Child Care Basics: Hygiene, Cleaning, and Infection Prevention

Why hygiene and cleaning matter in child care

In group care, germs spread quickly through hands, shared surfaces, toys, and bodily fluids (stool, vomit, mucus, blood). Hygiene and cleaning reduce the number of germs and lower the chance of illness spreading. In practice, you will use three different actions:

• Clean: remove dirt and most germs using soap/detergent and water.
• Sanitize: reduce germs to a safer level (often used for food areas and mouthed toys).
• Disinfect: kill more germs (used for diaper areas, toilets, and bodily-fluid spills).

Always follow your program’s written policy and the product label. If your policy and the label differ, follow the stricter instruction.

What to clean (high-priority targets)

Hands and skin

• Children’s and caregivers’ hands
• Any skin that has contact with stool, urine, vomit, mucus, or blood

Diapering and toileting areas

• Diaper changing surface, safety strap, and nearby handles
• Toilet seats, flush handles, potty chairs, bathroom sinks, faucet handles

High-touch surfaces

• Doorknobs, light switches, railings, phones/tablets, keyboards
• Tabletops, chair backs, cubbies, shared art supply handles

Food and drink areas

• Tables used for eating, highchair trays, counters, refrigerator handles
• Bottles/cups (handled per program policy)

Toys and learning materials

• Mouthed toys (teethers, rattles)
• Shared toys (blocks, dramatic play items)
• Soft toys and dress-up items

Laundry and linens

• Bedding, blankets, washable mats, towels, bibs
• Clothing soiled with stool, urine, vomit, blood, or heavy mucus

Bodily fluid spills and waste

• Any surface contaminated by vomit, diarrhea, blood, or large amounts of mucus
• Trash containers and diaper pails

When to clean (timing that prevents spread)

How to clean (step-by-step methods)

Handwashing: the most important routine

Use soap and running water whenever possible. Hand sanitizer can be a backup when hands are not visibly dirty, but it does not replace handwashing after diapering or when hands are soiled.

Caregiver and child handwashing steps

1. Wet hands with running water.
2. Soap: apply enough to cover all hand surfaces.
3. Scrub for 20 seconds: palms, backs of hands, between fingers, thumbs, fingertips, and under nails. A simple timer: sing a short 20-second song.
4. Rinse under running water.
5. Dry with a clean paper towel (or assigned personal towel per policy).
6. Turn off faucet using the paper towel if possible.

Helping young children: stand behind the child, guide their hands through scrubbing, and narrate what you’re doing (“soap, scrub, rinse, dry”). For children who resist, offer choices: “Do you want bubbles first or water first?”

Glove use: when and how

Gloves protect you from direct contact with bodily fluids, but they do not replace handwashing. Use single-use gloves for diapering, toileting accidents, cleaning bodily fluid spills, and when there is blood or open sores.

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Glove steps

1. Put gloves on right before the task.
2. Avoid touching your face, phone, door handles, and clean items while gloved.
3. Remove gloves safely: pinch the outside of one glove at the wrist and peel off; hold it in the gloved hand; slide fingers under the wrist of the remaining glove and peel off over the first glove.
4. Dispose in a lined trash can.
5. Wash hands immediately after.

Common mistake to avoid: wearing the same gloves from a “dirty” task (diapering) to a “clean” task (wiping a table). Change gloves and wash hands between tasks.

Diapering hygiene: a consistent routine

Set up a diapering area with supplies within reach so you never leave a child unattended. Keep clean supplies separate from the diapering surface.

Diaper change steps (clean-to-dirty-to-clean flow)

1. Prepare: gather diaper, wipes, cream (if authorized), gloves, disposable liner (if used), and a plastic bag for soiled clothes.
2. Gloves on.
3. Place child on the changing surface and secure safety strap if used.
4. Remove soiled diaper; fold it inward to contain stool/urine.
5. Clean the child front to back. Use a new wipe as needed.
6. Put on clean diaper and dress the child.
7. Bag soiled clothing (if any) in a sealed plastic bag labeled for the family.
8. Wash the child’s hands (or assist at sink). If a sink is not immediately available, use a program-approved method and wash at the next opportunity.
9. Dispose of diaper and wipes in a covered, lined container (or diaper pail per policy).
10. Clean then disinfect the changing surface (details below).
11. Remove gloves, dispose, and wash your hands.

Diaper creams: apply only with written permission and follow medication/authorization procedures per policy. Use a clean applicator (e.g., disposable glove or single-use applicator) to avoid contaminating the container.

Toileting and potty-training hygiene

Toileting routines should protect dignity while preventing contamination of hands and surfaces.

Toileting steps

1. Coach clothing management: help children keep sleeves and shirts away from the toilet.
2. Wipe front to back and use the minimum help needed; use gloves if you anticipate contact with stool/urine.
3. Flush and close lid if available (reduces spray).
4. Handwashing for the child and caregiver (if you assisted).
5. Clean/disinfect any surfaces that were splashed or touched with soiled hands.

Potty chairs: empty contents into the toilet (avoid splashing), rinse if needed, then clean and disinfect the chair after each use. Keep potty chairs out of food areas.

Surface sanitizing and disinfecting (with contact times in plain language)

Most disinfectants only work if the surface stays wet for a certain amount of time called contact time. If it dries too soon, it may not kill germs effectively.

Plain-language contact time examples

• “Keep it wet for 1 minute”: the surface should look visibly wet for a full minute before you wipe or let it air-dry.
• “Keep it wet for 5 minutes”: you may need to re-spray or re-wipe so it doesn’t dry early.
• “Air-dry”: do not wipe it off; let it dry on its own after the required wet time.

Important: Always check the product label for the exact contact time and whether it is a sanitizer or disinfectant. Use only products approved by your program for child care settings.

Three-step method for most surfaces

1. Clean: remove visible dirt with detergent/soap and water (or a cleaning wipe).
2. Apply sanitizer/disinfectant: cover the surface evenly.
3. Wait the contact time: keep the surface wet for the full time listed on the label, then air-dry or wipe if the label instructs.

Food-contact surfaces (tables, highchair trays): many programs use sanitize after cleaning. If your program uses a disinfectant here, confirm it is approved for food-contact surfaces and whether a rinse is required.

Quick reference: which level to use

• Sanitize: eating tables, highchair trays, mouthed toys (after cleaning).
• Disinfect: diaper changing surfaces, toilets/potties, and bodily fluid spills (after cleaning).

Toy cleaning (including “mouthed toy” handling)

Hard toys (plastic, sealed wood)

1. Remove the toy from play if it is mouthed or visibly dirty.
2. Clean with soap/detergent and water (or per program method).
3. Sanitize and keep wet for the label contact time.
4. Air-dry completely before returning to play.

Mouthed-toy bin system

Use a clearly labeled container (out of children’s reach) for toys that have been in mouths. Teach children a simple rule: “If it goes in your mouth, it goes in the bin.” Clean/sanitize the bin itself daily.

Soft toys and dress-up clothes

• Choose washable items when possible.
• Launder on a schedule (e.g., weekly) and immediately when wet/soiled.
• Limit sharing during outbreaks by rotating sets and laundering between uses.

Laundry handling (reduce contamination while moving items)

Handle soiled laundry as if germs can transfer to your hands and clothing.

Safe laundry steps

1. Wear gloves if items are soiled with stool, urine, vomit, blood, or heavy mucus.
2. Do not shake laundry (shaking spreads germs into the air).
3. Bag or contain items in a leak-proof bag or lined hamper.
4. Wash hands after handling.
5. Wash and dry using the warmest appropriate settings for the fabric; dry thoroughly.
6. Clean/disinfect hampers if they become contaminated.

Family-owned soiled clothing: place in a sealed plastic bag with the child’s name and send home the same day, following your program’s policy.

Safe disposal of bodily fluids (diarrhea, vomit, blood, mucus)

Respond quickly, protect others from exposure, and clean thoroughly.

Bodily fluid spill response steps

1. Block off the area so children do not walk through it.
2. Put on gloves (and additional protective items per policy if splashing is likely).
3. Remove bulk material with disposable towels; place directly into a lined trash bag.
4. Clean the area with detergent/soap and water.
5. Disinfect and keep the surface wet for the label contact time.
6. Dispose of all used towels and gloves in a lined trash can; tie off the bag if heavily contaminated.
7. Wash hands immediately.
8. Clean/disinfect any tools used (bucket, dustpan) or use disposable items per policy.

Carpet/upholstery: follow program procedures for extraction/steam cleaning and disinfectant products approved for soft surfaces. If you cannot disinfect effectively, restrict use until cleaned per policy.

Simple illness decision guide (monitor, separate for comfort, notify families)

This guide supports day-to-day decisions. Always follow your program’s written illness policy and local public health guidance.

Symptoms to monitor (track changes over the day)

• Fever (per your policy definition) and how the child is acting (sleepy, irritable, not drinking)
• Diarrhea (more frequent/looser stools than usual, especially if not contained)
• Vomiting
• Persistent cough or trouble breathing
• Rash with fever or behavior changes
• Eye drainage with redness/pain
• Sores that are open, weeping, or cannot be covered
• Unusual fatigue, poor appetite, signs of dehydration (dry mouth, no tears, fewer wet diapers)

When to separate a child for comfort (not as punishment)

Separate (within sight and supervision) when the child cannot comfortably participate or needs reduced contact to prevent spread. Examples:

• Repeated coughing that disrupts rest or group activities
• Diarrhea or vomiting—child needs immediate cleanup and a calm area while you contact family
• Fever with low energy—child needs rest and closer observation
• Any situation where bodily fluids cannot be contained

Comfort setup: a designated cot/chair away from play, a washable blanket assigned to the child, tissues, a lined trash can, and easy access to handwashing. Clean and disinfect the area after use.

When to notify families (per policy)

• Immediately for: vomiting, suspected contagious rash with fever, difficulty breathing, blood in stool/vomit, head injury with concerning symptoms, or any symptom your policy lists as urgent.
• Promptly (same day) for: diarrhea, fever, persistent cough, eye drainage, or when the child is too uncomfortable to participate.
• At pickup for: mild symptoms that are improving and do not meet exclusion criteria, if your policy allows (e.g., occasional runny nose without fever).

Documentation tip: record time symptoms started, what you observed (objective), steps taken (comfort, fluids offered), and when the family was contacted.

Caregiver scripts for sensitive conversations

Use calm, factual language. Focus on the child’s comfort and the program’s policy rather than blame.

Requesting spare clothes

Script: “Hi [Family Name], today we noticed [Child] doesn’t have a full set of spare clothes in their cubby. Accidents and messy play happen quickly, and having extras helps us keep them comfortable and clean. Could you send a labeled shirt, pants, socks, and underwear tomorrow? If that’s difficult, tell me and we’ll problem-solve together.”

Reporting diarrhea

Script: “I want to let you know that [Child] had [number] loose stool(s) today at [time(s)]. We cleaned them up right away and helped with handwashing. Per our health policy, we need you to [pick up/monitor at home] because diarrhea can spread quickly in group care. I can share the policy details and what to watch for tonight, like signs of dehydration.”

Reporting vomiting

Script: “At [time], [Child] vomited. They’re resting in a comfortable area while we stay with them. Because vomiting can be contagious, our policy requires pickup as soon as possible. Please let us know your estimated arrival time so we can keep [Child] calm and supported.”

Explaining return-to-care expectations

Script: “To return, our policy requires that [Child] can participate comfortably and that symptoms meet the return criteria: [state your program’s criteria in plain language, e.g., no vomiting/diarrhea for the required period, fever-free without fever-reducing medicine, etc.]. This helps protect [Child] and the other children. If you’d like, I can send you the written policy so it’s easy to reference.”

When a family disagrees

Script: “I hear that this is frustrating. I’m not making a medical diagnosis—I'm following our program’s health policy and what I’m observing today. Let’s look at the policy together and decide the next step. Our priority is [Child]’s comfort and preventing spread.”

Daily cleaning checklist (printable format)

Practical setup tips to make routines easier

• Create “clean/dirty zones”: keep diapering supplies in a clean container; keep cleaning chemicals out of children’s reach.
• Use visual cues: a small laminated “Clean → Disinfect → Wait” card near diaper and bathroom areas (no child-accessible chemicals).
• Batch toy cleaning: schedule two short toy-cleaning blocks daily so mouthed toys don’t pile up.
• Plan for contact time: after spraying disinfectant, set a simple timer so the surface stays wet long enough.