St. Leonhard Day-care Centre hygiene concept

All procedures and measures with the aim of preventing disease and maintaining the health of people and the environment. Hygiene measures are always preventive measures.

1. The management guides the employees in the planning and organisation of hygiene measures in accordance with the legal requirements.
2. The management organises and ensures the implementation and observance of the hygiene measures specified in the hygiene concept.
3. Caregivers at the St. Leonhard Day-care Centre organise the day-to-day care work in accordance with the prescribed hygiene regulations.
4. The cook runs the kitchen in such a way that the kitchen rooms, the kitchen equipment, the storage rooms/cupboards and the food meet the standard of the specified legal hygiene regulations at all times.
5. The separate regulations on kitchen hygiene must be followed.All tasks that are to be delegated to a cleaning company are set out in writing.

Physical care and support makes up a large part of the work in infancy and toddlerhood. We want to satisfy the needs of every single child in terms of hygiene and personal hygiene. We monitor the health of the children and their interests, dislikes and preferences in personal hygiene. The children should find nappy-changing a pleasant experience in a quiet environment and with loving care, thus developing a healthy, natural relationship with their bodies. As they grow older, we support the parents’ efforts to educate their children about cleanliness. In order to stay healthy, certain hygiene rules are also important, such as washing your hands after eating and after going to the toilet. Using finger games and songs, the children get to know their bodies and name the different parts of their bodies. They also learn to express their own bodily needs, e.g. thirst – hunger – going to the toilet. 

Regular hand washing can help to avoid the incidence of infectious diseases at day-care centres. Washing hands and the correct use of disposable paper towels are essential actions to reduce pathogens.

The hands should always be washed and disinfected:

• Always before starting work
• Before starting work in the kitchen
• After going to the toilet
• Before and after changing nappies
• After carrying out cleaning work
• Before and after the preparation of raw food
• Before and after meals
• Before feeding any child
• Before giving a child medicine

Soap from the soap dispenser is used to wash hands, which are then disinfected. Disposable paper towels are to be used for drying.

• The hygiene and safety of the childcare staff must be guaranteed.
• People with infectious diseases are not allowed to enter the day-care centre.
• Personal hygiene includes physical cleanliness and clean clothes.
• A neat appearance is expected. All clothing is to be in good condition, clean and suitable for the conditions.
• The hair is neat and clean. Long hair must be styled in such a way that it does not impair hygiene.
• Inside the day-care centre, all employees are required to wear clean and non-slip work shoes, which are only worn indoors. 
• Hands should always be washed and disinfected – see 4. Hand hygiene

With children, it is particularly important to pay attention to appropriate personal hygiene. Because children’s bodies in particular are very sensitive.

6.1 What needs to be taken into account when considering the personal hygiene of children?

Children’s delicate skin needs special care and teeth need to be brushed regularly.

6.1.2 Basically, the following applies to personal hygiene:

Teach the child to wash itself as early as possible. This not only promotes independence, but also helps your child to develop motor skills. It also promotes a healthy relationship with their own body.

As in so many other things, the carers are the role models from whom the child learns the essential things. In everyday life, a child observes the behaviour of the carers and acts accordingly. How often are teeth brushed? Who washes their hands before eating?

How neat and clean are the people to be looked after? Regular personal hygiene is carried out in such a way that the health and well-being of the child is maintained.

6.2 What can I do to prevent bacteria and viruses from multiplying?

• Avoid coughing and sneezing at people.
• Do not cough or sneeze into your hands.
• Do not shake hands in certain situations.
• Keep your hands away from your face.
• Use disposable tissues and dispose of them immediately afterwards.

6.3 How should hands be washed properly together with the children?

One of the most effective ways to make life difficult for viruses and bacteria is to thoroughly wash your hands regularly. The children need to get used to this from the outset. The carers should set a good example. In this way, the risk of an influenza virus, for example, being transmitted from one person to another is reduced many times over.

• Normal soap and about 15–25 seconds washing time are sufficient.
• Wet your hands under running water and then wash them thoroughly with soap.
• Don’t forget to include the back of your hand, thumb, nail bed and the gaps between your fingers.
• Afterwards, dry your hands with a clean and dry towel.

6.3.1 In which situations is hand cleaning particularly important for children?

• after they have just come back from outside
• after nose blowing
• after contact with animals
• after going to the toilet
• before you prepare food
• before eating

7.1 Hygiene concept for the St. Leonhard Day-care Centre kitchen

There is a separate and specific hygiene concept for personnel working in the kitchen, which is binding and an integral part of this hygiene concept.

7.2 Legal requirements

The kitchen must comply with the requirements of the relevant legislation.

To this end, the management instructs the cook and other kitchen staff about the hygiene regulations.

Anyone who produces, handles, stores, transports and delivers food must apply the following legal provisions: 

1. Obligationenrecht (OR, Code of Obligations), 
2. Lebensmittelgesetz (LMG, Food Law), 
3. Lebensmittelverordnung (LMV, Foodstuffs Ordinance), 
4. Produktehaftgesetz (PrHG, Product Liability Act)

Essential for personal hygiene:

1. Hygienic cleaning of hands using water, liquid soap
2. Hygienic cleaning of bottles, spoons and teats
   
   
   • Pre-rinse dishes etc. to prevent food residues from drying
   • Dismantle drinking bottles into their individual parts
   • Clean all parts in the dishwasher at 65°C (or wash using hot water and detergent and then dry them thoroughly)
   • Additional safety is achieved by boiling for at least two minutes; for babies under six months,this recommended after every use. Keep dry and protected from contamination until the next use
   • Strict hygiene standards and specific agreements are necessary for pumped breast milk. Frozen breast milk must be labelled with the date and consumed within 24 hours of thawing. After defrosting, store in the refrigerator. Fresh breast milk must be labelled with the date, stored in the refrigerator and must be consumed within 24 hours.

8.1 Preparation of powdered baby food

8.1.1 Preparing baby bottle food

• Bottle food must be kept in a separate, clean cabinet.
• As a rule, tap water is suitable for preparing baby food (if in doubt, ask your local water supplier).

8.1.2 Children from the age of 1 should only be given solid food on plates

1. Only use fresh water from the cold water tap, do not use water filters because of the risk of germs.
2. Prevent the multiplication of possible germs in the prepared food by mixing the powder just before the meal, water temperature approx. 40–50°C – If used immediately, it is sufficient to heat the water. If this is not the case, boil the water for 3 minutes as a precaution and let it cool down to 40°C. The younger the baby (< 6 months), the earlier the water should be boiled. Bring to drinking temperature as soon as possible. Feed within two hours. Always dispose of leftover prepared food.

The purpose of cleaning is to remove dirt and the germs it contains from surfaces, objects and floors. No dry dust removal should be carried out at the St. Leonhard Day-care Centre, only moist dust removal should be carried out, as dry dusting leads to dust being stirred up (pathogens are often bound to dust particles). WIBIS disinfectant cleaner 8709 is used to clean the surfaces. Please note that a special agent must be used for oak parquet floors.

• Visibly soiled laundry must be replaced immediately.
• All textiles should be washed in the facility.
• Bed linen and personal towels should be washed at no less than 60°C (use a detergent containing bleach; no short programme).
• Laundry soiled with infectious excreta should be washed at 90°C (e.g. especially during any outbreak of gastrointestinal diseases). Laundry that cannot be washed at 90°C should be washed with a disinfectant detergent (e.g. Desotherm).
• Kitchen linen should be washed with a disinfectant detergent (preferably at 90°C).
• Make sure that dirty laundry and clean laundry are kept separate. This also applies to transport, laundry bags, laundry stands and storage. Wash baskets of different colours should be used for clean and dirty laundry.
• Washed laundry must be stored dust-free and well protected.

Minimum change intervals for linen

These intervals may need to be shortened depending on the type of soiling that occurs.

During times of increased risk of infection (e.g. influenza outbreaks or gastrointestinal infections), the washing intervals should be shortened accordingly (bed linen, towels, etc.).

10.1 Hygiene of the washing machine and tumble dryer

There are always conflicts between infection control and environmental protection, for example when it comes to washing laundry. Nowadays, lower washing temperatures are promoted for energy conservation reasons. From an infection hygiene point of view, this is often counterproductive, sometimes even dangerous, because the pathogens are then no longer reliably killed.

11.1 Entrance area

Dirt is carried into buildings on the soles of shoes (approx. 80%). Doormats must therefore be vacuumed daily, tapped out weekly and machine-cleaned twice a year.  In the case of rigid doormats in frames, the recesses must be cleaned thoroughly once a week and the rigid doormats themselves cleaned twice a year using a high-pressure cleaner and a mild detergent, or more often depending on the degree of soiling.

11.2 Group rooms

Group rooms are used intensively and must be thoroughly cleaned regularly.

11.2.1 Play area

Upholstered furniture, sofas, mattresses and similar seating and lying surfaces should be provided with suitable removable and washable covers that can be washed regularly. If the upholstery is not washable or cannot be disinfected, disposal may become necessary in individual cases for hygienic reasons.

11.2.2 Fitted carpet

Vacuum the fitted carpet twice a week (preferably daily).

11.2.3 Materials cupboards

Materials cupboards must be cleaned 2x a year.

11.3 Toys

It is important to ensure that toys are easy to clean and can ideally be washed in a washing machine or dishwasher.

11.4 Sleeping and rest areas

If children take a regular midday nap then, from a hygienic point of view, the bed linen should always be used by the same child.

11.4.1 The cuddly toy/comfort blanket

Each child has its own cuddly toy/comfort blanket etc. which is stored in a child-specific location. It must be determined who is responsible for regular cleaning, the parents or the carer. Information on laundry hygiene – frequency, washing procedures, etc.

The function as a transition object should be taken into account when considering the question of cleaning.

11.4.2 Dummy

As the cleaning and reprocessing of dummies also depends on the different materials used for dummies, these tasks should be the responsibility of the parents. Parents may be advised to make sure that the material is food safe.

11.4.3 Soft toys

Cuddly toys must be washed in the washing machine at 40°C before any holidays and before the Christmas holidays. These intervals may have to be shortened depending on the degree of pollution of the soft toys.

11.5 Sanitary areas

The sanitary area requires special attention and must be thoroughly and regularly cleaned according to a fixed plan, so that the required cleanliness/hygiene is guaranteed.

11.5.1 Equipment and use of sanitary facilities

Disposable paper towels provide more security, shared towels are not allowed.

11.5.2 Cloths

11.5.3 Soap

1. Use liquid soap/mousse, do not use bar soap otherwise germs and pathogens may spread.
2. Soap dispensers should be permanently installed wherever possible and be easy for children to use. Refillable dispensers must be cleaned before refilling.Routine cleaning with disinfectants is not necessary in the sanitary area.

11.5.4 Sanitary rooms: bathroom and WC

No rugs are allowed in the bathroom.

1. Lockable waste bins are emptied and cleaned daily.
2. The shower is cleaned and disinfected daily.
3. The toilet is cleaned and disinfected daily.
4. The floor is cleaned daily.
5. Shelves and tiles are cleaned 1x per week.

11.5.5 Laptops

Keyboards must be cleaned once a week.

Laptops, computers and accessories such as computer mouse and keyboards must be thoroughly cleaned and disinfected once a month.

1. Descaling of the aerators at least every 3 months, depending on the hardness of the water.
2. Lime deposits on the shower heads must be removed at regular intervals.
3. Drinking water pipes that are not used regularly, especially showers, should be rinsed at 72-hour intervals for 3 minutes, e.g. after the weekend, holiday period, company holidays, etc.
4. Further information on legionella can be found on the Internet:  https://www.bag.admin.ch/bag/de/home/krankheiten/krankheiten-im-ueberblick/legionellose

A checklist provides information about cleaning, removal of hair, washing with soap and when it was replaced.

Potties must be used on a child-specific basis and cleaned as follows:

• Dispose of the contents via the toilets (caution: danger of infection by splashing).
• Clean with disinfectant and disposable paper towels after each use to prevent the spread of germs.
• Store potties out of the reach of children

Note:

For protection against infection, the nappy-changing area is one of the areas in day-care that requires special attention from the point of view of infection hygiene.

Due to the development of their immune system, small children have more infections than adults. At this age there is also an increase in gastrointestinal infections, e.g. from rotavirus or norovirus. It is quite possible that over 100 billion infectious particles per gram of stool are excreted by small children. 

15.1 Setting up the changing area

The nappy-changing area should be set up as a separate area, wherever possible separate from the group rooms to avoid air pollution and also separate from other hygienically sensitive areas, e.g. dining rooms or kitchen.

15.2 Plastic containers

The plastic containers used for cleaning must be thoroughly cleaned and disinfected each time the child is changed.

15.3 Preventive measures

The disinfectants and care products must not be accessible to children. These must be stored in lockable cupboards.

15.4 Observe hygiene during nappy changing

1. Caregiver cleans and disinfects their hands.
2. The nappy-changing surface must be easily washable and easy to disinfect.
3. After each nappy-changing process, disinfect with a surface disinfectant (follow the instructions for use, wear protective gloves if necessary; disposable disinfectant wipes are also practical).
4. The surface disinfection is to be carried out by wiping, spraying of the contact surface is to be avoided due to the strain on the respiratory tract.
5. Cleaning should only be carried out with clean cloths.
6. If reusable cleaning cloths are used for surface disinfection, they must be washed in disinfectant detergent (90°C).
7. In order to avoid direct skin contact by children with surface disinfectants, a (fabric) underlay must be used.
8. The textile cloths used to cover the changing mat must be personalised. Cloth towels or other textile materials used for nappy changing should be changed after each use
9. Dispensers or tubes are preferable for the care products. If cream cans are used, disposable wooden spatulas must be used for removal to avoid contamination.
10. The nappy buckets are to be emptied, cleaned and, if necessary, treated with a surface disinfectant at regular intervals at the end of the supervision period. The bins must be equipped with a bin liner insert and a lid (operated by foot lever).

All children learn how to brush their teeth.

Brushing is important for keeping children’s teeth healthy:

1. this training includes learning important hygienic behaviour:                                         

• Wash your hands before eating
• Brush your teeth after eating

16.1 Toothbrushes

The following hygienic requirements must be met:

1. Each child must have his or her own toothbrush to protect against communicable diseases.
2. Toothbrushes and cups must be clearly and permanently marked for children to prevent confusion.
3. Toothbrushes should be cleaned immediately after use under running water, toothpaste and food residues should be removed.
4. Tap the water out of the toothbrushes on the edge of the sink and then dry and store the toothbrushes with the heads upwards so that the heads of the toothbrushes do not touch each other.
5. Toothbrushes should be replaced as soon as the bristles bend, but at least every 3 months.
6. Cups/glasses should be washed in the dishwasher when visibly soiled, but at least once a week.

Children and adults need ‘air to breathe’. Each person consumes approx. 30 l of oxygen per hour from the room air and approx. 26 l of carbon dioxide is released into the room air. The consequences of increased carbon dioxide concentrations are decreasing concentration and fatigue. To prevent the accumulation of carbon dioxide and other air pollutants, a sufficient amount of fresh air must be available indoors for each person.

17.1 Practical advice on ventilation

Several times a day, intensive ventilation with windows fully open.

Tilt windows is not sufficient and should also be avoided during the heating period.

The air exchange rate can be further increased by cross-ventilation (opening opposite windows/doors).

There is a lot of advice on safety aspects, mainly from the accident insurance institutions. For safety and hygiene reasons, regular inspections of the facility and maintenance of the equipment and floor/protective mats etc. must be carried out in outdoor areas. The safety concept of the St. Leonhard Day-care Centre must be taken into account.

18.1 Paddling pool

The bacterial load is further increased by:

1. Introduction of dirt from outside (sand, earth, leaves) possibly from birds or other animals
2. Intense heating of the small amount of water leads to a massive increase in the concentration of germs
3. The water must be changed at least twice a week.

No poisonous plants may be brought into the day-care centre!

Other plants need regular and appropriate care.

After each use, the prams must be cleaned.   

They must be washed and disinfected once a month.

In the event of a pandemic/epidemic, the management develops a pandemic/epidemic plan in consultation with the board.

Note from the Swiss Childcare Association (www.kibesuisse.ch)

Quote: https://www.kibesuisse.ch

21.1 Definition

A pandemic is an infectious disease that spreads across countries and continents.

21.2 Development of a pandemic plan

An epidemic is localised. The management is responsible for dealing with questions relating to the pandemic and preparing the facility for the effects of a pandemic.

21.2 Recommendation

Verband Kinderbetreuung Schweiz recommends drawing up a pandemic plan adapted to the situation of the institution and introducing it adequately. This document will be reviewed on an ongoing basis.

The following steps serve as a suggestion when creating a pandemic plan:

• Preparation, as the necessary hygiene material, disinfectants, protective masks etc. should already be available before the outbreak of a pandemic; it is determined in advance who procures the required materials and how they are stored. 
• It is also advisable to prepare for staff shortages in order to safeguard core activities (care, catering, etc.).
• Sick children, young people or employees stay at home as usual.
• The institution management is informed about the illness. If an epidemic/pandemic or certain other communicable diseases are suspected, there is an obligation to inform the authorities (usually by the doctor treating the case) and an obligation to be excluded from any communal facility. In the event of a pandemic/epidemic, the instructions of the canton/the cantonal doctors must be followed.