Cleaning And Disinfection Procedures
Keeping the child care environment clean and orderly is very important
for health, safety, and the emotional well-being of both children
and providers. One of the most important steps in reducing the number
of germs, and therefore the spread of disease, is the thorough cleaning
of surfaces that could possibly pose a risk to children or staff.
Surfaces considered most likely to be contaminated are those with
which children are most likely to have close contact. These include
toys that children put in their mouths, crib rails, food preparation
areas, and surfaces likely to become very contaminated with germs,
such as diaper-changing areas.
Routine cleaning with soap and water is the most useful method for
removing germs from surfaces in the child care setting. Good mechanical
cleaning (scrubbing with soap and water) physically reduces the numbers
of germs from the surface, just as hand washing reduces the numbers
of germs from the hands. Removing germs in the child care setting
is especially important for soiled surfaces which cannot be treated
with chemical disinfectants, such as some upholstery fabrics.
However, some items and surfaces should receive an additional step,
disinfection, to kill germs after cleaning with soap and rinsing with
clear water. Items that can be washed in a dishwasher or hot cycle
of a washing machine do not have to be disinfected because these machines
use water that is hot enough for a long enough period of time to kill
most germs. The disinfection process uses chemicals that are stronger
than soap and water. Disinfection also usually requires soaking or
drenching the item for several minutes to give the chemical time to
kill the remaining germs. Commercial products that meet the Environmental
Protection Agency’s (EPA’s standards for “hospital
grade” germicides (solutions that kill germs) may be used for
this purpose. One of the most commonly used chemicals for disinfection
in child care settings is a homemade solution of household bleach
and water. Bleach is cheap and easy to get. The solution of bleach
and water is easy to mix, is nontoxic, is safe if handled properly,
and kill most infectious agents. (Be aware that some infectious agents
are not killed by bleach. For example, cryptosporidia is only killed
ammonia or hydrogen peroxide.) A solution of bleach and water loses
its strength very quickly and easily. It is weakened by organic material,
evaporation, heat, and sunlight. Therefore, bleach solutions should
be mixed fresh each day to make sure it is effective. Any leftover
solution should be discarded and the end of the day. NEVER mix bleach
with anything but fresh tap water! Other chemicals may react with
bleach and create and release a toxic chlorine gas. Keep the bleach
solution you mix each day in a cool place out of direct sunlight and
out of the reach of children. (Although a solution of bleach and water
mixed as shown in the accompanying box should not be harmful if accidentally
swallowed, you should keep all chemicals away from children.)
If you use a commercial (brandname) disinfectant, read the label
and always follow the manufacturer’s instructions exactly.
Recipe for Bleach Disinfecting Solution (For use in
bathroom, diapering areas, etc.)
1/4 cup bleach
1 gallon of cool water
1 tablespoon bleach
1 quart cool water
Add the house hold bleach (5.25% sodium hypochlorite) to the water.
Recipe for Weaker Bleach Disinfecting Solution
(For use on toys, eating utensils, etc.)
1 tablespoon bleach
1 gallon cool water
Add the bleach to the water
Washing and Disinfecting Toys
- Infants and toddlers should not share toys. Toys that children (particularly
infants and toddlers) put in their mouth should be washed and disinfected
between uses by individual children. Toys for infants and toddlers
should be chosen with this in mind. If you can’t wash a toy,
it probably is not appropriate for an infant or toddler.
-When an infant or toddler finishes playing with a toy, you should
retrieve it from the play area and put it in a bin reserved for dirty
toys. This bin should be out of reach of the children. Toys can be
washed at a later, more convenient time, and then transferred to a
bin for clean toys and safely reused by the other children.
To wash and disinfect a hard plastic toy:
• Scrub the toy in warm, soapy water. Use a brush to reach into
• Rinse the toy in clean water.
• Immerse the toy in a mild bleach solution (see above) and
allow it to soak
in the solution for 10-20 minutes.
• Remove the toy from the bleach and rinse well in cool water.
• Air dry.
- Hard plastic toys that are washed in a dishwasher or cloth toys
washed in the hot water cycle of the hot water cycle of a washing
machine do not need to be additionally disinfected.
-Children in diapers should only have washable toys. Each group of
children should have its own toys. Toys should not be shared with
-Stuffed toys used by only a single child should be cleaned in a washing
machine every week, or more frequently if heavily soiled.
-Toys and equipment used by older children and not put into their
mouths should be cleaned at least weekly and when obviously soiled.
A soap and water wash followed by clear water rinsing and air drying
should be adequate. No disinfection is required. (These types of toys
and equipment include blocks, dolls, tricycles, trucks, and other
-Do not use wading pools for children in diapers.
- Water play tables can spread germs.
To prevent the spread of germs:
• Disinfect the table with chlorine bleach solution before filling
it with water.
• Disinfect all toys to be used in the table with chlorine bleach
solution. Avoid using sponge toys. They can trap bacteria and are
difficult to clean.
• Have all children wash their hands before and after playing
in the water table.
• Do not allow children with open sores or wounds to play in
the water table.
• Carefully supervise the children to make sure they don’t
drink the water.
• Discard water after play is over.
Washing and Disinfecting Bathroom and Other
Bathroom surfaces, such as faucet handles and toilet seats, should
be washed and disinfected several times a day, if possible, but at
least once a day or when soiled. The bleach and water solution or
chlorine-containing scouring powers or other commercial bathroom surface
cleaner/disinfectants can be used in these areas. Surfaces that infants
and young toddlers are likely to touch or mouth, such as crib rails,
should be washed with soap and water and disinfected with a nontoxic
disinfectant, such as bleach solution, at least once every day, more
often if visibly soiled. After the surface has been drenched or soaked
with the disinfectant for at least 10 minutes, surfaces likely to
be mouthed should be thoroughly wiped with a fresh towel moistened
with tap water. Be sure not to use a toxic cleaner on surfaces likely
to be mouthed. Floors should be washed and disinfected at least once
a day and whenever soiled.
Washing and Disinfecting Diaper Changing
Diaper Changing Areas should:
• Only be used for changing diapers.
• Be smooth and nonporous, such as Formica (NOT wood).
• Have a raised edge or low “fences” around the
area to prevent a child from falling off.
• Be next to a sink with hot and cold running water.
• Not be used to prepare food, mix formula, or rinse pacifiers.
• Be easily accessible to providers.
• Be out of reach of children.
Diaper changing areas should be cleaned and disinfected after each
diaper changer as follows:
• Clean the surface with soap and water and rinse with clear
• Dry the surface with a paper towel.
• Thoroughly wet the surface with the recommended bleach solution.
• Air dry. Do not wipe.
Washing and Disinfecting Clothing, Linen,
Do not wash or rinse clothing soiled with fecal material in the child
care setting. You may empty solid stools into the toilet, but be careful
not to splash or touch toilet water with your hands. Put the soiled
clothes in a plastic bag and seal the bag to await the pick-up by
the child’s parent or guardian at the end of the day. Always
wash your hands after handling soiled clothing. Explain to parents
that washing or rinsing soiled diapers and clothing increases the
chances that you and the children may be exposed to germs that cause
diseases. Although receiving soiled clothes isn’t pleasant,
remind parents that this policy protects the health of all children
and providers. Each item of sleep equipment, including cribs, cots,
mattresses, blankets, sheets, etc., should be cleaned and sanitized
before being assigned to a specific child. The bedding items should
be labeled with that child’s name, and should only be used by
that child. Children shall not share bedding. Infants’ linens
(sheets, pillowcases, blankets) shall be cleaned and sanitized daily,
and crib mattresses shall be cleaned and sanitized weekly and when
soiled or wet. Linens from beds of older children shall be laundered
at least weekly and whenever soiled. However, if a child inadvertently
used another child’s bedding, you shall change the linen and
mattress cover before allowing the assigned child to use it again.
All blankets shall be changed and laundered routinely at least once
Cleaning up Body Fluid Spills
Spills of body fluids, including blood, feces, nasal and eyed discharges,
saliva, urine, and vomit shall be cleaned up immediately. Ware gloves
unless the fluid can be easily contained by the material (e.g., paper
tissue or cloth) being used to clean it up. Be careful not to get
any of the fluid you are cleaning in your eyes, nose, mouth or any
open sores you may have. Clean and disinfect any surfaces, such as
counter tops and floors, on which body fluids have been spilled. Discard
fluid contaminated material in a plastic bag that has been securely
sealed. Mops used to clean up body fluids should be (1) cleaned, (2)
rinsed with a disinfecting solution, (3) wrung as dry as possible,
and (4) hung to dry completely. Be sure to wash your hands after cleaning