1. ChildNet Module 7: Germs – Yours, Mine, and Ours
A training series by Iowa’s Child Care Resource & Referral
with funding from Iowa Department of Human Services
Welcome and announcements
Module 6 It’s Your Business review of homework
Intro topic by explaining objectives:
understand ways disease is spread and how to interrupt the spread
learn key points in developing policies
know the resources and people who can help us
how to reduce the risk of SIDS
Review Best Practices for Module 7
Conduct the “Spreading Disease Awareness” activity
Review key terms on handout 7-6
Give “Guide to Childhood Illness”
ask “What illnesses did they experience as a child?”
“what have they experienced in child care?
“are there illnesses that used to be common that are no longer common?
“what has happened to make them less common?

2. Germs: How they Spread Person to Person Person – Object – Person
Skin contact
Cough or sneeze droplets
Feces, blood, or body fluid
Person – Object – Person
Animal to Person
Germs: They are all around, in our environment and on our bodies. Some are good and some can cause illness , disability, and death.
Use module 7 ChildNet notes to give info on person to person contact
Person-object-person activity:
List the items as participants answer the question: “what are some common objects found in your child care setting?
Animal to Person
Follow DHS rules for allowable animals, animal health checks, and supervision and handling of animals

3. Stopping Germ Spread Wash Hands Frequently Clean and Disinfect
Use gloves
Get and maintain vaccinations
We can stop the spread of germs and most illnesses by using these 4 practices

4. Wash Hands BEFORE: Starting work and play
Moving from one group of children to another (B & C homes)
Eating and handling food
Giving medication
Water play
Give Hand-washing poster and review steps
How long do you lather with soap? 20 seconds or the length of the alphabet song.
Children should also wash when they arrive, when they eat, and play in water

5. Wash Hands AFTER: Toileting and diaper checks/changes
Touching body fluids
Caring for pets
Water, sand, or other sensory play
Touching uncooked foods
Cleaning waste containers and handling garbage
Suggest books for children

6. Cleaning, Sanitizing, and Disinfecting
Follow a schedule
Use an EPA registered product and follow the instructions
Bleach solution:
Find specific product information for dilution
Mix new solution after 24 hours
Keep out of children’s reach
Read definition of sanitizing and disinfecting from pg. 440 Caring for Our Children
EPA registration info is on label. Follow directions! Some need a “sit time” of 10 minutes! Impossible – they evaporate before time is up.
Bleach is best, cheapest, and safest
Give or pass around appendix K “Guide for Cleaning, Sanitizing, and Disinfecting” (schedule)

7. Using Gloves Non-latex gloves Exam / first-aid quality Use when:
Changing diaper
Cleaning up bodily fluids, blood
Gloves designed for food service are not appropriate. They are not designed to protect you from exposures to germs we may be dealing with in child care
Give each participant a pair of gloves.
Demonstrate proper glove removal.
Demonstrate again as they follow along.

8. Vaccinations
Maintaining up-to-date vaccinations disrupts the spread of illness
Get brochures by calling
Give Immunization law, child, and adult immunization brochures
Allow time to look through
Review list of occupational health hazards from CFOC pg. 426
Emphasis regular consultation with physician and current immunizations
Use handout 7-4 to answer statements 1 and 3 (handwashing and cleaning-disinfecting)

9. Diaper Changing Use a clean, non-porous, non-fibrous surface
Wear gloves
Handle the diaper as little as possible
Disposable diapers reduce the spread of germs that cause diarrhea, hepatitis A, and other viruses and parasites
Disinfect the diapering surface between changes
Check diapers hourly and change when wet or soiled
Surfaces: Cloth surfaces allow germs to live in the fibers
Plastic mats may split or crack and give places for germs to live
Disposable waxed paper offers a good barrier between child and surface for added protection against germ spread
Handle the diaper as little as possible, using gloves.
The less you handle the diaper, the less you risk coming into contact with germs, as well as unknowingly transferring them to the environment and others in your home.
Ask if anyone uses cloth diapers…
Cloth diapers need to have a waterproof covering. The soiled diapers should be placed in a container that is lined with a plastic bag and can be sealed closed – preventing children from accessing the diapers. Soiled cloth diapers as well as soiled clothing are sent home with parents daily or sent off with a diaper service for laundering and sanitizing
Check diapers often – changing when needed
When children develop rash, they need creams. Creams and other diapering lotions and ointments should be treated as medication with a signed form from the parent explaining their use.
The containers are not to be disinfected in order to prevent contamination of the product…therefore they should always be handled as if contaminated. Label each item with the child’s name and keep out of reach and stored away from other medications.

10. Diaper Changing Procedure
Get Organized
Help child to diapering surface
Open the diaper and clean the child’s diaper area, disposing of wipes
Remove the soiled diaper, clothing, and soiled paper from the changing surface
Remove your gloves
Put on a clean diaper and dress child
Use clean gloves to apply creams, then remove/dispose
Wash the child’s hands and return them to a supervised play area
Clean and disinfect the diapering surface
Wash your Hands
Engage participants in activity to correctly organize the 9 steps
Reveal the answers
explain how to fold the dirty diaper over when cleaning skin
emphasize a step on trash can for disposing of diapers
A wipe can be used on child’s hands and your hands after removing all soiled items
Starting at step 6 we should only be working with clean items (gloves are gone…paper is gone…etc)
Note when to apply cream

11. Potty Chairs Keep out of reach Child hand-washing after use
Child Care Provider:
Empty contents to toilet
Rinse with water from sink – pour into toilet
Flush toilet
Wash and disinfect potty chair
Wash and disinfect sink
Wash your hands
A modified toilet seat and step stool is best; but if a potty chair is used follow these guidelines to prevent the spread of germs.
Handout 7-4 respond to statement #2

12. Exclusion Policy and Practice
Two main considerations:
Can the child participate comfortably in the day’s activities?
Does the child need more care than you can give them while still meeting the needs of the other children?
Activity:
Have all Stand UP
“Remain standing if you’ve ever had a parent try to leave an ill child with you”
“Remain standing if you have a written exclusion policy for ill children”
“Remain standing if you have given all of your parents a copy of your exclusion policy this year”
How to solve the problem of parents bringing ill children is to HAVE A POLICY
Reveal the Main Considerations
add that we need to consider the other children and the quality and safety of their care

13. Exclusion Policies & Practice
USE the Iowa Department of Public Health’s
“Guide to Childhood Illness”
Give to parents
Post in your home near the phone
Get answers to questions from your HCCI Child Care Nurse Consultant
Some illness require medical attention and medication.
If medication is required; best practice is that the child should not return to care for 24 hours after receiving the first dose.
This is to watch for any signs of reaction to the medication as well as to allow the medication time to work. Ex: A child is usually not contagious after 24 hours on an antibiotic.
What are the best practices and regulations we know about administering medications?
Original container labeled with child’s name, dosage information, doctor and pharmacy information
Signed and dated form from parent with instructions for administering the medication
Proper storage out of reach of other children – in separate container in fridge to prevent cross contamination
Medication administration form J “Heartland Family Child Care Handbook”
Pass book and note policies, form J, and Illness/Daily Health Check info

14. Policies
Use
“Model Child Care Health Policies”
The 2 main considerations for exclusion
The IDPH “Guide to Childhood Illness”
“The child care provider, not the child’s family, makes the final determination about whether the … ill child can receive care in the child care program.” (from Model Child Care Health Policies)
Also refer to DHS guidelines and ChildNet certification requirements to make sure you include written statements that they require.
Respond to Handout 7-4 question #4

15. Daily Health Check
Observe for simple signs of well-being when children arrive and parents are still present
Look for:
Paleness
Fever
Unusual tiredness
Rash
Sores
Runny nose
Watery eyes
Hoarseness
Coughing
Get close to the child and talk to the child.
Use all your senses to look, listen, feel, smell, and hear any symptoms.
If you notice any of the indicators for possible illness; ask the parent for more information
If you don’t feel the child is well enough to stay at child care; remind the parent of your exclusion policy and require the parent to return home with the child
For children who come to you from school; contact parent or emergency contact immediately if you suspect contagious illness
Conduct the role play scripts with 2 willing participants taking roles of parent and provider
Respond to handout 7-4 question

16. Reducing the Risk of SIDS
Follow best practice for infant care
All infants under age 1 need to be protected from SIDS
Share information with all parents by obtaining brochures from CCR&R
Include a Safe Sleep policy in your parent handbook
View video
Reveal rest of slide / Review main points
Handout respond to SIDS question

17. Going Forward Re-visit the Best Practices worksheet, handout 7-1
At home, look at 1 or more of the page references listed on the agenda
Determine a change you can make by next week
(turning a new leaf)