SANITARY PRACTICES POLICIES AND PROCEDURES December 2016 This section contains sanitary practices that must be followed for the following activities: Hand Washing for Caregivers and Children Use of Disposable Gloves Bleach: Water Solutions Toy Cleaning Sensory Bins Water Play Care of Pets Diaper Changing and Use of Potty Chairs HAND WASHING Hand washing is the best way to prevent transmission of most types of infections. Hands, more than any other part of the body, are in constant contact with the environment and are prone to picking up many types of organisms. Microorganisms can be carried on hands to spread infections from person to person. Normal skin flora is composed of resident and transient organisms. Resident organisms are those that can survive and multiply on skin and are not easily removed by scrubbing. Transient organisms survive on the skin less than 24 hours and are easily removed by hand washing. It is these organisms that are most likely to cause infections. You should wash your hands to protect yourself and the children you care for: at the beginning of the day before changing a diaper after changing a diaper after using the toilet before handling food after contact with body fluids (blood, mucous, vomit, etc.) after removing gloves after contact with any nasal or oral secretions after caring for an ill child after sneezing or coughing after handling and caring for animals If hand washing is impossible, for example, on field trips, an alcohol based wet-wipe may be used. Children should wash their hands to protect themselves and other children: when they arrive at the child care setting after diapering and toileting before eating or drinking after contact with any nasal or oral secretions on return from outdoor play before communal play after handling animals Hand Wash Sinks Hand washing sinks must be readily accessible in diapering areas, food handling areas and washrooms. They must be equipped with hot and cold running water, liquid soap in a dispenser and paper towels. If sinks and soap dispensers are inaccessible for children, a stable, solid and secure step must be provided.
Shared basins full of water and soap are not an acceptable means of hand washing as more bacteria may be transmitted to the hands than is removed. If basins are used after painting or other messy activities to remove visible material, proper hand washing must still be done at the hand wash basin. Hot water temperature must not exceed 43C (110F) in order to avoid scalding. A supply of liquid soap in a dispenser is required at all hand washing sinks. Liquid soap in a pump or mounted dispenser is best because children can dispense the soap easily and the liquid soap is less likely to be contaminated. Anti-bacterial soap is not necessary. To prevent soap on the bottom of the dispenser from providing a medium for bacterial growth the dispenser must be cleaned before refilling. Hand Lotion (For care givers only) Hand lotion should be used to prevent dermatitis, as cracked dry hands can harbour large number of microorganisms that are difficult to remove. Studies have shown that even antiseptics cannot reduce bacteria on cracked and dry skin. Hand lotion should be in a dispenser instead of a communal dip-in jar. Containers that are re-used must be washed before refilling. Hand lotion should not be used on children unless the medication sheet is signed by a parent. GLOVE USE Disposable gloves are not a substitute for hand washing, but they do provide some protection for the Caregiver. Fresh gloves are recommended for every diaper change. Gloves can be useful: if a Caregiver has dermatitis, cuts, or open sores on the hands if there is a risk of exposure to blood and/or body fluids during outbreaks of an enteric/diarrhea disease Disposable latex or vinyl gloves must never be washed and reused. Hands must be washed prior to gloving and after removing gloves as bacteria can multiply on the hands in the warm, moist environment of the glove. Care must be taken when removing soiled gloves. The outside of the glove may contain microorganisms. Avoid touching the outside of the glove with your bare hand. Vinyl and Latex gloves are available for staff to use. Adequate cleaning and sanitizing in child care settings will aid in the prevention of transmission of infections.
TOY CLEANING Under the Durham Region Health Department, cleaning and disinfecting are 2 separate processes. Cleaning: the physical removal of visible dirt and organic matter from objects using detergent, warm water and friction. The cleaning process requires rinsing surfaces with clean water to remove detergent film. This process helps to physically remove microorganisms from surfaces but does not kill those that remain. Cleaning is an important first step in removing disease-causing microorganisms from the day nursery environment. Disinfection: a process that destroys (kills) most disease-causing microorganisms on objects or surfaces using chemical solutions. Chemical disinfectants are grouped into different levels of disinfection depending on their use. At Gingerbread, we use bleach (5.25% sodium hypochlorite) and water solutions, it is changed daily and chlorine test strips are used to test the desired strength. Disinfectant solutions must be labeled and stored out of the reach of children AT ALL TIMES. Bleach should be in a closed container and in its original bottle. BLEACH DILUTION LEVELS High: For cleaning up blood or body fluids (pee, vomit, poo), we use 10ml of bleach to 90 ml of water with a contact time of 10 minutes. Low: For disinfecting tables, toys and other surfaces, we use 5 ml of bleach to 1 litre of water with a contact time of 1 minute. Steps to cleaning and disinfecting surfaces are as follows. 1. Using a clean cloth or paper towel, spray with soap and water using a friction movement to remove dirt 2. Using a second clean cloth or paper towel, spray with clean water to remove soapy film 3. Using a third clean cloth or paper towel, spray on bleach/water solution, let sit for designated time, and wipe. 4. Let the surface air dry Steps to cleaning and disinfecting toys are as follows: 1. Clean and sanitize ALL sinks 2. Fill one sink with hot water and detergent, using a friction movement to remove dirt. 3. Fill the second sink with hot water 4. Fill the third sink with hot water and bleach using the low level ratio, dip toys in 5. Place on a clean drying surface and allow to air dry. 6. Once the toys are dry, they may be put in their designated spots or storage. Steps to cleaning and disinfecting dishes are as follows: 1. Clean and sanitize all sinks and drain boards before each use. 2. Don t wash utensils and prep food in sinks at the same time. 3. Rinse all dishes in separate container 4. Wash dishes in hot water with detergent 5. Rinse dishes in hot water. 6. Immerse washed and rinsed dishes in the bleach water solution (30ml:13.5L) for one minute 7. Place on drain board to air dry 8. Put dishes away. TOYS: Toys should be cleaned and disinfected on a weekly basis. Toy washing will be documented in the Toy Washing Book. Clean and sanitize toys that have had contact with a child s mouth on a daily basis using an appropriate sanitizing solution by using the spray-wipe-spray or immersion technique. DRESS UP CLOTHES: Launder dress up clothes weekly. In the event of head lice or scabies, dress up clothes will be laundered and put away until the outbreak has ended.
PLUSH TOYS: Machine wash or dry clean soft, cuddly (plush) toys weekly or more often if required. During an outbreak, plush toys will be laundered and removed from the play areas. NATURAL ITEMS:. Natural materials will be used under the nursery school s discretion. It is the supervisor s responsibility to assess each item before it is placed in circulation. Bird nests and other natural items deemed germy will be maintained in clear containers to minimize the risk of infection. Natural Items will be washed or thrown out weekly. During an outbreak natural items will be thrown out or removed from the play areas. LARGE TOYS: Clean all larger toys, activity centres and toy storage shelves on a weekly basis. CARPETING & FLOORING: Carpets must be cleaned to maintain a satisfactory appearance. Vacuum all carpeted areas daily and steam cleaned twice a year. Floors are swept daily and are cleaned and disinfected by the maintenance staff at the West Shore Community Centre. SENSORY AND WATER PLAY TABLES: Sensory play will be done at a table/tub that is easy to move, clean and disinfect. Tables/tubs will be cleaned and disinfected when the sensory material is changed. Children will wash hands before and after play periods. Food material used in play must be used with discretion. Cooked food must not be used for sensory play. Any product that emits dusts or powders will not be used. Agricultural grade material (corn, hay, bird seed etc.) will be avoided due to possible contamination by pesticides, or insects. All food products will be discarded at the end of activity sessions (maximum one week) not to be repackaged and stored. Non-food items in sensory bins must be carefully considered. Avoid any size of item that may be accidentally swallowed WATER: Studies involving water play in child care centres have shown that bacteria can survive and be a potential source of infection. Regular cleaning and sanitizing is necessary to reduce the risk of infection. Problems can be avoided by following a few guidelines. Wash hands of children prior to water play activity. Fill individual containers with water from an approved source. All toys and articles used in water play must be cleaned and sanitized prior to use and after. Empty water from the receptacle after each play session. Clean and sanitize after use, allow to air dry During an outbreak there will be no use of water play tables. Only non-absorbent toys will be used for water play. SAND: will be discarded once a month. FOOD: Dry food, playdough, nature items and other materials will be discarded weekly, if the food product becomes wet, it must be discarded and replaced immediately. MISCELLANEOUS: Door telephones, handles and light switches will be cleaned and disinfected weekly. Door ledges will be cleaned biweekly.
Mirrors will be cleaned when necessary. Items that cannot be properly cleaned and disinfected are not used for crafts (toilet paper rolls, egg cartons etc.) ABSORBANT MATERIALS: Separate cloths must be used for tables, dish washing and toy washing. Cloths for wiping tables, washing dishes and toys will be used only once and placed in a laundry basket out of children s reach. The laundry basket must be made of non-absorbent material and easy to clean and disinfect. CLEANING AND SANITIZING THE TOILETING AREA Item Clean Sanitize Frequency Comments Hand Washing Sinks X X Daily or when soiled Sanitize with Bleach Faucets X X and water solution Surrounding Counters X Toilet Bowls X Weekly Cleaned by WSC Staff Toilet Seats & Rims X X Daily or when soiled Sanitize with Bleach Flushing Handles X X and water solution Door Knobs X X Floor X Change Table X X After every diaper change Sanitize with Bleach and water solution POTTY SEATS: Potty seats are labeled with the child s name and are only used by that child. They will be cleaned and disinfected after each use, using the High Level Bleach: Water solution. Potty seats will be stored in a sanitary manner when not in use. PETS AND ANIMALS Pets and other animals are not allowed in areas occupied by children during our program, unless they are a service animal. When a Service Animal is on the premises, the children are not permitted to touch, tease, or chase the animal. The animal is not permitted in the playroom, kitchen or storage areas. The owner is responsible for providing a copy of the Veterinary Care Statement for Animals Visiting Child Care Centres as proof of the animal s health. This will be kept on file for one year and made available to public health unit staff or parents/guardians who may request to see them. The staff are required to keep on-going records for visiting animals and keep them on site for one year. These records are made available to public health unit staff or parents/guardians who may request to see them. RABIES: Any bite, scratch, or attack by an animal must be reported immediately to Durham Region Health Department. In order to protect children and staff from infection, Gingerbread Nursery School must report all animal bites or scratches to the Health Department immediately. This includes scratches or bites that may have come from the family s pet(s).