1. Child Care Quality & Nutrition and Physical Activity National Standards, Performance Standards, Accreditation Requirements, QRIS, and Licensing Rules

2. National Performance Standards Caring for Our Children, 3 rd Ed. http://cfoc.nrckids.org CFOC Spinoff: Preventing Childhood Obesity in Early Care and Education Programs

3. Caring For Our Children http://cfoc.nrckids.org Joint publication from American Academy of Pediatrics, American Public Health Association, Maternal and Child Health Bureau Available for purchase at www.aap.org or online at http://cfoc.nrckids.orgwww.aap.org 686 national standards 86 Technical Panel Experts Contributions from 184 stakeholders Ongoing updates Format is Standard, Rationale, Comments, Type of Facility, Related Standards, References

4. Preventing Childhood Obesity in Early Care And Education Programs Spinoff from CFOC 3 rd Edition All the Standards that influence best practices in Nutrition, Physical Activity, and Screen Time including policies, training and resources Available online at http://cfoc.nrckids.org/StandardView/SpcCol/ Preventing_Childhood_Obesity http://cfoc.nrckids.org/StandardView/SpcCol/ Preventing_Childhood_Obesity Available for purchase at www.aap.org

5. Performance Standards, Accreditation Requirements, QRIS Individual association requirements to help improve quality Head Start, Early Head Start, NAEYC, NAFCC, States Usually incentive to comply May or may not agree with CFOC, 3 rd edition May or may not be available to all—our state does not include health and safety standards in QRIS

6. Licensing Rules Child Care Nutrition and Physical Activity; A Comparison of Current Guidelines to National Evidence Based Standards-- http://cshelwa.org/downloads/CSHEL_Crosswalk. pdf A crosswalk comparing licensing rules to CFOC 3 rd edition Standards Calls for improved licensing rules, consistent across all forms of licensed care, and improved access to support for implementation

7. Licensing Rules Achieving a State of Healthy Weight 2014— www.nrckids.org www.nrckids.org A look at all states’ licensing rules addressing nutrition, physical activity and screen time compared to each other and CFOC 3 rd edition. Washington State not in the top tier – continued need for improvement

8. 2013 Washington State survey of Health and Nutrition in Child Care UW Center for Public Health Nutrition http://depts.washington.edu/uwcphn/work/ece/waccs urvey.shtml http://depts.washington.edu/uwcphn/work/ece/waccs urvey.shtml Some of the healthy nutrition standards are followed. If a program participated in CACFP they did serve more nutritious food, but not always what is recommended. Half or less of programs followed the physical activity recommendations, with family child care having more challenges Policies and trainings following recommendations happen in only about half as well.

9. Recommendations Revise the WAC to be consistent with National Standards for all forms of licensed care, include policy and training WACs. Add health and safety to QRIS, especially nutrition, physical activity, screen time and training/administrative requirements that promote health and safety. Improve outreach and support for CACFP— opportunities for grants from Dept of Agriculture, etc.