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Soaring to New Heights. Through Child Care Health Consultation, Quality Assurance, and Evaluation. Objectives. Explain the services child care health consultants provide Identify the immediate and long term outcomes of having the consistent presence of a consultant. Objectives.

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Soaring to New Heights

Through Child Care Health Consultation, Quality Assurance, and Evaluation

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  • Explain the services child care health consultants provide

  • Identify the immediate and long term outcomes of having the consistent presence of a consultant

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  • Apply basic evaluation techniques such as CDC framework for program evaluation and logic modeling

  • Apply quality assurance measures such as action planning

  • Utilize ITERS and ECERS as child care center assessment tools

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Importance of Center Assessments

  • Identify and maintain center strengths

  • Identify areas of improvement

  • Identify needs of center staff

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Importance of Center Assessments

  • Gauge client satisfaction

  • Gauge staff commitment

  • Gauge Goal setting and attainment

    Where are you and where do you want to go?

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Tools for Assessment

  • Child Care Health Consultant

  • Infant and Toddler Environment Rating Scale- ITERS

  • Early Childhood Environment Rating Scale-ECERS

  • CDC Framework for Program Evaluation

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What tools do you need to use?

  • Varies center by center

  • Resources

    • Financial

    • Manpower

  • Time

  • Need

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A quick look at the tools reveal…

  • Child care health consultant

    • Contract with a certified health professional

    • One person- multiple tasks

    • External evaluator

    • Consultation, assessment, linkage to Resources

    • Center commitment

    • Progress reporting

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A quick look at the tools reveal…


    • Center staff may be trained to conduct the assessment

    • Time consuming

    • Reveals weaknesses and strengths in a variety of areas: personal care routines, language-reasoning, activities, program structure, etc.

    • Assessment results is used by the center to facilitate change

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A quick look at the tools reveal…

  • CDC Evaluation Framework

    • External or internal evaluation

    • Must clearly define the center’s activities, objectives, and outcomes

    • Need data or baseline information to evaluate

    • The evaluation findings must be used to identify ways to improve the quality of services the center provides

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Child Care Health Consultation

  • Certified consultant

  • Healthcare professional

  • Resource referral

  • Training

  • Health consultation

  • Policy development

  • Evaluation

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Benefits to Consultation

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Benefits to Consultation- Center

  • Increased knowledge and compliance of health and safety guidelines

  • Discover a network of resource training tools and classes

  • Increased referrals and linkages to community resources

  • Assurance of active policy development

  • Movement of center towards higher accreditation level

  • Reduction of communicable disease among staff

  • Reduction of sick leave

  • Increase in revenue

  • Reduction of employee turnover

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Benefits to Consultation-Children

  • Protection from communicable diseases via immunization mandates and increase in health and safety practices

  • Protection from injury

  • Mental, emotional, and social readiness for post pre-care settings

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Benefits to Consultation-Parents

  • Protection from communicable diseases through infected child

  • Reduction in time off due to child care issues

  • Increased knowledge in health and safety issues and parenting skills

  • Increase in the practice of health and safety practices and parenting skills

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Assessing the Center ITERS/ECERS

  • Infant-Toodler Enviromental Rating Scale (ITERS) and Early Childhood Environmental Rating Scale(ECERS) are standard assessments for child care centers.

  • ITERS/ECERS assessments can be the tool to start a center on it’s journey to self improvement and higher credentialing. 

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Age Appropriate Assessments



    Designed to assess group programs for children of preschool through kindergarten age, 2½ through 5.

Designed to assess group programs for children from birth to 2½ years of age.

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Benefits to ITERS/ECERS


  • Research Proven

  • Based on Best Practices

  • A Reliable and Valid Tool

  •  Based on NAEYC definition of program quality

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Components of ITERS/ECERS

  • ITERS/ECERS assesses:

    • Space and Furnishing

    • Personal Care Routines

    • Listening and Talking (ITERS)

    • Language – Reasoning (ECERS)

    • Activities

    • Interaction

    • Program Structure

    • Parents and Staff

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Space and Furnishings

  • Furniture for play, learning, care, relaxation and comfort

  • Room size, arrangement, and privacy allowance

  • Space for gross motor play and equipment

  • Display for infants

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Personal Care Routine

  • Greeting at arrival and departure from the care givers to the children

  • Meals and Snacks

  • Naps/Rest

  • Toileting and or Diapering

  • Health and Safety Practices

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Helping children understand and use language

Introduction to books


Using books and pictures

Encouraging communication

Using language to develop reasoning skills

Informal use of language

Listening and TalkingLanguage - Reasoning

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  • Fine motor skills and active physical play

  • Art, Music, Blocks, Sand and Water,

  • Dramatic Play

  • Nature, Science and Math

  • TV, Video, Computer use

  • Promoting Diversity

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  • Supervision of children

  • Discipline

  • Staff – Child Interaction

  • Peer Interaction

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Program Structure

  • Scheduled Activities

  • Free Play

  • Group Time

  • Provisions for children with Disabilities

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Parent and Staff

  • Provisions for parents

  • Provisions for:

    • Personal needs of staff

    • Professional needs of staff

    • Supervision and evaluation of staff

    • Opportunities for professional growth

  • Staff interaction and cooperation

  • Staff Continuity

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A Step in the Right Direction

  • The Challenge: to provide child care settings for children that promote optimal physical, mental and emotional development.

  • One Solution: ITERS/ECERS, a tool that can help assess the needs of the child care center and obtain the highest level of accreditation.

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Additional Information


  • Also Available:

    • FDCRS

      Family Day Care Rating Scale

      Designed to assess family child care programs conducted in a provider's home.

    • SACERS

      School – Aged Care Environment Rating Scale

      Designed to assess group-care programs for children of school age, 5 to 12.

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CDC Framework for Program Evaluation

  • Engage stakeholders

  • Describe the program

  • Focus the evaluation

  • Gather credible evidence

  • Justify conclusions

  • Ensure lessons learned

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Engage Stakeholders

  • Identify stakeholders- staff, parents, local businesses, civic organizations, educators

  • Identify stakeholder role

    • Part of evaluation team

    • Data collectors

    • Evaluation advisors

  • Create a plan for their involvement

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Describe the program

  • Define the need for the program

  • Identify program resources

  • Identify the current status of the program

  • Explain the context of the program

  • Describe program activities

  • State program objectives

  • Develop a logic model

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Logic Model

Does increasing the number of caregivers increase the level of supervision ?





Caregivers provide appropriate level of supervision and guidance to the children.

Hire more caregivers.

Child to care giver ratio increases.

Center Director

Center Staff


Provide training for caregivers in early childhood development and health and safety issues.

Caregivers are trained in early childhood development and health and safety issues.

Caregivers uses appropriate standard procedures.

Children who attend this ECE center exemplify school readiness.

Redesign student curricula based on best practices.

A new curricula is developed.

Do children appear to learn more and be ready for school after attending the center?

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Focus the Evaluation

  • What’s the purpose of the evaluation?

  • What will you do with the results?

  • What are the most important evaluation questions?

  • Is there baseline data available?

  • How will you collect comparison data?

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Gather Evidence

  • Collect data

  • Develop indicators- measures

  • Link indicators to data sources

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Putting It All Together

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Justify Conclusions

  • Check data for errors

  • Analyze data

  • Compare actual and intended outcomes

  • Document potential bias

  • Examine limitations of the evaluation

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Ensure Use and Share Lessons Learned

  • Pick a format for dissemination that will be readily accepted and used by stakeholders

  • Share evaluation findings

  • Use evaluation findings

  • Make recommendations for change

  • Address recommendations made by stakeholders

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ACTIVITY- Using the Framework

  • You spent months planning a social for your staff, parents, and community stakeholders.

  • You’ve been asked to do the social on a quarterly basis.

  • A center director who you’re friendly with is thinking about doing something similar and she wants to know if it was worth all the time and effort.

  • How would you evaluate the success of your social?

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The cost of the social does not exceed the budget amount

Center staff


Community members

Develop a budget

Locate a venue

Venue is cost effective and is ideal for a social event

Find a caterer

Guest represent all community stakeholders.

Develop a guest list

Invite guests

Invited guests are happy and see the event as a great networking opportunity

Welcome guests and conduct social activities

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Evaluation Framework

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Okay, I did the evaluation- now what?

  • Develop recommendations

  • Prioritize

  • Develop an action plan

  • Implement the action plan

  • Track progress

  • Evaluate

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Prioritization tool

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Action plan

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Where do you go from here?

  • No evaluation is worth the effort unless:

    • the results lead to recommendations

    • the recommendations lead to plans

    • The plans lead to action

  • Consider External Resources

    • Child Care Health Consultant

    • Inclusion Specialist

    • Other Community Agencies

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Thank you!!!

Any Questions?

For more information:

Angela Moore- [email protected]

Cathy Wiley- [email protected]

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