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Cleaning Objects and Surfaces in a Child Care Center: Self-Learning Module


Module: Infection Control

Unit: Cleaning Surfaces and Objects

Unit Overview:  This unit on Cleaning Objects and Surfaces is a self-paced, self-administered learning module designed to educate and train child care employees on the correct cleaning technique for objects and surfaces found in the child care setting.

Pre-requisite Universal Precautions: Self Learning Module

 

Topic Completion Time Approximately 60 minutes 

 

Target Audience Child care employees

 

How To Use This Unit
  1. Read all the material.
  2. Complete the test.
  3. Complete the course evaluation.
When To Use This Unit
bulletInitial orientation of new child care employees
bulletAnnual review of child care employees

Learning Objectives

Following completion of the Cleaning Objects and Surfaces in a Child Care Setting, the child care employee will be able to meet the following program objectives:

bulletDiscuss the importance of maintaining properly cleaned surfaces and objects.  
bulletDescribe the cleaning procedure for objects such as toys, changing tables, bathrooms, potty chairs and walls; and surfaces such as floors and walls.
bulletUnderstand the difference between disinfection and sanitization.  
bulletExplain the correct technique for disposing of cloth and disposable diapers and contaminated clothing.

Contents

Introduction
Changing Tables
Toys
Objects Normally Placed in the Mouth
Bathrooms and Sinks
Potty Chairs
Surfaces Used for Indoor Activities
Beds, Cots, Pads
Bedding
Crib Mattresses
Soiled Diapers and Clothing
Floors, Walls and Ceilings
Disposal of Cloths Used for Cleaning
Disinfection
Sanitization

Introduction

Proper cleaning and disinfection of toys and surfaces limits the spread of many diseases.  Guidelines for the procedures listed below are based on the National Health and Safety Performance Standards Guidelines for Out-Of-Home Childcare and the Center for Disease  Control (CDC) The ABCs of Safety and Healthy Child Care.

Important: If your state has additional or more stringent requirements, be sure to follow them.

Changing Tables

Even if you use disposable, protective paper, you must still clean and disinfect the surface of the changing table.   Be sure to change the paper immediately after each use.

Use of Gloves

The use of gloves for routine cleaning is not required, but it is recommended.  Wear gloves for cleaning diapering surfaces that have been contaminated with blood or blood-containing fluid.  If surfaces are contaminated with blood or blood-containing fluid, you must also follow Universal Precautions

Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, disinfect them before removing.

Cleaning Frequency

Following each use.

Cleaning Procedure

  1. Wipe the surface with a soap and water solution to remove visible soil.  
  2. Dry the surface with a cloth.
  3. Thoroughly wet the surface with an approved disinfection solution.
  4. Allow to air-dry.

Disposal of Cloths Used for Cleaning

Follow the correct procedure for disposing of cleaning cloths.  

Toys

Use of Gloves

The use of gloves for routine cleaning is not required, but it is recommended.  Wear gloves for cleaning diapering surfaces that have been contaminated with blood or blood-containing fluid.  If surfaces are contaminated with blood or blood-containing fluid, you must also follow Universal Precautions.  

Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, disinfect them before removing.  

Toys Used by Infants and Toddlers

Infants and toddlers (children still in diapers) frequently suck and drool on toys.  Because saliva is a common agent for the transmission of disease-causing germs, infants and toddlers should not be allowed to share saliva-contaminated toys until the toys have been cleaned and disinfected. 

bulletToys that are contaminated with saliva, urine, vomit, feces or blood should be cleaned and disinfected before being used by another child.
bulletToys that that are touched by infants and toddlers, but not contaminated by saliva, should be cleaned and disinfected once a day.  In this age group it is often difficult to determine if a toy has been in a child's mouth, so the safest approach is to separate toys (do not allow sharing) or clean toys after individual use.
bulletIf a toy cannot be disinfected, its use should be limited to an individual child.  Be sure to label the toy with the child's name.  

Toys Used by Older Children

bulletToys that have not been in a child's mouth should be cleaned at least once a week.
bulletToys that are contaminated with saliva, urine, vomit, feces or blood should be cleaned and disinfected before being used by another child.

Cleaning Procedure for Plastic Toys

bulletScrub the toy with warm, soapy water.  Use a small brush, such as a toothbrush, to clean crevices. 
bulletRinse well.
bulletAir-dry.

Disinfecting Procedure for Plastic Toys

bulletScrub the toy with warm, soapy water.  Use a small brush, such as a toothbrush, to clean crevices. 
bulletRinse well.
bulletSubmerge the toy in a disinfecting bleach solution for at least 10 minutes.
bulletRemove the toy and rinse well.
bulletAir-dry.

Cleaning and Disinfecting Procedure for Cloth Toys

Important:  Toy parts can become loose following washing and drying.  Be sure that all toy parts are securely fastened.

bulletUsing the hot cycle, machine-wash cloth toys.
bulletMachine-dry or air-dry the toys.

Disposal of Cloths Used for Cleaning

Follow the correct procedure for disposing of cleaning cloths.  

Objects Normally Placed in the Mouth

Use of Gloves

The use of gloves for routine cleaning is not required, but it is recommended.  Wear gloves for cleaning diapering surfaces that have been contaminated with blood or blood-containing fluid.  If surfaces are contaminated with blood or blood-containing fluid, you must also follow Universal Precautions

Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, disinfect them before removing. 

Items to be Cleaned

Objects normally placed in the mouth such as thermometers and pacifiers. 

Cleaning Frequency

Following individual use.

Cleaning Procedure

  1. Wipe the object with a solution of soap and water to remove visible soil.  
  2. Thoroughly wet the object with an approved disinfection solution.
  3. Allow to air-dry.

Important:  If the object is contaminated with blood, urine, feces or vomit, disinfection is necessary.

Bathrooms and Sinks

Use of Gloves

Wear gloves when cleaning bathrooms.  Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, dedicate a pair for bathroom and potty-chair cleaning (don’t use those gloves to clean other surfaces or objects).  Sanitize the gloves before removing them.  

Items to be Cleaned

Clean bathroom floors, handwashing sinks, utility sinks, toilets (especially the seat cover and flushing handle), counters and door handles.

Cleaning Frequency

bulletAt least once a day; more often when obviously soiled  
bulletImmediately after use if a sick child has used the toilet or potty chair and soiled it with diarrhea or vomit

Type of Cleaning

bulletAt a minimum, sanitize the surfaces and objects.
bulletIf an item is heavily soiled or contaminated by the vomit or diarrhea from a sick child, disinfect the surface or object.  If the surface or object is contaminated with blood, disinfection is necessary. 
bulletDry the surface with a cloth or allow to air-dry.

Disposal of Cloths Used for Cleaning

Follow the correct procedure for disposing of cleaning cloths.  

Potty Chairs

Use of Gloves

Wear gloves when cleaning potty chairs.  Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, dedicate a pair for bathroom and potty-chair cleaning (don’t use the gloves to clean other surfaces or objects).  Sanitize the gloves before removing them.  

Cleaning Frequency

After each use.

Cleaning Procedure

  1. Empty the urine and/or feces into the toilet.
  2. Rinse the potty-chair bowl in a utility sink
  3. Sanitize all parts of the potty chair.
  4. Dry with a cloth or allow to air-dry.
  5. Store the potty chair in the bathroom.

Disposal of Cloths Used for Cleaning

Follow the correct procedure for disposing of cleaning cloths.  

Surfaces Used for Indoor Activities

Use of Gloves

The use of gloves for routine cleaning is not required, but it is recommended.  Wear gloves for cleaning diapering surfaces that have been contaminated with blood or blood-containing fluid.  If surfaces are contaminated with blood or blood-containing fluid, you must also follow Universal Precautions

Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, disinfect them before removing. 

Items to be cleaned

bulletTables (play and eating)
bulletChairs
bulletAny other surface or item associated with indoor activities

Cleaning Frequency

bulletAt least once a week; more often when obviously soiled  
bulletImmediately after use if a sick child has used the activity surface

Cleaning Procedure

  1. Wipe the surface with a solution of soap and water to remove visible soil.  
  2. Dry with a cloth.
  3. Thoroughly wet the surface with an approved disinfection solution.
  4. Allow to air-dry.

Important:  If the surfaces are contaminated with blood, urine, feces or vomit, disinfection is necessary.

Disposal of Cloths Used for Cleaning

Follow the correct procedure for disposing of cleaning cloths.  

Beds, Cots, Pads

Use of Gloves

The use of gloves for routine cleaning is not required, but it is recommended.  Wear gloves for cleaning diapering surfaces that have been contaminated with blood or blood-containing fluid.  If surfaces are contaminated with blood or blood-containing fluid, you must also follow Universal Precautions.   

Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, disinfect them before removing. 

Cleaning Frequency 

When soiled or before use by another child.

Cleaning Procedure

Wash all surfaces of the bed, crib, cot or mat with soap and water.  If possible, allow to air-dry.  

Important:  If the bed is contaminated with blood, urine, feces or vomit, disinfection is necessary.

Bedding

Bedding includes sheets, pillowcases, mattress pads and blankets.  Linen does not include blankets.

Cleaning Frequency 

bulletInfant's bedding should be washed when soiled, before use by another child or daily if used by one child.
bulletChildren's linen should be washed when soiled, before use by another child or once a week if used by one child.
bulletChildren's blankets should be washed when soiled, before use by another child or once a month if used by one child.

Cleaning Procedure for Bedding

bulletMachine-wash all bedding in warm water.  Use hot water if the bedding has been contaminated with blood, urine, feces or vomit.  
bulletIf the bedding was supplied by the parents, send the bedding home, as specified in Cleaning Frequency.

Crib Mattresses

Use of Gloves

The use of gloves for routine cleaning is not required, but it is recommended.  Wear gloves for cleaning diapering surfaces that have been contaminated with blood or blood-containing fluid.  If surfaces are contaminated with blood or blood-containing fluid, you must also follow Universal Precautions.   

Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, disinfect them before removing. 

Cleaning Frequency 

Weekly or when soiled.

Cleaning Procedure

Sanitize the mattress. 

Important:  If the mattress is contaminated with blood, urine, feces or vomit, disinfection is necessary.

Soiled Diapers and Clothing

Use of Gloves

The use of gloves for routine cleaning is not required, but it is recommended.  Wear gloves for cleaning diapering surfaces that have been contaminated with blood or blood-containing fluid.  If surfaces are contaminated with blood or blood-containing fluid, you must also follow Universal Precautions.   

Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, disinfect them before removing.  

Clothes and Cloth Diapers Supplied by the Child

Note:  If the diaper or clothing is soiled with solid feces, carefully empty the feces into the toilet.  Avoid splashing the toilet water.

bulletPlace the diaper or article of clothing in a plastic bag.
bulletSecure the bag with a twist-tie.
bulletWash your hands.

Do Not

bulletRinse the diaper or clothing.
bulletWash the diaper or clothing on the premises.

Rinsing and washing soiled clothing supplied by parents unnecessarily exposes other children and childcare center staff to potential disease causing germs.

Cloth Diapers Supplied by the Child Care Center

Place soiled cloth diapers in a labeled container with a tight-fitting lid provided by an accredited commercial diaper service or in a plastic bag that is closed with a twist-tie seal.

Do Not

bulletRinse the diaper.

Washing Cloth Diapers

Diapers should be washed in an environment and manner accredited by the Diaper Service Accreditation Council. 

Disposable Diapers

Place disposable diapers in plastic-lined trash containers.

Floors, Walls and Ceilings

Use of Gloves

The use of gloves for routine cleaning is not required, but it is recommended.  Wear gloves for cleaning floors, walls or ceilings that have been contaminated with blood or blood-containing fluid.  If surfaces are contaminated with blood or blood-containing fluid, you must follow Universal Precautions.   

Dispose of single-use gloves when cleaning is complete.  If you wear non-disposable (multi-use) gloves, disinfect them before removing.  

Type  Frequency Procedure
Walls and Ceilings
bulletClean when soiled.
bulletClean the ceiling and walls with soap and water
bulletRinse with clear water.
bulletAllow to air-dry.

 

Carpeted Floors and large floor rugs.
bulletVacuum at least daily.
bulletShampoo (steam-clean or shampoo) at least monthly.
bulletSpot-clean when contaminated with bodily fluid.

 

bulletShampoo the carpet when the children are not present.
bulletUse only hypoallergenic cleaning products

 

Small rugs
bulletShake outside or vacuum at least daily.
bulletMachine wash weekly or when soiled.

 

bulletMachine wash in hot or warm water.
bulletMachine dry if possible.

 

Non-Carpeted Floor Clean daily or more often if soiled.
bulletSweep or vacuum the floor.
bulletSanitize the floor.

 

Important:  If the surfaces are contaminated with blood, urine, feces or vomit, disinfection is necessary.

Disposal of Cloths Used for Cleaning

Follow the correct procedure for disposing of cleaning cloths.

Disposal of Cloths Used for Cleaning

If disposable cloths were used for cleaning

bulletPlace the disposables cloths in plastic bag secured with a twist tie.  
bulletPlace the sealed bag in an outside trash container. 

If non-disposable cloths were used for cleaning

bulletPlace the cloths in a covered laundry receptacle before removing your cleaning gloves.  
bulletUse the hot cycle of the washing machine to launder the soiled cleaning cloths. 

Disinfection

Guidelines and procedures for disinfection solutions are based on the National Health and Safety Performance Standards Guidelines for Out-Of-Home Childcare and on information from the Center for Disease Control (CDC).

Disinfection kills most disease-causing organisms such as streptococcus, staphylococcus, E. coli, salmonella and the agents that cause HIV and hepatitis.  A product that claims to be a disinfectant must be registered with the Environmental Protection Agency (EPA).  

Disinfection Methods

Disinfection removes almost all germs from an object.

Bleach Disinfection Solution
bulletA solution of 1/4 cup household, liquid chlorine bleach in one gallon of cool tap water (or 1 tablespoon of bleach to 1 quart of water), prepared fresh daily, is an effective disinfectant for environmental surfaces.  An effective disinfection solution should have a faint chlorine smell.  If the odor is not present, regardless of when the solution was made, discard the solution and prepare a fresh mixture.  Sun, evaporation and heat weaken the solution, so keep the solution covered, out the sun and away from heat sources.  
bulletCaution:  Never mix bleach with any liquid other than water.  Mixing bleach with a liquid such as vinegar or ammonia can cause a dangerous chemical reaction.  
bulletNote:  Some germs, such as cryptosporidia, are not killed by a bleach solution.  
Commercially Prepared Disinfection Solution
bulletCommercially prepared disinfection solutions that have been approved by the Environmental Protection Agency and the state or local health department are available.  These products are usually labeled as "germicide" or "hospital-grade." 

Heat

Prolonged, intense heat, which occurs when using a dishwasher or hot cycle of a washing machine, is an effective disinfectant.  Tap water is not hot enough to be an effective disinfectant.

Procedure

Bleach Solution

  1. Clean the surface or object with soap and water to remove all visible dirt.
  2. Wipe the object with a disinfectant solution or submerge the surface in the solution.  If wiping, apply enough solution to wet the item thoroughly and allow the solution to remain on it for a few minutes; if submerging, allow the item to remain in the solution for a few minutes.
  3. Partially dry the object (if desired) to remove most of the wetness, but leave a small amount of solution on the object or surface to air dry.

Commercial Solution

To ensure disinfection, follow the manufacturer's instructions.

Safety Precaution

Keep all disinfection solutions out of the reach of children. 

Note:  The bleach solution, if mixed as directed above, is not harmful if ingested.

Sanitization

Guidelines and procedures for sanitation are based on the National Health and Safety Performance Standards Guidelines for Out-Of-Home Childcare and on information from the Center for Disease Control (CDC).

Sanitizing removes the visible dirt from an object or surface and reduces the number of disease-causing organisms to a level that is unlikely to transmit disease.  Sanitizing is more effective than cleaning, but less effective than disinfection.  

Sanitation Procedure

  1. Clean the surfaces with soap and water to remove visible dirt.
  2. Rinse with clean water.
  3. Scrub the surfaces again with soap and water, a commercial sanitization product, a cleanser that contains bleach or a sanitizing bleach solution (1 tablespoon of household bleach to one gallon of cool water).
  4. Rinse with clean water.
  5. When possible, allow surface to air dry. 

Procedure to Follow when Using a Commercial Sanitation Product

To ensure sanitation, follow the manufacturer's instructions.

Safety Precaution

Keep all sanitation products out of the reach of children.

Proceed to the written test .

 

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