R381-100-15. Health and Infection Control

  (1) The building, furnishings, equipment, and outdoor area shall be kept clean and sanitary including:

  (a) walls, and flooring shall be clean and free of spills, dirt, and grime;

  (b) areas and equipment used for the storage, preparation, and service of food shall be clean and sanitary;

  (c) surfaces used by children shall be free of rotting food or a build-up of food;

  (d) the building and grounds shall be free of a build-up of litter, trash, and garbage; and

  (e) the facility shall be free of animal feces.

  (2) The provider shall take safe and effective measures to prevent and eliminate the presence of insects, rodents, and other pests.

  (3) All toys and materials including those used by infants and toddlers shall be cleaned:

  (a) at least weekly or more often if needed,

  (b) after being put in a child's mouth and before another child plays with the toy, and

  (c) after being contaminated by a body fluid.

  (4) Fabric toys and items such as stuffed animals, cloth dolls, pillow covers, and dress-up clothes shall be machine washable and washed weekly, and as needed.

  (5) Highchair trays shall be cleaned and sanitized before each use.

  (6) Water play tables or tubs shall be cleaned and sanitized daily, if used by the children.

  (7) Bathroom surfaces including toilets, sinks, faucets, and counters shall be cleaned and sanitized each day.

  (8) Potty chairs shall be cleaned and sanitized after each use.

  (9) Toilet paper shall be accessible to children and kept in a dispenser.

  (10) The provider shall post handwashing procedures that are readily visible from each handwashing sink and shall ensure that the procedures are followed.

  (11) Staff and volunteers shall wash their hands thoroughly with liquid soap and running water at required times including:

  (a) before handling or preparing food or bottles,

  (b) before and after eating meals and snacks or feeding a child,

  (c) after using the toilet or helping a child use the toilet,

  (d) after contact with a body fluid,

  (e) when coming in from outdoors, and

  (f) after cleaning up or taking out garbage.

  (12) Caregivers shall teach children how to wash their hands thoroughly and shall oversee handwashing whenever possible.

  (13) The provider shall ensure that children wash their hands thoroughly with liquid soap and running water at required times including:

  (a) before and after eating meals and snacks,

  (b) after using the toilet,

  (c) after contact with a body fluid,

  (d) before using a water play table or tub, and

  (e) when coming in from outdoors.

  (14) Only single-use towels from a covered dispenser or an electric hand dryer may be used to dry hands.

  (15) Personal hygiene items, such as toothbrushes, combs, and hair accessories, shall not be shared and shall be stored so they do not touch each other, or they shall be sanitized between each use.

  (16) Pacifiers, bottles, and nondisposable drinking cups shall:

  (a) be labeled with each child's name or individually identified; and

  (b) not shared, or washed and sanitized before being used by another child.

  (17) A child's clothing shall be promptly changed if the child has a toileting accident.

  (18) Children's clothing that is wet or soiled from a body fluid shall:

  (a) not be rinsed or washed at the center,

  (b) be placed in a leakproof container that is labeled with the child's name, and

  (c) be returned to the parent, or

  (d) thrown away with parent consent.

  (19) Staff shall take precautions when cleaning floors, furniture, and other surfaces contaminated by blood, urine, feces, or vomit. Except for diaper changes and toileting accidents, staff shall:

  (a) wear waterproof gloves;

  (b) clean the surface using a detergent solution;

  (c) rinse the surface with clean water;

  (d) sanitize the surface;

  (e) throw away in a leakproof plastic bag the disposable materials, such as paper towels, that were used to clean up the body fluid;

  (f) wash and sanitize any nondisposable materials used to clean up the body fluid, such as cleaning cloths, mops, or reusable rubber gloves, before reusing them; and

  (g) wash their hands after cleaning up the body fluid.

  (20) A child who is ill with an infectious disease may not be cared for at the center except when the child shows signs of illness after arriving at the center.

  (21) When a child becomes ill while in care:

  (a) the provider shall contact the child's parent or, if the parent cannot be reached, an individual listed as the emergency contact to immediately pick up the child; and

  (b) if the child is ill with an infectious disease, the child shall be made comfortable in a safe, supervised area that is separated from the other children until the parent arrives.

  (22) When any child or employee has an infectious disease, an unusual or serious illness, or a sudden onset of an illness, the provider shall notify the local health department on the day the illness is discovered.

  (23) The provider shall post a notice at the center when any staff member or child has an infectious disease or parasite. The notice shall:

  (a) not disclose any personal identifiable information,

  (b) be posted in a conspicuous place where it can be seen by all parents,

  (c) be posted and dated on the same day that the disease or parasite is discovered, and

  (d) remain posted for at least 5 days.

  (24) To prevent contamination of food, the spread of foodborne illnesses, and other diseases:

  (a) individuals who prepare food in the kitchen shall not change diapers or help in toileting children;

  (b) caregivers who care for diapered children shall only prepare food for the children in their care, and they shall not prepare food outside of the room used by the diapered children or prepare food for other children and adults in the facility; and

  (c) individuals with an infectious disease or showing symptoms such as diarrhea, fever, and vomit shall not prepare or serve foods.