Staff Compliance Research
Daycare CPR & First Aid Certification Requirements
A plain-language guide to the CPR and First Aid rules every licensed childcare program has to meet: how often staff need to be certified, the difference between pediatric CPR and Heartsaver, the on-site-at-all-times staffing rule, and what actually counts at inspection.
Last updated: June 2026
By the TotReady Research TeamShort answer: Most daycare staff renew CPR and First Aid every two years, because that is how long a certification from the American Heart Association or American Red Cross stays valid. Childcare staff need pediatric CPR (infant and child, not adult only), and most states require at least one certified person on site at all times children are in care.
How often do daycare staff need CPR certification?
The honest answer is that most state regulations do not name a renewal interval. Instead, they require staff to hold a current CPR and First Aid certification at all times — and they let the certifying body set the expiration date. Both the American Heart Association and the American Red Cross issue CPR cards that are valid for two years. So in day-to-day practice, daycare staff renew CPR every two years, on the cycle their course card runs on.
First Aid certification usually runs on the same two-year clock. A few states accept a longer First Aid interval, and some clinical courses (like Basic Life Support) also expire at two years. The rule that matters for compliance is simple: the card on file for every required staff member must not be expired when an inspector checks it.
Pediatric CPR vs. Heartsaver: which course do I need?
CPR course names confuse a lot of new providers. Here is the short version: for working with children, you need a course that teaches infant and child rescue techniques — not adult-only CPR. The course names below all describe how the same skill set is packaged by different providers.
| Course | What it covers | Counts for daycare? |
|---|---|---|
| Heartsaver Pediatric First Aid CPR AED (AHA) | Infant, child, and adult CPR + First Aid + AED, for non-clinical caregivers | Yes — this is the standard childcare course |
| Pediatric CPR + First Aid (American Red Cross) | Infant and child CPR, First Aid, and AED use | Yes |
| BLS for Healthcare Providers (AHA) | Adult, child, and infant CPR at a clinical level | Usually yes — it includes pediatric CPR |
| Heartsaver Adult CPR AED only | Adult CPR and AED — no infant or child component | No — missing the pediatric component |
| Online-only CPR certificate | Video lessons with no in-person skills check | Often rejected — most states require a hands-on test |
When in doubt, ask the training provider for the Heartsaver Pediatric First Aid CPR AED course (AHA) or the Red Cross equivalent. Both bundle pediatric CPR and First Aid into one card, satisfy most state rules, and include the hands-on skills check inspectors expect.
The on-site-at-all-times rule
Two states can both "require CPR" and still mean very different things. The split usually comes down to whether every staff member counted in your ratio needs a current card, or whether it is enough to have at least one certified person physically present whenever children are in care.
The second version sounds easier, but it is the one that quietly creates citations. "At all times" includes the 6:45 a.m. early drop-off before your certified lead arrives, the late-pickup hour after they leave, and every field trip and bus run. If your only certified staffer is out sick, you may be out of compliance the moment the doors open. Build your certification coverage into the schedule the same way you build coverage for ratios.
CPR & First Aid rules by state
Each entry below is pulled from that state's licensing statute or administrative code, with the citation kept intact so you can verify it. These describe when and how childcare staff must hold CPR/First Aid certification; they do not restate the two-year provider expiration, which applies on top. Where a state's code did not yield a quotable CPR sentence, the entry points you to your licensing office instead.
Coverage: 24 of 50 states with a statute-cited CPR rule surfaced below.
Code ch. 660-5-26); CPR and First Aid training does not count toward required hours.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
At least 15 hours of health and safety training, including pediatric first aid and pediatric CPR plus a one-time preventive health practices course (and, for licenses issued after January 1, 2016, one additional hour of childhood nutrition training), is required as a condition of licensure for the family day care home licensee or for at least one director or teacher at each child care center, with first aid/CPR administered through approved providers (Cal.
CPR rule not available in our dataset — confirm with your state licensing office.
Connecticut does not prescribe a pre-service clock-hour figure; instead, before final approval of a family child care home license the applicant must verify current certification in first aid and in cardiopulmonary resuscitation (CPR), per Conn.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
Georgia does not set a single statewide pre-service clock-hour number; before submitting a Family Child Care Learning Home license application the responsible applicant must complete Department-approved licensure orientation, a pre-licensure provider competencies course, and CPR/first aid training, and the Provider and all staff must complete initial program orientation before being assigned to children (Ga.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
For licensed child care HOMES, no numeric annual continuing-education clock-hour total is specified; requirements are task-based: at least one direct caregiver trained in pediatric CPR annually and a first aid course completed every three (3) years (470 IAC 3-1.1-33.5).
Before registration, an Iowa child development home provider must complete department-approved minimum health-and-safety training covering ten required topic areas, complete two hours of Iowa's mandatory child-abuse-reporter training, and hold current first-aid and infant/child CPR certification (Iowa Admin.
Kansas does not specify a fixed number of pre-service clock-hours; instead each applicant must complete an orientation program before applying for a license, and each provider/staff member must complete approved health-and-safety training before being given sole responsibility for the care and supervision of children (for family child care homes per K.A.R. 28-4-114a; for centers/preschools, orientation not later than seven calendar days after the date of employment and before sole responsibility per K.A.R. 28-4-428a), with first aid and pediatric CPR certification obtained before or not later than 30 calendar days after the date of employment (K.A.R. 28-4-114a; K.A.R. 28-4-428a).
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
Family child care: either the provider or at least one staff member must hold current Adult and Pediatric First Aid and CPR certification and must have completed at least 6 hours of pre-licensing training in healthy/safe environments, child development and related topics (10-148 CMR Ch. 33 §7.A.4.b); all staff must receive orientation training within the first 90 days of service, with fire/disaster/emergency procedures completed within the first week (10-148 CMR Ch. 33 §8.A).
A Maryland family child care provider must complete either the 90-clock-hour pre-service course or its approved equivalent OR at least 24 clock hours of approved training that includes 4 clock hours in each of the six core-of-knowledge competencies (within the 2 years before application), plus first aid, CPR, and emergency/health-and-safety training before providing care, per COMAR 13A.15.06.02; a child care teacher or director in a preschool center must complete 6 semester hours or 90 clock hours of approved pre-service training or hold the Child Development Associate (CDA) credential, per COMAR 13A.16.06.09.
Massachusetts does not set a fixed numeric pre-service orientation clock-hour count in regulation; all educators must attend a Department-approved orientation to early education and care, and family child care licensees must hold current basic first aid and age-appropriate CPR certification prior to licensure, but no specific clock-hour minimum is stated (606 CMR 7.09).
Michigan sets no fixed pre-service clock-hour total for child care center staff; instead, within 30 calendar days after being present at the center and before caring for children unsupervised, program staff must complete training on required safety topics (e.g., discipline policy, emergency procedures, health policies, infection control), with additional topics (medication administration, allergy response, building safety, child development, pediatric first aid/CPR) required within 90 days, and staff must be supervised until orientation is complete (Mich.
Family child care applicants must complete at least 4 hours of child development and learning and behavior guidance training prior to initial licensure plus the 6-hour Supervising for Safety for Family Child Care course, in addition to pediatric first aid and pediatric CPR training that must be completed before initial licensure and before caring for a child (no fixed clock-hour minimum is specified in statute for first aid or CPR) (Minn.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
Montana does not set a fixed pre-service clock-hour total; instead, before providing unsupervised care a staff member must complete current infant/child/adult CPR (hands-on), infant choking response, and pediatric first aid certification, prevention of sudden infant death syndrome and safe sleep practices, and prevention of shaken baby syndrome and abusive head trauma, all as part of department-approved early childhood teacher orientation due within 30 days of hire (ARM 37.95.163(2)(a)-(d)); the remaining orientation topics (infectious-disease control, child development, medication administration, emergency preparedness, hazardous-materials handling, transportation, and child-abuse reporting) must be completed within 90 days of hire (ARM 37.95.163(3)).
Before a Family Child Care Home I provisional license is issued, the applicant must complete a two-hour orientation training provided by the Department plus CPR and First Aid training; child care center staff and volunteers must be provided orientation prior to having direct responsibility for the care of children (391 NAC 1-006.04A and 391 NAC 3-006.10A).
Nevada does not set a single named pre-service clock-hour total before unsupervised contact; instead, newly employed staff must be given a written and oral orientation within the first 2 weeks after commencing employment (NAC 432A.320), and the enumerated initial training topics (CPR, first aid, illness recognition, SIDS, shaken-baby/abusive-head-trauma prevention, medication administration, building/premises safety, emergency preparedness, child abuse recognition, wellness, etc.) must be completed within 90 days or 120 days of hire depending on the topic (NAC 432A.323).
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
After the first year of employment, North Carolina child care center staff and family child care home operators must complete annual on-going training that scales with education and experience: 5 clock hours (four-year or higher degree in a child-care-related field), 8 (two-year degree in a child-care-related field or a NC Early Childhood Administration Credential), 10 (certificate or diploma in a child-care-related field or a NC Early Childhood Credential), 15 (10 years documented experience as a teacher, director, or caregiver in a licensed arrangement), or 20 clock hours if none of these criteria apply; CPR and First Aid do not count toward this requirement (10A NCAC 09 .1103(a),(c) for centers; 10A NCAC 09 .1703(d) for family child care homes).
CPR rule not available in our dataset — confirm with your state licensing office.
Ohio does not set a fixed number of pre-service orientation clock hours before staff may work with children; instead OAC 5180:2-12-10 requires specified trainings within set windows after hire - child abuse and neglect recognition and prevention 'completed within the first sixty days of hire' and first aid and CPR 'completed within the first ninety days of hire' - with at least one trained staff member on-site in each building during all hours of operation until staff are current (OAC 5180:2-12-10).
CPR rule not available in our dataset — confirm with your state licensing office.
Oregon does not set a single pre-service clock-hour total; before approval a Registered Family Child Care provider must complete Introduction to Registered Family Child Care Parts I and II, Introduction to Child Care Health & Safety, a minimum of 2 hours of training on Oregon child abuse and neglect law, Safe Sleep for Oregon's Infants, current pediatric CPR and first aid, Foundations for Learning child development training, and a current Oregon food handler's certification (OAR 414-210-0370(1)); at a Certified Child Care Center, all staff must receive an orientation within the first 10 days of hire and before having unsupervised access to children, and complete Introduction to Child Care Health and Safety plus a minimum of 2 hours of recognizing-and-reporting child abuse training within 30 days of hire (OAR 414-305-0370(1)-(2)).
Code § 3270.11), and each staff person must complete health and safety professional development (infectious disease, SIDS/safe sleep, medication administration, food-allergy response, building/hazard safety, shaken-baby prevention, emergency preparedness, hazardous materials, transportation, and pediatric first aid/CPR) within 90 days of hire (55 Pa.
CPR rule not available in our dataset — confirm with your state licensing office.
In South Carolina child care centers, directors must complete at least 20 clock hours of training annually and all direct-care staff at least 15 clock hours annually (first aid and CPR not counted), per S.C.
No fixed clock-hour count is set; under ARSD 67:42:17:17 all providers must, within 90 days after the date of employment, complete and obtain documentation of orientation in 13 listed health-and-safety areas (infectious disease control; SIDS prevention/safe sleep; medication administration; food and allergic-reaction emergencies; building/premises safety; shaken baby syndrome/abusive head trauma; emergency preparedness; hazardous materials; transporting children; recognition and reporting of child abuse and neglect; pediatric first aid; pediatric CPR; and child development), and may not care for children without supervision until orientation in each area is complete, per the SD DSS Guide to Child Care Licensing Rules (effective May 2026).
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
CPR rule not available in our dataset — confirm with your state licensing office.
Virginia does not set a numeric pre-service clock-hour total; instead, child day center staff must complete orientation training covering 11 required topics (including child abuse and neglect reporting, emergency preparedness, and SIDS/shaken-baby/abusive-head-trauma prevention) prior to working alone with children and no later than seven days after assuming job responsibilities, with the VDOE-sponsored orientation course completed within 90 calendar days of employment and first aid/CPR within 30 days of the first day of employment (8VAC20-780-240).
CPR rule not available in our dataset — confirm with your state licensing office.
No fixed statewide pre-service clock-hour total applies before contact; orientation must be received before a staff member has sole responsibility for children, and specific thresholds vary by setting—a child care center must provide each staff member orientation prior to or during the first week of employment and before sole responsibility for a group of children, ensure CPR/First Aid within six (6) months of employment, and, for an infant/toddler (24 months and under) program, ensure each qualified staff member completes a minimum of forty (40) hours of approved training related to the care of children 24 months and under before the program starts (78 CSR 1 §8.6.d, §8.6.f.1, §8.6.i.1); family child care home caregivers must obtain basic first aid plus two (2) hours of approved health and safety training within the first six months of registration (78 CSR 19 §6.3.a.1 and §6.3.a.2).
Before licensure or working with children, a family child care provider must complete an approved entry-level early childhood education course (3 credits or a department-approved non-credit course, the Registry Family Child Care Credential, or a Child Development Associate credential) and department-approved shaken baby syndrome/abusive head trauma training before working with children under 5; a department-approved infant/child CPR-AED certificate must be obtained within 3 months of licensure or hire, and at least 10 hours of department-approved infant and toddler care training within 6 months of caring for children under age 2 (Wis.
CPR rule not available in our dataset — confirm with your state licensing office.
Want every requirement for your state in one place — ratios, training hours, background checks, and required policies?
See State RequirementsComparing training obligations across states? See the pre-service and annual training hours by state dataset, which carries the same statute-cited source text the table above draws from.
What counts, and what inspectors check
- ✓
A pediatric component is mandatory
The card must cover infant and child CPR. Adult-only CPR does not meet childcare rules in any state.
- ✓
Hands-on skills check, not online-only
Most states require an in-person skills demonstration. A fully online certificate is commonly rejected at inspection.
- ✓
Recognized provider
American Heart Association, American Red Cross, ASHI, or an equivalent nationally recognized provider. Some states publish an approved-provider list.
- ✓
Current, not expired
The card on file for every required staff member must be unexpired on the day of inspection. Track expiration dates the way you track license renewals.
- ✓
Documentation in the file
Keep a copy of each staff member's CPR and First Aid card in their personnel file. Inspectors routinely ask to see current cards during routine visits.
Not sure what your state requires for staff? The free compliance checker walks through it for all 50 states.
Check My StateFrequently asked questions
- How often do daycare staff need CPR certification?
- Most childcare staff renew CPR every two years, because that is how long the two main course providers — the American Heart Association and the American Red Cross — keep a CPR certification valid. States generally require the certification to stay current at all times rather than naming a renewal interval of their own, so the provider's two-year expiration is the deadline that matters in practice. First Aid certification usually runs on the same two-year cycle, though a few states accept a longer First Aid interval; always check your state's exact rule and your course card's expiration date.
- Is pediatric CPR or Heartsaver CPR required for daycare?
- For working with children, you want pediatric CPR — a course that covers infant and child rescue techniques, not just adult CPR. The American Heart Association's general-public course is called Heartsaver, and the version childcare staff need is Heartsaver Pediatric First Aid CPR AED, which covers infants, children, and adults. The clinical-provider course (BLS for Healthcare Providers) also satisfies most state rules because it includes infant and child CPR. A plain adult-only CPR card usually does not meet childcare licensing requirements.
- Does every staff member need to be CPR certified, or just one?
- It varies by state. Some states require every person counted in the staff-to-child ratio to hold current CPR and First Aid certification. Others set a lower bar: at least one certified staff member must be physically present at all times children are in care. The on-site-at-all-times rule is the one that trips centers up — it means your schedule has to guarantee a certified person on the floor during every shift, including early drop-off, late pickup, and field trips. Verify your state's specific rule before you finalize staffing.
- What CPR and First Aid courses count for childcare licensing?
- Most states accept courses from the American Heart Association, the American Red Cross, the American Safety & Health Institute (ASHI), or an equivalent nationally recognized provider, and many require a hands-on (in-person) skills check rather than a fully online course. The card must cover pediatric CPR (infant and child), and First Aid is usually required alongside it. Online-only CPR certificates are frequently rejected at inspection. Keep each staff member's certification card on file — inspectors routinely ask to see current cards.
- When does new daycare staff have to complete CPR certification?
- Timing differs by state. Some states require CPR and First Aid before a new hire works alone with children; others give a grace window — commonly 30 to 90 days after the date of hire — during which the employee must complete it while supervised. A handful of states require it as a condition of licensure for the provider or director before the program opens at all. Check your state's rule below and build the deadline into your onboarding checklist so a lapsed or missing card never shows up at an inspection.