Chapter 3: Health Promotion and Protection
3.3 Cleaning, Sanitizing, and Disinfecting
3.3.0
3.3.0.1: Routine Cleaning, Sanitizing, and Disinfecting
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.
| Activity | Type of Product | Method | Comments |
|---|---|---|---|
| Clean | Soap/detergent and water, or all-purpose cleaners, to remove germs, dirt, oils, and sticky substances from surfaces or objects | Clean 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). |
| Sanitize | Chemical product that reduces the number of most germs on non-porous surfaces or objects to a safe level | Sanitize 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. |
| Disinfect | Chemical product to kill bacteria and viruses on surfaces or objects | Disinfect 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. |
|---|
- Always disinfect surfaces or objects soiled with blood, body fluids that are bloody, and other potentially infectious body fluids (such as vomit, pus, urine, and feces) by following Occupational Safety and Health Administration (OSHA) Standard Precautions. Refer to CFOC Standard 3.2.3.4 Prevention of Exposure to Blood and Body Fluids and Appendix L: Cleaning Up Body Fluids.
- 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
- Cleaning and Disinfecting Your Facility - CDC
- Green Cleaning, Sanitizing and Disinfecting: A Toolkit for Early Care and Education -Western States Pediatric Environmental Health Specialty Unit (PEHSU), University of California, San Francisco. A set of resources developed in 2021 in collaboration with the EPA.
- Protecting Workers Who Use Cleaning Chemicals – OSHA-NIOSH
POSTERS
UCSF (University of California, San Francisco) California Childcare Health Program Posters (available in English, Chinese and Spanish)
- Safer Cleaning, Sanitizing and Disinfecting: Choose Safer Products
- Safer Cleaning, Sanitizing and Disinfecting: Use the Right Tool for the Job
- Step by Step Cleaning for Child Care Programs
- Step by Step Sanitizing for Child Care Programs
- Step by Step Disinfecting for Child Care Programs
TYPE OF FACILITY
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care HomeRELATED STANDARDS
3.2.1.4 Diaper Changing Procedure3.2.3.4 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 L: Cleaning Up Body Fluids
Appendix W: Sample Food Service Cleaning Schedule
REFERENCES
-
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):2429. PMID: 26591334.
- 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):16681675. doi: 10.1111/jam.12473. Epub 2014 Mar 20. PMID: 24524673.
- 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):3341. doi: 10.1177/1059840509354383. Epub 2009 Nov 10. PMID: 19903773.
NOTES
Standard was last updated 09/26/2022 and 10/27/2022 (for formatting).