BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1820
                                                                  Page  1

           Date of Hearing:   April 24, 2012

                        ASSEMBLY COMMITTEE ON HUMAN SERVICES
                                Jim Beall Jr., Chair
                    AB 1820 (Block) - As Amended:  March 29, 2012
           
          SUBJECT  :  Child Safety: day care facilities: push pins

           SUMMARY :  Prohibits licensed child day care facilities from 
          using or possessing push pins in areas accessible to children 
          who are six years of age or younger.  Specifically,  this bill  :  

          1)Prohibits a licensed child day care facility from using or 
            possessing push pins in any area of the facility accessible to 
            children who are six years old or younger.

          2)Requires the Department of Social Services (DSS) to determine 
            compliance with this section only during a regularly 
            scheduled, authorized inspection.

          3)Does not require nor preclude DSS from conducting an 
            independent or separate inspection visit for an alleged 
            violation of this section.

          4)Subjects violations of this section to existing law, which 
            makes it a misdemeanor for violation of this prohibition, 
            punishable by a fine not to exceed $1,000, or no more than 180 
            days in county jail, or a combination of a fine and 
            imprisonment. 

           EXISTING LAW  

          1)Establishes the California Child Day Care Facilities Act 
            (CDCFA) to provide a comprehensive, quality system for 
            licensing child care facilities to ensure a quality day care 
            environment and states that good quality child care services 
            are essential services for working parents.

          2)Sets licensing requirements and provides authority to DSS to 
            develop and adopt regulations to administer the act, including 
            the authority to set licensing standards for facilities that 
            provide nonmedical care to children under the age of 18.

          3)Defines a "day care center" as any child day care facility 
            other than a family day care home, and includes infant 







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            centers, preschools, extended day care facilities, and school 
            age child care centers.

          4)Defines a "family day care home" as a home that regularly 
            provides care, protection and supervision for 14 or fewer 
            children for periods of less than 24 hours per day.

          5)By regulation, requires child care centers to be clean, safe, 
            sanitary, and in good repair at all times to ensure the safety 
            and well-being of children, employees and visitors.

          6)By regulation, requires child care centers to be maintained, 
            in good condition, free of sharp, loose or pointed parts.  All 
            play equipment and materials shall be age appropriate.

          7)By regulation, requires child care centers to provide safe 
            toys, play equipment and materials and the (child care) home 
            shall be free from defects or conditions which might endanger 
            a child.

          8)Requires child day care centers and family day care homes to 
            have on site at least one staff person who holds a valid 
            certification in pediatric first aid and pediatric 
            cardiopulmonary resuscitation (CPR) whenever children are 
            present at the center or home. 

          9)Allows a parent or guardian of a child receiving services from 
            a licensed child day care facility the ability to enter and 
            inspect the facility providing services to their child without 
            advance notice during normal operating hours. 

          10)Allows any person to file a complaint against a child day 
            care facility, either in writing or orally, alleging a 
            violation of law.

          11)Requires DSS, if determined to be made on a reasonable basis, 
            to make an onsite inspection of the facility within ten days 
            of receipt of the complaint.

          12)Provides authority to DSS to deny, temporarily suspend, 
            suspend, or revoke the license of any licensed child care 
            agency if DSS determines that the facility engaged in efforts 
            to aide, abet, or act in violation of the law.

          13)Provides that a person who willfully or repeatedly violates 







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            any provision of the CDCFA may be charged with a misdemeanor.  
            If convicted, the individual may be subject to a fine of no 
            more than $1,000 or 180 days in county jail, or a combination 
            of both, for each violation.

           FISCAL EFFECT  :  Unknown

           COMMENTS  :  In February, 2010 the American Academy of Pediatrics 
          published an article titled "Prevention of Choking Among 
          Children."  According to this article, choking is a leading 
          cause of morbidity and mortality, especially those aged three 
          years or younger.  It sites a number of reasons why young 
          children are more likely than older children to suffer from 
          airway blockages:

             1)   Young children have decreased developmental physical 
               abilities reflective of their young age who oftentimes do 
               not have the physical ability to properly chew and swallow 
               food or pass foreign objects through their digestive 
               system. 

             2)   Due to the smaller diameter of a child's airway, small 
               objects are much more likely to get stuck in their throat 
               or esophagus. 

             3)   As children learn to crawl and walk, they become more 
               mobile and inquisitive about their surrounding environment, 
               which includes greater exploration and experiences that can 
               include putting non-food foreign objects into their mouths. 


          The article concludes that choking is an important public health 
          problem for young children and that choking hazards are 
          primarily associated with food, coins and toys. However, it is 
          not unreasonable to determine that any small object, whether it 
          is food, a toy, or an item such as a push pin can present a 
          danger to young children if swallowed or ingested.

          Additionally, in a ten-year review of young children who 
          suffered from a blocked airway due to the ingestion of a foreign 
          object published in the International Journal of Pediatric 
          Otorhinolaryngology, it was found that food is the most common 
          cause of airway blockages in young children.  Most common to 
          cause blockages are "globular food objects" such as hotdogs, 
          nuts, candies and grapes.  In regards to non-food blockages, it 







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          was found that rubber balloons and small plastic items were the 
          most frequent cause of choking in young children. 

          There are a number of studies, reports and published articles 
          available that highlight the dangers and threat choking hazards 
          present to young children.  In many of these published 
          documents, there are a variety of items documented as having 
          caused an airway blockage in young children.  They include 
          rocks, plastic pen caps, balloons, peanuts, etc. 

          In 1994, the federal Hazardous Substance Act was amended by the 
          Child Safety Protection Act (CSPA) to require hazard warning 
          labels be placed upon packaging for small toys that can present 
          a choking hazard for young children.  The CSPA requires, among 
          other things, the banning or labeling of toys that pose a 
          choking risk to small children.  The CPSA specifically requires: 


                 The banning of small balls (or toys that contain small 
               balls) with a diameter of 1.75 inches if the toy or ball is 
               intended for use by children under 3 years of age.

                 Any toy or game that is intended for use by children who 
               are at least 3 years old but less than 7 years of age be 
               conspicuously labeled with a warning statement that the toy 
               contains a small part and it therefore poses a choking 
               hazard to small children.  The Act defines a small part as 
               one that fits completely into a small part tester with a 
               diameter of 1.25 inches.

                 Any latex balloon (or toy or game that contains a latex 
               balloon) be conspicuously labeled to warn parents about the 
               choking hazards associated with an un-inflated balloon, or 
               broken balloons.

          Although this bill proposes to singularly prohibit the use or 
          possession of push pins in child day care facilities, the causes 
          of choking are vast and can be anything within reach of a young 
          child that is small enough to get lodged in their throat or 
          esophagus.  Would it be more prudent to align this bill with the 
          choking hazards specifications established by the CSPA to ensure 
          greater uniformity with federal law and provide more generally 
          inclusive restrictions to prevent young children access to any 
          choking hazard?








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          Additionally, amending the Health and Safety Code to 
          specifically prohibit the use or possession of pushpins in child 
          day care facilities may inadvertently give rise to repeated 
          legislative efforts to itemize specific choking hazards, which 
          could lead to the code becoming cumbersome and overly 
          prescriptive. 

          It can be argued that DSS licensing regulations already prohibit 
          the use or possession of pushpins in child care facilities, as 
          it may fall under the restriction of items that could present a 
          danger to young children. However, neither the statute nor 
          licensing regulations specifically restrict the presence of 
          choking hazards. Amending this measure to be more reflective of 
          choking hazards in general, rather than that of a specific type 
          of hazard would help to clarify current law and provide a 
          greater general protection against choking hazards for young 
          children. 

           Need for this bill:  

          According to the author, push pins "pose a heightened risk for 
          small children if ingested due to their small size, design and 
          sharp point."  Due to its sharp point, if ingested, a push pin 
          can become lodged in the throat, airway, esophagus or other part 
          of a child's digestive system, which can prove to be nearly 
          impossible to retrieve under normal first aid procedures, 
          including the use of CPR or the Heimlich maneuver. 

           RECOMMENDED AMENDMENTS:  

          Staff recommends the following amendments:

          Since choking hazards can include a variety of items, this bill 
          should be amended to reflect the need to address the increased 
          health problems choking hazards cause for young children.  
          Rather than address specifically a singular item, utilizing the 
          choking hazard specifications established by the CSPA, this bill 
          should require areas used to serve children under the age of six 
          in child day care facilities be free of choking hazards, such as 
          pushpins, small toys, and other items that measure less than 
          1.75 inches in diameter.   Specifically, amend page two of this 
          bill, lines three through five to read:

               1596.918. (a) A licensed child day care facility shall 
               prohibit the use or possession of   pushpins  choking hazards, 







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               such as push pins, small toys, marbles, and other items 
               that measure less than 1.75 inches in diameter  in any area 
               of the facility accessible to children 6 years of age or 
               younger.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          None on file

           Opposition 
           
          None on file
           
          Analysis Prepared by  :    Chris Reefe / HUM. S. / (916) 319-2089