5.3.21

Napping Procedures (EHS/HS)

Preschool & Toddler

Naptime Training Video

Preschool and Toddler Nap Time Guidelines

Basic Materials and Procedures

Ensure that you have the appropriate napping equipment:

• Cots/mats – enough for one per child and 1 or 2 extras in case a child has a toileting accident.
• Sheets – enough for each cot and extras to change when soiled.
• Books – have books and baskets available for naptime. There should be at least one per child.
• Music – have a variety of calm music to play during nap time.
• Sanitation – have disinfectant and sanitation solutions readily available for sanitizing and disinfecting cots on a regular basis. Cots should be disinfected weekly or when soiled.
• Blankets – each child will need a blanket. The blankets need to be small enough to fit on the cot and store safely. Crib blankets work well.
• Laundry – sheets and blankets should be washed weekly for preschool age children. Decide if blankets will be brought from home and sent home to launder or if the center will provide and launder the blankets. Have a procedure for disinfecting cots and laundering bedding.
  • For toddlers, all bedding should be washed daily after use. Laundry is done at the center. Also, all cots should also be disinfected daily after use.
  • Also see Cleaning and Laundry
• Universal Precautions – train staff on the procedures to follow in the case that a child soils a cot.
• Storage – think about where cots will be stored. The location should be easily accessible. Cots should be stored in a place that is sanitary and can be maintained in safe condition. Avoid storing cots in bathrooms for sanitation issues. Cots should be stored so that bedding from one cot does not touch bedding from another.
• Rocking chair – sometimes a rocking chair can be helpful during nap time to help children relax.
• Cot tags-each cot should be labeled with the child’s name. This prevents children from accidently sharing bedding. Cot labels can be purchased. Masking tape or sticky labels can be used, however overtime it leaves a sticky residue that is difficult to clean.

Supervision and Zoning

Supervision during nap time is of the utmost importance. This will require zoning and strategic set up of the environment.

• Explore the space in the classroom and create zones for cot placement. This may require moving shelves and other furniture. The zones will ensure direct supervision and correct cot spacing.
• Position staff strategically inside of each zone so that all children are visually supervised.
• Zones for napping should correspond with the number of staff overseeing nap time. For instance, if there are three (3) staff, then three zones could be used. Always have a backup plan for times when you are understaffed, such as how to create the nap area with two zones.
• The cots need to be spaced three (3) feet apart. Shelves and other furniture do not count as a barrier between children. The shelf width can count as part of the three feet spacing.

Routines

It is important to set a nap time routine so that each child knows what to expect. This also helps staff know their roles during nap time and allows for a smooth transition. Some ideas for a routine:

• Play soft music to set the transition to nap time. There are many nap time CDs available. The music can help the children relax during rest time.
• Have a system in place so that each child has the opportunity to use the bathroom or have their diaper changed just before nap time.
• Allow children to pick a book to read or look at on their cot. Selectively choose the books that will be placed out for nap time. Choose books that are short and have a calm story plot. Board books are great for nap time because of their length and durability.
• Offer gentle back rubs.

Individualize

It is important to know the temperament and sleeping patterns of each child. Nap time can be scary and stressful for some children, especially if this is their first experience of napping in a center. Keep in mind that some children have experienced trauma and nap time can be a trigger. Here are some items to consider for individualization:

• Allow the child to bring something from home for nap time, such as a blanket or a small stuffed animal. This could help ease the stress of nap time and provide security and a connection to home.
• Know what helps each child relax. Some children may like a gentle back rub, a deep pressure hand on their back, or a gentle rub on their arm. Other children may not want to be touched at all. Respect the child’s wishes and always ask what they would like.
• Some children may need extra support during nap time. Perhaps a child will need to be rocked for a short time. Another child may need to look at the book on their cot for an extended time. Support each child in their needs.
• Intentionally think about the placement of each child’s cot. Some children will sleep for an extended time where others may not sleep at all. Place children who are extended sleepers in a more secluded quiet area. Place the children who do not sleep in a location that is easy for them to transition to quiet activities. The location should be in an area that is easy to put the cots away without disrupting the sleeping children.
• Some children may have a hard time relaxing when placed next to certain children. Strategically place children so that they surrounded by children that will not make nap time difficult for them.
• Nap Chart – Once the best placement for each child has been determined create a nap chart (or map) that shows the placement of each child’s cot. This is especially helpful when substitutes or volunteers are in the classroom.

Power Struggles

Community Care Licensing does not require that children remain at rest time for a designated amount of time. Nap time can be very frustrating for children for several reasons. Sometimes the children have grown out of needing a nap. Other children do not feel secure in taking a nap in the classroom. Keep the rest time short for those who will not sleep. If a child is not sleeping after about 20 minutes of quiet, allow them to participate in quiet activities. Other points to consider regarding power struggles:

• Offer choices when possible. This helps the child feel like they have some control over the rest time. Allow them to choose their book, whether to sleep with their shoes on or off, or whether to cover or uncover with their blanket. These are just a few examples.
• Avoid insisting the child lies down. If the child is sitting quietly on their cot, let them be.
• Avoid insisting that a child lies perfectly still. Some children need to fidget to self soothe. A child at this age needs to move, it would not be developmentally appropriate to expect a child of this age to be perfectly still.
• Reassure the child that the rest time will be over soon and that they will be allowed to get up.
• Avoid talking aloud to a child across the room. If a child needs your direct attention, go over to the child, lower your body so that it is close to the child, and whisper to the child.

Quiet Activities

Be prepared for quiet activities for non-napping children. Consider the following:

• Have a designated space set up with quiet activities each day. This could be at a table in a corner of the room.
• Create individual tubs that consist of quiet activities. Give non-napping children a tub on their cot or allow them to play with activity next to their cot.
• This could be an opportunity to go outside and play. There could be an area set up for reading books or doing art. Just consider the adult/child ratios for both indoors and outdoors when choosing this option.

Infants Under Two Years of Age

Infant Sleep Positions

For the health and safety of all infants, Shasta Head Start will follow the guidelines established by the American Public Health Association and the American Academy of Pediatrics regarding Sudden Infant Death Syndrome (SIDS) prevention.

Refer to: What does a Safe Sleep Environment Look Like?

Infant Nap Time Guidelines

• Infants up to twelve months of age must be placed for sleep in a supine position (wholly on their back) for every nap or sleep time unless the infant’s primary health care provider has completed a signed waiver indicating that the child requires an alternate sleep position. When an infant (up to 12 months of age) has the ability to roll from their front to their back and their back to their front, the LIC 9227 sections C and D must be completed immediately.  Should an infant not have the LIC 9227 sections C and D completed and the infant is found in a position other than on their back while napping, they must be moved back to their back.
• Infants must be placed for sleep in safe sleep environments; which includes: a firm crib mattress covered by a tight-fitting sheet in a safety-approved crib (the crib should meet the standards and guidelines reviewed/approved by the U.S. Consumer Product Safety Commission [CPSC] and ASTM International [ASTM]), no monitors or positioning devices should be used unless required by the child’s primary care provider, and no other items should be in a crib occupied by an infant except for a pacifier;
• Only one infant should be placed in each crib;
• Soft or loose bedding should be kept away from sleeping infants up to 12 months and out of safe sleep environments. These include, but are not limited to: bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, etc. Also, blankets/items should not be hung on the sides of cribs. One-piece sleepers or sleep sacks that allow the child’s arms to be free may be used.  Weighted sleep sacks may not be used.
• Toys, including mobiles and other types of play equipment that are designed to be attached to any part of the crib should be kept away from sleeping infants and out of safe sleep environments;
• When caregivers place infants in their crib for sleep, they should check to ensure that the temperature in the room is comfortable for a lightly clothed adult, check the infants to ensure that they are comfortably clothed (not overheated or sweaty), and that bibs, necklaces, and garments with ties or hoods are removed;
• Infants should not nap or sleep in a car safety seat, bean bag chair, bouncy seat, infant seat, swing, jumping chair, play pen or play yard, highchair, chair, futon, or any other type of furniture/equipment that is not a safety-approved crib (that is in compliance with the CPSC and ASTM safety standards);
• If an infant arrives at the facility asleep in a car safety seat, the parent/guardian or caregiver should immediately remove the sleeping infant from this seat and place them in the supine position in a safe sleep environment (i.e., the infant’s assigned crib);
• If an infant falls asleep in any place that is not a safe sleep environment, staff should immediately move the infant and place them in the supine position in their crib;
• Infants must be directly observed by sight and sound at all times, including when they are going to sleep, are sleeping, or are in the process of waking up;
• All napping infants under 2 years of age must be visually checked and their condition recorded every 15 minutes using the EHS Nap Log.
• Bedding must be changed between children, and if mats are used, they should be cleaned between uses.

EHS Nap Log

It is a Community Care Licensing requirement that children under two years of age have written documentation that they were visually checked, and their condition monitored for signs of distress every 15 minutes during naps.  Staff will use the EHS Nap Log (PDF) to document that infants, under two years of age, were checked every 15 minutes during their nap.

EHS Nap Log Directions:

• Fill in child’s name
• Fill in the week of
• Fill in date, start and end time of each nap
• Set a timer (using the tablet) to go off every 15 minutes during the child’s nap (detailed instructions can be found in the Infant Sleep Requirements training video)
• At each 15-minute check:
  • Write the time
  • Initial
  • Note the sleeping position (if other than on their back) – If child is found in a position other than on their back and does not have it documented on LIC 9227 that they can roll, place them back on their back
  • Note any potential signs of distress – if child is experiencing extreme signs of distress, take immediate emergency action
• Keep the EHS Nap Log with the child’s daily logs during the week, and file in the Education section of the child file at the end of the week.

The EHS Nap Log training can be found in the Infant Sleep Requirements Training video located on the SOP.  This video is required viewing for all center-based EHS Education Staff.

Care of Cots, Mats, Cribs and Bedding in All-Day Care

Napping children must be provided with an individual cot, mat, crib and sheet to sleep on. This reduces the risk of infection between children and allows for easy access to all napping infants/children in the event of an emergency. Children may bring additional blankets or bedding from home.

When cots/cribs are used for sleeping/napping, they must be:

• Maintained in a safe condition
• Spaced 3 feet apart
• Wiped or sprayed with disinfectant weekly (or more if soiled). It is recommended to clean cots every Friday, P.M., allowing them to air-dry (un-stacked) over the weekend
• For infants and toddlers crib mattresses and cots will be disinfected daily (or more often if soiled).
• Stacked carefully when not in use so that sleeping surfaces do not touch.
• Sheets covering the cots must be:
  • Tight-fitting (straps must be attached)
  • Used for one child only (cots are labeled with the child’s name)
  • Stored so that they don’t touch other sleeping surfaces (i.e. the sheets or cots of other children)
  • Replaced if torn or frayed
  • Wash weekly or more often if soiled; Wash daily for infants and toddlers

Blankets or other laundry brought from home must be sent home weekly for laundering (recommend every Friday).

References

• Universal Precautions
• What Does a Safe Sleep Environment Look Like?/Safe Sleep for Your Baby(SP)
• Related SOPs:
  • Cleaning and Laundry

Resources

• Infant Nap Log PDF