Caring for Our Children (CFOC)

Chapter 3: Health Promotion and Protection

3.3 Cleaning, Sanitizing, and Disinfecting

3.3.0

3.3.0.1: Routine Cleaning, Sanitizing, and Disinfecting

Standard was last updated 09/26/2022.


Cleaning, sanitizing, and/or disinfecting surfaces are important steps in reducing the risk of spreading infectious diseases to children, staff, and visitors in early childhood programs.

In most situations, routine cleaning with soap and water is enough to remove dirt and some germs from surfaces. Sanitizing and/or disinfecting may be needed after cleaning to further reduce the risk of spreading illness. Sanitizers and disinfectants need to be applied to a clean surface to work effectively at killing germs. 

ActivityType of ProductMethodComments
CleanSoap/detergent and water, or all-purpose cleaners, to remove germs, dirt, oils, and sticky substances from surfaces or objectsClean surfaces, preferably with a microfiber cloth/mop, rinse the surface thoroughly, and air dry. Or dry with a paper towel or a clean microfiber cloth.If using a cleaner other than soap and water, choose a product that has safer chemical ingredients and is certified by a third party (Safer Choice, Green Seal, or UL Ecologo).
SanitizeChemical product that reduces the number of most germs on non-porous surfaces or objects to a safe levelSanitize surfaces that touch food (dishes, cutting boards, or mixed-use tables), or objects that a child might place in their mouth (toys).Choose an Environmental Protection Agency (EPA)-registered product with directions for food-contact surfaces on the label.
DisinfectChemical product to kill bacteria and viruses on surfaces or objectsDisinfect equipment and surfaces that are used in toileting or diapering and in cleaning body fluids. 
Allow disinfectant to sit on the surface and be visibly wet for the number of minutes listed on the product label. 
Follow the manufacturer’s instructions for use and safe handling of products.
Choose a disinfectant product certified by the EPA’s Design for the Environment program.

 

Detailed definitions of Clean, Sanitize, Disinfect, and Germ[s] (microbes such as bacteria, viruses, fungi) that can cause disease are in the CFOC Online Glossary.

Programs need to write up and follow a routine schedule of cleaning, sanitizing, and disinfecting.

Refer to CFOC Appendix K: Routine Schedule for Cleaning, Sanitizing and Disinfecting.

  • During illness outbreaks, programs may need to sanitize or disinfect surfaces more often and should refer to state, local, tribal, or territorial health authorities and child care licensing for more information.

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 trusted to reduce or destroy germs. The EPA registration label will also describe the product as a sanitizer or disinfectant.

The EPA Design for the Environment (DfE) now certifies products that meet certain health and environmental standards. DfE-certified products do not have ingredients that may pose long-term health risks, such as the potential to cause cancer or negatively impact the health of young children. The EPA also added more information to reduce the environmental impact of products. This includes how quickly chemicals break down, and how they affect fish and other aquatic life.

Before choosing a cleaning or antimicrobial product, you will need to know whether the surface needs to be cleaned, sanitized, or disinfected. Cleaning products may have hazardous chemicals that should not be used near children. Always follow the manufacturer’s instructions (listed on the label) for safe use, storage, and disposal of products. 

To reduce exposure to cleaning product fumes, ventilate the space by opening windows or doors or by bringing in outside air with a heating, ventilation, and air conditioning (HVAC) system. If you do not have an HVAC system, use a portable, high-efficiency particulate air (HEPA) cleaner in individual rooms. Child-safe portable fans or ceiling fans increase the circulation of fresh air from open windows. Placing a fan by an open window to blow inside air out encourages airflow throughout the room. Refer to CFOC Standard 5.2.1.1 Ensuring Access to Fresh Air Indoors.

CFOC Appendix J: Selection and Use of a Cleaning, Sanitizing and Disinfecting Productlists specific information on the following topics:

  • Products Registered with the Environmental Protection Agency (EPA)
  • Choosing Safer Products: Safety Data Sheet (SDS) and Required Staff Training
  • Product Labeling Requirements
  • Indoor Air Quality and Ventilation
  • Protecting Staff and Children’s Health
  • Safer Products Options and Third Party Certifications logos
  • How to Safely Prepare and Use Bleach Solutions
  • Tools and Tips for Cleaning, Sanitizing, and Disinfecting
  • Resources on Selection and Use of a Cleaning, Sanitizing, or Disinfecting Product
RATIONALE
Infectious illnesses easily spread in the early childhood programs, since there is close contact between children, staff, and families. Infants and young children in early childhood programs and family child care homes are more likely to get ear infections, upper respiratory infections, and stomach illnesses than when children are cared for primarily in their own homes. Illnesses may spread in a variety of ways, such as by coughing, sneezing, direct skin-to-skin contact, or touching a contaminated object or surface. Infants and young children freely explore their environment by touching items, hugging and kissing children and adults, and putting their hands in their mouths. Surfaces and objects can carry germs, including toys, tables, floors, sinks, doorknobs, sandboxes, water play tables, etc.1,2,3

Safe practices need to be developed for each product that early childhood programs use to clean, sanitize, and disinfect. Each product has specific hazards, precautions, and directions for maximum safety and effectiveness. OSHA requires employers to give their staff information about hazards, including access to and review of the Safety Data Sheets (SDSs), if the facility uses toxic substances such as cleaning, sanitizing, and disinfecting supplies. The SDSs explain the risk of exposure to products so that staff can take necessary precautions.
COMMENTS

ADDITIONAL RESOURCES

POSTERS

UCSF (University of California, San Francisco) California Childcare Health Program Posters (available in English, Chinese and Spanish)

 
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
3.2.1.4 Diaper Changing Procedure
3.2.3.4 Prevention of Exposure to Blood and Body Fluids
3.3.0.2 Cleaning and Sanitizing Toys
3.3.0.3 Cleaning and Sanitizing Objects Intended for the Mouth
3.3.0.4 Cleaning Individual Bedding
3.3.0.5 Cleaning Crib Surfaces
4.3.1.10 Cleaning and Sanitizing Equipment Used for Bottle Feeding
4.9.0.9 Cleaning Food Areas and Equipment
5.2.1.1 Ensuring Access to Fresh Air Indoors
5.2.7.5 Labeling, Cleaning, and Disposal of Waste and Diaper Containers
5.4.1.8 Cleaning and Disinfecting Toileting Equipment
9.2.3.10 Sanitation Policies and Procedures
Appendix J: Selection and Use of a Cleaning, Sanitizing or Disinfecting Product
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
Appendix L: Cleaning Up Body Fluids
Appendix W: Sample Food Service Cleaning Schedule
REFERENCES
  1. Ibfelt T, Engelund EH, Permin A, Madsen JS, Schultz AC, Andersen LP. Presence of pathogenic bacteria and viruses in the daycare environment. J Environ Health. 2015 Oct;78(3):2429. PMID: 26591334.

  2. Martínez-Bastidas T, Castro-del Campo N, Mena KD, Castro-del Campo N, León-Félix J, Gerba CP, Chaidez C. Detection of pathogenic micro-organisms on children’s hands and toys during play. J Appl Microbiol. 2014 Jun;116(6):16681675. doi: 10.1111/jam.12473. Epub 2014 Mar 20. PMID: 24524673.
  3. Bright KR, Boone SA, Gerba CP. Occurrence of bacteria and viruses on elementary classroom surfaces and the potential role of classroom hygiene in the spread of infectious diseases. J Sch Nurs. 2010 Feb;26(1):3341. doi: 10.1177/1059840509354383. Epub 2009 Nov 10. PMID: 19903773.
NOTES

Standard was last updated 09/26/2022.

3.3.0.2: Cleaning and Sanitizing Toys

Frequently Asked Questions/CFOC Clarifications

Reference: 3.3.0.2

Date: 11/07/2012

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 CFOC 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, Early Head Start, Head Start, Large Family Child Care Home, Small 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, Early Head Start, Head Start, Large Family Child Care Home, Small 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 Guidelines for Taking Children’s 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, Early Head Start, Head Start, Large Family Child Care Home, Small 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, Early Head Start, Large Family Child Care Home, Small 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.