Sanitation

Lindsey Allen, B.S.,CHESChild Care Health ConsultantCherokee Co. Health DepartmentSanitationLayout of TrainingPre-testObjectivesTrainingPost-testEvaluation

ObjectivesParticipants will be able to define sanitation and sanitation classification.

Participants will be able to describe proper hand washing procedure and the importance of it.

Participants will be able to describe proper diapering procedure and the importance of it. Objectives ContinuedWill be able to describe basic food preparation and storage rules and regulations.

Will be able to describe sanitizing of equipment and utensils.

Will be able to describe proper sanitizing and storage of cots, mats, etc.

Will be able to describe proper sanitizing of toysSanitation DefinedSanitation refers to the development and application of sanitary measures for the sake of cleanliness, protecting health, etc.

Sanitation ClassificationInspections are required twice per year in accordance with the NC General Statute 15A NCAC 18A.2800.

Classifications: Superior: 0-15 demerits (no 6 point)Approved: 16-30 demerits (no 6 point)Provisional: 31-45 demerits (or any 6 point)Disapproved: 46 or more demerits, or failure to improve a Provisional classification.DefinitionsCleaning-removing visible soil and debris. Includes scrubbing, washing with detergent and water, and rinsing. Always clean before sanitizing or disinfecting.

Sanitizing-kills nearly 99.9% of germs. Includes covering cleaned area with solution (concentration dependent upon surface area).

Disinfecting-kills nearly 100% of germs and is used in same manner as sanitizer.

Handwashing-Why?Single most important step in the prevention and spread of diseases (especially with diarrheal and respiratory illnesses).

Total of 10 demerits may be deducted for handwashing during inspection.

Saves time and money

Modes of TransmissionRespiratory or airborne (like coughing or sneezing).Fecal-oral contact (hands contaminated with human waste).Contact (touching).Contact with infected blood and secretions (like urine or saliva). The Child Care SettingThe most common form of transmission in a child care setting is by fecal-oral contact. This means human waste is on your hands and they are not washed properly. Then, in turn, is passed onto someone else. Common Pathogens-ShigellaSymptoms can occur within one day to one week of exposure.Symptoms include: stomach cramps, diarrhea, vomiting, fever, and headache. Transmitted strictly by human feces. 14,000 confirmed cases every year in US. Last between 5 to 7 days.

Common Pathogens-RotavirusWheel-like appearance Almost all children infected20-70 deaths per year Symptoms-severe fever, diarrhea, and vomiting all leading to severe dehydration. Spread through fecal-oral contact Cannot be treated with antibiotics. Outbreaks from November to May.

Steps for Proper HandwashingUse liquid soap and tempered water (80 to 110 degrees).Rub hands vigorously for 15 seconds.Wash all surfaces (back of hands, palms, wrists, under fingernails, and between fingers).Rinse well for 10 seconds.Dry hands with a paper towel Turn off faucet with paper towel. Employees-When?Upon reporting for workBefore and after handling foodBefore bottle feeding or serving foodBefore handling utensilsAfter bathroom or handling body fluidsAfter diaper changingAfter handling soiled itemsAfter being outdoorsAfter handling animals or animal cagesAfter removing gloves

Children-When?Upon arrival at the centerAfter diaper changing or visit to the toiletBefore eating meals or snacksBefore and after water play After outdoor activityAfter handling animals or animal cages

Hand SanitizersTo be used only when outdoorsNever to be used after diaperingPotential for alcohol poisoningDrug resistant bacteriaHormone disruptionPotential for weakened immune system

Handwashing ActivityGlo-germ activity Diaper ChangingDiaper changing surfaces are some of the most contaminated surfaces in a classroom and could contain all the pathogens we mentioned earlier.

What is required?Designated area with hand sink nearby

Diapering surface must be smooth, intact, and a non-absorbent surface

4 demerits will be taken if anything is stored on diapering surface or if the pad/surface is in disrepair

How should it be cleaned?With soapy water, wiped dry, and then a disinfecting solution appliedSolution should be between 500 to 800 parts per million (ppm) of chlorine bleach (1/4 cup bleach per gallon of water) Bottle labeled and stored out of reach (5ft or higher)6 demerits may be taken if not properly cleaned and disinfected or if disinfectant does not meet the required strength of 500-800ppmSo much more than an inspectionEach individual should be able to prepare solution

Kills germs-reduces sickness among children

Weakens if not prepared daily

Protect yourself!Proper Diaper ChangingGather supplies BEFORE placing child on tablePut on gloves (if needed or required by center)Remove clothes and soiled diaper, using a moist towelette wipe front to back to clean childDispose of gloves if used, soiled items in plastic-lined, covered receptacleWipe hands with disposable towelette or paper towelSlide a clean diaper, fasten, and redressWash childs hands or if child is unable to support their head, clean the childs hands with disposable towelette, and return child to supervised area

Steps Continued8. Spray entire diapering surface with soapy water and wipe clean, using disposable paper towels9. Spray entire surface with approved disinfecting solution and allow to remain on surface for minimum of 2 minutes10. Wash your hands following proper handwashing procedures even if disposable gloves are used

*Special Note: Be sure posters are posted in handwashing and diapering areas!*

Food SuppliesFree from spoilage, filth, or other contamination (6 demerits)Safe for human consumption (6 demerits)Items from home properly labeled and datedUsing outside sources for food supplyFood Storage and ProtectionStored in approved, clean, tightly covered, storage containersDry foods stored in containers labeledStored above the floorNot be stored under exposed sewer linesRaw food shall be stored on shelving beneath and separate from other foodsPotentially hazardous food lower than 45, or higher than 140.

Food PreparationPrep can only take place in designated areasWith least possible manual contact, with utensils, and clean and sanitized surfacesUtensils and surfaces cleaned after raw food preparationFruits and vegetables must be washedFoods being cooked-all parts 165 except in certain instancesMetal stem-type numerically scaled accurate to 2 degrees shall be usedThawing Foods (5 demerits)In refrigerated units at a temperature not to exceed 45 degreesUnder potable water of a temperature of 70 degrees or belowIn a microwave oven only when the food will be immediately transferred to conventional cooking equipment

Cleaning & SanitizingEach center should have at least a two-compartment sink, drainboards, or countertop spaceSeparate lavatory for handwashing Removal of food particlesSinks cleaned and sanitized prior to use Equipment and utentils shall be washed in first compartment with hot detergent solutionTabletops (eating and childrens work tables), food contact surfaces, food prep surfaces, etc should be sanitized with solution 50-200ppmCommon Foodborne IllnessesBotulismCampylobacterE.ColiListeriaMad Cow diseaseNorovirusSalmonellaStaphTrichinosisFood Safety Report Card

Beds, Cots, Mats, & LinensGood repair (3 demerits)Stored to prevent contamination (floor side not to touch sleeping side)Cleaned and sanitized between usersEasy to clean surfacesMattresses and mats waterproof materialAssigned and labeled with individual linens (3 demerits)Wash cloths, bibs, and burping cloths shall not be used for more than one child and laundered when soiled (3 demerits)Toys, Equipment, & FurnitureShall be kept clean and in good repair (4 demerits)Toys and other mouthed surfaces shall be cleaned and sanitized daily in rooms where children arent toilet trained (4 demerits)Shall be free of peeling, flaking, or chalking paintWater play centers filled just prior to each session and emptied after each sessionsToys used in water centers shall be cleaned and sanitized after use

ResourcesChild Care Center Handbook. Division of Child Development. Oct 2009.

Cleaning, Sanitizing, and Disinfecting-Using Bleach Solutions. NC Child Care Health and Safety Resource Center. 2009.

Module 1: Sanitation Classification, Handwashing and Diaper Changing. Guildford County Department of Public Health, Childrens Environmental Health Section. Sept 2008.

The Big 9 Foodborne Illnesses and what they do to you. Calorie Lab. 2008. http://calorielab.com/news/2008/06/23/foodborne-illnesses/

Questions?Lindsey Allen, B.S., CHESChild Care Health ConsultantCherokee County Health DepartmentPhone: (828) 837-7486 ext. 506Lindsey.allen@cherokeecounty-nc.gov