Infection Control

Public Health helps child care providers provide safe, healthy environments for kids by inspecting all licensed child care centres and reviewing the centre’s infection control practices. Public Health also responds to complaints about child care centres, and works with the child care centre staff to prevent illness and minimize the spread of illness.

The risk of spreading infections at your centre can be decreased by following recommended infection control practices. 

Hand hygiene and glove use

Handwashing is the best wy to stop the spread of germs. It is important to wash your hands before you:

  • Prepare food or snacks
  • Put on gloves

Or after you:

  • Help a child to blow their nose or blow your own nose
  • Cough or sneeze
  • Use the washroom, help a child use the toilet, or change a diaper
  • Handle animals, feed animals, or clean up animal feces
  • Handle garbage
  • Take off gloves

Wash your hands before and after wearing gloves as your hands can become contaminated when taking the gloves off. Gloves are single-use and task specific. Gloves must not be reused or worn from task-to-task and are not a substitute for washing your hands.

To prevent illness from spreading, staff can teach children to wash their hands with sooap and water for 15 seconds. You can sing the ABCs, Twinkle Twinkle Little Star, or another song to encourage children to wash their hands for the sufficient length of time.

Do not refill or top up soap containers. Once the container is empty, clean the contain, then refill or discard and replace. Use liquid soap instead of bar soap. Bar soap is not recommended because it can harbour germs that can spread person-to-person.

Hand sanitizer can be used for handwashing if hands are not visible soiled.

  • Ensure that children are supervised while using hand sanitizer. They should avoid touching thei eyse, nose, or mouth until hands are dry.
  • Hand sanitizers that do not contain alcohol are not recommended as the chemical used in these products is not effective against common germs including the common cold (rhinovirus) and norovirus (vomiting and diarrhea).
  • Check to make sure the hand sanitizer has at least 70% alcohol content. Hand sanitizer with 60-70% alcohol content may be used if the child care centre is not experiencing an increase in illness.

Tips to remember:

  • Thin “deli-style” gloves often used for food preparation should not be used when changing diapers.
  • Some individuals may have allergies to latex. Consider using non-latex gloves if staff have identified an allergy.
  • Use personal protective equipment (PPE) such as gloves and mask when cleaning up blood, vomit, feces, or other body fluids.

Cleaning and disinfection

Cleaning is the physical removal of dirt and germs from a surface by wiping or scrubbing, while disinfection kills germs using a chemical solution such as accelerated hydrogen peroxide or bleach and water.

Tips to remember:

  • Not all products are equal: some are cleaners only, some are disinfectants only, and some can be used for both. Review the product label and ingredients to figure out what your product can be used for.
  • A bleach and water solution is only a disinfectant. If this is used in your centre, all surfaces must first be cleaned with soap and water, rinsed, and then the bleach and water solution applied.
  • Always follow the manufacturer’s instructions for product use (e.g., how long it must stay wet on a surface, mixing, and safety instructions).
  • Have a schedule for cleaning and disinfecting toys. A sample schedule is available from Public Health.
  • Wear PPE (mask and gown) when cleaning up blood, vomit, or feces. 

Diapering and Toileting

When you change diapers or assist a child with toileting, there is a high risk of spreading germs to others via surfaces or unwashed hands. Make sure you:

  • Wash the child’s hands and your hands after changing the diaper and removing your gloves. Gloves are single use and must be thrown out after use.
  • Clean and disinfect the change table/mat after each use.
  • Designate an area for changing diapers; do not change diapers where food is served or prepared.
  • If cloth diapers are used, have an infection control policy and procedure in place for the handling and use of cloth diapers.
  • Ensure any product applied to the child (ointment/cream) is supplied by the parent, used only on one child, and labelled with the child’s name. Use clean gloves when applying creams or ointments.
  • Use clean gloves or use a single-use applicator when dispensing creams or ointments.
  • Do not store toys or other items such as craft supplies in the washrooms or change table area.
  • Have bins for diaper disposal that are labelled, covered, and kept out of children’s reach.
  • Store potty seats off the floor and make sure they are not damaged. clean and disinfect after each use.

Bites from children

Bites in child care centres can be common among young children. When the skin is broken there is a small risk of spreading blood borne infections such as hepatitis B, hepatitis C, and HIV.

Be prepared before a bite happens by ensuring that:

  • Your facility has a written policy and procedure for managing child and employee exposures to blood and body fluids, including bites
  • Staff have received training for the proper care of bite wounds
  • First aid equipment is readily available
  • Staff are immunized against hepatitis B

When the skin is not broken:

  • Clean wound with soap and water and/or disinfectant
  • Apply cold compress/ice
  • Gently soothe child
  • Document incident and actions taken
  • Notify parents/guardians
  • Watch for redness and swelling

When the skin is broken:

  • Allow wound to bleed without squeezing
  • Clean wound with soap and water (wear gloves) and apply first aid as per your policy
  • Have the biter rinse their mouth out with water
  • Notify barents of children involved as soon as possible (within 2 hours)
  • Encourage the parents to have the child assessed by a physician regarding post-exposure immunization and advice
  • Document incident and actions taken

Resident and visiting animals

Diseases like Salmonella, E. coli, and others can spread from animals to humans, sometimes causing illness. Young children are at the greatest risk of severe illness because of their developing immune system. For this reason, pets are generally not recommended in child care centres. Exotic animals, reptiles,  and poultry (including baby chicks and incubators) are not permitted in child care centres due to the risk of disease transmission. If you are considering having animals either visit or live at your centre, contact Public Health before having the animal onsite.

Reminders:

  • Ill animals must not be allowed at the centre
  • Animals should be kept in enclosed cages or under appropriate restraints
  • Keep animals out of areas where food is consumed, stored, or served
  • Inform parents/guardians of the propsed animals as some children may have allergies, be immunocompromised, or be scared; considerations such as allergies, transmission of infection, safety and the welfare of the animal must be thought out before an animal is brought to the child care centre
  • Have a policy in place for care of the pet (e.g., who takes responsibility for the pet, cage/tank cleaning and schedule, how to meet the animal’s daily requirements)
  • Ensure animal health information is documented on a veterinary care statement for every visiting and/or resident animal other than fish and invertebrate species
  • Have an up-to-date rabies vaccination certificate on file for dogs, cats, and ferrets visiting the centre
  • Report any animal bite or scratch using the Rabies Exposure Report (PDF, 1 page, 151 kb). This is mandatory under the Health Protection and Promotion Act
  • Do not allow children to come into contact with feces, clean cages, or handle raw animal food/treats