The infant deaths mentioned in Jonathan Martin’s column demonstrate the most tragic of health and safety issues that occur in Washington state child-care facilities [“Make child care transparent for parents,” Opinion, March 4].

HB 2165 is an essential step toward understanding the causes and remedies for such incidents. However, what are we doing to prevent death and injury in child care?

State law mandates a monthly visit from a nurse consultant to child-care centers licensed for four or more infants. The nurse reviews safe sleeping and other health and safety issues. There is no such rule for child-care homes. They are not required to have ongoing health training or technical assistance from a health professional. The result: Home child-care providers may not know about current health and safety standards, including safe sleep.

The Department of Early Learning’s Early Achievers child-care rating system provides a tool for assessing child-care programs and providing teacher support. However, the program lacks the inclusion of trained child-care health professionals and best-practice health information. A 5-month-old swaddled baby would not be noted in an Early Achievers assessment.

The state Department of Health oversees the protection of children’s health. However, fragmented services provide no direct support to child-care providers. Both the Department of Early Learning and the Department of Health, coming together to incorporate trained health professionals into the child-care infrastructure, can help improve health and safety practices and avoid tragedy — in particular to all providers who care for infants.

Catherine Dewar Paul and Peggy King, Coalition for Safety and Health in

Early Learning