N O R T H C A R O L I N A

W arm weather is here and with it comes that annual rite,Spring-Cleaning! What better

time to focus on sanitation issues in childcare? Children’s health and developmentare influenced by everything in theirenvironment, including the air theybreathe, the water they drink and thesurfaces they touch. It’s no wondersanitation topics range from hand-washing procedures to air quality, andfrom plumbing connections to leadexposure prevention. Sanitationguidelines were created to promotewellness and healthy child development,to prevent accidents, and stop the spreadof infectious disease. EnvironmentalHealth Specialists inspect child carefacilities twice a year to help programsmaintain healthy environments.Children come in contact with disease-causing germs every day. These germsare on toys, tables, rugs and furniture.Children’s immune systems areimmature, making it more difficult forthem to fight off disease. Children inchild care are exposed to many moregerms than children cared for at homeand contract diseases twice as often.Their parents lose an average of 13workdays every year in order to care for them. Five of those days are due to illnesses that cause diarrhea, anespecially difficult condition to managein the child care setting.Sanitation procedures are designed tokill or reduce disease-causing germs.Viruses cause CMV, flu, respiratoryillness, and Hepatitis A. Bacterialinfections cause illnesses such as strepthroat and meningitis. Infections alsoresult from parasites like pinworms orlice, or by funguses such as ringworm.Often illnesses are transmitted byexposure to bodily fluids. Followingrecommended sanitation procedures,such as handwashing, sanitizing anddiapering, helps reduce the spread ofcommunicable diseases and conditions.

Reducing exposure to environmentaltoxins is another major health concern.Children’s small, developing bodies areespecially vulnerable to damagingtoxins. Lead is particularly harmful tochildren because it interferes withhealthy growth and brain development.Mercury, pesticides and arsenic areairborne poisons found in higherconcentrations close to the groundwhere children breathe and play.Environmental Health Specialists fromthe local health department can identifyenvironmental toxins and help programsreduce or remove them from the childcare setting. Sanitation guidelines alsoaddress environmental triggers forasthma. Common culprits are tobaccosmoke, mold, dust mites, and cockroach-es. Children in child care must be cared for in smoke free environments.Controlling other common asthmatriggers may require changes to theenvironment. Molds grow in wet dampplaces and can be harmful. Repairingplumbing leaks and water-damagedsurfaces helps keep molds from growing.Frequent vacuuming reduces dust mites.Controlling cockroaches may require an exterminator. Creating an asthmafriendly environment increases thelikelihood that children with asthma will stay healthy and be able toparticipate in daily activities.Best practice sanitation recommenda-tions can be found in Caring for OurChildren and the NC requirements arefound in the NC Sanitation Rules. Both are available at our web site:http://www.healthychildcarenc.org

The NC Child Care Health and SafetyResource Center is a project of theDepartment of Maternal and ChildHealth, School of Public Health, TheUniversity of North Carolina at ChapelHill. Funding for the Resource Centeroriginates with the Maternal and Child Health Title V Block Grant ofUSDHHS’s Health Resources andServices Administration/Maternal andChild Health Bureau, awarded to theUniversity under a contract from theDivision of Public Health, NCDHHS.

The development, translating, printing,web posting and mailing of the Health andSafety Bulletin are supported by fundingfrom the Child Care and DevelopmentFund Block Grant of the Child CareBureau, Administration on Children and Families, USDHHS, through acontract between the Division of ChildDevelopment, NCDHHS, and theDepartment of Maternal and ChildHealth, School of Public Health, The University of North Carolina at Chapel Hill.

1 Sanitation and Health:Making the Connection

2 Cleaning and Sanitizing

2 Keep It Clean

3 Did You Know...

3 Water Outdoors

4 Buckle Up America Week

4 Announcements/Health Observances

5-6 Parent Pages – Healthy Homes

7 Spick and Span Spring

8 Ask the Resource Center

In This Issue

About TheResource Center

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CHILD CARE HEALTH AND SAFETY BULLETIN

NORTH CAROLINA CHILD CARE HEALTH AND SAFET Y RESOURCE CENTER

Sanitation and Health:Making the Connection

References on Page 6

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2 • HEALTH AND SAFETY BULLETIN • APRIL-MAY 2004

Cleaning and Sanitizing: What’s thedifference and how are they done?

Sometimes in child care the terms “cleaning”, “sanitizing”, and “disinfecting”are used interchangeably. But are they all the same? These terms mean verydifferent things and involve distinctly different solutions. Child care providers need to know the differences to apply the appropriate technique for the circumstance.

Cleaning involves scrubbing, washing and rinsing to remove visible soil and debris. The cleaning solution used is made up of detergent and water.Sanitizing is covering the cleaned area with a sanitizing solution such as bleach and water. The best practice recommendation is to leave thesanitizing solution on the surface for a minimum of 2 minutes beforewiping it dry. It can also be left to air dry. This will kill and clean away enough germs so that it would be unlikely that someone could become ill from contacting that surface.Cleaning and sanitizing cannot be done at the same time. Clean, Rinse,then Sanitize to reduce the spread of diarrhea and other communicableillnesses.Disinfecting is covering an already cleaned area with a disinfecting agentthat is non-toxic for children, such as a stronger bleach and water solution.This kills all of the germs on a surface. Best practice recommends leaving thedisinfecting solution on the surface for a minimum of 2 minutes or leavingit to air dry. This practice is used for body fluid spills to eliminate thespread of bloodborne illnesses such as Hepatitis B and HIV.The following are bleach solution concentrations listed by source.Remember that child care centers must at least meet the requirements ofNC Sanitation of Child Care Centers. Family Child Care Homes areencouraged to follow these guidelines.

Bleach Solution Tips• Assign responsibility for mixing a

bleach solution.• Set up a specific location for

mixing the bleach solution.• Keep the bleach solution out of

reach of children.• Keep the bleach out of direct

sunlight to preserve theeffectiveness of the chlorine.

• Mix a fresh bleach solution daily. • Use caution in mixing the bleach

solution. If bleach is mixed withother cleaners/ chemicalshazardous gases may be released.

• NC Sanitation Rule .2819 ( c )requires that a suitable test or kitbe used daily to test the strengthof bleach solutions.

• Label the sanitizing solution spray bottle with a “B” for bleach.

AnnouncingKeep It Clean!

Keep It Clean is an interactive trainingmodule providing a fresh, engagingand enlightening approach to thetopics of handwashing, diaperchanging and food preparation. Itbrings together highly recommendedactivities, games and experimentsfrom CCHCs across the state andwas designed with the child careprofessional in mind. A fun factor is built in to Keep It Clean to makelearning these critical skills easy andenjoyable. Reducing the spread ofinfectious diseases keeps everyonehealthier in child care.These research proven methods weredeveloped and tested by the QualityEnhancement Project for Infants andToddlers (QEP) and they work!Child care providers trained in Keep It Clean improved theirhandwashing, diaper changing andfood preparation behaviors to theextent that their scores on healthand safety items on the EnvironmentRating Scales showed improvements.To locate a CCHC who can providethis training in your area, or to get moreinformation about the training, call theResource Center, 1-800-367-2229.

Source Classroom Manual Toileting and Universalof Standard Surfaces Dishwashing Diapering Precautions

or Regulation (tables, toys, (dishes, utensils) (surfaces, toilets) (body fluid spills)water play)

CFOC 1/4 c. bleach 1 TB bleach: 1/4 c. bleach: 1/4 c. bleach:National Health 1 gallon water 1 gallon water 1 gallon water 1 gallon water

and Safety (1 TB bleach: Dishes: 1 1/2 tsp (1 TB bleach: (1 TB bleach:Performance 1 quart water) bleach: 1 gallon 1 quart water) 1 quart water)

Standards Appendix I water. Standard 3.015 Standard 3.026 Standard 4.065 Appendix I Appendix I & J

NC Sanitation of 1 1/2 tsp bleach: 1 1/2 tsp bleach: 1 TB bleach:Child Care 1 gallon water 1 gallon water 1 gallon water

Centers 50 parts per million 50 ppm 100 ppm N/A.2822 & .2812 2812 (B) .2817, .2818 &

15A NCAC 18 A .2819

OSHA Standards 1/4 - 1 1/2 c. bleach:

1 gallon waterUS Dept. of Labor *depending on the

Occupational size of spill*Safety and Health Bloodborne

Administration PathogenStandard

1910.1030(d)(4)

APRIL-MAY 2004 • HEALTH AND SAFETY BULLETIN • 3

Did You Know:• White-out or correction fluid

is toxic and must be kept in alocked container or roomwhen not in use and out of thereach of children when it isbeing used. Always read labelsto determine if a product must be kept out of reach of children.

• Push pins, tacks and staplesthat find their way to the floorand into the hands of youngchildren become choking andinjury hazards. Choose analternative method for postinginformation and displays forparents, staff and children.

• Every medication must be keptlocked up except when it isbeing given out.

• Many common indoor plantsare poisonous – know thetypes of plants in your facility.www.ces.ncsu.edu/depts/hort/consumer/poison/poison.htmincludes a comprehensive listof poisonous plants in NC.

A Caution

About

Crock Pots

Manufacturers of Crock Potsdo not recommend using themto warm infant bottles. Thewarm temperature of mostcrock pots is 140-160º F andthe liquid temperature mayreach 200ºF. The NationalHealth and Safety PerformanceStandard 4.018 recommendsthat the water temperature of aslow-cooking device like aCrock Pot, not exceed 120ºFand that the container beemptied, sanitized and refilledwith fresh water daily. Thesafest method for warminginfant bottles, human milk orformula, is to place them underwarm running water.

Managing Water OutdoorsEnvironmental health inspectors and DCD licensing consultants look for avariety of health and safety hazards when they visit a child care center.Water provides children with wonderful learning experiences; water alsocreates a potential safety hazard.Hazardous water situations• Standing water can be a drowning hazard. Children can drown in as

little as one inch of water. • Even a tiny amount of standing water can be a breeding ground for

mosquitoes, which can carry diseases such as West Nile virus. A newgeneration of mosquitoes can be up and biting in just 7 days.

• Germs breed readily in the warm, moist environment created by standing water.

Standing water can accumulate on the ground, in gutters, planters, sandtoys, water tables, or sandbox covers. Eliminate all standing water toreduce water hazards.

Safe water experiences. Because children often put waterin their mouths, always use drinking water, or “potablewater” for all water play activities. Rainwater, orrunoff from roofs or other surfaces could becontaminated with chemicals or otherunknown substances.

Water feels cool and soothing to warm skin onhot summer days and provides children withnew opportunities for tactile stimulation. Waterplay also provides opportunities for children tomeasure, pour, squirt, and blow bubbles. Give childrencups of various sizes and shapes, funnels, watering cans, dishpans, buckets,and toys that sink and float.

Safe use of water tables/bins. Water play is often offered outdoors,where children can splash freely without worrying about making a mess. If water tables are stored outdoors they should be covered. Clean andsanitize water tables or individual water bins before filling with potablewater. To prevent the spread of germs children should wash their handsbefore and after water play. Children with runny noses, diarrhea, skinrashes or open sores should use individual water bins rather than sharewith other children. Clean and sanitize water tables after each use.

Safe use of flowing water systems. Water systems may be a series ofwater troughs with waterfalls, or a manmade “creek”. Pumps, hoses or othersystems are used to supply flowing potable water. Direct flowing waterinto a drain to prevent standing water from accumulating, or send thewater to your flower or vegetable garden. Watering thirsty plants teacheschildren to value water and not be wasteful. Flowing water systems are lesslikely to spread germs or pose a drowning hazard because the water doesnot accumulate.

Sprinkler water systems can be as simple as connecting a clean sturdyhose to a sprinkler head on a grassy lawn. Using multiple sprinklers withunique and varied methods of delivering the water can create a morecomplex “Water Park”. Install water systems over non-skid, rubberizedsurfaces to protect children from falls. Because sprinkler systems do not collect water they pose no risk of drowning and little threat ofspreading germs.

4 • HEALTH AND SAFETY BULLETIN • APRIL-MAY 2004

Arsenic Treated Wood AlertAs of December 31, 2003, arsenic (CCA – chromated copper arsenate)will no longer be used in treating wood. Arsenic can be released fromCCA treated wood and exposure to arsenic can result in health risks tochildren. You can protect children by sealing the wood every 1-2 yearswith a weather-resistant coating such as an oil-based stain sealant.More information on public health recommendations can be found athttp://www.epi.state.nc.us/epi/oii/cca.html or by calling Dr. LuanneWilliams at 919-715-6429.

Don’t Forget!Week of the Young Child • April 18th – 24th

“Children’s Opportunities – Our Responsibilities”go to www.naeyc.org for celebration guide and resource materials

DCD Child Care Rules Changes Effective May 1st

For a summary of the changes go to www.ncchildcare.net.

1-800-367-2229North Carolina Child Care Health & Safety Resource CenterProviding Training, Consultation & Resources for North Carolina’s Child Care Community

Buckle Up America WeekBegins May 24th

Nearly one out of every two parentsfails to restrain their infant or toddlerproperly in the car! When a crashoccurs only 30% of infants and 60%of toddlers are protected by the restraints.The “best” car safety seat is the onethat fits the child, is installedcorrectly, and will be used every timethe child rides in a vehicle.Car Seat Safety Rules to follow:• “No car seat, no travel.”• Buckle Up, Then Ride – it’s

the law!• Use a safe car seat: one that is less

than 5 years old, has a knownhistory, and has all its parts,instructions and labels.

• Follow manufacturers’ directions forproper installation.

• Use the right size car seat: checkrecommendations for height and weight.

• Infants under 12 months and less than 20 lbs. MUST be in a rear-facing seat.

• BACK seats are the BEST seats:Children under 12 should ride inthe back seat.

• Check to see if your car seat hasbeen recalled: call the Auto SafetyHot Line at 888-DASH-2-DOT(888-327-4236) and give themthe name of manufacturer, modelname and #, and date made.

April isNational Autism Awareness Month

National Youth Sports Safety MonthNational Child Abuse Prevention Month

Public Health MonthApril 7 World Health Day

April 18 – 24 Week of the Young ChildApril 26 – 30 Playground Safety Week

April 25 – May 1 Infant Immunization Week

May is Asthma and Allergy Awareness Month

Child Passenger Safety Month Bicycle Safety MonthMental Health Month

Skin Cancer Awareness MonthHealthy Vision Month

May 1– 8 Safe Kids WeekMay 10 – 16 Food Allergy Awareness Week

May 1 Worthy Wage DayMay 4 Childhood Depression Awareness Day

May 5 Children’s Day, Cinco de MayoMay 7 National Child Care Provider Appreciation Day

May 15 International Day of FamiliesMay 31 World No Tobacco Day/ Kick Butts Day

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Healthy HomesProviding children with a safe and healthy home is a top priority for most parents. Childproofingchecklists are long, but when completed allow us tobreathe a sigh of relief knowing we have done ourbest to keep our children safe. One aspect of this“childproofing” involves environmental health. Theair we breathe and the water we drink have anenormous impact on health, especially on thehealth of young children who are particularlyvulnerable to conditions in the environment.

Indoor Air Quality

Most people spend over 90% of their time indoors.Keeping indoor air free from too many pollutantswill help keep children healthy. Indoor airpollutants come from a number of sources includingcleaners, molds, pets, pesticides, and smoke.

Providing a smoke free home for children canprotect them from the harmful effects of second-hand smoke. Secondhand smoke is the smokegiven off by the burning end of a cigarette, pipe, orcigar, as well as the smoke exhaled from the lungsof smokers. Exposure to secondhand smoke, alsocalled passive smoking, can cause lung cancer innonsmokers and is a serious health risk to children.Infants and young children whose parents smokeare among the most seriously affected. Childrenexposed to secondhand smoke are at increased riskfor lower respiratory tract infections such aspneumonia, are more likely to have reduced lungfunction and symptoms of respiratory irritation suchas cough, excess phlegm (thick mucus) andwheezing. Passive smoking can also lead to a

buildup of fluid in the middle ear, and causeirritation of the eye, nose, and throat.

To reduce the health risks of passive smoking, don’t allow smoking in your house and don’t smokeany time children are present. Do not allow baby-sitters or others who work in your home to smoke in the house or near your children.Asthmatic children are especially at risk. Smoking,pets in the home, and damp basements can alsoaffect indoor air quality and may cause or add tobreathing problems.

Mold and Moisture

Damp houses provide an environment thatencourages the growth of mold. Molds may bevery harmful and some may increase the severity ofcertain allergy and asthma symptoms.

Carbon Monoxide

Carbon monoxide is a deadly gas that cannot beseen or smelled. It can come from your stove,heater, or other appliances if they are not workingcorrectly. Have your appliances serviced regularlyand get a carbon monoxide detector to help preventexposure to dangerous levels of carbon monoxide.

Lead

Lead can poison children if it gets in their mouthsor if they breathe it in from the air. Lead is foundin some paints and sometimes in water pipes. Someolder vinyl mini-blinds as well as older painted toysand furniture can also be lead hazards. Leadpoisoning can be very serious for young children,sometimes causing lifelong problems with learning, growth and behavior. Have your home professionally tested for lead since manyhome test kits do not adequately distinguishbetween high and low levels of lead. Local health departments often provide assistance withidentifying and managing lead problems in homes.

Call the Resource Center, 1-800-367-2229, for thebrochure Lead Poisoning and Your Child. Available inSpanish and English.

P a r e n t

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Drinking Water

If your water comes from a private well, test it everyyear to make sure it is safe. Water

from a water company or utility istested before it is piped into yourhome, however, it is important

that your pipes are in goodcondition, since lead pipes and lead solder can contaminatedrinking water.

Hazardous Household Products

Many commonly used household products can beharmful or poisonous. Medications, paint thinners,bleach, rat poison, and drain cleaners are allpotentially dangerous. Make sure allhazardous products are stored safelyby locking them in a closet, cabinet orother secure location, definitely out ofchildren’s reach and out of children’ssight. Always read labels and when possible chooseless toxic or non-toxic products. Learn AboutChemicals Around Your House is available at the Environmental Protection Agency web site:www.epa.gov/kidshometour/.

Pesticides

Bug spray, rat poison, andgarden weed killer are alltypes of pesticides and arefound in almost every household.The chemicals that kill pests arealso harmful to you and yourfamily. Storage and alternativeapproaches to dealing with pestproblems will help preventchildren from being exposed.

More information about pesticidesis available at: www.epa.gov/pesticides/about/faqs.htm.

Home Safety

Your chances of getting hurt at home are muchhigher than they are at work or school. The leading causes of death in the home are from falls,drowning, fires, poisoning, suffocation, choking, andguns. Very young children and older adults are themost likely to get hurt at home. Help protectchildren from hazards by storing items safely andpreventing access to hazardous areas. Make sureplants in the home and yard are not poisonous or cannot be accessed by a child.

Information is available at the NC Poison Centerweb site: http://www.ncpoisoncenter.org/index.cfm.

Poison Control – 1-800-222-1222

Outdoor Safety

Make sure that outdoor playequipment meets recommendedsafety standards. If play equipmentis being constructed, refer to theConsumer Product SafetyCommission (www.cpsc.gov) and ASTM(www.astm.org) for guidance on safety. If wood isused for construction, do not use arsenic treatedwood (CCA – chromated copper arsenate). Ifarsenic treated wood is in existing structures such asdecks, picnic tables, landscaping timbers, gazebos,fencing, patios, walkways, and play equipment, sealthe wood with an oil-based, semi-transparent stainsealant every 1 – 2 years. Do not use arsenic treatedwood in or near a vegetable garden.

For more information on making your home healthy,go to www.uwex.edu/healthyhome/topics.html for a widerange of links to specific topics.

References:

Division of Cooperative Extension of the University ofWisconsin-Extension (2002).

Help Yourself to a Healthier Home. retrieved 2/27/04 fromhttp://www.uwex.edu/healthyhome/topics.html.

U.S. Environmental Protection Agency, EPA DocumentNumber 402-F-93-004, July 1993. Retrieved 2/27/04 from

http://www.epa.gov/iaq/pubs/etsbro.html

6 • HEALTH AND SAFETY BULLETIN • APRIL-MAY 2004

Sanitation and Health, page 1, References:

Committee on Environmental Health. Pediatric EnvironmentalHealth, 2nd edition. American Academy of Pediatrics, 2003.

Young, Frank, MD, PHD. In Day-Care Centers, Cleanliness Is aMust, US Food and Drug Administration, FDA Consumer,

January 2003 http://vm.cfsan.fda.gov/~dms/wh-dcare.html.

In all they do and say, adults act asrole models for the children in theircare. If the environment is cleanand well organized…. little eyesare watching and following yourpositive example!

Teacher Resource for PlanningWork and Cleaning Activities:

• Active Learning Seriesby Debby Cryer, Thelma Harms,Beth Bourland, and Adele Ray

Children’s Books on

Cleaning and Work

• Babies Help Outby Marcia Leonard 2001 (i/t – preschool)

• Max Cleans Upby Rosemary Wells 2002 (i/t – preschool)

• Amelia Bedelia Helps Outby Peggy Parrish 1989 (preschool – school-age)

• Let Me Help!by Louise Vitellaro Tidd 1999(preschool – school-age)

“Spick-and-Span Spring”

“Babies love to help out, Babies think chores are fun! Babies don’t hesitate,When there’s work to be done.”

~excerpt from Babies Help Outby Marcia Leonard

By participating in “real work”, work that ismeaningful to the group, children in childcaresettings develop skills that will prepare themfor being responsible caring adults. Children

learn that their contributions matter. So, as you’re preparing forSpring-cleaning include the children in your preparations. GetReady…Get Set….Clean!

Ways Children Can Participate in Taking Care of Their Environment:

• Help infants notice adults and older children as they work. Point outchildren doing jobs and give words to the actions they see. “Look…Bradley is helping carry the cleaning rags outside to help wash thewindows! Do you see Tasha using the spray bottle to squirt water on the chair …she’s helping clean up!” By giving language to theactions infants see and by providing role models of care for theirenvironment, the groundwork is laid for children adoptingresponsible practices in the future.

• Toddlers can assist with a “Clean Up” Day. Pull out the child-sizedbrooms, dustpans, mops. Using a spray bottle of water and acleaning rag, toddlers can assist with cleaning chairs, shelf tops orriding toys. Plan for it being messy!

• Sing a “Clean-Up Song” …Clean up, clean up, everybodyeverywhere. Clean up, clean up, everybody do your share” ….toencourage participation in organizing the indoor or outdoorplayspace after play. Special “clean-up” tapes or CDs could beincorporated into this transition time. How about cleaning to aLatin beat or floating the cushions back in the reading corner tonature sounds? Be respectful of children’s ongoing work andprojects. Find a special table or corner for projects children wouldlike to continue working on or want to save and show to familymembers later in the day.

• Setting the table for lunch is a job preschoolers enjoy. Child-made laminated placemats, with outlines of plates, cups and silverware, allow children to practice beginning math skills –counting and one-to-one correspondence (one plate shape…so Ineed one plate).

• Planting a tree for Arbor Day, the last Friday in April, allows for many cooperative jobopportunities. Children can work together to dig ahole for a tree, carry the buckets of soil away (maybeto a garden area) and then make sure that the tree iswatered. *The Pine Tree is North Carolina’s state tree!

• Preschool environments offer a wide range of possibilities for dailyjob opportunities: sweeping and dusting, filling and/or emptying thesand or water table, caring for a classroom pet or plant, reading afavorite book to younger children in the program, or helping washthe tables after snacks or meals.

Call theResource Center 1-800-367-2229

to get the brochure Cleaning to Control Allergies and Asthma

APRIL-MAY 2004 • HEALTH AND SAFETY BULLETIN • 7

References:

Readdick, Christine A. and Douglas, Kathy.More Thank Line Leader and Door Holder: EngagingYoung Children in Real Work, Young Children,Vol. 55, Number 6, Nov. 2000.

Teaching Young Children through Work and Play,NAEYC Early Years are Learning Yearshttp://www.naeyc.org/resources/eyly/2001/02.asp.

Photos on this page by Dave Hardy.

Nonprofit Org

US Postage

PAIDChapel Hill, NCPermit No. 177

8 • HEALTH AND SAFETY BULLETIN • APRIL-MAY 2004

NC Child Care Health & Safety Resource Center1100 Wake Forest Road, Suite 100Raleigh, NC 27604

POSTMASTER: Please deliver as soon as possible – time dated material enclosed

Ask the Resource CenterWhat should I look for when buying children’s books for my family child care home?Look for books that will catch the eye of young children, stimulate their imagination, andhold their attention.Nursery rhymes allow children to “luxuriate” in the sounds and rhythms of language. Begin“bathing” children in this verbal “potion” beginning in infancy by reading Mother Goosepoems or silly Dr. Seuss rhymes.Infants and toddlers enjoy picture books with bright colors and simple shapes. Wordlessbooks, colorful ABC’s, and books with interesting patterns are good choices as are concept

books that introduce colors, shapes and comparisons. Choose books with familiarobjects and simple stories about everyday life. Cloth, board and vinyl books

work well with very young children because they are easy to hold and manipulate.

Preschool children are ready for stories illustrated with more complexand detailed artwork. Illustrations should go hand in hand with a well-told tale. Look for good word choice, clear sentence structure, and simple plots. Select stories with settings and characters that are believable. Believable does not necessarily mean realistic. Children’sliterature is full of talking ducks and fairies with magic wands.Characters are believable if they are consistent and make sense withinthe context of the story.Children want to make sense of the world around them and enjoybooks about nature, animals, foods and science. Tales about solving

everyday problems, growing up and developing empathy for others willalso captivate many young listeners.

Include a selection of folk/fairy tales. These “fantastic” tales frequentlytackle the battle between good and evil and are often beautifully illustrated.

Evil is overcome by the courageous acts of small, seemingly powerlessindividuals. When children identify with these characters they find symbolic models forconfronting and overcoming their own challenges. The “happily ever after” messagecommunicates hope, love and comfort to children navigating the sometimes-difficult watersof growing up.Finally, make sure to include books reflecting a broad variety of interests, abilities and ages.Choose stories with familiar cultural settings as well as those that show people from diversebackgrounds. Reading aloud to children and surrounding them with terrific books are two of the best ways to support the development of early literacy skills.The following web sites provide lists of recommended books.http://kids.nypl.org/reading/recommended2.cfm?ListID=61http://www.ala.org/ala/alsc/awardsscholarships/literaryawds/caldecottmedal/caldecottmedal.htmhttp://pbskids.org/lions/books/all_print.html

HEALTH BULLETINEDITORS: VOL. 4 ISSUE 2Janet McGinnis, Jacqueline Quirk

CONTRIBUTORS:Lucretia Dickson, Viet Nguyen, JeannieReardon, Judy Sowerby, Jonathan Kotch

DOWNLOAD:You may download a copy of thispublication from our website at:www.healthychildcarenc.org

REPRINTING:Articles may be reprinted withoutpermission if credit is given to thebulletin and the material is notreproduced for commercial purposes.

This publication is produced by theNorth Carolina Child Care Health andSafety Resource Center and distributedto licensed child care facilities, CCR&Ragencies, DCD child care licensingconsultants, and child care healthconsultants throughout North Carolina.

10,000 copies of this document were printed at a cost of $.46 per copy

We’d like to hear from you…

Call us at 1-800-367-2229 toshare your comments

and requests for articles or information.