Join Our E-Mail List and Database for Child Care Health Consultants

All Child Care Health Consultants (CCHCs) in California are invited to participate in two resources: a CCHC e-mail list and a CCHC database.

With the data we collect from you on the registration form we will be creating a profile of CCHCs in California and the information in this form will help us to promote and support the CCHC workforce in the state.

CCHC E-MAIL LIST: The CCHC e-mail list will give you the opportunity to discuss ideas and share resources with your colleagues in the field of child care health consultation. As a list member, you will receive a monthly e-mail with the latest health and safety information, resource links and announcements. In addition to these monthly e-mails, you will be able to participate in e-mail discussions with other list members on an ongoing basis. All e-mails posted to the list will be archived on a Web site accessible to list members. List members will include CCHCs and other health care professionals working as CCHCs in California. The CCHC list will be moderated by the California Childcare Health Program (CCHP)—that is, all e-mails posted to the list will be sent to CCHP first to ensure that they are applicable to the list before they are posted.

CCHC DATABASE: CCHCs who join the database on the California Childcare Health Program's Web site will be listed as experts in California who are available to conduct workshops, provide on-site consultations and respond to other requests for CCHC services received by CCHP. The Web site contact information will include your name, title, professional background, areas of expertise, services provided, county served, phone number and e-mail address.

* indicates a required field

1. What is your contact information?
First Name *
Last Name *
Work E-mail *
Degree(s):
Job Title
Organization
Address
City
State
ZIP
County
Phone
Fax

2. What type of work do you do?
Provide child care health consultation in one or more ECE program(s).
Work in an ECE program, but do not provide child care health consultation.


(please specify type of work)

Other (please specify)

3. How many days per week do you work?
1 day
2 days
3 days
4 days
5 days

4. How many days do you work as a CCHC?
1 day
2 days
3 days
4 days
5 days

5. What is your professional background? (check all that apply)
Public health nurse
Registered nurse
Nurse practitioner
School nurse
Physician
Physician's assistant
Psychologist
Social worker
Occupational therapist
Physical therapist
Speech and language pathologist
Certified health education specialist
Graduate student (child health-related discipline)
Registered dietitian
ECE professional

Other (please specify)

6. Where did you receive your training as a CCHC? (check all that apply)
California Training Institute CCHC training
National Training Institute CCHC training
American Academy of Pediatrics (AAP)-sponsored training
National Association of Pediatric Nurse Practitioners (NAPNAP)-sponsored training
Other (please specify)

7. How do you stay up-to-date for your CCHC work? (check all that apply)




Other (please specify)

8. What are your areas of expertise? (check all that apply)
Child care operations
Child growth, development and behavior
Environmental issues in child care
Infant and toddler caregiving
Health and safety training resources
Safety promotion and injury prevention
Identifying and caring for children with special needs
Staff health and child health promotion
Infant feeding and early childhood nutrition
Obesity prevention
Infectious disease prevention and control
Immunizations
Management of chronic health conditions (e.g., seizures, diabetes, cystic fibrosis)
Mental and behavioral health
Oral health resources
Asthma management resources
Child abuse and violence prevention
Emergency preparedness for ECE programs
Other (please specify)

9. What kind of services do you provide? (check all that apply)
Consultation with child's health professional about medication
Development or update of policies and procedures for ECE programs
Interpretation of standards or regulations
Linkages to community resources
On-site consultation
Parent/family training about health and safety issues
Program policy development or implementation
Review of health records of children or providers
Screening and assessment
Staff training about health and safety issues
Telephone consultation
Other (please specify)

10. How are you compensated for your CCHC services? (check all that apply)

My Employer

School District
Child Care Resource & Referral Agency
State Department of Health
Local Department of Health
Other (please specify)

Fee for service

From child care provider
From other (please specify)

I am not compensated
Other (please specify)

11. Would you like to join the CCHC e-mail list?
Yes
No
Already belong to the CCHC e-mail list

12. Would you like to join the CCHC referral network?
Yes
No
Already belong to the CCHC network

13. Additional comments or questions.