3.6.2.2: Space Requirements for Care of Children Who Are Ill

Environmental space utilized for the care of children who are ill with infectious diseases and cannot receive care in their usual child care group should meet all requirements for well children and include the following additional requirements:

1. Indoor space that the facility uses for children who are ill, including classrooms, hallways, bathrooms, and kitchens, should be separate from indoor space used with well children. This reduces the likelihood of mixing supplies, toys, and equipment. The facility may use a single kitchen for ill and well children if the kitchen is staffed by a cook who has no child care responsibilities other than food preparation and who does not handle soiled dishes and utensils until after food preparation and food service are completed for any meal;
2. If the program for children who are ill is in the same facility as the well-child program, well children should not use or share furniture, fixtures, equipment, or supplies designated for use with children who are ill unless they have been cleaned and sanitized before use by well children;
3. Children whose symptoms indicate infections of the gastrointestinal tract (often with diarrhea) should receive their care in a space separate from other children with other illnesses. Limiting child-to-child interaction, separating staff responsibilities, and not mixing supplies, toys, and equipment reduces the likelihood of disease being transmitted between children
4. Children with chickenpox, pertussis, measles, mumps, rubella, or diphtheria, require a room with separate ventilation including fresh outdoor air (1);
5. Each room/home that is designated for the care of children who are ill should have a handwashing sink that can provide a steady stream of clean, running water that is at a comfortable temperature at least for twenty seconds (2). Soap and disposable paper towels should be available at the handwashing sink at all times. A hand sanitizing dispenser is an alternative to traditional handwashing (3,4);
6. ach room/home that is designated for the care of children who are ill and are wearing diapers should have its own diaper changing area adjacent to a handwashing sink and/or hand sanitizer dispenser.

 

RATIONALE

Transmission of infectious diseases in early care and education settings are influenced by the environmental sanitation and physical space of the facilities (5).
 
Handwashing sinks should be stationed in each room that is designated for the care of ill children to promote hand hygiene and to give the caregivers/teachers an opportunity for continuous supervision of the other children in care when washing their hands. The sink must deliver a consistent flow of water for twenty seconds so that the user does not need to touch the faucet handles. Diaper changing areas should be adjacent to sinks to foster cleanliness and to enable caregivers/teachers to provide continuous supervision of other children in care. 

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
3.2.2.5 Hand Sanitizers
3.6.1.1 Inclusion/Exclusion/Dismissal of Ill Children
5.4.1.10 Handwashing Sinks

REFERENCES

1. Aronson, S. S., T. R. Shope, eds. 2017. Managing infectious diseases in child care and schools: A quick reference guide, 4^th Edition.Elk Grove Village, IL: American Academy of Pediatrics.
2. Centers for Disease Control and Prevention. 2015. Handwashing: Clean hands save lives. http://www.cdc.gov/handwashing/.
3. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2016. Show me the science-When and how to use hand sanitizer. http://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html.
   
4. Santos, C., Kieszak, S., Wang, A., Law, R., Schier, J., Wolkin, A.. Reported adverse health effects in children from ingestion of alcohol-based hand sanitizers — United States, 2011–2014. MMWR Morb Mortal Wkly Rep 2017;66:223–226. DOI: http://dx.doi.org/10.15585/mmwr.mm6608a5
   

5. American Academy of Pediatrics. Enterovirus D68 In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. 31st Edition. Itasca, IL:  American Academy of Pediatrics; 2018: 331-334, 658, 692

6. American Academy of Pediatrics. Out-of-home child care In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. 31st Edition. Itasca, IL:  American Academy of Pediatrics; 2018: 122-123

NOTES

Content in the STANDARD was modified on 8/9/2017.