Public Health Emergency Preparedness
This resource was part of AHRQ's Public Health Emergency Preparedness program, which was discontinued on June 30, 2011, in a realignment of Federal efforts.
Now this resource is supported by the Administration for Children and Families (ACF).
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Appendix E. Standards and Indicators for Disaster Shelter Care for Children
To provide guidance to shelter managers and staff that ensures children have a safe, secure
environment during and after a disaster—including appropriate support and access to
Standards and Indicators for All Shelters
- Under most circumstances, a parent, guardian, or caregiver is expected to be the
primary resource for his or her children, ages 18 and younger.
- In cases where parents or guardians are not with their children, local law enforcement
personnel and local child protective/child welfare services must be contacted to assist
- Children are sheltered together with their families or caregivers.
- Every effort is made to designate an area for families away from the general shelter
- Family areas should have direct access to bathrooms.
- Parents, guardians, and caregivers are notified that they are expected to accompany
their children when they use the bathrooms.
- Every effort is made to set aside space for family interaction:
- This space is free from outside news sources, thereby reducing a child's repeated exposure to coverage of the disaster.
- If age-appropriate toys are available, they will be in this space, with play
supervised by parents, guardians, or caregivers.
- Shared environmental surfaces in shelters that are frequently touched by children's
hands or other body parts should be cleaned and disinfected on a regular basis. High contact areas may include diaper changing surfaces, communal toys, sinks, toilets,
doorknobs, and floors. These surfaces should be cleaned daily with a 1:10 bleach
solution or a commercial equivalent disinfectant based on the manufacturer's cleaning
instructions. Local health department authorities may be consulted for further
infection control guidance.
- When children exhibit signs of illness, staff will refer children to on-site or local health
services personnel for evaluation and will obtain consent from a parent, guardian, or
caretaker whenever possible.
- When children exhibit signs of emotional stress, staff will refer children to on-site or
local disaster mental health personnel and will obtain consent from a parent, guardian,
or caretaker whenever possible.
- Children in the shelters come in all ages and with unique needs. Age-appropriate and
nutritious food (including baby formula and baby food) and snacks are available as
soon as possible after needs are identified.
- Diapers are available for infants and children as soon as possible after needs are
identified. General guidelines suggest that infants and toddlers need up to 12 diapers a
- Age-appropriate bedding, including folding, portable cribs or playpens are also
- A safe space for breastfeeding women is provided so they may have privacy and a
sense of security and support. (This can include a curtained-off area or providing
blankets for privacy.)
- Basins and supplies for bathing infants are provided as soon as possible after needs are
Standards and Indicators for Temporary Respite Care for Children
Temporary respite care for children provides temporary relief for children, parents,
guardians, or caregivers. It is a secure, supervised, and supportive play experience for
children in a disaster recovery center, assistance center, shelter, or other service delivery
site. When placing their child or children in this area, parents, guardians, or caregivers are
required to stay on-site in the disaster recovery center, assistance center, or shelter or
designate a person to be responsible for their child or children, who shall also be required
to stay on-site
In cases where temporary respite care for children is provided in a disaster recovery center,
assistance center, shelter, or other service delivery site, the following standards and
indicators shall apply:
- Temporary respite care for children is provided in a safe, secure environment following
- Temporary respite care for children is responsive and equitable. Location, hours of
operation, and other information about temporary respite care for children is provided
and easy for parents, guardians, and caregivers to understand.
- All local, State, and Federal laws, regulations, and codes that relate to temporary respite
care for children are followed.
- The temporary respite care for children area is free from significant physical hazards
and/or architectural barriers and remains fully accessible to all children.
- The temporary respite care for children area has enclosures or dividers to protect
children and ensure that children are supervised in a secure environment.
- The temporary respite care for children area is placed close to restrooms and a
drinking water source; hand washing and or hand sanitizer stations are available in the
temporary respite care for children area.
- Procedures are in place to sign children in and out of the temporary respite care for
children area and to ensure children are released only to the parent(s), guardian(s),
caregiver(s), or designee(s) listed on the registration form.
- All documents—such as attendance records and registration forms (which include
identifying information and parent, guardian, or caregiver names and contact
information); information about allergies and other special needs; and injury and/or
incident report forms—are provided, maintained, and available to staff at all times.
- Toys and materials in the temporary respite area are safe and age-appropriate.
- Prior to working in the temporary respite care for children area, all shelter staff
members must receive training and orientation. In addition, such staff must
successfully complete a criminal and sexual offender background check. Spontaneous
volunteers are not permitted. When inside the temporary respite area, staff shall visibly
display proper credentials above the waist at all times.
- When children are present, at least two adults are to be present at all times. No child
should be left alone with one adult who is not the parent, guardian, or caregiver.
- All staff members must be 18 years of age or older. Supervision of the temporary
respite care for children area is provided by a staff person at least 21 years of age.
- An evacuation plan will be developed with a designated meeting place outside the
center. The evacuation plan will be posted and communicated to parent(s),
caregiver(s), and guardian(s) when registering their child.
- The child-to-staff ratio is appropriate to the space available and to the ages and needs
of the children in the temporary respite care for children area at any time.
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