The health and safety standards presented in this document represent the consensus of many practitioners about good practice in child care. The standards are intended to guide a wide audience such as caregivers, public health professionals, licensing agencies, departments of education, and parents. Standards directed to facilities appear in chapters 1 through 8. Recommendations to federal, state, and local organizations and to entities other than facilities are in chapter 9. For each standard presented in chapters 1 through 8, a rationale column explains the intent of and the need for the standard, and also serves as an educational tool. A comments column includes other explanatory information relevant to the standard. These 8 chapters present over 44 standards for the following areas of child care practice: (1) staffing; (2) activities for healthy development; (3) health protection and health promotion; (4) nutrition and food service; (5) facilities, supplies, equipment, and transportation; (6) infectious diseases; (7) children with special needs; and (8) administration. Chapter 9 presents seven recommendations, with discussion, for licensing and community action. Thirty-nine appendices, with references, include additional standards and recommendations, sample forms, and suggested plans and policies. A glossary of terms is also included. Each chapter contains references. (TJQ)