Caring for Our Childen, 3rd Edition (CFOC3)

Chapter 3: Health Promotion and Protection

3.3 Cleaning, Sanitizing, and Disinfecting

3.3.0

3.3.0.1: Routine Cleaning, Sanitizing, and Disinfecting


Keeping objects and surfaces in a child care setting as clean and free of pathogens as possible requires a combination of:

  1. Frequent cleaning; and
  2. When necessary, an application of a sanitizer or disinfectant.

Facilities should follow a routine schedule of cleaning, sanitizing, and disinfecting as outlined in Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting.

Cleaning, sanitizing and disinfecting products should not be used in close proximity to children, and adequate ventilation should be maintained during any cleaning, sanitizing or disinfecting procedure to prevent children and caregivers/teachers from inhaling potentially toxic fumes.

RATIONALE
Young children sneeze, cough, drool, use diapers and are just learning to use the toilet. They hug, kiss, and touch everything and put objects in their mouths. Illnesses may be spread in a variety of ways, such as by coughing, sneezing, direct skin-to-skin contact, or touching a contaminated object or surface. Respiratory tract secretions that can contain viruses (including respiratory syncytial virus and rhinovirus) contaminate environmental surfaces and may present an opportunity for infection by contact (1-3).
COMMENTS
The terms cleaning, sanitizing and disinfecting are sometimes used interchangeably which can lead to confusion and result in cleaning procedures that are not effective (4).

For example, if there is visible soil on a diaper changing or table surface, clean it with detergent and water before spraying the surface with a sanitizer or disinfectant. Using a sanitizer or disinfectant as this “first step” is not effective because the purpose of the solution is to either sanitize or disinfect. Each term has a specific purpose and there are many methods that may be used to achieve such purpose.

Task

Purpose

Clean

To remove dirt and debris by scrubbing and washing with a detergent solution and rinsing with water. The friction of cleaning removes most germs and exposes any remaining germs to the effects of a sanitizer or disinfectant used later.

Sanitize

To reduce germs on inanimate surfaces to levels considered safe by public health codes or regulations.

Disinfect

To destroy or inactivate most germs on any inanimate object, but not bacterial spores.

Note: The term “germs” refers to bacteria, viruses, fungi and molds that may cause infectious disease. Bacterial spores are dormant bacteria that have formed a protective shell, enabling them to survive extreme conditions for years. The spores reactivate after entry into a host (such as a person), where conditions are favorable for them to live and reproduce (5).

Only U.S. Environmental Protection Agency (EPA)-registered products that have an EPA registration number on the label can make public health claims that can be relied on for reducing or destroying germs. The EPA registration label will also describe the product as a cleaner, sanitizer, or disinfectant. In addition, some manufacturers of cleaning products have developed "green cleaning products". As new environmentally-friendly cleaning products appear in the market, check to see if they are 3rd party certified by Green Seal: http://www.greenseal.org, UL/EcoLogic: http://www.ecologo.org, and/or EPA's Safer Choice: http://www.epa.gov/saferchoice. Use fragrance-free bleach that is EPA-registered as a sanitizing or disinfecting solution (6). If other products are used for sanitizing or disinfecting, they should also be fragrance-free and EPA-registered (7). All products must be used accordining to manufacturer's instructions. The following resource may be useful: Green Cleaning, Sanitizing, and Disinfecting: A Toolkit for Early Care and Education

Employers should provide staff with hazard information, including access to and review of the Safety Data Sheets (SDS) as required by the Occupational Safety and Health Administration (OSHA), about the presence of toxic substances such as, cleaning, sanitizing and disinfecting supplies in use in the facility. The SDS explain the risk of exposure to products so that appropriate precautions may be taken.

TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
3.3.0.2 Cleaning and Sanitizing Toys
3.3.0.3 Cleaning and Sanitizing Objects Intended for the Mouth
5.2.1.6 Ventilation to Control Odors
Appendix J: Selecting an Appropriate Sanitizer or Disinfectant
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
REFERENCES
  1. Thompson, S. C. 1994. Infectious diarrhoea in children: Controlling transmission in the child care setting. J Paediatric Child Health 30:210-19.
  2. Butz, A. M., P. Fosarelli, D. Dick, et al. 1993. Prevalence of rotavirus on high-risk fomites in day-care facilities. Pediatrics 92:202-5.
  3. D. Leduc, eds. 2015. Well beings: A guide to health in child care. 3rd ed. (revised) Ottawa, Ontario: Canadian Paediatric Society.
  4. U.S. Centers for Disease Control and Prevention. 2014. How to clean and disinfect schools to help slow the spread of flu. http://www.cdc.gov/flu/school/cleaning.htm Microbiology Procedure. Sporulation in bacteria. http://www.microbiologyprocedure.com/microorganisms/sporulation-in-bacteria.htm.
  5. Children’s Environmental Health Network Fragrances. Retrieved from: http://www.cehn.org/our-work/eco-healthy-child-care/ehcc-faqs/fragrances/.
  6. Children’s Environmental Health Network 2016. Household chemicals.   http://cehn.org/wp-content/uploads/2015/12/Household_chemicals_1_16.pdf.

3.3.0.2: Cleaning and Sanitizing Toys

Frequently Asked Questions/CFOC3 Clarifications

Reference: 3.3.0.2

Date: 11/7/2012

Topic & Location:
Chapter 3
Health Promotion
Standard 3.3.0.2: Cleaning and Sanitizing Toys

Question:
This standard states that plastic toys can be cleaned in a dishwasher but the Children's Environmental Health Network/Eco-Healthy Child Care generally discourages programs from exposing plastics to heat, including heated dishwashers, due to the potential risk of exposure to harmful chemicals in plastics, which could include toys that are frequently mouthed by children. What's your take on this issue considering that CFOC3 Standard 5.2.9.9: Plastic Containers and Toys also includes a standard on plastics, which states, “Do not place plastics in the dishwasher”?

Answer:

BPA, phthalates, and other additives may leach from a plastic toy while being exposed to the heat of a mechanical dishwasher. Hence, the reason standard 5.2.9.9 states that following the guideline of not placing plastics in the dishwasher "may reduce exposure to phthalates and BPA."

However, there is no evidence available to either support or refute the use of a mechanical dishwasher to clean, rinse, and sanitize toys. To best limit exposure to toxins, caregivers/teachers should follow the cleaning instructions provided by the toy's manufacturer, while also following their local regulations.


Toys that cannot be cleaned and sanitized should not be used. Toys that children have placed in their mouths or that are otherwise contaminated by body secretion or excretion should be set aside until they are cleaned by hand with water and detergent, rinsed, sanitized, and air-dried or in a mechanical dishwasher that meets the requirements of Standard 4.9.0.11 through Standard 4.9.0.13. Play with plastic or play foods, play dishes and utensils, should be closely supervised to prevent shared mouthing of these toys.

Machine washable cloth toys should be used by one individual at a time. These toys should be laundered before being used by another child.

Indoor toys should not be shared between groups of infants or toddlers unless they are washed and sanitized before being moved from one group to the other.

RATIONALE
Contamination of hands, toys and other objects in child care areas has played a role in the transmission of diseases in child care settings (1). All toys can spread disease when children put the toys in their mouths, touch the toys after putting their hands in their mouths during play or eating, or after toileting with inadequate hand hygiene. Using a mechanical dishwasher is an acceptable labor-saving approach for sanitizing plastic toys as long as the dishwasher can wash and sanitize the surfaces and dishes and cutlery are not washed at the same time (1).
COMMENTS
Small toys with hard surfaces can be set aside for cleaning by putting them into a dish pan labeled “soiled toys.” This dish pan can contain soapy water to begin removal of soil, or it can be a dry container used to bring the soiled toys to a toy cleaning area later in the day. Having enough toys to rotate through cleaning makes this method of preferred cleaning possible.
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
3.3.0.1 Routine Cleaning, Sanitizing, and Disinfecting
4.9.0.11 Dishwashing in Centers
4.9.0.12 Dishwashing in Small and Large Family Child Care Homes
4.9.0.13 Method for Washing Dishes by Hand
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
REFERENCES
  1. Grenier, D., D. Leduc, eds. 2008. Preventing infections. In Well beings. 3rd ed. Ottawa, Ontario: Canadian Paediatric Society

3.3.0.3: Cleaning and Sanitizing Objects Intended for the Mouth


Thermometers, pacifiers, teething toys, and similar objects should be cleaned, and reusable parts should be sanitized between uses. Pacifiers should not be shared.
RATIONALE
Contamination of hands, toys and other objects in child care areas has played a role in the transmission of diseases in child care settings (1).
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
3.1.4.3 Pacifier Use
3.3.0.1 Routine Cleaning, Sanitizing, and Disinfecting
3.6.1.3 Thermometers for Taking Human Temperatures
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
REFERENCES
  1. Grenier, D., D. Leduc, eds. 2008. Preventing infections. In Well beings. 3rd ed. Ottawa, Ontario: Canadian Paediatric Society.

3.3.0.4: Cleaning Individual Bedding


Bedding (sheets, pillows, blankets, sleeping bags) should be of a type that can be washed. Each child’s bedding should be kept separate from other children’s bedding, on the bed or stored in individually labeled bins, cubbies, or bags. Bedding that touches a child’s skin should be cleaned weekly or before use by another child.
RATIONALE
Toddlers often nap or sleep on mats or cots and the mats or cots are taken out of storage during nap time, and then placed back in storage. Providing bedding for each child and storing each set in individually labeled bins, cubbies, or bags in a manner that separates the personal articles of one individual from those of another are appropriate hygienic practices (1).
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.4.5.1 Sleeping Equipment and Supplies
REFERENCES
  1. Pickering, L. K., C. J. Baker, D. W. Kimberlin, S. S. Long, eds. 2009. Red book: 2009 report of the Committee on Infectious Diseases, 153. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics.

3.3.0.5: Cleaning Crib Surfaces


Cribs and crib mattresses should have a nonporous, easy-to-wipe surface. All surfaces should be cleaned as recommended in Appendix K, Routine Schedule for Cleaning, Sanitizing, and Disinfecting.
RATIONALE
Contamination of hands, toys and other objects in child care areas has played a role in the transmission of diseases in child care settings (1).
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
5.4.5.1 Sleeping Equipment and Supplies
5.4.5.2 Cribs
REFERENCES
  1. Grenier, D., D. Leduc, eds. 2008. Preventing infections. In Well beings. 3rd ed. Ottawa, Ontario: Canadian Paediatric Society.