Healthy Kids, Healthy Care: Cleaning and Sanitizing

Healthy Kids, Healthy Care:
Cleaning and Sanitizing
National Resource Center for Health and Safety in Child Care
1-800-598-5437
http://nrckids.org

Key Questions

Are areas clean and surfaces, rugs, furniture and toys in good condition?

Are spills wiped up immediately?

Does the program have a regular cleaning schedule for the facility and equipment?

Are caregivers trained on proper cleaning and sanitizing, including handling blood and other body fluids?

Do you observe caregivers applying sanitizing solution properly (See Want to Know More? Section for proper procedure)?

Are cleaning supplies locked away and out of children's reach?

SPECIAL NOTE: Many of the subject areas in Healthy Kids, Healthy Care contain some aspect on cleaning and sanitizing, such as Food Preparation, Toxic Substances and Handwashing - please check out the other topics in this guide for a comprehensive look at proper cleaning and sanitizing in child care.

Want to know more?

• Cleaning, Sanitizing, and Disinfecting - What is the Difference?

Cleaning - Removing dirt and soil with water and soap.

Sanitizing - Removing dirt and soil AND certain bacteria so that the number of germs is reduced to such a level that the spread of disease is unlikely. This procedure applies to many routine housekeeping procedures involving, for example, bedding, bathrooms, kitchen countertops, floors, and walls. See Appendix I Selecting an Appropriate Sanitizer from Caring for our Children, 2nd Ed.

Disinfecting - Removing dirt and soil AND bacteria AND virtually all germs.

Note: Sanitizing and Disinfecting are often used to describe the same type of "cleaning "-- to remove germs to a level that the spread of diseases from one person to another is unlikely.

• Sanitizing Solution and Process

The most common method of sanitizing in a child care program is the use of a Bleach Solution.

Recommended Bleach Solution:

Made fresh daily (the solution loses strength once it is mixed).

¼ cup household (not industrial strength) bleach + 1 gallon of cool water.

1 tablespoon bleach + 1 quart of cool water.

Sanitizer solutions can be applied in various ways to surfaces that have been cleaned with detergent and rinsed:

Spray bottles for diaper changing surfaces, toilets, door knobs, cabinet handles, phone receivers, countertops, and tables.

Example

Clean surface with detergent and water.
Spray surface with bleach solution.
Wipe bleach solution over the surface with a paper towel. Do not dry off.
Allow to air dry for 2 minutes.

Cloths rinsed in solution for food preparation areas, large toys, books, and activity centers.

Dipping objects, such as small toys, into a container filled with the sanitizing solution.

Note: Spray bottles and other containers should ALWAYS be labeled with the name and strength of the solution they contain and kept out of reach of children. Also, fresh air should be moving about when sanitizing (a large fan or windows open).

Note: Some caregivers and other parents may be concerned about using bleach daily. Concerns vary from the smell to possible bleach spots on clothing. If other sanitizing materials are used, the important factors to keep in mind are:

the product must be registered by the Environmental Protection Agency as a safe and effective household sanitizer (see EPA's website - http://www.epa.gov/oppad001/ad_info.htm);

approved for use on the particular surfaces or items planned for use and

the user follows the manufacturer's instructions carefully.

• Sample Cleaning/Sanitizing Schedule

AREA	CLEAN	SANITIZE	FREQUENCY
Classrooms/Child Care/Food Areas
Countertops/tabletops, floors, door and cabinet handles	X	X	Daily and when soiled.
Food preparation and service surfaces	X	X	Before and after contact with food activity; between preparation of raw and cooked foods.
Carpets and large area rugs	X		Vacuum daily when children are not present. Clean with a carpet cleaning method approved by the local health authority. Clean carpets only when children will not be present until the carpet is dry. Clean carpets at least monthly in infant areas, at least every 3 months in other areas and when soiled.
Small rugs	X		Shake outdoors or vacuum daily. Launder weekly.
Utensils, surfaces and toys that go into the mouth or have been in contact with saliva or other body fluids	X	X	After each child's use, or use disposable, one-time utensils or toys.
Toys that are not contaminated with body fluids. Dress-up clothes not worn on the head. Sheets and pillowcases, individual cloth towels (if used), combs and hairbrushes, wash cloth and machine-washable cloth toys. (None of these items should be shared among children.)	X		Weekly and when visibly soiled.
Blankets, sleeping bags, cubbies	X		Monthly and when soiled.
Hats	X		After each child's use or use disposable hats that only one child wears.
Cribs and crib mattresses	X		Weekly, before use by a different child, and whenever soiled or wet.
Phone receivers	X	X	Weekly.
Toilet and Diapering Areas
Handwashing sinks, faucets, surrounding counters, soap dispensers, door knobs	X	X	Daily and when soiled.
Toilet seats, toilet handles, door knobs or cubicle handles, floors	X	X	Daily, or immediately if visibly soiled.
Toilet bowls	X	X	Daily.
Changing tables, potty chairs (Use of potty chairs in child care is discouraged because of high risk of contamination).	X	X	After each child's use.
General Facility
Mops and cleaning rags	X	X	Before and after a day of use, wash mops and rags in detergent and water, rinse in water, immerse in sanitizing solution, and wring as dry as possible. After cleaning and sanitizing, hang mops and rags to dry.
Waste and diaper containers	X		Daily.
Any surface contaminated with body fluids: saliva, mucus, vomit, urine, stool, or blood	X	X	Immediately, as specified in Caring for Our Children, 2nd Ed. STANDARD 3.026.

Source: Caring for Our Children, 2nd Ed. Standard 3.028

• Checklist of other items to look for with regard to proper cleaning

Do equipment, furniture and toys have smooth, nonporous surfaces or washable fabric surfaces that are easy to wash?

Are all floors, walls and ceilings in good repair and easy to clean when they become dirty?

Are food preparation areas separate from diaper changing areas?

Are paths and sidewalks kept cleared of trash, falling leaves, snow and ice?

Are toys picked up after each use and checked for dirt? Are they set aside to clean if dirty or if they have been in a child's mouth?

Is the sandbox clean and covered when not in use?

Is trash covered and stored so that children can not gain access to it?

Are dishes and silverware clean and sanitized, free of cracks and chips?

Are sheets and other bedding changed and washed between children and when dirty?

Is fresh air being moved about by fans or open windows to reduce odors?

See Also Food Preparation, Handwashing, Playground Safety and Toy Safety Sections

• Special considerations for cleaning up blood and body fluids

Caregivers should wear leak proof gloves when cleaning up blood or body fluids such as urine, feces, blood, saliva, nasal and eye discharges, oozing sores or pus. Gloves are optional when cleaning up human milk.

Spills of body fluids and human milk must be cleaned up immediately.

Areas that come in contact with the spill should be cleaned and sanitized.

Special care should be taken to avoid splashing any contaminated materials containing blood or potentially infectious material, onto eyes, nose, and mouth.

Blood-contaminated material and diapers must be put in a plastic bag with a secure tie.

Floors, rugs and carpeting that have been contaminated by body fluids should be cleaned by blotting to remove the fluid as quickly as possible, then sanitized by spot-cleaning with a detergent-disinfectant, and shampooing, or steam-cleaning the contaminated surface.

Note: Surfaces that may come in contact with potentially infectious body fluids must be disposable (like a paper changing pad) or made of a material that can be sanitized.

For more details on this issue, see Appendix J: Cleaning Up Body Fluids from Caring for Our Children, 2nd Ed.

• Storage and Labeling of Cleaning Supplies

Are cleaning supplies stored in their original labeled container? If the cleaner is a mixed solution, is the container properly dated and labeled with the ingredients?

Are all cleaning supplies locked and unreachable by children?

Are cleaning supplies stored separate from foods and medicine?

Is the poison control center number (1-800-222-1222) posted at every phone in the unfortunate chance that a cleaning supply is swallowed by a child?

How to help your caregiver with this topic

Supply your caregiver with a box of disposable gloves for cleaning and sanitizing.

A gift of hand lotion for dry hands or a colorful smock/apron to protect from bleach will be appreciated.

Teach your children to clean up after themselves: picking up toys, throwing paper towels in the trash can, etc. This will free up your caregiver for more deep cleaning, sanitizing and disinfecting.

If you or your caregiver are concerned about using bleach, contact the Environmental Protection Agency's Antimicrobial Hotline, phone 703-308-0127; fax: 703-308-6467; e-mail: info_antimicrobial@epa.gov , for alternative solutions.

Additional Resources

Bleach Fact Sheet (U.S. Environmental Protection Agency)
http://www.epa.gov/pesticides/factsheets/chemicals/bleachfactsheet.htm

CHEC HealtheHouse (Children's Health Environment Coalition)
http://www.checnet.org/healthehouse/virtualhouse/index.asp

Cleaning Poster (California Child Care Program)
English – http://www.ucsfchildcarehealth.org/pdfs/posters/BWDisinfecCleaningEN.pdf
Spanish – http://www.ucsfchildcarehealth.org/pdfs/posters/BWDisinfectCleaningSP.pdf

Environmental Protection Agency's Antimicrobial Hotline
Phone 703-308-0127; fax: 703-308-6467; e-mail: info_antimicrobial@epa.gov

Healthy Homes Partnership (United States Department of Agriculture, the Department of Housing and Urban Development and University of Wisconsin-Extension)
English – http://www.uwex.edu/healthyhome/consumers.html
Spanish – http://www.uwex.edu/healthyhome/bookespanol.html

Household Products Database (National Institutes of Health)
http://hpd.nlm.nih.gov/products.htm

Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide (2005), edited by SS Aronson and TR Shope. Available from the American Academy of Pediatrics. http://www.aap.org; 1-888-227-1770. (There is a fee for this publication; also check with your public library or community hospital library for a copy.)

Healthy Kids, Healthy Care is based on Caring for Our Children: National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs, 2nd Edition, 2002, (American Academy of Pediatrics, American Public Health Association, and National Resource Center for Health and Safety in Child Care)

STANDARD 3.014 DIAPER CHANGING PROCEDURE
STANDARD 3.019 MAINTENANCE OF CHANGING TABLES
STANDARD 3.020 SITUATIONS THAT REQUIRE HANDWASHING
STANDARD 3.021 HANDWASHING PROCEDURE
STANDARD 3.023 TRAINING AND MONITORING FOR HANDWASHING
STANDARD 3.026 PREVENTION OF EXPOSURE TO BLOOD AND BODILY FLUIDS
STANDARD 3.028 ROUTINE FREQUENCY OF CLEANING AND SANITATION
STANDARD 3.030 EQUIPMENT USED FOR CLEANING AND SANITIZING
STANDARD 3.031 RAGS AND DISPOSABLE TOWELS USED FOR CLEANING
STANDARD 3.036 USE OF TOYS THAT CAN BE WASHED AND SANITIZED
STANDARD 4.063 DISHWASHING IN CENTERS
STANDARD 4.065 METHOD FOR WASHING DISHES BY HAND
STANDARD 5.068 LABELING, CLEANING AND DISPOSAL OF WASTE AND DIAPER CONTAINERS
STANDARD 5.077 SURFACES OF EQUIPMENT, FURNITURE, TOYS AND PLAY MATERIALS
STANDARD 5.079 FLOORS, WALLS AND CEILINGS
STANDARD 5.100 USE AND STORAGE OF TOXIC SUBSTANCES
STANDARD 5.144 SLEEPING EQUIPMENT AND SUPPLIES
APPENDIX D - GLOVING
APPENDIX I - SELECTING AN APPROPRIATE SANITIZER
APPENDIX J - CLEANING UP BODY FLUIDS
GLOSSARY

Disclaimer: Healthy Kids, Healthy Care is for reference purposes only and shall not be used as a substitute for medical consultation, nor be used to authorize actions beyond a person's licensing, training, or ability.