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Playgrounds are common within child related facilities and often are the source of numerous injuries. 75% of injuries occur as a `result of falls from play equipment. Of all the possible measures to prevent injury there is no substitute for active close supervision. However to minimise this risk educational organisations should be aware of:

• Soft surfaces should always be present where equipment is over 500mm high.
• QUALITY OF EQUIPMENT – Poorly designed equipment can have potential hazards such as sharp edges and moving parts that can crush or pinch small fingers.
• SHADE SAILS – Children are extremely vulnerable to sunburn. Where possible, try to provide some form of shade. This might be in the form of trees, shade sails, or building structures. Metal surfaces exposed to direct sun light heat up quickly causing burns to children’s skin upon direct contact.
• CONSTANT SUPERVISION – Of all the possible measures to prevent injury there is no substitute for active close supervision.

• Furniture should be durable, nontoxic and the correct size for small children.
• Corners should be rounded or have corner protection/ plastic guards.
• Slats on furnishings (particularly cribs) and railings on other structures should be spaced close enough together so that a child’s head cannot get caught between them.
• Shelving should be properly secured
• In order to minimise the falling hazard all furniture should be placed away from windows and shelves.
• Tall bookshelves pose a climbing/falling hazard and should not be accessible to infants and children

Good perimeter security/fencing around outdoor play areas is necessary:

• to ensure that children cannot impulsively run out into dangerous situations;
• to keep undesirable parties out of the childcare centre.

The design and height of fencing should be sufficient to prevent children from climbing over or crawling under it. Automatic locking mechanisms should be installed on gates. However, the provision of fencing is not a substitute for consistent supervision of children in outdoor play areas.

Child Care Regulations also specify the qualification requirements for carers in childcare centres and home based services (for family day care coordinators).

Adequate supervision of children is particularly important to reduce possible injuries. The ratio of children to carers must be adhered to and whether this meets licencing requirements.

Important risk considerations include:

• Correct storage and reheating of food and drinks is important for food safety.
• Whether food preparation and eating areas are clean and tidy
• Whether all food is cleaned up after snack and meal times
• Policies and procedures such as hygiene regulations and nutrition standards.
• Use of correct food handling techniques
• Hygiene (see below)
• The kitchen area should be separated from  the main area and the door to the kitchen fitted with a child proof latch
• Cleaning materials and chemicals should be out of reach, as should knives and other potentially dangerous utensils

Children should not be allowed in food preparation areas except under strict supervision.

Good hygiene is essential to prevent the spread of infections and diseases. Good practice for childcare centres includes:

• Adequate hand washing by staff and children;
• Correct use of serving utensils.
• Correct sharing of food at tables (for example, when fruit platters are shared).
• Strict washing/sterilising of materials and equipment after use including:
  • washcloths,
  • thermometers,
  • any items used by an ill child.
  • toilets, sinks and drinking fountains,
  • water play tables, play equipment, play tables, and floors.
  • cribs, cots, mats, playpens, sheets, and other linens.
  • toilet training chairs, changing tables,
  • toys mouthed by infants or toddlers before being given to another child,
  • feeding equipment.

Staff should wash their hands with soap and running water:

• before preparing and serving food;
• after using the toilet;
• after assisting a child in toileting;
• after caring for a sick child; and
• after coming in contact with any dirt, or an animal.

If sinks have photoelectric cell faucets this is a positive risk feature as clean hands do not have to touch the faucet to turn off the water.

The changing table surface should be smooth, flat, clean, dry, non-absorbent, and in good repair.

Preferably staff usually use latex gloves when changing nappies, which are disposed of after each use in a closed container with a leak-proof lining which is emptied daily.

Good hygiene and hand washing is the most important line of defence against infectious disease. Other areas to consider are:

• The centre approach to sick children (i.e. stay at home policy)
• Whether children who develop symptoms of infectious disease during daycare are immediately separated until the parent can pick them up
• Education of parents and staff in measures necessary to prevent the spread of common illnesses.
• Immunisation pre-checks conducted by the centre

• Whether, if the childcare centre is requested to give a child medication by the parent, the centre obtains release forms signed by the parents.
• The party responsible for administering medication and their qualifications
• Whether medicines are kept in a locked cabinet
• Record-keeping regarding each child’s illnesses and accidents.
• Whether emergency release forms are signed by parents authorising transportation to hospitals in the event of an emergency
• Whether the childcare establishes any allergies as part of pre-check procedures
• Whether there is a first aid kit available in each room and at least one staff member trained in first aid and infant/child CPR.

Increasing media attention has been given to this issue in recent years.

The most effective risk management controls in respect of abuse/sexual misconduct are

• Statutory Screening Protocols
• The 2 adult rule

In the current environment reporting is prompt and future levels of claim rate are expected to be lower due to:

• Risk management;
• Mandatory reporting;
• Recognition of assaults as a harmful and criminal act; and
• Awareness of parents and carers.

However, claim sizes are likely to increase if experience follows US trends.

Physical and sexual abuse also can occur in the child’s home, and a childcare centre could be held liable for failing to report suspected abuse to the proper authorities.

Employees should be trained to look for the telltale physical and behavioural signs of abuse and to report any such signs immediately to the appropriate authority.

Most childcare centres these days contain some form of air conditioning or air quality regulation. Heat related stress can result in increased fatigue, caused by increases in heart rate, blood pressure, sweat production, dehydration and collapse. The body becomes increasingly devoted to remaining cool, resulting in a reduced capacity for physical and mental work.  The environments provided for children, staff, or visitors should therefore aim to be within the comfort zone.

Biological contaminants such as dust mites, moulds, fungi, spores, pollen and bacteria (such as Legionella) can also cause health problems, including allergic reactions and infections. Microbes can also contaminate air-conditioning units and cooling towers which can result in health problems.

Prevention and problem solving of indoor air quality problems involves two main actions – the management of pollutant sources and the use of ventilation to control pollutants.

Most childcare centres establish a nap time routine. In this connection:

• The provision of adequate bedding is necessary to ensure that children have access to a bed and have undisturbed sleep.
• Age appropriate sleeping facilities must be provided.
• Sleeping facilities must be spaced to allow safe movement between children and assist emergency evacuation if necessary.
• The provision of individual bed linen and implementation of adequate hygienic measures are necessary to minimise the risk of cross infection.

Things to consider:

• where are the cots and bedding are stored
• cleaning frequency
• monitoring of infants during nap time
• whether there is  a centre procedure that ensures children do not share the same bed or bed linen prior to washing the bed linen.

There should be a rigorous sign-in/out procedure for pick up of children.

Recommendations include:

• An approved power point cover should be fitted to any socket which is accessible to children.
• Electrical cords should be maintained in good condition
• Electrical outlets, cords and appliances should not be covered by soft furnishings or other items which may create a fire hazard.
• Electrical installations should comply with AS3000 and be protected with a residual current device (RCD).
• Electric light fittings and power outlets in areas accessible to children should be at a minimum height of 1.5 m above the floor.

• Fan heaters must be two metres above floor level when in use or guarded as a fire.
• Flammable items should not be placed in close proximity to heaters.
• Kerosene and bar heaters should not be used.
• The hot water supply should be set at a low level (50degC) or all services should be fitted with a child proof device
• Any hot water or liquid over 50degC  in any tap, pipe, vessel, cooking heating or any other appliance or in any container (eg, coffee cup) must be out of reach of children.

• All play equipment should be made from non-toxic materials and be in good repair, with no sharp, rough, loose or damaged parts.
• Infants and toddlers toys should be large enough to prevent swallowing and choking and washed frequently to prevent cross-infection.
• Children using play equipment must be supervised at all times. The level of supervision will depend upon the age of the children and the activity or play they are participating in.

Drowning is the leading cause of death for children aged 1-4 years in Australia. Whilst most drowning occurs in backyard swimming pools, it is important to be aware that children can drown in as little as 5cm of water. Other water hazards in relation to child injuries and illnesses are: nappy buckets, toilets, wading pools, spas, bathtubs, fish ponds, fountains, pet drinking bowls etc.

All pools (other than small, plastic wading pools) should be completely enclosed by a fence with a childproof locked gate, equipped with an alarm/buzzer if opened. Pool fencing and gates should be checked regularly to ensure they are working correctly and it is important that the area around the fence free of pot plants, chairs etc that could be used to climb the fence.

Water should be drained immediately after use from wading pools and buckets. Toilet seats should be kept in the “down” position and locked with a child-resistant safety latch. Small children can drown in only an inch or two of water. Therefore staff should be instructed never to leave infants and children unattended or unsupervised when around water.

With careful planning, supervision and maintenance, play environments can be made safe for children and unnecessary injuries can be avoided.

Falls from equipment are the largest cause of serious injury in the playground. Other injuries include entrapment, collisions with equipment, needle stick injuries, cuts from broken glass, protrusions and other children.

Common hazards are:

• Rusty protruding nails & screws
• Splintered timber
• Sharp metallic edges
• Brittle and cracked plastic seats
• Red back spiders in cubby houses
• Concrete play surfaces
• Bricks and rocks on the ground around equipment
• Swings too close to fences, walls and other equipment
• Hanging ropes and chains with noose like loops tied in them.

A safe playground should:

• Have fencing similar to that required around swimming pools
• Have equipment without protrusions and entrapment hazards
• Have equipment that is appropriate for the age of the children using it
• Have an adequate soft fall surface for all equipment. If the equipment is more than 500mm in height the surface must comply with Australian Standards (AS/NZS 4422:1996)
• Have shade and seating for supervision
• Have rules displayed ie appropriate ages, no food or drink, no glass, no running etc
• Be regularly inspected and maintained, especially the soft fall surface. Detailed records of these inspections should be kept.

Australian Standards are:

• AS 4685.1 – 2004 – Playground equipment – General Safety Requirements & Test Methods
• AS 4422 – Playground surfacing
• AS 4486 – Playgrounds and Playground Equipment. Part 1:  Development, Installation, Inspection, Maintenance and Operation

Customers and visitors (other than children) to the premises include:

• Parents as they drop off or pick up their children visit premises at least twice a day.
• Delivery staff

Delivery people should be restricted from the areas where children are cared. Some centres permit and encourage parents to visit and observe workings of the centre at any time.

The childcare centre is likely to have a variety of incidental contracts with utilities suppliers, landlords, equipment hire etc. The advisor needs to confirm whether or not the insurance policy provides automatic cover for such incidental contracts where they impose a duty greater than the business’ common law liability.

Good record keeping is the cornerstone of compliance and management.

Records include:

• Accident/Illness/Injury reports, to ensure an accurate tracking and appropriate follow-up of all injury related incidents and illnesses, happening within the childcare centre. Information on such reports includes:
  • The type of treatment performed
  • The name(s) of the person/people performing the treatment
  • The place where the treatment was performed.
  • Date/time that the parents were notified
• Child registration documents, which will include:
  • Notations regarding individual health problems, such as diabetes, epilepsy, asthma or HIV. Find out whether any inquiries were made from the parents on such problems.
  • Authorisation to dispense medications
  • Emergency treatment authorisation
  • Contact details in case of emergency
• Sign in/out forms which will help ensure that only the authorised person picks up a child.

An important issue is how the staff member releasing the child knows and ensures that a person is authorised to pick up a child. The system must be robust, and a designated staff should always stay with children until his or her guardian picks up last child at the end of the day.