California requires every licensed child care facility to keep at least one person with current pediatric first aid and pediatric CPR certification on-site whenever children are in care. The certification has to come from the American Red Cross, the American Heart Association, or another program approved by the California Emergency Medical Services Authority (EMSA), and beginning January 1, 2026, the course must also cover anaphylaxis prevention and the emergency use of epinephrine auto-injectors. These are the core California child care pediatric first aid and CPR requirements, and the rest of this article walks through how they apply to your facility.1California Legislative Information. California Health and Safety Code HSC 1596.866
Who Has to Be Certified
The coverage rule is the same across facility types: at least one certified staff member must be physically present at all times children are in care, including during field trips and other off-site activities.1California Legislative Information. California Health and Safety Code HSC 1596.866
At a child care center, at least one director or teacher must complete the full health and safety training, which includes pediatric first aid and CPR. Beyond that person, the center must ensure someone holding a current course completion card is on-site every moment children are present and travels with them off-site.2Legal Information Institute. California Code of Regulations Title 22 Section 101216 – Personnel Requirements The statute does not require every employee to be certified, but staffing a single certified person creates coverage risk, and many centers certify extra staff for that reason.
At a family child care home, the licensee who directly provides care must hold the certification. If the licensee is ever absent during operating hours, at least one other on-site staff member must have a current completion card in pediatric first aid and CPR.1California Legislative Information. California Health and Safety Code HSC 1596.866 The law says additional staff beyond that minimum are not required to be certified, though the Department of Social Services encourages it.3California Department of Social Services. Family Child Care Homes Manual
What the Course Has to Cover
The pediatric first aid and CPR component runs eight hours: four hours of pediatric first aid and four hours of pediatric CPR/AED training.4California Emergency Medical Services Authority. EMSA Childcare Provider Training Requirements Approved courses cover infant and child CPR technique, use of an automated external defibrillator, managing conscious and unconscious choking, controlling bleeding, and responding to common pediatric emergencies.
As of January 1, 2026, any pediatric first aid or CPR course used to satisfy licensing must also include instruction on the prevention and treatment of anaphylaxis, including the emergency use of epinephrine auto-injectors.1California Legislative Information. California Health and Safety Code HSC 1596.866 If you certified on or before December 31, 2025, and your course did not include anaphylaxis, you do not have to recertify immediately. Your next renewal course does have to meet the new standard, so anyone renewing in 2026 or later should confirm the course covers epinephrine auto-injector use before enrolling.
Approved Providers and Course Format
EMSA approves the training programs that satisfy the licensing requirement. The statute names the American Red Cross and the American Heart Association, and EMSA approves other vendors that meet its curriculum and instructor standards.1California Legislative Information. California Health and Safety Code HSC 1596.866 Before paying, ask to see the program’s EMSA approval so you know the course will count.
Format matters. Pediatric first aid and CPR must be completed either fully in-person or through a hybrid format that pairs a virtual lecture with in-person skills practice and testing.4California Emergency Medical Services Authority. EMSA Childcare Provider Training Requirements A fully online first aid or CPR course does not satisfy the requirement, regardless of who offers it. EMSA also prohibits replacing a live instructor with pre-recorded video; recordings can supplement live teaching but cannot stand in for it.
Renewal Every Two Years
Pediatric first aid and CPR certification must be renewed every two years. Each renewal covers the same eight hours as initial certification: four hours of first aid and four hours of CPR. There is no abbreviated refresher.4California Emergency Medical Services Authority. EMSA Childcare Provider Training Requirements
The certification has to stay current continuously. Even a one-day gap between your expired card and a new one puts the facility out of compliance if you are the only certified person on site. Book the renewal well before the expiration date printed on your card. If an instructor tries to run the course in fewer hours than required, EMSA asks that you report it to ChildCare@emsa.ca.gov.
Proof for Licensing Visits
The Community Care Licensing Division of the California Department of Social Services conducts both announced and unannounced visits and can ask for proof of current certification.5California Department of Social Services. Community Care Licensing Division Acceptable proof is a current course completion card in pediatric first aid and CPR issued by the American Red Cross, the American Heart Association, or an EMSA-approved training program.3California Department of Social Services. Family Child Care Homes Manual Keep copies on-site. The card should show the provider’s name, completion date, and expiration date. If a licensing analyst asks and you cannot produce it, the facility can be cited even if the person is actually trained.
What Happens if Certification Lapses
A missing or expired certification is treated as a licensing deficiency. The Community Care Licensing Division can issue citations, and uncorrected serious deficiencies can escalate to conditions on the license or revocation.
Children With Specialized Health Needs
One boundary worth flagging: standard pediatric first aid and CPR does not cover condition-specific protocols for children with complex medical needs, such as insulin or glucagon administration for a child with diabetes. Under the Americans with Disabilities Act, providers must make reasonable modifications so children with disabilities can participate, which can include training staff to assist with those interventions.6ADA.gov. Equal Access to Child Care If your facility serves a child with those needs, plan on supplemental training worked out with the child’s parents and physician, on top of the EMSA-approved course.