should check for worn or damaged wood, bolts, chains, anchors, etc. The organization should use a standardized checklist for monthly inspections and observations should be documented. While routine checks of playground equipment can be performed by trained staff, the inspection, and maintenance of playground equipment is highly technical and best performed annually by an industry professional.

  • FP
    CA-ECE 4.16

    Stairwells have railings and are closed off from child care classrooms.

    NA None of the organization’s ECE facilities have stairwells. 

  • CA-ECE 4.17

    The facility provides an optimal care and learning environment that is:

    1. clean;
    2. welcoming;
    3. well lit, with natural light where possible and emergency lighting throughout;
    4. maintained at a safe, comfortable temperature and noise level;
    5. odour free; and
    6. adequately ventilated.

  • FP
    CA-ECE 4.18

    Smoking is prohibited anywhere on the premises, including outside entrances, outdoor play areas and program vehicles.

  • FP
    CA-ECE 4.19

    Toys and other materials are child-proof, non-toxic, and maintained in good repair.

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