21 Safe & Healthy Environment Practice Questions & Answers

1. 1. Four children are playing at the water table in a preschool room. Where should the teacher position herself, and why?

   • A.Beside the water table, within arm's reach and facing the children so every child stays in her sight and hearing, because a young child can drown quickly and silently in very little water✓ Answer
   • B.At her desk a few feet away, glancing over every few minutes while she finishes the daily notes
   • C.Out of the area entirely, so the children can explore the water without an adult influencing their play
   • D.Across the room with her back turned, listening for splashing so the children can play independently

   Active supervision means an authorized adult stays close enough to see, hear and reach children at all times. Drowning in young children is silent and can occur in a few inches of water in seconds, so nearness and an unobstructed line of sight — not periodic glances — are the controls that prevent it.

   Source: Caring for Our Children (AAP/APHA/NRC), supervision near water; CDA Competency Standards, Council for Professional Recognition — safe environmentReport a problem with this question

2. 2. When a class comes in from the playground, the teacher looks at each child, says the child's name to herself, and then compares her list to the group. Why is this better than simply counting heads?

   • A.Children behave better during transitions when they hear their names
   • B.Matching each face to a name shows exactly WHO is present, so a correct total cannot hide the fact that one specific child was left behind✓ Answer
   • C.A head count is only allowed for infants and toddlers
   • D.Counting heads takes longer than saying names

   A number can be right while the group is wrong — another child may have joined, or a visiting sibling may be counted. Name-to-face counting identifies the individual child, which is why it is done at every transition and at every arrival and departure from an area.

   Source: Caring for Our Children (AAP/APHA/NRC), name-to-face counting and supervision at transitionsReport a problem with this question

3. 3. At pickup time an adult the teacher does not recognize says he is there for a child. He is not listed on the child's release form, and the family has not called. What should the teacher do first?

   • A.Release the child but write an incident note for the file
   • B.Release the child if the adult can correctly state the child's full name and birthday
   • C.Ask the child whether he knows the adult and follow the child's answer
   • D.Keep the child safely in the classroom and contact the parent or guardian on file to verify the person before releasing the child to anyone✓ Answer

   A child may be released only to a parent, guardian, or a person the family has authorized in writing. Personal details about a child are easy to learn and prove nothing, so verification with the family on file is the only step that protects the child.

   Source: CDA Competency Standards, Council for Professional Recognition — release of children to authorized adults; Caring for Our Children (AAP/APHA/NRC), sign-in and release proceduresReport a problem with this question

4. 4. Why are whole grapes, hot dogs cut into rounds, and raw carrot coins considered especially dangerous foods for very young children?

   • A.They are round, firm and smooth, so a piece can match the shape of a young child's airway and seal it completely✓ Answer
   • B.They are high in sugar and salt, which irritates a young child's throat
   • C.They stain children's clothing and are hard to clean up
   • D.They spoil quickly at room temperature and cause stomach illness

   Choking risk comes from a food's shape, size and texture, not its nutrition. Round, firm, smooth or compressible pieces can wedge into the airway and form an airtight plug that a child cannot cough out, which is why such foods are cut into small, irregular pieces or not served to the youngest children at all.

   Source: Caring for Our Children (AAP/APHA/NRC), foods that are choking hazards for young childrenReport a problem with this question

5. 5. During the morning outdoor check a teacher finds a tricycle with a cracked, wobbling wheel. What is the best action?

   • A.Leave it out but stand near it whenever a child rides it
   • B.Take it out of the play area and keep it out until it is repaired or replaced✓ Answer
   • C.Allow only the oldest and most capable children to use it
   • D.Remind the children to ride that tricycle carefully and slowly

   Prevention outranks supervision: removing or repairing the hazard eliminates the risk, while rules and close watching only reduce the chance that an adult sees the injury happen. Equipment children use must be in good repair before it is offered.

   Source: CDA Competency Standards, Council for Professional Recognition — safe equipment and materialsReport a problem with this question

6. 6. How should cleaning, sanitizing and disinfecting products be stored in a room used by children, and why?

   • A.In their original labeled containers, locked or otherwise inaccessible to children while remaining accessible to staff, because removing children's access — not watching them — is what prevents poisoning✓ Answer
   • B.On a low shelf under the sink so staff can reach them quickly during cleanup
   • C.In the classroom cubby area, since children are told never to touch them
   • D.Poured into unlabeled cups or bottles so the products do not attract children's attention

   Young children explore by mouth and act faster than an adult can intervene, so access control is the reliable barrier. Original labeled containers also matter because they carry the ingredient, dilution and first-aid information a caregiver or poison center needs in an emergency.

   Source: Caring for Our Children (AAP/APHA/NRC), storage of toxic and cleaning substances; CDA Competency Standards, Council for Professional Recognition — safe environmentReport a problem with this question

7. 7. While setting up cots for nap, a teacher notices a looped window blind cord hanging down beside one cot. What should she do first?

   • A.Tie the cord into a knot at the height children can reach so it is shorter
   • B.Secure the cord out of children's reach or remove the loop entirely, then place the cots✓ Answer
   • C.Note it on the maintenance list and bring it up at the next staff meeting
   • D.Move that cot a short distance away and remind the children not to touch the cord

   Any cord, string or drawstring long enough to form a loop can tighten around a child's neck, and a sleeping or unattended child cannot free himself. Eliminating the loop removes the strangulation hazard; moving furniture, shortening the cord within reach, or waiting for a meeting leaves it in place.

   Source: Caring for Our Children (AAP/APHA/NRC), strangulation hazards from cords and stringsReport a problem with this question

8. 8. Why must the surface under and around climbing equipment be a shock-absorbing material kept loose and at an even depth?

   • A.Falls to the surface cause the most serious playground injuries, and loose, evenly deep surfacing absorbs the force of a fall✓ Answer
   • B.It keeps the metal parts of the equipment from rusting in wet weather
   • C.It makes the equipment easier to sanitize between groups of children
   • D.It discourages children from running, which is the main cause of playground injury

   Falls to the surface are the leading cause of serious playground injury, so the surfacing — not the equipment — is the main protection. Loose-fill material packs down and shifts, especially under swings and at slide exits, which is why it is raked level and checked daily.

   Source: Caring for Our Children (AAP/APHA/NRC), playground surfacing and fall zonesReport a problem with this question

9. 9. The fire alarm sounds while children are at free play. What should the teacher do FIRST?

   • A.Telephone the families to let them know what is happening
   • B.Have the children put away materials and collect their coats and cubby items
   • C.Check the building to find out what set off the alarm
   • D.Take the daily attendance record and lead the children out along the posted evacuation route, accounting for every child on the way out and again at the meeting place✓ Answer

   In an evacuation, getting children out comes before belongings, phone calls or investigating the cause. The attendance roster is what turns an evacuation into a verified one: it is used to account for every child and adult when leaving, at the evacuation site and on return.

   Source: Caring for Our Children (AAP/APHA/NRC), evacuation procedures and accounting for children; CDA Competency Standards, Council for Professional Recognition — emergency proceduresReport a problem with this question

10. 10. An infant arrives at the center asleep in her car seat. What should the caregiver do?

    • A.Leave her in the car seat until she wakes on her own so her nap is not interrupted
    • B.Lay her on a soft folded blanket on the floor next to the caregiver
    • C.Move her to her crib and lay her wholly on her back on a firm mattress with a tight-fitting sheet and nothing else in the crib✓ Answer
    • D.Place the car seat inside the crib so she is in her own sleep space

    Sitting devices hold an infant semi-upright, so her head can fall forward and close off her airway. A firm, flat, bare sleep surface with the infant on her back keeps the airway open and prevents suffocation and rebreathing of exhaled air, which is why a sleeping infant is moved promptly.

    Source: Caring for Our Children (AAP/APHA/NRC), safe sleep practices for infantsReport a problem with this question

11. 11. A caregiver has just finished helping a child use the toilet and is about to put out food for snack. What must happen in between?

    • A.The caregiver wipes her hands on a clean paper towel and goes on
    • B.The caregiver uses hand sanitizer only, since she will handle the food with tongs
    • C.Both the caregiver and the child wash their hands with soap and running water, rubbing long enough to loosen germs and rinsing them down the drain✓ Answer
    • D.The caregiver puts on gloves over her unwashed hands

    Germs from stool spread on hands to food, mouths and surfaces, and toileting followed by food handling is exactly the moment that link is broken. Friction with soap loosens germs and running water carries them away; sanitizer is only a substitute when soap and running water are not available, and gloves over dirty hands do not stop contamination.

    Source: Caring for Our Children (AAP/APHA/NRC), situations that require hand hygiene and handwashing procedureReport a problem with this question

12. 12. Midway through a diaper change, a caregiver realizes the wipes are on a shelf across the room. What should she do?

    • A.Fasten the safety strap and step away for the few seconds it takes
    • B.Ask a nearby child to bring the wipes to her
    • C.Keep one hand on the child and stretch as far as she can to reach the shelf
    • D.Take the child with her to get the wipes, then begin again with every supply within reach at the changing table✓ Answer

    A child on a raised changing surface must never be left alone or held at arm's length, even for an instant — a roll and a fall take less than a second, and straps are not a substitute for hands. Gathering every supply before the child is placed on the table is what keeps the caregiver from ever having to reach or leave.

    Source: Caring for Our Children (AAP/APHA/NRC), diaper changing procedure and never leaving a child unattended on the changing surfaceReport a problem with this question

13. 13. Why must a visibly soiled snack table be washed with detergent and water before a sanitizer is applied?

    • A.Sanitizer damages table surfaces unless detergent is applied first
    • B.Cleaning and sanitizing mean the same thing, so either step alone is enough
    • C.Food residue and soil shield germs from the sanitizer, so cleaning must remove the soil first for the sanitizer to reach and reduce the germs✓ Answer
    • D.Detergent kills more germs than any sanitizer does

    Cleaning, sanitizing and disinfecting are three different steps: cleaning physically removes soil, sanitizing reduces germs to a safe level on food-contact and mouthed items, and disinfecting destroys germs on surfaces such as changing tables and toilets. A product sprayed on top of soil simply cannot contact the germs underneath.

    Source: Caring for Our Children (AAP/APHA/NRC), cleaning before sanitizing or disinfectingReport a problem with this question

14. 14. A child's nose bleeds onto the classroom carpet. What should the caregiver do?

    • A.Put on disposable gloves, care for the child, then clean and disinfect the area, treating the blood as if it were infectious✓ Answer
    • B.Cover the spot with a rug and clean it after the children go home
    • C.Quickly wipe up the blood with a paper towel and wash her hands afterward
    • D.Ask the child's family to take care of the spot at pickup time

    Standard precautions require treating every person's blood and body fluids as potentially infectious, because you cannot tell by looking who carries a bloodborne germ. Gloves plus prompt cleaning and disinfection of the surface break the route of transmission before another child touches the spot.

    Source: Caring for Our Children (AAP/APHA/NRC), standard precautions and handling of body fluid spillsReport a problem with this question

15. 15. Two children arrive at the same time. One has a clear runny nose but is playing, eating and joining the group as usual. The other is unusually sleepy, hard to rouse, and has a rash that is spreading quickly. What is the best decision?

    • A.Keep the child with the runny nose in the group, and separate the very sleepy child with the spreading rash, notify the family and seek medical guidance✓ Answer
    • B.Send both children home, since both show symptoms
    • C.Keep both children, since neither has a diagnosis from a doctor
    • D.Let each family decide whether its child stays for the day

    Exclusion decisions rest on how the child is functioning, not on the presence of any symptom: a child is excluded when he cannot take part comfortably, needs more care than staff can give without shortchanging the group, or shows signs of severe illness such as lethargy or a rapidly spreading rash. Most mild illnesses do not require exclusion, and staff — not families — apply the program's written policy.

    Source: Caring for Our Children (AAP/APHA/NRC), inclusion and exclusion of children who are illReport a problem with this question

16. 16. At lunch a child eats a small amount and says he is full. What is the best response?

    • A.Tell him he will not get an afternoon snack if he does not finish
    • B.Accept what he says, let him stop eating, and keep him with the group at the table until the meal ends✓ Answer
    • C.Tell him he must clean his plate before he may leave the table
    • D.Offer him a dessert if he takes three more bites of his lunch

    In responsive feeding the adult decides what food is offered and when, and the child decides whether and how much to eat. Pressuring, bargaining with dessert, or withholding a later snack overrides the child's own hunger and fullness signals and turns food into a reward or punishment.

    Source: Caring for Our Children (AAP/APHA/NRC), responsive feeding and mealtime practices; CDA Competency Standards, Council for Professional Recognition — appropriate mealtime experiencesReport a problem with this question

17. 17. A child in the classroom has a documented peanut allergy and a written care plan on file. Besides not serving him peanut products, what most reduces his risk at mealtime?

    • A.Serving him his meal after all the other children have finished eating
    • B.Seating him alone at a separate table away from the other children
    • C.Washing hands and cleaning and sanitizing tables, chairs and serving utensils before and after meals, and using separate serving utensils so his food never contacts peanut residue✓ Answer
    • D.Reminding the other children not to share their food with him

    Most allergic reactions in group care come from cross-contact — invisible traces left on hands, tables and shared utensils — rather than from the child eating an obvious serving of the food. Removing residue addresses the actual mechanism, while isolating the child singles him out socially without making the surfaces he touches any safer.

    Source: Caring for Our Children (AAP/APHA/NRC), care of children with food allergies and prevention of cross-contactReport a problem with this question

18. 18. Why should a caregiver never prop a bottle for an infant, even when the room is busy?

    • A.The milk in a propped bottle cools down too quickly to be safe
    • B.It teaches the baby to hold her own bottle before she is ready
    • C.Milk keeps flowing whether or not the baby is actively sucking, which raises the risk of choking, ear infection and tooth decay, and no adult is there to read her feeding cues✓ Answer
    • D.A propped bottle is harder to clean and sanitize afterward

    A propped bottle removes the infant's control over the flow, so milk can pool in the mouth and enter the airway or the eustachian tubes and bathe the teeth. Holding the baby also keeps the adult present to notice when she signals that she has had enough, which is the foundation of responsive feeding.

    Source: Caring for Our Children (AAP/APHA/NRC), feeding infants and prohibition of bottle proppingReport a problem with this question

19. 19. At drop-off a parent hands the teacher a plastic bag holding several loose pills and says, "Please give him one after lunch." What should the teacher do?

    • A.Ask the child to point out which pill he usually takes
    • B.Decline to give it and explain that medication must arrive in its original labeled container with the family's written authorization on file, and that every dose given is documented✓ Answer
    • C.Give half a pill to be on the safe side
    • D.Give the pill as asked, because the parent is the child's legal guardian

    Written authorization and an original labeled container are what let staff verify the right child, right medication, right dose, right route and right time — verbal permission and loose pills make that verification impossible. Documenting each dose then prevents a second adult from repeating it.

    Source: Caring for Our Children (AAP/APHA/NRC), medication administration and labeling; CDA Competency Standards, Council for Professional Recognition — written parental authorization for medicationReport a problem with this question

20. 20. Over several weeks a caregiver notices unexplained bruises on a child and sees him flinch when any adult reaches toward him. She is not certain that abuse is occurring. What should she do?

    • A.Tell the director about her concern and consider her responsibility met
    • B.Report her reasonable suspicion to the authorities herself, because the legal standard is suspicion rather than proof and the duty belongs to her personally✓ Answer
    • C.Wait until she has proof before saying anything to anyone
    • D.Ask other families whether they have noticed anything unusual about the child

    Early childhood educators are mandated reporters, and the trigger for reporting is reasonable suspicion — investigating and proving are the authorities' job, not the caregiver's. The duty is individual, so it is not discharged by informing a supervisor, and questioning other families would spread private information without protecting the child.

    Source: CDA Competency Standards, Council for Professional Recognition — recognizing and reporting suspected child abuse and neglect; Caring for Our Children (AAP/APHA/NRC), mandated reporting duty of caregiversReport a problem with this question

21. 21. After a caregiver has made a report of suspected abuse, how should she treat the child and the family at the program?

    • A.Avoid contact with the family so that things do not become uncomfortable
    • B.Tell the family that she was the one who made the report so they hear it from her
    • C.Share the situation with other families so they can keep an eye on the child
    • D.Continue the same warm, consistent care and daily routines, stay professional with the family, and keep the information confidential, sharing it only with those who have a legal need to know✓ Answer

    A predictable, caring relationship with a trusted adult is one of the strongest protective factors for a child who may be experiencing harm, so withdrawing support harms the child twice. Confidentiality also protects the child and the integrity of the investigation, which is why the information goes only to those legally entitled to it.

    Source: CDA Competency Standards, Council for Professional Recognition — supporting children after a report and maintaining confidentialityReport a problem with this question

Practice questions based on the CDA Competency Standards published by the Council for Professional Recognition, the NAEYC position statement on developmentally appropriate practice and its Code of Ethical Conduct, and the national health and safety performance standards for early care and education (Caring for Our Children). CDA and Child Development Associate are marks of the Council for Professional Recognition; this site is not affiliated with or endorsed by the Council. Child care licensing — ratios, group sizes, training hours, and background checks — is set by each state and differs everywhere, so confirm your own state's regulations and the current credentialing requirements before you apply. About the CDA credential →