Under the federal CCDF rules, providers caring for children whose families receive subsidy must be trained on 11 health and safety topics — safe sleep, emergency preparedness, pediatric first aid and CPR, and child abuse reporting among them.
States set the annual hours and name the topics that must be finished before you work unsupervised; the federal rule itself requires pre-service or orientation training to be completed within three months.
Head Start is the exception on hours, with its own federal number: all its staff need at least 15 clock hours of professional development a year.
What the federal health and safety topics are
The checklist starts with federal rules.
The Child Care and Development Fund (CCDF) rules at 45 CFR 98.41 — the child care subsidy rules the Administration for Children and Families (ACF) administers — require health and safety standards and training on 11 topics for providers receiving CCDF subsidy:
- Prevention and control of infectious diseases (including immunizations)
- SIDS prevention and safe sleep practices
- Medication administration
- Prevention of and response to food and allergic reactions
- Building and premises safety
- Prevention of shaken baby syndrome, abusive head trauma and child maltreatment
- Emergency preparedness
- Handling and storage of hazardous materials and biocontaminant disposal
- Transportation precautions
- Pediatric first aid and CPR
- Recognizing and reporting child abuse and neglect
The list holds exactly 11 required items under 98.41(a)(1)(i)-(xi), and states may add optional topics on top — the rule's own examples are nutrition, physical activity and caring for children with special needs.
Treat the sections below as a walkthrough of that checklist, topic by topic, from the part of the job each one touches to where the training comes from.
How the list reaches your job is part federal, part state.
Federal CCDF rules (45 CFR 98.44) require states to have pre-service or orientation health-and-safety training completed within three months, and to name the topics critical enough to finish before you care for children unsupervised; annual training hours have no federal number, because each state sets its own minimum.
Head Start is the written exception: its standards require all staff to complete at least 15 clock hours of professional development per year, plus annual training on mandatory child abuse reporting and on positive strategies for social-emotional development, and the Head Start Act sets the same 15-clock-hour floor for Head Start teachers.
The layer-by-layer version of this — hours, deadlines, who approves what — lives in our guide to required childcare training.
Some topics are courses of their own elsewhere on this site: safe sleep training, pediatric CPR and first aid, medication administration training and mandated reporter training.
The reporting topic carries particular weight in law — a Child Welfare Information Gateway compilation of state laws current through May 2023 counts 36 states plus DC, and several territories, that explicitly name child care providers as mandated reporters of child abuse and neglect.
Confirm your state's list before you enroll
Emergency preparedness and response
Emergency preparedness is the list's topic for how a program responds when something goes seriously wrong.
It is also a topic you can probe before you take a job: ask a hiring director how drills run, how children are accounted for during one, and where the written emergency plan lives.
How deep your state's required training goes — drill frequency, what a written plan must cover, how families get notified — is decided in state rules, so confirm the specifics with your state child care licensing agency rather than assuming a national standard.
Hazardous materials and building safety
Two list topics share a physical focus.
Handling and storage of hazardous materials covers what its name says — how dangerous products get handled and stored, and how biocontaminants get disposed of.
Building and premises safety covers the space itself, indoors and out.
On the job, these are habits as much as course content: where supplies get locked, how a scrape that bleeds gets cleaned up, what gets checked before children use the playground.
Which products a state permits and what must be secured are licensing questions — your state child care licensing agency owns the specifics.
Transportation safety
Transportation precautions is the list's topic for anything that puts children near vehicles: field trips, center vans and school-age pickup and drop-off routes.
The federal rule supplies the topic name; what training it turns into for a role that drives is state implementation.
If you drive for a program, those state rules arrive on top of your employer's own vehicle policies — the two layers are separate, and both apply.
Confirm the transportation training that applies to your role with your state child care licensing agency before your first route.
Bloodborne pathogens and infection control
Two parts of the list feed this section: prevention and control of infectious diseases, including immunizations, and the biocontaminant disposal named under hazardous materials.
Bloodborne pathogens is the workplace term for the blood-and-body-fluids side of that work, but the federal list does not use it, and our research did not confirm a separate bloodborne-pathogens training rule for childcare staff — confirm what your state requires with your state child care licensing agency.
The infection-control topic names immunizations directly.
On that point, BLS notes that childcare staff often must have a complete immunization record to qualify for licensure, alongside a background check and a minimum training requirement.
The day-to-day cleaning and sanitation procedures are state rules, so your state child care licensing agency owns the specifics.
Allergies and food safety
Prevention of and response to food and allergic reactions is the list's allergy topic, and it touches every meal and snack: knowing which children have allergies on file, keeping allergens away from them, recognizing the signs of a reaction, and acting quickly when one starts.
Where a response involves medication, medication administration training is the course that covers what staff may give and how.
Food programs can add a training layer of their own.
If your program's meals run through the Child and Adult Care Food Program (CACFP) under a sponsoring organization, that sponsor must train key staff of sponsored facilities before program operations begin and at least annually after that — on meal patterns, meal counts, claims, recordkeeping and reimbursement.
That requirement sits beside the health and safety list rather than replacing it.
Where to take health and safety training (often free)
Start with the body that owns the rules.
Your state child care licensing agency decides which courses satisfy its health and safety training requirements, so it can tell you what counts before you spend an evening on one that doesn't; your director is the other natural stop, because pre-service training ties to the hiring window and onboarding is when it gets scheduled.
Free options are real.
Cox Campus, for example, describes itself as a free online learning platform with IACET-accredited courses — a self-description, and our research did not confirm which states accept its hours toward licensing requirements.
That acceptance question is the catch with free training: whether an online-only course counts, how long a CPR card stays valid and which providers' hours a state recognizes are state- or certifier-specific decisions that the national sources we reviewed do not settle.
One quality signal comes from the federal rule itself: ongoing training should, to the extent practicable, award continuing education units (CEUs) or be credit-bearing.
When two free courses cover the same topic, the one that issues CEUs is the better bet for a training record that travels with you.
For the wider picture — certificates, catalogs and what to watch for — see our guide to free childcare training online.
This page is career and employer information, not licensing or legal advice. Confirm the health and safety training your state requires for your role and setting with your state child care licensing agency.
Free is not the same as accepted