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 and 10/27/2022 (for formatting).

Cleaning, sanitizing, and/or disinfecting surfaces are important steps in reducing the risk of spreading infectious diseases to children, staff, and visitors in early care and education 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 Product lists 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 care and education programs, since there is close contact between children, staff, and families. Infants and young children in early care and education 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.1-3

Safe practices need to be developed for each product that early care and education 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.

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 and Other Sleep 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 W: Sample Food Service Cleaning Schedule
Appendix L: Cleaning Up Body Fluids
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 and 10/27/2022 (for formatting).

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.

Content in the STANDARD was modified on 3/20/2023.

Cleaning and sanitizing toys are important steps to reduce the risk of spreading infectious diseases in early care and education programs. Toys that cannot be cleaned and sanitized should not be used. Toys that children have placed in their mouths or that are contaminated by bodily fluids (secretion or excretion) should be set aside and not used until they are cleaned and sanitized. Collecting toys as they become dirty throughout the day and sorting them into separate containers (one for cloth toys and one for hard toys) can make it easier to clean and sanitize at the end of the day.

The following methods for cleaning and sanitizing toys should be used:

  • Washing toys by hand: Wash toys with fragrance-free soap or detergent and water, then rinse with water, sanitize, and air dry. It is important to clean toys before sanitizing them because the sanitizer works better on clean surfaces. It is important to follow the instructions for the sanitizer and allow the sanitizer to air dry for the recommended time. Wooden toys that cannot be submersed in water or put in a dishwasher should be cleaned with a soapy cloth, then rinsed with a damp cloth, and then sanitized by applying a solution. The wooden toys should then be wiped dry or allowed to air dry. Always check the manufacturer’s recommendations for cleaning wooden toys.
  • Washing toys in a dishwasher: Some hard toys can be cleaned and sanitized in a dishwasher. Check the manufacturer’s instructions on the toy to make sure the toy is dishwasher safe. Use the correct amount of fragrance-free dishwashing detergent and run the complete wash cycle. Make sure the dishwasher has a “sanitizing cycle” or is set to heat dry. Use a dishwasher with a sanitizing cycle that is certified to meet the NSF/ANSI 184 standard. This standard helps confirm that a residential dishwasher can reduce bacteria by at least 99.999% when run on the sanitizing cycle.4 Do not wash toys with dirty dishes, utensils, etc. A small mesh laundry bag can be used to hold small toys.
  • Washing toys in a washing machine: A washing machine can clean many soft toys (e.g., stuffed animals, puppets, play clothing). Check the manufacturer’s instructions on the toy to confirm that it can go in a washing machine. Wash in the warmest temperature, and dry completely. Use a dryer on a high heat setting when possible. Rotating soft toys, puppets, and dramatic play clothing can help reduce the need to wash the material often.

Children playing with plastic or play foods, dishes, and utensils should be closely supervised to prevent shared mouthing of these toys. Only 1 child at a time should use machine-washable cloth toys. These toys should be laundered before another child uses them. Indoor toys should not be shared between groups of infants or toddlers unless the toys are washed and sanitized before being moved from one group to the other. For more information on toys such as play dough and other manipulative sensory items, see CFOC Standard 5.2.9.8.

See the Comments section below for more resources on cleaning schedules, choosing the right cleaning product, important information about using bleach products, and safer choice products. Always follow the manufacturer’s instructions for all products.

RATIONALE

Infectious diseases spread easily in early care and education programs, since children, staff, and families are all in close contact. Surfaces and objects can carry germs and have spread diseases.1–3 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 dishwasher that has a “sanitizing cycle” or is set to heat dry is an acceptable way to save time and work when sanitizing plastic toys, as long as it’s not washing dishes and cutlery at the same time. Developing effective cleaning strategies and policies are important steps to reduce the risk of illness in early care and education programs.

COMMENTS

Early care and education 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.

For more information on choosing a cleaning, sanitizing, or disinfecting product, please refer to CFOC Appendix J: Selection and Use of a Cleaning, Sanitizing, or Disinfecting Product. Appendix J also has important information about the use of bleach products, how to prepare bleach solutions, and health and safety precautions. Never mix bleach with other household cleaners, especially those that have ammonia.

The use of products that have safer (less toxic) chemicals helps reduce health and environmental concerns. Manufacturers may claim that their products are “green,” “natural,” or “earth friendly,” but these claims are often misleading and might not be about a chemical’s safety. Organizations now certify and label products that meet certain health and environmental standards. These certifications can help you find less hazardous cleaning, sanitizing, and disinfecting products. CFOC Appendix J has more information on Third Party Certifications logos and these safer (less toxic) chemicals. Safer disinfectant options can be found at https://www.epa.gov/pesticide-labels/dfe-certified-disinfectants. Using the least hazardous products available will help protect the health of children, and early care and education program staff and custodial personnel.

TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
3.2.2.1 Situations that Require Hand Hygiene
3.2.2.2 Handwashing Procedure
3.2.2.3 Assisting Children with Hand Hygiene
3.2.2.4 Training and Monitoring for Hand Hygiene
3.2.2.5 Hand Sanitizers
3.3.0.1 Routine Cleaning, Sanitizing, and Disinfecting
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 and Other Sleep Surfaces
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
5.2.9.8 Use of Play Dough and Other Manipulative Art or Sensory Materials
Appendix J: Selection and Use of a Cleaning, Sanitizing or Disinfecting Product
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
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. 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

  4. Western States Pediatric Environmental Health Specialty Unit. Green cleaning, sanitizing, and disinfecting: A tooklit for early care and education, 2nd ed. San Francisco, CA: University of California, San Francisco; 2021

NOTES

Content in the STANDARD was modified on 3/20/2023.

3.3.0.3: Cleaning and Sanitizing Objects Intended for the Mouth

Content in the STANDARD was modified on 3/20/2023.

Thermometers, pacifiers, teething toys, and similar objects that are intended for the mouth should be cleaned, and reusable parts should be sanitized between uses. For more information on how to clean and sanitize mouthed objects, see CFOC Standard 3.3.0.2. For thermometers, refer to the manufacturer’s instructions for cleaning.

Children should never share pacifiers. Pacifiers need to be sanitized if they look dirty or if another child has used them. Use a sanitizer safe for contact with food, or boil the pacifier for 1 minute in water that can be for drinking or meal preparation, and air-dry. Using a dishwasher to sanitize can also replace the need for chemical sanitizers. Using a dishwasher that has a “sanitizing cycle” or that is set to heat-dry is an acceptable way to save time and work when sanitizing pacifiers and objects that are dishwasher-safe ¾ as long as the dishwasher can wash and sanitize the surfaces, and it doesn’t wash dishes and cutlery at the same time. Use a dishwasher with a sanitizing cycle that is certified to meet the NSF/ANSI 184 standard. This standard helps confirm that a residential dishwasher can reduce bacteria by at least 99.999% when run on the sanitizing cycle.1

After you clean a pacifier, water often stays in the nipple. Be sure to squeeze any water through the nipple hole of the pacifier to be sure it is clean. Program staff should ensure their hands are thoroughly washed before squeezing the pacifier nipple. Squeeze the pacifier away from you, as water may still be hot. If water drops remain in the nipple, let the pacifier air-dry. Make sure the pacifier has cooled completely before giving it to the child.

RATIONALE

Infectious diseases spread easily in early care and education programs, since children, staff, and families are all in close contact. Mouthed objects can carry germs and have spread diseases.2–4 Developing effective cleaning strategies and policies are important steps to reduce the risk of illness in early care and education programs.

COMMENTS

Early care and education 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.

For more information on selecting a cleaning, sanitizing, or disinfecting product, please refer to CFOC Appendix J: Selection and Use of a Cleaning, Sanitizing, or Disinfecting Product. Appendix J also has important information about the use of bleach products, how to prepare bleach solutions, and health and safety precautions. Never mix bleach with other household cleaners, especially those that have ammonia.

The use of products that have safer (less toxic) chemicals helps reduce health and environmental concerns. Manufacturers may claim that their products are “green,” “natural,” or “earth friendly,” but these claims are often misleading and might not be about a chemical’s safety. Organizations now certify and label products that meet certain health and environmental standards. These certifications can help you find less hazardous cleaning, sanitizing, and disinfecting products. CFOC Appendix J has more information on Third Party Certifications logos and these safer (less toxic) chemicals. Safer disinfectant choices can be found at https://www.epa.gov/pesticide-labels/dfe-certified-disinfectants. Using the least hazardous products available will help protect the health of children, and early care and education program staff and custodial personnel.

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
3.2.2.2 Handwashing Procedure
3.3.0.1 Routine Cleaning, Sanitizing, and Disinfecting
3.3.0.2 Cleaning and Sanitizing Toys
3.6.1.3 Guidelines for Taking Children’s Temperatures
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 J: Selection and Use of a Cleaning, Sanitizing or Disinfecting Product
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
REFERENCES

  1. Western States Pediatric Environmental Health Specialty Unit. Green cleaning, sanitizing, and disinfecting: A tooklit for early care and education, 2nd ed. San Francisco, CA: University of California, San Francisco; 2021

  2. 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

  3. 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

  4. 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

Content in the STANDARD was modified on 3/20/2023.

3.3.0.4: Cleaning Individual Bedding

Content in the STANDARD was modified on 3/20/2023.

Bedding (sheets, pillows, pillowcases, blankets, sleeping bags, sleep sacks) in early care and education programs should only be made of materials that are washable. Each child’s bedding should be kept separately from other children’s bedding, either on the bed or stored in individually labeled bins, cubbies, or bags. Bedding should be removed from individual sleep equipment (cots, mats) before they are stored or stacked. Bedding that touches a child’s skin should be cleaned weekly if only 1 child uses the bedding or before another child uses it.1

When cleaning bedding, it is important to use these guidelines:

  • Follow the instructions on the laundry detergent container.
  • Wash the bedding at the warmest temperature, and dry completely. Use a dryer on a high heat setting when possible.
  • If the bedding is soiled with body fluids, launder with a disinfectant ¾ for example, non-chlorine bleach (preferred) or bleach ¾ and dry completely.

Early care and education programs should have written policies and procedures for collecting, handling, and washing soiled bedding. Programs that have laundryequipment in the kitchen must also make sure not to do laundry at the same time as preparing food. Surfaces must be cleaned and disinfected before food preparation and after laundering.

See the Comments section below for more resources on cleaning schedules and choosing the right cleaning and disinfecting product.

RATIONALE

Infectious diseases spread easily in early care and education programs, since children, staff, and families are all in close contact. Surfaces and objects can carry germs and have spread diseases.2–4 Children in early care and education programs often nap on mats or cots that are taken out of storage for nap time, and then placed back in storage. Improper cleaning of bedding materials may increase the risk of spreading disease. Bedding can collect germs and insects (e.g., lice) that grow well in a moist and warm environment. But, the spread of disease is rare if bedding is cleaned and dried properly.5 Having bedding for each child, and storing each set in individually labeled bins, cubbies, or bags ¾ that clearly separate each child’s personal bedding ¾ are proper hygienic practices.6 Developing effective cleaning strategies and policies are important steps to reduce the risk of illness in early care and education programs.

COMMENTS

Early care and education 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.

 For more information on choosing a cleaning, sanitizing, or disinfecting product, please refer to CFOC Appendix J: Selection and Use of a Cleaning, Sanitizing, or Disinfecting Product. Appendix J also has important information about the use of bleach products, how to prepare bleach solutions, and health and safety precautions. Never mix bleach with other household cleaners, especially those that have ammonia.

 The use of products that have safer (less toxic) chemicals helps reduce health and environmental concerns. Manufacturers may claim that their products are “green,” “natural,” or “earth friendly,” but these claims are often misleading and might not be about a chemical’s safety. Organizations now certify and label products that meet certain health and environmental standards. These certifications can help you find less hazardous cleaning, sanitizing, and disinfecting products. CFOC Appendix J has more information on Third Party Certifications logos and these safer (less toxic) chemicals. Safer disinfectant choices can be found at https://www.epa.gov/pesticide-labels/dfe-certified-disinfectants. Using the least hazardous products available will help protect the health of children, and early care and education program staff and custodial personnel.

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
3.3.0.2 Cleaning and Sanitizing Toys
3.3.0.3 Cleaning and Sanitizing Objects Intended for the Mouth
3.3.0.5 Cleaning Crib and Other Sleep Surfaces
5.4.4.1 Laundry Service and Equipment
5.4.4.2 Location of Laundry Equipment and Water Temperature for Laundering
5.4.5.1 Sleeping Equipment and Supplies
Appendix E: Child Care Staff Health Assessment
Appendix J: Selection and Use of a Cleaning, Sanitizing or Disinfecting Product
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
REFERENCES

  1. American Academy of Pediatrics. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide. Aronson SS, Shope TR, eds. 5th ed. Itasca, IL: American Academy of Pediatrics; 2020

  2. 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

  3. 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

  4. 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

  5. Toronto Public Health. Infection prevention and control in child care centres. Requirements and best practices. Last updated 2019. Accessed November 3, 2022. https://www.toronto.ca/wp-content/uploads/2019/07/98cb-CCC-IPAC-RBP-Revised-2018-2019-AODA.pdf

  6. American Academy of Pediatrics. Section 2: Recommendation for care of children in special circumstances; children in group childcare and schools. In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, eds. Red Book: 2021 Report of the Committee on Infectious Diseases. Elk Grove Village, IL: American Academy of Pediatrics; 2021:124-125 

NOTES

Content in the STANDARD was modified on 3/20/2023.

3.3.0.5: Cleaning Crib and Other Sleep Surfaces

Content in the STANDARD was modified on 3/20/2023.

Cribs, crib mattresses, cots, mats, and other sleep surfaces (e.g., portable cribs, playyard/pen cradleboards) should have a nonporous, easy-to-wipe surface. Crib surfaces and materials should be cleaned weekly using an appropriate cleaning product with a microfiber cloth or disposable paper towel if the same child use the surfaces and materials each day. If different children use the crib surface and materials each day, they must always be cleaned before another child uses them. The crib surface should be cleaned and disinfected if soiled with body fluids. Allow the crib surface to air dry before the next use. Visible dirt and debris should be vacuumed.1 Always follow the manufacturer’s instructions for cleaning crib surfaces. See the Comments section below for more resources on cleaning schedules and choosing the right cleaning and disinfecting product.
RATIONALE

Infectious diseases spread easily in early care and education programs, since children, staff, and families are all in close contact. Surfaces and objects, including crib surfaces, can carry germs and have spread diseases.2–4 Developing effective cleaning strategies and policies are important steps to reduce the risk of illness in early care and education programs.

COMMENTS

Early care and education programs need to write up and follow a routine schedule of cleaning, sanitizing, and disinfecting for all sleep surfaces and equipment. Refer to CFOC Appendix K: Routine Schedule for Cleaning, Sanitizing and Disinfecting.

For more information on choosing a cleaning, sanitizing, or disinfecting product, please refer to CFOC Appendix J: Selection and Use of a Cleaning, Sanitizing, or Disinfecting Product. Appendix J also has important information about the use of bleach products, how to prepare bleach solutions, and health and safety precautions. Never mix bleach with other household cleaners, especially those that have ammonia.

The use of products that have safer (less toxic) chemicals helps reduce health and environmental concerns. Manufacturers may claim that their products are “green,” “natural,” or “earth friendly,” but these claims are often misleading and might not be about a chemical’s safety. Organizations now certify and label products that meet certain health and environmental standards. These certifications can help you find less hazardous cleaning, sanitizing, and disinfecting products. CFOC Appendix J has more information on Third Party Certifications logos and these safer (less toxic) chemicals. Safer disinfectant choices can be found at https://www.epa.gov/pesticide-labels/dfe-certified-disinfectants. Using the least hazardous products available will help protect the health of children, and early care and educationprogram staff and custodial personnel.

TYPE OF FACILITY
Center, Early Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS
3.1.4.1 Safe Sleep Practices and Sudden Unexpected Infant Death (SUID)/SIDS Risk Reduction
3.3.0.1 Routine Cleaning, Sanitizing, and Disinfecting
3.3.0.4 Cleaning Individual Bedding
5.4.5.1 Sleeping Equipment and Supplies
5.4.5.2 Cribs
Appendix J: Selection and Use of a Cleaning, Sanitizing or Disinfecting Product
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
REFERENCES

  1. Children’s Environmental Health Network. Crib mattress/nap mat hygiene. CEHN.org Web  site. https://cehn.org/download/crib-mattress-nap-mats-hygiene/.Last updated August 18, 2021. Accessed February 1, 2023.

  2. 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

  3. 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

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NOTES

Content in the STANDARD was modified on 3/20/2023.