Environmental cleaning and disinfection in child care settings and schools

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:

Concentration

Uses

Mixture

Contact time

100 parts per million (ppm)

To sanitize items such as combs, brushes and floors

To sanitize kitchen utensils in a commercial dishwasher

2 mL of bleach with 1 litre of water

OR ½ teaspoon (tsp) of bleach with 4 cups of water

1 minute

200 ppm

To sanitize dishes and utensils in place when they are too large to be washed in a dishwasher or submerged in a sink

To sanitize kitchen surfaces such as counter tops and cutting boards

4 mL of bleach with 1 litre of water

OR

¾ tsp of bleach with 4 cups of water

1 minute

500 ppm

To sanitize child care surfaces, diapering stations, toys, play areas, pet cages and high touch surfaces

10 mL of bleach with 1 litre of water

OR

2 tsp of bleach with 4 cups of water

2 minutes

1000 ppm

During outbreaks, to sanitize child care surfaces, diapering stations, toys, play areas, pet cages and high touch hard surfaces.

20 mL of bleach with 1 litre of water

OR

4 tsp of bleach with 4 cups of water

1 minute

5000 ppm

To disinfect surfaces or items that have been in contact with blood or body fluids, including blood spills, vomit or fecal (stool) contamination

100 mL of bleach with 1 litre of water

OR

½ cup of bleach with 4 cups of water

≥10 minutes

*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.

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