5.2.7.1: On-Site Sewage Systems

A sewage system should be provided and inspected in accordance with state and local regulations. Whenever a public sewer is available, the facility should be connected to it. Where public sewers are not available, an on-site sewage system or other method approved by the local public health department should be installed. Raw or treated wastes should not be discharged on the surface of the ground.

The wastewater or septic system drainage field should not be located within the outdoor play area of a child care program, unless the drainage field has been designed by a sanitation engineer with the presence of an outdoor play area in mind and meets the approval of the local health authority.

The exhaust vent from a wastewater or septic system and drainage field should not be located within the children’s outdoor play area.

RATIONALE

Sewage must not be allowed to contaminate drinking water or ground water. It must be carried from the facility to a place where sanitary treatment equipment is available. Raw sewage is a health hazard and usually has an offensive odor.

The weight of children or the combined weight of children and playground equipment may cause the drainage field to become compacted, resulting in failure of the system. Some structures are anchored in concrete, which adds weight. The legs of some equipment, such as swing sets, can puncture the surface of drainage fields. In areas where frequent rains are coupled with high water tables, poor drainage, and flooding, the surface of drainage fields often becomes contaminated with untreated sewage.

COMMENTS

Whether the presence of an outdoor play area would adversely affect the operation of an on-site sewage system will depend on the type of playground equipment and method of anchoring, the type of resilient surface placed beneath playground equipment to reduce injury from falls, the soil type where the field would be placed (some soils are more compactable than others), the type of ground cover present (a cover of good grass underlain by a good sandy layer is much better than packed clay or some impermeable or slowly impermeable surface layer), and the design of the drainage field itself. Septic systems are now most commonly called “on-site sewage systems” or “on-site systems” because they treat and dispose of household wastewater on the household’s own property (1).

Staff should consult with the local public health department regarding sewage storage and disposal. The national/international organization representing on-site wastewater/sewage interests is the National On-Site Wastewater Recycling Association, Inc. (NOWRA).

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

REFERENCES

1. National Onsite Wastewater Recycling Association (NOWRA). Homeowner’s onsite system guide and record keeping folder. http://www.nowra.org/documents/HomeownerOnsiteSystemGuide.pdf.

5.2.7.2: Removal of Garbage

Garbage and rubbish should be removed from rooms occupied by children, staff, parents/guardians, or volunteers on a daily basis and removed from the premises at least twice weekly or at other frequencies required by the regulatory health authority.

RATIONALE

This practice provides proper sanitation and protection of health, prevents infestations by rodents, insects, and other pests, and prevents odors and injuries.

COMMENTS

Compliance can be tested by checking for evidence of infestation and odors.

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

5.2.7.3: Containment of Garbage

Garbage should be kept in containers approved by the regulatory health authority. Such containers should be constructed of durable metal or other types of material, designed and used so wild and domesticated animals and pests do not have access to the contents, and so they do not leak or absorb liquids. Waste containers should be kept covered with tight-fitting lids or covers when stored.

The facility should have a sufficient number of waste and diaper containers to hold all of the garbage and diapers that accumulate between periods of removal from the premises. Plastic garbage bag liners should be used in such containers. Exterior garbage containers should be stored on an easily cleanable surface. Garbage areas should be free of litter and waste that is not contained. Children should not be allowed access to garbage, waste, and refuse storage areas.

If a compactor is used, the surface should be graded to a suitable drain, as approved by the regulatory health authority.

RATIONALE

Containers for garbage attract animals and insects. When trash contains organic material, decomposition creates unpleasant odors. Therefore, child care facilities must choose and use garbage containers that control sanitation risks, pests, and offensive odors. Lining the containers with plastic bags reduces the contamination of the container itself and the need to wash the containers, which hold a concomitant risk of spreading the contamination into the environment.

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

5.2.8.1 Integrated Pest Management

5.2.7.4: Containment of Soiled Diapers

Soiled diapers (disposable and cloth), and training pants should be stored inside the facility in containers separate from other waste. A secure, hands-free, plastic-lined container with firmly fitting and tightly covered lid, that does not require touching with contaminated hands or objects, should be provided, within arm’s reach of diaper changing tables, to store soiled diapers (1,2). The container for soiled diapers should be designed to prevent the user from contaminating any exterior surfaces of the container or the user when inserting the soiled diaper (1,2). Soiled disposable diapers do not have to be individually bagged before placing them in the container for soiled diapers. Soiled cloth diapers and soiled clothing that are to be sent home with a parent/guardian, however, should be individually bagged (2).

The following types of diaper containers should not be used;
a.    Those that require the user’s hand to push the diaper through a narrow opening;
b.    Those with exterior surfaces that must be touched with the hand;
c.     Those with exterior surfaces that are likely to be touched with the soiled diaper while the user is discarding the soiled diaper;
d.    Those that have lids with handles.
 
Separate containers should be used for disposable diapers, cloth diapers (if used), and soiled clothes and linens. All containers should be inaccessible to children and should be tall enough to prevent children reaching into the receptacle or from falling headfirst into containers (1,2). The containers should be placed in an area that children cannot enter without close adult supervision (1,2).

RATIONALE

Separate, plastic-lined waste receptacles that do not require touching with contaminated hands or objects and that children cannot access enclose odors within, and prevent children from coming into contact with body fluids. Anything that increases handling increases potential for contamination (1,2). Step cans or other hands-free cans with tightly fitted lids provide protection against odor and hand contamination.

COMMENTS

Fecal material and urine should not be mixed with regular trash and garbage. Where possible, soiled disposable diapers should be disposed of as biological waste rather than in the local landfill. In some areas, recycling depots for disposable diapers may be available. The facility should not use the short, poorly made domestic step cans that require caregivers/teachers to use their hands to open the lids because the foot pedals don’t work. Caregivers/teachers will find it worthwhile to invest in commercial-grade step cans of sufficient size to hold the number of soiled diapers the facility collects before someone can remove the contents to an outside trash receptacle. These are the types used by doctor’s offices, hospitals, and restaurants. A variety of sizes and types are available from restaurant and medical wholesale suppliers. Other types of hands-free containers can be used as long as the user can place the soiled diaper into the receptacle without increasing contact of the user’s hands and the exterior of the container with the soiled diaper.

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

3.2.1.1 Type of Diapers Worn
3.2.1.2 Handling Cloth Diapers
3.2.1.4 Diaper Changing Procedure
3.2.1.5 Procedure for Changing Children’s Soiled Underwear, Disposable Training Pants and Clothing
3.2.3.4 Prevention of Exposure to Blood and Body Fluids

REFERENCES

1. American Academy of Pediatrics. Managing infectious diseases in child care and schools: A quick reference guide. Aronson SS, Shope TR, eds. 4^th ed. Elk Grove Village, IL; 2017.
   
2. American Academy of Pediatrics. Infections Spread by the Fecal-Oral Route 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: 143

NOTES

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

5.2.7.5: Labeling, Cleaning, and Disposal of Waste and Diaper Containers

Early care and education programs should check their state child care regulations for diapering requirements. Many child care regulations say that programs should keep soiled disposable diapers and disposable wipes in a closed, labeled, hands-free, plastic-lined container in the diaper changing area. Keep waste and diaper containers separate from other trash. Empty, clean, and disinfect these containers daily to keep them free from soil and odor.

 

Pour wastewater from cleaning and disinfecting down a toilet or floor drain. Do not pour wastewater on the ground or into handwashing sinks, laundry sinks, kitchen sinks, or bathtubs.

RATIONALE

Proper disposal of diapers, and proper cleaning and disinfecting of the diaper areas are important to the health of children and staff. Diapers can be contaminated and spread illness among children as well as staff. ¹

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

3.2.1.2 Handling Cloth Diapers
3.2.1.4 Diaper Changing Procedure
3.2.2.1 Situations that Require Hand Hygiene
5.2.7.4 Containment of Soiled Diapers
5.4.2.4 Use, Location, and Setup of Diaper Changing Areas
5.4.2.5 Changing Table Requirements
Appendix J: Selection and Use of a Cleaning, Sanitizing or Disinfecting Product
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting

REFERENCES

1. Uko EA, Ntekpere EI. Microbial contamination of infant diapers. Communication in Physical Sciences. 2020;6(1). Accessed August 7, 2022

NOTES

Content in the standard was modified on 12/20/2022.

5.2.7.6: Storage and Disposal of Infectious and Toxic Wastes

Infectious and toxic wastes should be stored separately from other wastes, and should be disposed of in a manner approved by the regulatory health authority.

RATIONALE

This practice provides for safe storage and disposal of infectious and toxic wastes.

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

5.2.9.1 Use and Storage of Toxic Substances
5.2.9.3 Informing Staff Regarding Presence of Toxic Substances
5.2.9.4 Radon Concentrations
5.2.9.5 Carbon Monoxide Detectors
5.2.9.6 Preventing Exposure to Asbestos or Other Friable Materials
5.2.9.7 Proper Use of Art and Craft Materials
5.2.9.8 Use of Play Dough and Other Manipulative Art or Sensory Materials
5.2.9.9 Plastic Containers and Toys
5.2.9.10 Prohibition of Poisonous Plants
5.2.9.11 Chemicals Used to Control Odors
5.2.9.12 Treatment of CCA Pressure-Treated Wood
5.2.9.13 Testing for and Remediating Lead Hazards
5.2.9.14 Shoes in Infant Play Areas
5.2.9.15 Construction and Remodeling