"Early Head Start staff have really helped me make my home safe for my toddler. She is deaf and can't hear me when I say things like, 'Don't touch the hot stove,' or ‘Watch out for the wet floor.' I've learned to use hand signs and picture cues to help her understand.” – A parent in a home visiting program

This chapter talks about how to keep children with disabilities or special health needs safe. As a disability services coordinator, you work with others to make sure all children are safe.

Your main partners are:

• The health manager, who helps protect children’s health and safety.
• The facilities manager, who makes sure all areas — inside and outside — are safe and easy for all children to use.

By working together, you can build a strong safety culture in your program.

Key Ideas

• Keeping children safe is a top goal in Head Start programs.
• Safety is especially important for children with disabilities.
• All staff help keep children safe, both indoors and outdoors.
• You can support families in making their homes safer.
• Families may have different views on safety based on their culture and experiences.
• Buildings and play areas should be easy for all children to use.
• A strong safety plan includes everyone and helps all children take part in every activity.

Safety Practices in Head Start Programs

Head Start programs follow federal standards to make sure children are safe. These requirements are part of the Performance Standards. They cover everything from classroom size to transportation and emergency planning.

Safe Classrooms and Group Sizes

To create safe learning spaces, programs must follow rules about how many children can be in a group and how many staff must be present. Find these rules in Program Structure, 45 CFR §1302 Subpart B.

• Classrooms must have enough space for children to move around safely.
• If state rules are stricter than federal ones, programs must follow the stricter rule.

Health and Safety Training

Programs must have a clear plan to keep children safe and healthy. This includes clean facilities, safe equipment, and good hygiene practices. According to Safety practices, 45 CFR §1302.47:

• Staff must pass background checks.
• New staff must complete safety training within their first three months.
• All staff must continue learning about health, safety, and child care rules.
• Programs must create a disaster plan and train staff on how to follow it.

Safe Buildings and Playgrounds

All facilities must be safe and accessible. Under Inspection of work, 45 CFR §1303.56:

• New buildings must pass a final inspection.
• Facilities must meet the standards of the Americans with Disabilities Act (ADA) and other safety laws.
• All children, including those with disabilities, must be able to use the space safely.

Safe Transportation

If a program provides transportation, it must follow the rules in Safety procedures, 45 CFR §1303.74:

• Children must be taught safety procedures.
• They must take part in bus evacuation drills to practice what to do in an emergency.

In addition, Children with disabilities, 45 CFR §1303.75 ensures that transportation of children with disabilities includes: 

• School buses or vehicles designed for their safe transport.
• IFSP- or IEP-required changes for pick-up or drop-off, special seating needs, or additional adult assistance.

Reporting Serious Incidents

When something serious happens that affects a child’s health or safety, it must be reported. According to Program Management and Quality Improvement, 45 CFR §1302 Subpart J:

• Programs must report the incident to the U.S. Department of Health and Human Services within seven calendar days.

Planning for Partnerships

As you build partnerships in your community, work closely with your program’s health, transportation, and facilities managers. These team members can help you:

• Reach out to specialists in health care, early intervention, special education, and more.
• Create emergency and injury prevention plans that include children with disabilities or health needs.
• Offer joint training so everyone understands their role in keeping children safe.
• Develop a communication plan to keep staff and families informed with clear, timely updates.
• Include families’ voices and ideas in your planning.

What is your role in safety and injury prevention?

Keeping children safe is one of your most important jobs. Children with disabilities and special health care needs may be more likely to get hurt — and their injuries may be more serious. As the DSC, you work with many systems and services to support safety as part of your coordinated approach.

Your program likely has written health and safety plans. These may include:

• Checklists to keep facilities clean and safe
• Guidelines to prevent dangerous situations
• Emergency procedures and training

Safety starts with leadership, but everyone shares the responsibility. All staff must:

• Make sure no child is left alone or at risk.
• Respond quickly and appropriately to unsafe behavior or hazards.
• Watch for changes in the environment as children grow and develop.
• Complete regular safety checks and fix any problems.

Working with Transportation and Education Staff

• Partner with transportation staff to make sure they follow safety practices for children with disabilities.
• Ensure they understand and follow each child’s IFSP or IEP.

Active Supervision

Active supervision is key to keeping children safe in all settings. As a DSC, help staff:

• Position themselves to see and hear all children.
• Watch, listen, and count children at all times.
• Use what they know about each child to predict behavior and redirect when needed.

Example: A preschooler places a heavy toy truck on a shelf. A child with a mobility challenge is playing nearby. The truck could fall and hurt the child, who can’t move quickly. The teacher should move the truck right away to prevent injury.

Creating Safe Learning Environments

To help children with disabilities participate safely:

• Work with experts in health, facilities, education, early intervention, and special education.
• Think about each child’s physical, emotional, cognitive, and sensory needs.
• Consider all settings (e.g., classrooms, homes, indoor and outdoor spaces).

Also, partner with family service staff to support safety at home. Ask families:

• What safety steps are already in place?
• Do they need help with things like walkers, communication tools, or mental health support?

Teaching Safety and Self-care

The Head Start Early Learning Outcomes Framework includes goals for learning safe behaviors and self-care. Work with education staff to:

• Adjust the curriculum
• Add learning opportunities that help children with disabilities build these skills

Develop Specialized Safety Plans

Individualized Safety Planning

Many children with disabilities need a personalized safety plan. While an Individualized Health Plan (IHP), Individualized Family Service Plan (IFSP), or Individualized Education Program (IEP) may include some safety needs, they don’t always cover emergencies. You, the staff, and the family may need to create additional plans.

Here are some examples:

• A child with hearing and sensory challenges is scared by loud alarms. Teachers have a plan for fire drills — but what happens during an unexpected alarm?
• A child who uses leg braces moves more slowly. How will staff help the child exit quickly during an emergency?
• A toddler with a visual impairment can’t see hazards like other children. How will teachers alert the child to changes in the classroom or playground?
• An infant with low muscle tone needs tummy time, as listed in her IFSP. But during a home visit, you notice that tummy time isn’t happening because the floor is too crowded. What home safety tips would you offer this family? 

Emergency Planning for All Children

Your program’s emergency plan must include children with disabilities and special health needs. Make sure the plan covers:

• Medications and special foods children need if you must shelter in place.
• Identify staff who will bring these items if you need to evacuate.
• Special transportation needs for children with mobility or communication challenges.

Train all staff on their roles before emergencies or drills. Everyone should feel confident and prepared. You can also contact your local fire department and paramedics. Let them know about children who may need extra help during a disaster or emergency.

Transportation Safety

Children with disabilities who ride program vehicles may need special evacuation plans. These may be included in their IHP, IFSP, or IEP. Consider:

• Children with limited mobility may need help getting on or off the bus.
• Children with communication delays may feel scared or confused during an emergency.
• Staff must know each child’s plan and practice evacuation drills regularly.

Ready.gov offers guidance for emergencies, with specific notes about children and adults with disabilities.

Helpful Resources

• Review the guide Creating a Culture of Safety for strategies to build a program-wide approach to safety. It includes tips on leadership, staff training, communication, and continuous improvement.

Tips for Creating a Safe Environment and Preventing Injury

• Make safety a shared responsibility.
• Conduct regular safety checks. Work with education staff, home visitors, and managers to inspect indoor and outdoor spaces, as well as program vehicles. Look for hazards and make sure adaptations are in place for children with disabilities.
• Partner with the facilities manager. Ensure that all areas meet ADA requirements and are accessible to all children.
• Emphasize active supervision. Review your program’s supervision policies. Make sure there are enough staff indoors and outdoors, and that they use strategies like positioning, watching, listening, and counting.
• Provide training. Teach all staff, volunteers, and consultants about injury prevention and their role in active supervision.
• Plan for emergencies. Include children with disabilities and special health care needs in your emergency plans. Practice drills like fire evacuations and shelter-in-place procedures.
• Support home safety. Help families create safe home environments for children with disabilities. Share tips and resources.
• Connect with community partners. Reach out to local organizations and services that support child safety. Work together to promote safety in your community.

Everyone — staff, volunteers, and families — should be alert to hazards and focused on keeping children safe.

People Who Can Help

• Health manager and staff
• Facilities manager
• Transportation manager and staff
• Education manager and staff
• Program leadership
• Partners engaged in community safety, such as first responders
• Health care providers
• Part B, Part C, and related service providers
• Families

Questions to Ask Your Team

• How do we ensure safe environments for children with disabilities and special health care needs? How do we engage families?
• How do we identify and reduce risks to children with disabilities?
• What accommodations help prevent injuries?
• What support do we offer families in keeping children safe at home and in the community?
• Do we have emergency plans that include children with disabilities and special health care needs? 

Scenario: Supporting Carlos’s Safety Outdoors

Janet, a Disability Services Coordinator, meets regularly with teachers to support children with disabilities. One of the children, Carlos is 4 years old and uses a walker due to a congenital condition. He has an Individualized Health Plan but does not qualify for IDEA services. The teachers have arranged the classroom so Carlos can move around easily. They feel confident supporting him indoors. However, they’re worried about his safety outside:

• What if other children run into him?
• How will he get through the heavy door to the playground?
• Who will help him navigate the steps?
• What if he falls?
• Do they have enough staff to supervise both Carlos and the other children?

Janet listens to their concerns and reminds them that safety is a top priority for all children. She works with the health manager, facilities manager, and teachers to come up with solutions:

• Classmates can help hold the door for Carlos.
• A volunteer can assist during transition times.
• The health manager can talk to Carlos’ parents about his risk of falling.
• The team can create a personalized safety plan for Carlos.

At their next meeting, the team shares their progress:

• Children enjoy helping and now take turns holding the door as a classroom “job.”
• A volunteer joins the outdoor transition time to support Carlos and the group.
• The health manager gathers helpful information from Carlos’ doctor and parents.
• Carlos’ parents share that he has fallen at home before, but they want him to play outside like the other children. They teach the staff how to help him if he falls and help write a safety plan.

The health manager sends the safety plan to Carlos’ doctor for approval. The team — Janet, the health manager, and the teachers — work together to make sure Carlos can safely and fully participate in outdoor play.