Health assessments - Guidelines for Early Childhood Education (ECE) services - HE8153

Effective 20th April 2026

Health New Zealand | Te Whatu Ora works with ECE services to ensure safe environments and good health practices to support the health and wellbeing of children. An important part of this is carrying out health assessments on services. These guidelines let ECE services know about the assessment process and what to expect.

What is a health assessment?

We carry out health assessments as part of licensing or relicensing of ECE services, or if a concern has been raised by the Ministry of Education.

Health assessments are based on requirements under the relevant licensing criteria and are completed in accordance with the Education (Early Childhood Services) Regulations 2008. An assessment is required before the Ministry of Education will issue a license to operate.

The main aspects we will look at during a health assessment are:

• Illness policies and methods of controlling the spread of diseases.
• Nappy changing procedures and bathroom hygiene.
• General cleaning schedules and upkeep of the service.
• Adequacy of ventilation.
• Ensuring safe noise levels.

Establishing a new ECE service

When establishing a new ECE service, contact the National Public Health Service (NPHS) in your region. They will schedule a time for your assessment visit and request any documentation required (e.g. health procedures). They can also review any procedures if necessary to provide health advice regarding the design of the ECE service. 

It is important that your ECE service is ready so we can carry out an assessment. At the time of the assessment, it is expected that the service will be as it is on the opening day.

• All building work and renovations must be completed e.g. a Code Compliance Certificate has been issued, and a current Building Warrant of Fitness has been issued for premises that require a compliance schedule under the Building Act.
• All equipment must be operating e.g. water temperatures have been tempered, fridges are operating etc.
• Fixtures, fittings and furniture must be in place.

Preparing for a health assessment

Before the assessment visit, we recommend you read all the information we send you so you can address health and hygiene in the design and management of your ECE service. A copy of the assessment form will be provided to you before the visit. We recommended you do a pre check before the visit to ensure everything is in place.

We aim to work with you to undertake the assessment at a date and time suitable (providing the premises are ready to be assessed). If your ECE service is not ready for the visit, please let us know so a new date can be scheduled.

To arrange a visit, reschedule a visit or for further information, please contact the NPHS in your region.

During the health assessment visit

We will carry out a health assessment of the premises. We recommend that someone with detailed knowledge of the ECE service and its operations (e.g. manager or supervisor) is available to assist us during the assessment.

At the end of the visit, we will give a verbal summary of the outcomes. A written report will be sent to you and a copy to the Ministry of Education within seven working days following the assessment.

The Ministry of Education will consider the information within the report and determine what (if any) actions must be undertaken by your ECE service before granting a license.

Health and hygiene documents

Policies and procedures

ECE services will have a range of polices dealing with health and hygiene issues. We recommended policies contain two parts. The first part being a policy statement, which is a short statement that gives a reason for the need for the policy. The second part contains the practices or procedures that will occur at the ECE service to ensure the policy is met.

We will need to review the following documents as part of the health assessment:

• Wash down procedure.
• Nappy changing procedure.
• Procedure outlining how your service will respond to injury, illness and incidents.

The following procedures are recommended to have as good practice and not required under the licensing criteria. We are happy to review them and provide feedback:

• Laundry procedure.
• Animal procedure.
• Blood and body fluid exposure procedure.
• Sun safe procedure.
• Smoke and vape free procedure.
• Cleaning procedure and cleaning schedule.

Please supply copies of these documents prior to the health assessment.

Immunisation records

On 8 January 2026, the Health (Immunisation) Regulations 1995 were revoked. These regulations required ECE services to maintain onsite immunisation registers by requesting immunisation certificates from parents/ guardians of children born from 1 January 1995. These are no longer required as the Aotearoa Immunisation Register (AIR) has replaced this function. Free immunisation resources are available at All – Tagged "Vaccinations and immunisations"– HealthEd

Acoustic report

To support children’s wellbeing and communication, you must take all practicable steps to ensure that noise levels do not unduly interfere with normal speech or cause distress or harm. If your service has used an acoustic specialist, please supply copies of the acoustic report. If concerns are raised during the health assessment, you may be asked to obtain a report.

Health education resources

There is a wide range of health education resources that ECE services may find useful. To view and order the current resources refer to HealthEd