title: Assessing health and safety in early care and education programs: development of the CCHP health and safety checklist.
abstract: BACKGROUND
  To assess health and safety in early care and education (ECE) programs, an objective, standardized instrument was developed based on the recommended national health and safety standards.
  
  
  METHODS
  The California Childcare Health Program Health and Safety Checklist was developed by conducting a literature review, identifying a gold standard, revising and updating the original Checklist, consulting with an advisory group, and pilot testing the Checklist. The Checklist included 66 items grouped into 10 subscales, and each item was rated on a three-point scale: meeting, partially meeting, or not meeting national standards. Face, content, and construct validity along with measures of reliability, inter-rater reliability, and internal consistency were established.
  
  
  RESULTS
  The Checklist was completed in 127 ECE centers. The highest subscale score was for emergency preparedness and the lowest was for handwashing routines and equipment maintenance. Cronbach's alpha subscale scores ranged from moderate to strong (0.27 to 0.70).
  
  
  CONCLUSIONS
  The Checklist provides valid and reliable information to assess adherence to key national health and safety standards and objective data to develop intervention programs to improve health and safety in ECE programs.
authors.affiliation: Department of Family Health Care Nursing, University of California, San Francisco School of Nursing, San Francisco, CA 94143-0606, USA. abbey.alkon@nursing.ucsf.edu
authors.forename: Abbey
authors.initials: A
authors.lastname: Alkon
authors.forename: Kim
authors.initials: K
authors.lastname: To
authors.forename: Mimi
authors.initials: M
authors.lastname: Wolff
authors.forename: Joanna F
authors.initials: JF
authors.lastname: Mackie
authors.forename: Jane
authors.initials: J
authors.lastname: Bernzweig
mesh_terms: D002648:Child; D002654:Child Care; D002675:Child, Preschool; D004493:Education; D006801:Humans; D012449:Safety