The enforcement of careful sanitation procedures has been proven to decrease the spread of illness in childcare settings. Required sanitation procedures are as follows:

General Cleanliness and Sanitation

The entire play area shall be thoroughly cleaned every evening by Georgetown University maintenance staff, and cleaned as needed during the day by center staff. Toilet areas, diaper changing tables (see diaper changing procedures), counter tops, and tables and chairs must be cleaned and sanitized as needed throughout the day by staff. 

Cleaning and disinfection procedures are as follows:

To prepare cleaning solution for 7 spray bottles:

  1. Wear goggles and gloves.
  2. Pour 1/8 cup (1 oz.) of PLAAPC (Professional LYSOL® Antibacterial All Purpose Cleaner) into one gallon (128 oz.) jug of water & stir.
  3. Pour into spray bottles with funnel. One gallon will fill about 5 of our 7 spray bottles
  4. Prepare a second gallon of mixture and fill the remaining bottles.
  5. Place left over PLAAPC mixture under sink with safety latch. Prepare a third gallon to be placed in the upstairs sink.
  6. Refill bottles as needed. 
  7. Gallon jugs and spray bottles containing the solution should be labeled with the EPA Registration number, a photo of PLAAPC bottle and mixture amount (1:128)

Spray bottles do not have to be emptied. Solution retains sanitizing and cleaning properties indefinitely per Reckitt Benckiser’s Customer Service hotline.

  • When using PLAAPC to clean and sanitize, it is recommended to wear gloves.
  • To sanitize the solution must be left on the surface for two minutes.
  • When not using the PLAAPC solution it must be kept in a locked cabinet.
  • Children cannot have contact with the PLAAPC solution
  • When cleaning & sanitizing mouthed objects, spray with PLAAPC solution, allow to sit for two minutes; rinse with water; wipe with a clean paper towel


Staff are required to wear plastic gloves when changing diapers, and when cleaning diaper changing tables, toilets or potty seats of diarrhea, vomit, blood or other body fluids. Gloves must be discarded after each use according to trash disposal procedures. Staff must wash their hands according to proper procedures after gloves are discarded.

Mouthed toys need to be washed and sanitized when one child finishes playing with the toy. Toys will be sanitized with PLAAPC solution, and allowed to air dry on a drying rack or net bag. A basin should be kept available to drop dirty toys into until staff has time to sanitize them.

Mouthed toys may instead be washed in a dishwasher, if rinsed in cool water first to remove saliva since saliva may be baked on in a dishwasher and become a medium for bacteria.

Paper towels should be used as much as possible for cleaning and for drying hands and faces. Cloth towels and washcloths will not be used except when bathing a child.

The Cleaning and Sanitation Frequency table and checklist is posted in each kitchen. Please refer to it often. Some things are the responsibility of the contracted cleaning crew and are delineated so. Otherwise, everyone needs to pitch in to ensure that these tasks are completed. Sometimes that will mean delegating a task that can be done while supervising napping children to a student worker who is covering in your class. 

Hand Washing

Proper and frequent hand washing has been proven to significantly reduce illness in child care centers.


  • Children and adults wash their hands: 
  • On arrival for the day 
  • After diapering or using the toilet.
  • After handling body fluids (e.g., blowing or wiping a nose, coughing on a hand, or touching any mucus, blood, or vomit); 
  • Before and after meals and snacks
  • Before and after preparing or serving food and handling any raw food that requires cooking (e.g., meat, eggs, poultry); 
  • After playing in water. 
  • After handling pets and other animals or any materials such as sand, dirt, or surfaces that might be contaminated by contact with animals 
  • When moving from one group to another. 

Adults also wash their hands: 

  • Before and after feeding a child
  • As required in the diapering process 
  • Before and after administering medication; 
  • Before after assisting a child with toileting 
  • After handling garbage or cleaning. 

Proper hand-washing procedures are followed by adults and children and include: 

  • Using liquid soap and running water 
  • Rubbing hands vigorously for at least 10 seconds, including back of hands, wrists, between fingers, under and around any jewelry, and under fingernails; rinsing well; drying hands with a paper towel, a single-use towel, or a dryer; and avoiding touching the faucet with just-washed hands by using a paper towel to turn off water. 
  • Staff wears gloves when contamination with blood may occur.
  • Staff are encouraged to wear gloves when handling body fluids (e.g., blowing or wiping a nose, feces, urine and/or touching any mucus, blood, or vomit); 
  • Staff wears gloves when preparing food.
  • When putting on and taking off gloves, staff wash their hands and change gloves between children when diaper changing or working with clothing soiled in bodily fluid
  • Staff does not use hand-washing sinks for bathing children or for removing smeared fecal material. 
  • In situations where sinks are used for both food preparation and other purposes, staff clean and sanitize the sinks before using them to prepare food. 

Trash disposal procedures

These procedures are to be followed when handling trash resulting from cleaning blood or bodily fluids.

  • Put trash in a can with a lid, lined with a plastic garbage bag.
  • Tie and remove plastic bag from the building when full, or when containing vomit, diarrhea or blood.
  • Put bag removed from the building in a closed container where the bag cannot be opened up. 
  • The trash can should be disinfected daily by the janitorial staff. 

Handling Blood

When the potential for handling blood or body fluids occurs (changing diapers, cleaning diarrhea, caring for cuts and abrasions, cleaning vomit, etc.), staff must:

  • Wear gloves.
  • Wear aprons if clothes might get soiled.
  • Properly dispose of trash.
  • Clean and sanitize properly.
  • Follow proper hand washing procedures in addition to wearing gloves.

Diaper Changing Procedures

Child caregivers shall never leave a child alone on a table or countertop, even for an instant. A safety strap or harness shall not be used on the diaper changing table. If an emergency arises, caregivers shall put the child on the floor or take the child with them.

**Applicable to all children at all times, staff members may take only one child at a time for diaper changing on a changing table. Simultaneously, if other children are in the bathroom using the toilet, another staff member must be present and responsible for the child(ren) using the toilet. (rev.3/10)

Step 1: Get organized. Before you bring the child to the diaper changing area, wash your hands, gather and bring what you need to the diaper changing table:

  • Non-absorbent paper liner large enough to cover the changing surface from the child’s shoulders to beyond the child’s feet;
  • Fresh diaper, clean clothes (if you need them);
  • Wipes for cleaning the child’s genitalia and buttocks removed from the container or dispensed so the container will not be touched during diaper changing;
  • A plastic bag for any soiled clothes;
  • Disposable gloves, if you plan to use them (put gloves on before handling soiled clothing or diapers);
  • Diaper Cream, if needed. A Clean Disposable Glove for application.

Step 2: Carry the child to the changing table, keeping soiled clothing away from you and any surfaces you cannot easily clean and sanitize after the change.

  • Always keep a hand on the child;
  • If the child’s feet cannot be kept out of the diaper or from contact with soiled skin during the changing process, remove the child’s shoes and socks so the child does not contaminate these surfaces with stool or urine during the diaper changing;
  • Put soiled clothes in a plastic bag and securely tie the plastic bag to send the soiled clothes home.

Step 3: Clean the child’s diaper area.

  • Place the child on the diaper change surface and unfasten the diaper but leave the soiled diaper under the child.
  • Lift the child’s legs as needed to use disposable wipes to clean the skin on the child’s genitalia and buttocks. Remove stool and urine from front to back and use a fresh wipe each time. Put the soiled wipes into the soiled diaper or directly into a plastic-lined, hands-free covered can.

Step 4: Remove the soiled diaper without contaminating any surface not already in contact with stool or urine.

  • Fold the soiled surface of the diaper inward.
  • Put soiled disposable diapers in a covered, plastic-lined, hands-free covered can. 
  • If gloves were used, remove them and put them into a plastic-lined, hands-free covered can.
  • Whether or not gloves were used, use a disposable wipe to clean the surfaces of the caregiver’s hands and another to clean the child’s hands, and put the wipes into the plastic-lined, hands-free covered can.
  • Check for spills under the child. If there are any, use the paper that extends under the child’s feet to fold over the disposable paper so a fresh, unsoiled paper surface is now under the child’s buttocks.

Step 5: Put on a clean diaper and dress the child.

  • Slide a fresh diaper under the child.
  • Use a glove to apply any necessary diaper creams
  • Note and plan to report any skin problems such as redness, skin cracks, or bleeding.
  • Fasten the diaper. 

Step 6: Have the child wash their hands using soap and water. Making certain the child or the teacher turns off the faucet with a paper towel

  • Use soap and water, no less than 60 degrees F and no more than 120 degrees F, at a sink to wash the child’s hands

Step 7: Clean and sanitize the diaper-changing surface.

  • Dispose of the disposable paper liner used on the diaper changing surface in a plastic-lined, hands-free covered can.
  • Clean any visible soil from the changing surface with detergent and water; rinse with water.
  • Wet the entire changing surface with the sanitizing solution (e.g. spray a sanitizing PLAAPC solution of 1/8 cup of PLAAPC in one gallon of tap water).
  • Put away the spray bottle of sanitizer. If the recommended PLAAPC dilution is sprayed as a sanitizer on the surface, leave it in contact with the surface for at least 2 minutes. The surface can be left to air dry or can be wiped dry after 2 minutes of contact with the PLAAPC solution.

Step 8: Wash your hands according to the Handwashing Policy

This policy was taken from Caring for our Children: National Health and Safety Performance Standards, Standard 3.014, pages 93-95. Procedures regarding cloth diapers were removed and the procedure to apply diaper cream was altered.

Diapering is a wonderful time for one-on-one conversation with the child!