Infection Prevention and Control in Child Care Settings

Infants and young children share toys and often place them in their mouths. This increases the risk of spreading infections. To reduce this risk, play areas and storage spaces should be cleaned and disinfected on a regular basis. Ensure that the disinfectant is safe and suitable for use on toys. Consult the manufacturer's recommendations for dilution and contact times for these disinfectants.

Cleaning and disinfecting hard plastic toys

• Remove toys from the play area after use and place them in a collection box for cleaning and disinfection
• Clean and disinfect the collection box at the same time that toys are being cleaned and disinfected
• Clean toys in hot soapy water prior to using a disinfectant
• Use a brush to clean crevices or hard to reach areas
• Rinse toys well under running water as soap may neutralize the disinfectant
• Soak toys in an appropriate disinfectant for required amount of time (contact time)
• Rinse toys with clean water to remove any disinfectant solution, if indicated on the label; bleach does not require rinsing
• Clean and disinfect dishwasher-safe, hard plastic toys in a commercial dishwasher with a sanitizer or a hot rinse cycle
• Completely air dry toys before they are returned to use
• Keep a record of when toys were cleaned and disinfected

Cleaning and disinfecting soft, porous toys or dress up clothes

• Launder fabrics or plush toys in a washing machine with hot water, and dry in a clothes dryer on a hot cycle
• Avoid using disinfectant products on porous surfaces

Cleaning other items

• Clean and disinfect other items (e.g., scissors, puzzles, storage bins, etc.) when they are visibly dirty
• Items such as books and some craft equipment may be difficult to clean, so consider discarding them once they are soiled
• Avoid sensory play during an outbreak, such as activities using play dough, sand or water
• Clean and disinfect computer keyboards, mice and other electronics between uses

Follow instructions

It might be tempting to mix cleaning products to make sure your facility is germ-free -- but don’t. Mixing some cleaners and disinfectants (like chlorine bleach and ammonia) can be harmful, even deadly. Others can irritate your eyes, nose, or throat and cause breathing problems.

For more information, call Ottawa Public Health at 613-580-6744.

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Germs (agent)

• Bacteria
• Viruses
• Parasites

Where germs live (reservoir)

• People
• Animals/Pets (dogs, cats, reptiles)
• Wild animals
• Food
• Soil
• Water

How germs get out (portal of exit)

• Mouth (vomit, saliva)
• Cuts in the skin (blood)
• During diapering and toileting stool

Germs get around (mode of transmission)

• Contact (hands, toys, sand)
• Droplets (when you speak, sneeze or cough)

How germs get in (portal of entry)

• Mouth
• Cuts in the skin
• Eyes

Next sick person (susceptible host)

• Babies
• Children
• Elderly
• People with a weakened immune system
• Unimmunized people
• Anyone

Cycle repeats

Keeping children's hands clean is the best way to keep them from spreading germs. Young children need to be taught when and how to clean their hands.

It is important for children to clean their hands frequently, including, but not limited to:

• After going to the washroom
• Before eating
• After coughing, sneezing or blowing their nose
• After playing with shared toys
• After touching animals
• After outdoor activities

Hand hygiene techniques

Cleaning children's hands can be done by washing them with warm running water and soap or by using alcohol based hand sanitizers. Children may need assistance and supervision while washing their hands to ensure that they are washed correctly. 

Washing a young child's hands

1. Wet a paper towel with water and a small amount of liquid soap
2. Rub child's hands for 15 seconds
3. Rinse under running water
4. Dry hands with a paper towel

Cleaning a young child's hands with hand sanitizer

1. Clean your hands first using the method above
2. Place a dime size drop of hand sanitizer on your own hands
3. Rub child's hands until dry (at least 15 seconds)

For more information, call Ottawa Public Health at 613-580-6744

Shared items and high touch surfaces can be sources for spread of infection, especially in child care settings and schools. Such surfaces may include door knobs, taps, handrails, phones, computer keyboards, elevator buttons, countertops, as well as shared sports equipment or toys. These surfaces and items can easily become contaminated by viruses or bacteria which can spread from one person to another. Developing policies and procedures for cleaning and disinfection is important to prevent the spread of infections in your setting or school.

Cleaning

Cleaning is the physical action of removing debris from a surface. Cleaning with soap or detergent, and water, will remove organic material such as food, body fluids, fecal matter, or soil from surfaces. Residue from the soap or detergent must be rinsed off prior to disinfection to prevent neutralization of some disinfectants.

Disinfection

Disinfection must occur after cleaning. Disinfection inactivates or kills microorganisms (germs) that may be present on surfaces and that cleaning does not remove. A number of disinfectant products can be used in a child care setting on a regular basis. A different disinfectant may be required in outbreak situations. This may be discussed with your product supplier or with Ottawa Public Health as needed.

All-in-one cleaning/disinfecting products must contain a drug identification number (DIN) from Health Canada. The disinfectant contact time, which is the time that a surface must remain wet for a disinfectant to be effective, varies between products. Follow manufacturers' instructions for disinfectant contact times, dilution and handling of products, including for pre-saturated disinfectant wipes. If gloves are indicated for handling a product, ensure they are single use and discarded between tasks.

Flip-top bottles are preferred to apply cleaning solution. If using a spray bottle, saturate the cloth first then wipe the surface. Avoid the use of aerosol cans as this can propel the germs and cleaning solution into the air.

Household bleach diluted in water is an inexpensive and effective disinfectant and can be used for most surfaces. It should be prepared daily. Ensure that surfaces are cleaned with a detergent or cleaning agent before the household bleach mixture is used as a disinfectant.

Follow instructions

It might be tempting to mix cleaning products to make sure your facility is germ-free -- but don’t. Mixing some cleaners and disinfectants (like chlorine bleach and ammonia) can be harmful, even deadly. Others can irritate your eyes, nose, or throat and cause breathing problems.

The following table can be used as a reference for preparing household bleach solutions:

*Note: The contact time, also known as the wet time, is the time that the disinfectant needs to stay wet on a surface to make sure it can kill all the germs. It is the length of time you leave the solution on the surface before wiping it down.