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 AB 1820 Page 2 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 AB 1820 Page 3 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 AB 1820 Page 4 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? AB 1820 Page 5 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 ofpushpinschoking hazards, AB 1820 Page 6 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