Needs assessment of child care centres in the former city of Toronto.

In 1994 the City of Toronto Public Health Department conducted a needs assessment in the 235 child care centres (CCCs) in the former Toronto area. The purposes of the study were to construct a profile of Toronto's CCCs, to acquire a better understanding of these centres' operations and administration, and to assess their levels of compliance with current public health standards and regulatory requirements. During the study period, five certified environmental health officers audited the 235 centres and interviewed their supervisors using a standardized questionnaire to record self-reported and observational data. The study identified five priorities for public health intervention: written policy regarding monitoring and management of ill children, handling body substances, environmental sanitization procedures and frequencies, water-play table, and injury prevention. The results clearly call for expanding the conventional inspection focus (i.e., primarily food safety) to include other aspects of disease and injury prevention, and for strengthening the on-the-job training programs for CCC caregivers.