Several million children throughout the United States are placed within the responsibility of child care facilities. O’Connor and colleagues surveyed licensed child care facilities to identify the safety hazzards present in these settings and the injury prevention practices being used.

A random sample of 130 child care facilities was studied. Facility representatives were interviewed by telephone about the presence of hazards that might contribute to burns, falls, suffocation and poisoning, as well as the extent of safety training and practices of the child care staff.

The survey results showed that these facilities had a significant prevalence of avoidable hazards. Most providers surveyed did not know the temperature setting of their hot-water heater. Among those who did, 27 percent stated that it was over 54.4[degrees]C (130[degrees]F. Tap water scalds can be prevented if hot-water thermostats are kept at 48.9[degrees]C (120[degrees]F). Although unguarded heat sources area a potential hazard to children, 14 percent of providers reported that space heaters were accessible to children.

More than 60 percent of providers reported that their facility did not have impact-absorbing surfaces under outdoor playground equipment. One-third of facilities with stairs accessible to children did not have safety gates. In centers caring for children younger than age three, 17 percent did not have safety straps on highchairs or infant seats.

Nearly two-thirds of child care facilities had regular staff meetings. Of those that had meetings, 75 percent included injury prevention strategies as a topic of discussion. About 44 percent of providers could not locate and report the local poison control center telephone number during the interview. However, 80 percent could easily locate and report the local ambulance number. More than half reported that they had syrup of ipecac on the premises. In half of these cases, the provider could demonstrate possession of the syrup by reading the bottle’s expiration date; one-third of the bottles had passed the expiration date.

The findings demonstrate that many child care facilities not only have several specific safety hazards but also have a lack of knowledge and skill regarding injury prevention. The authors recommend that child care providers and parents of young children be counseled on injury prevention.