To avoid near-miss choking events, childcare facilities should ensure that staff members are properly trained, implement strict control strategies, and manage the physical environment. This study was based on an online survey conducted among staff members working at facilities belonging to the National Childcare Association, public childcare centers, and social welfare corporation–run facilities in Japan. It aimed to clarify the near-miss choking incidents occurring in childcare facilities and investigate the facility- and food-related factors to support risk alleviation and preventive approaches. In 79.1 % of children, no notable concerns regarding physical growth were recorded, whereas 31.7 % showed developmental concerns. With respect to the causes of near-miss events, 59.1 % were attributed to facility-related factors, such as food preparation practices and supervision arrangements. The most frequent way of information sharing between individual staff members was verbal communication (63.0 %), followed by staff meetings or morning briefings attended by all personnel (30.6 %). Near-miss events were associated most frequently with staple foods, including noodles, rice, and bread (32 %), followed by main dishes such as meat or fish (26 %). The findings revealed that immediate, on-site information sharing and routine safety practices serve as effective preventive measures for reducing event risk. Moreover, common staple foods, such as meat, bread, and rice, require proactive risk-reduction approaches by caregivers, including careful observation and texture modification. These events were affected not by a single factor, such as utensil use or food category, but by a combination of several interacting factors.
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