Child Health, Safety, and Well-being 

Cleaning, Sanitizing, and Disinfecting Practices

Information on cleaning, sanitizing, and disinfecting within the child care setting.

Bleach Solution for Sanitizing and Disinfecting

Cleaning, sanitizing, and disinfecting surfaces are key steps in the prevention, reduction, and control of communicable diseases within a child care setting.

Cleaning, sanitizing, and disinfecting within a child care setting have different meanings:

CLEANING

SANITIZING

DISINFECTING

 

·        Uses a solution made of soap and water.

·        Physically removes any dirt or debris from surfaces. 

 

·        Uses a solution made of bleach and water.

·        Reduces the amount of germs on surfaces.

·        Used on food contact surfaces and on items that children may place in their mouths.

 

·        Uses a solution made of bleach and water that is stronger than the sanitizing solution.

·        Destroys germs on surfaces.

·        Used on diaper changing tables and surfaces contaminated with blood or blood containing body fluids. 

It is important to use the right solution for the right purpose and apply it in the right way.  Bleach is a chemical and can be irritating, the recommended bleach to water solutions ensure that they are effective while limiting potential harmful effects to children and childcare providers when mixed and used the right way. Appropriate personal protective equipment and measures should be used when using bleach solutions.

Sodium Hypochlorite is the active ingredient in commercial bleach. The percentage of sodium hypochlorite in the commercial bleach product used is important as it controls the amount of bleach to mix with water which affects how long the solution needs to have contact with the surface.

Commercial bleach products to water mixtures should be mixed to result in appropriate chlorine parts per million (PPM) residuals. Residual PPM affects contact time and drying recommendations based on the frequency of use, purpose, and the reason the surface is being sanitized and/or disinfected. 

Soft or porous surfaces contaminated with blood or body fluids should be blotted or wiped to absorb with an appropriate disposable agent or material.  The disposable item used should be placed in a plastic bag to be discarded. Carpeted/ upholstered furniture or areas may need to be steam cleaned at 158ºF for at least five minutes or at 212ºF for one minute. Contaminated cloth toys or linens may be washed with water temperatures of 140-160ºF and then completely dried on the highest dryer setting.  Severely contaminated cloth toys or linens should be discarded in a plastic bag. Preventive Medicine should be consulted for instances of porous surface blood and body fluid contamination to ensure appropriate disinfecting procedures are conducted.

The following steps correlate to non-porous (hard) contaminated surfaces (diaper changing tables, table tops, high chairs, non-cloth toys, non-carpeted flooring, etc.).

1.  Identify the bleach concentration, below a mixture ratio are provided for 8.25% and 5.25-6.00% sodium hypochlorite commercial bleach products. Note, only use unscented, liquid-type bleach.  The use of splash-less or gel bleach products is not recommended.

2. Clean the surface with soap and water.  Surfaces should be cleaned to remove any visible debris, dirt, and other contamination before using the appropriate bleach solution.

3. Choose the right bleach solution mixture.  Bleach solutions, except for blood and body fluid disinfection preparations, should be made fresh daily for sanitizing and disinfecting. Blood and body fluid disinfecting solution should be made on an as needed basis.  Bleach should be added to cool water and not mixed with any other cleaning products.

4. Sanitize, disinfect, or conduct blood and body fluid disinfecting procedures by wetting the entire surface, allowing the solution to remain on the surface for at least two minutes, and then dry with a disposable paper towel or allowing to air dry as directed.  Note food contact surfaces must be air dried only.

Generally solutions should be used in accordance with prescribed established guidance for childcare provider use.

Below is a table of general bleach product to water mixtures and use guidance, verify concentrations using a chlorine test strip. 

Sanitize

Disinfect

Blood and Body Fluid Disinfectant

Clean and Sanitize After Each Use:

·       Mouthed Toys

·       Food-contact surfaces, such as tables and highchair trays 

Clean and Disinfect After Each Use:

·       Diaper Changing Tables

·       Potty Chairs

Use Only As Needed For:

·       Vomit

·       Diarrhea

·       Blood  

Clean and Sanitize Daily: Toys used by children 3 years old and younger 

Clean and Disinfect Daily:  Diaper Pails

Ensure you are following correct precaution and personal protective equipment (PPE) when using the solution.

 8.25% Sodium Hypochlorite (Bleach Concentration) 

 Sanitize

100-200 PPM

 Disinfect

600 PPM

 Blood and Body Fluid Disinfectant

5000 PPM

1/8 teaspoon of bleach to a pint of water

¾ teaspoon bleach to a pint of water

2 tablespoons of bleach to a pint of water

¼ teaspoon of bleach to a quart of water

1 ½ teaspoon of bleach to a quart of water

4 tablespoons of bleach to a quart of water

1 teaspoon of bleach to a gallon of water

2 tablespoons of bleach to a gallon of water

1 cup of bleach to a gallon of water

  5.25-6.00% Sodium Hypochlorite (Bleach Concentration)  

 Sanitize

100-200 PPM

 Disinfect

600PPM

 Blood and Body Fluid Disinfectant

5000PPM

1/4 teaspoon of bleach to a pint of water

2 ¼ teaspoon of bleach to a quart of water

1/3 cup and 1 tablespoon of bleach to a quart of water

½ tablespoon of bleach to a gallon of water

3 tablespoons of bleach to a gallon of water

1 ½ cup of bleach to a gallon of water

  **Sanitizing solutions (100-200ppm) should be used to soak toys (such as mouthed toys after each use). Toys should be cleaned, submerged for a period of 2 minutes in a sanitizing solution, rinsed with water, and then allowed to air dry.

For More Information:

U.S. Environmental Protection Agency.External link  Resource for maintaining a healthy child care environment.

Caring for Our Children, National Health and Safety Performance Standards Guidelines for Early Care and Education Programs,External link 3rd Edition, National Resource Center for Health and Safety in Child Care and Early Education. Information regarding the changes in commercial bleach concentrations.

FDA Federal Regulation Title 21.External link General sanitizing solution guidance based on purpose, type, and use.

Caring for Our Children, National Health and Safety Performance Standards Guidelines for Early Care and Education Programs, External link 3rd Edition, National Resource Center for Health and Safety in Child Care and Early Education. Standard for routine cleaning, sanitizing, and disinfecting practices within the child care setting.

National Association for the Education of Young Children. External link  Cleaning, sanitizing, and disinfecting frequency table.

APHC Tip Sheet Preparing and Measuring High Chlorine Solutions for Disinfection. (APHC)  Technical information paper on appropriate disinfecting procedures.