Indoor Air Unit 625 Robert St N PO Box 64975 St. Paul, MN 55164-0975 651-201-4601 Building Evaluation Procedure for Asthma Triggers - Instructions The Building Evaluation Procedure consists of 15 sections (A-O) with questions and instructions for inspections. The questions should be directed to the most knowledgeable individuals who deal with the specific issues. This could include the building owner, building maintenance staff, contracted service providers, and specific child care staff. Visual inspections should be completed to ensure a complete and thorough evaluation of the indoor environment. The inspections should be completed on a normal day to learn about typical conditions in the building. Rooms should have the normal number of people present when inspected, where possible. Visual inspections could be completed during each season, to catch problems that change over time (such as moisture and ventilation problems). The evaluator should judge whether a deficiency will likely be addressed and then circle “See Notes” for these issues. Details of the issue should be noted, such as: ¾ the specific time it is observed (for issues that may change), ¾ names of people who identified the issue, ¾ rooms or areas that are affected, and ¾ individuals who are ultimately responsible for making changes. Each issue identified has a corresponding recommended intervention and explanation. The recommendations should be used as guidelines to improve policies and procedures. Child care providers are not required to implement the recommendations, although some of the recommendations are related to child care licensing rules and food codes (these are noted where applicable). If recommendations seem to conflict with code or licensing requirements, child care staff should follow the requirements. In addition, child care center staff should follow their official health consultant’s recommendations, especially regarding disinfection practices. Building Evaluation Procedure for Asthma Triggers Question/Issue Recommendations A. General Operations and Maintenance Practices and Procedures A.1 Perform a walk-through of your center How often do staff walk annually to identify existing and potential through the building problems. One of the following checklists are specifically for the purpose of recommended: looking for problems related to • MDH’s Building Evaluation Procedure moisture, disrepair, inadequate or Model Environmental Asthma cleanliness, poor ventilation, Trigger Prevention Plan and general housekeeping (such • U.S. Environmental Protection as plants, animals, personal Agency’s Tools for Schools checklists, items, chemicals, food)? available at: www.epa.gov/iaq/schools/toolkit.html Explanation It’s important to periodically examine your building, to identify and prevent problems before they become a significant or expensive problem. Inspect seasonally heating, ventilation and air conditioning equipment and areas prone to moisture problems (e.g. basements) A.2 How large is the space used by the child care center in square feet (includes rooms, hallways, bathrooms, kitchens, bathrooms)? How many staff hours per week are spent cleaning the building (including both custodians and other staff?) A.3 How large is the indoor classroom area for children? (excluding hallways, stairways, closets, utility rooms, lavatories, kitchens, and space occupied by cribs) A.4 How often are vacuum cleaner parts checked, repaired, and emptied (filters, bags, canisters, hoses, connections, and beater bars) Check vacuum cleaners in rooms and storage areas: • clogged filter • full bag or canister • gaps in hose, filter, at connections • broken beater bar • poor pick-up • odor when run OK See Notes About 40 hours of weekly cleaning work should be done for every 25,000 square feet. OK See Notes Implement the state requirement for 35 square feet per child. OK See Notes Instruct staff to daily remove dust and debris from filters and to replace bags and empty canisters per manufacturer instructions (typically when the bag/canister is half-full). Consult the manual, the manufacturer, or the equipment vendor about proper maintenance of the vacuum, including replacing filters and belts. If no specific schedule can be found, then consider • replace filters and belts yearly, • inspect other components monthly, such as hoses, connections, filters, and beater bars (repair as needed) OK See Notes 2 A healthful learning environment requires adequate time spent cleaning, to remove bacteria, viruses, mold spores, allergens, and other contaminants present in the dust that settles on various surfaces. In addition to being a child care licensing requirement, maintaining this ratio of area to child may help to reduce odors, the transmission of viruses, humidity, and other air contaminants. Vacuum cleaners play a critical role in removing many allergens from the indoor environment. They loose suction as dust clogs the filters and other components. Vacuum cleaners can leak large amounts of allergens and become less effective at cleaning, if they aren’t properly maintained. Question/Issue A.5 When replacing vacuum cleaners do you purchase vacuum cleaners that: • are “high performance” • have high efficiency particulate air (HEPA) exhaust filters • features that reduce dust leakage such as double thickness or microfiltration bags. Check vacuum cleaners in rooms and storage areas: • no microfiltration or double bags • no HEPA exhaust A.6 Do staff help the cleaning work done at the end of the day, • by placing chairs on top of tables or stacking chairs in a corner? • by stacking cots in a corner? • by placing the waste basket in the hallway? Check rooms at the end of the day. A.7 Are parents surveyed about specific things that may trigger a child’s allergies? This could be a part of the written health care summary. Recommendations When replacing vacuum cleaners, select high performance vacuums with HEPA exhaust filters and microfiltration or double-thickness bags. Suggestions for selecting vacuum cleaners are available through consumer reports (www.consumerreports.org) and the “Green Label” vacuum program (www.carpet-rug.org/). OK See Notes Instruct staff to place chairs on tables at the end of the school day, stack cots in a corner, and place the waste basket in the hallway. OK A parent survey (e.g., the written health care summary) should prompt parents to list all irritants and allergens that may trigger asthma symptoms and any special precautions the center staff should take to prevent children’s exposure to them. OK See Notes Assign each student a locker, container, cubby, or hook that keeps clothing, bags, pillows, blankets, and other such items separate. Place shoes and other wet items (e.g., sleds) on a mat, in a container, or in a cubby. OK All the floor surface area needs to be mopped or vacuumed. The room needs to be setup for efficient cleaning. See Notes Inform all staff about children’s specific allergies, especially to food. A.8 Do students have their own separate storage space to place coats, bags, pillows, blankets, and other such items Check storage areas: • bedding not kept separate. • bags, coats, etc not kept separate. • shoes and wet items left on floor. Explanation Vacuum cleaners vary considerably in their ability to pick-up and retain allergens and dust. HEPA (high efficiency particle air) filters will catch virtually all the dust blown through the vacuum cleaner, if maintained properly. Microfiltration bags also help to prevent dust from leaking out of the unit. High performance vacuum cleaners are those tested and found to remove higher amounts of dust and debris. See Notes 3 A number of environmental agents may trigger asthma (such as food, cleaning chemicals, art supplies, personal products, animals, plants, latex, certain drugs, outdoor air pollution, outdoor pollen, field trips to zoos/parks). Minnesota state rules require child care center staff are informed about children’s food allergies. Pet allergens are brought from home on children’s clothing. It is prudent to keep each child’s clothing and sleeping items in a separate storage area, to limit the amount of allergens and other contaminants from transferring to the center and other children’s clothes. ? An acceptable storage space could be a hook for coats plus a shelf for items, a cubby, or some kind of container. This is also a state requirement for child care centers. A.9 Are custodial staff and teachers trained periodically about the proper use and maintenance of equipment and supplies? A.10 Do staff periodically run the faucet in sinks that aren’t used weekly and pour water down the floor drains? Check unused sink and all floor drains (kitchens, bathrooms, storage rooms): • odors • history of sewer odors • seems dry (look with flashlight) • floor drains missing Complete refresher trainings for all staff that does cleaning. If possible, schedule formal trainings (your cleaning supply vendor or manufacturer may be available to complete trainings or provide instruction materials). OK See Notes Pour water into floor drains routinely—this could be done weekly to monthly, depending on the drain. Water should be run down sinks that are not used at least once a week. Install floor drains in bathrooms, laundry areas, and custodial rooms. If odors persist, consider a specialized enzyme drain solution. OK OK See Notes Install or repair the air conditioning system in your building. OK Floor drains are present to help remove water if a pipe bursts or toilet over-flows. If water is not quickly removed from surfaces, significant damage may occur, including mold and bacteria growth. The “traps” in floor drains and sinks should have water in them. The water prevents sewer gases and microbial contaminants from entering your indoor air through the plumbing system. These contaminants may irritate the airways of some people. See Notes B. Heating, Ventilation, and Air Conditioning Repair or install a mechanical ventilation B.1 system—it should deliver outdoor air at a level Does each occupied room have sufficient for the number of people in each ventilation that provides room. In a home, this could be a heat adequate outdoor fresh air for exchanger. the number of occupants? If there is no mechanical fresh If you have an air conditioner, see if it has an air ventilation, do you ensure “air exchange” or “fan only” setting. Use as good air circulation in rooms weather permits (follow manufacturer where children are present? instructions). Check rooms: If a mechanical system is not present or • no ventilation system affordable, then at least open windows, keep or no operable room doors open, run fans, and operate windows. bathroom exhaust fans (where feasible during • no airflow from vents the day when children are present). • vents are covered or obstructed (large Uncover ventilation diffusers and move large items <3 feet away) items (such as furniture) at least 3 feet away from diffusers. B.2 Does the building have working air conditioning? The maintenance and proper operation of vacuum cleaners, cleaning chemicals, wet vacuum extractors, and other cleaning supplies determines how well the center is cleaned. This will affect the amount of dust and allergens present in the center. See Notes 4 An educational facility should have mechanical ventilation, to provide adequate outdoor fresh air. Air exchange will help to remove asthma triggers from the indoor air, such as dust, allergens, chemicals, and odors. It should also help to control humidity, which may contribute to mold and dust mites. If there is no mechanical ventilation system in a building, air movement and outdoor air exchange can be increased through other means. However, windows should not be opened frequently in buildings with adequate mechanical ventilation because this may disrupt the ventilation system and it also brings in unfiltered outdoor air. Also, don’t keep windows open when the a/c runs because this wastes energy and may create moisture problems due to warm air hitting cooled surfaces. Air conditioning systems remove humidity from the air, which may help to reduce mold, bacteria, and dust mites. Also, air-conditioning allows windows to be closed during the summer, which reduces the amount of outdoor allergens and air pollution that enter the building (on days with elevated outdoor allergens and pollution). B.3 Is their air movement during daily custodial cleaning? This could involve running the ventilation system or furnaces continuously or opening windows and turning on fans (until cleaning is complete). Operate the ventilation system, furnace, or window air-conditioning unit on with outdoor air entering the building, until the custodial work is completed. B.4 Is there a written preventive maintenance schedule for periodic inspection, calibration, cleaning, and replacement of mechanical equipment (such as heating, ventilation, air conditioning system, and dehumidifier components)? Develop a written schedule for the preventive maintenance of your heating, ventilation, air conditioning, and dehumidification equipment. Check equipment in boiler, mechanical, and storage rooms for: • loud noise • vibrations • leaks B.5 Check the room or area where furnace or ventilation equipment is located: • water, moisture or mold • chemicals, clutter, garbage • air blowing into room If there is no mechanical ventilation system, then open windows and run fans during cleaning, as weather permits. The maintenance should include routine inspection, lubrication, filter changing, cleaning, and component replacement. Follow the manuals, manufacturer specifications and any contractor recommendations. OK See Notes Correct moisture or mold problems Remove clutter, garbage, and chemicals Investigate and address excess negative pressure. OK See Notes 5 Cleaning causes dust and chemicals to contaminate the air. Running the ventilation system or opening windows will allow some of these contaminants to be diluted with fresh air or removed by the ventilation system filters. You may want to set the mechanical system timer to run during cleaning or switch the furnace to continuous fan operation. Preventive maintenance is crucial to ensure proper operation. Properly maintained equipment will filter out particles, remove humidity, control temperature, dilute air pollutants with fresh air, and save energy. Typically equipment should be inspected at least 4 times a year to ensure proper operation during different seasons. Air conditioners and dehumidifiers remove moisture from the air and tend to collect dust--this is a combination that can allow for mold or bacteria to grow inside these devices. The area housing mechanical equipment should not have chemicals, garbage, or other items that may emit odors, dust, or microbial pollutants. These contaminants can enter the air stream and be quickly distributed through the building. Clutter and garbage attracts pests. Air blowing into the room can indicate that air is being sucked into the mechanical system from the hallway, which might mean less air is entering through the air intake. B.6 Check inside of mechanical ventilation units and window air conditioning ventilators, including heating coils, cooling coils, fans, ducts, and condensate drainage areas: • not accessible • dirty (metal not visible) • standing water or stains • strong odors • disrepair (gaps, loose belts, torn belts, broken doors,) vibration) • gap around door • insulation present on interior of ducts next to air handler Install hatches, repair doors. Clean heavy coating of dust or debris Correct moisture problems. Remove source of odors Repair problems (e.g., replace belts and motors). Seal around doors. Remove or encapsulate porous interior insulation lining the ducts adjacent to air handlers. Consider hiring a qualified technician to investigate and address problems. OK See Notes Air handling unit components need to be easily accessible for periodic inspection, replacement, and maintenance. A thick coating of dust or debris in the mechanical equipment can allow for mold growth, may clog the filters more quickly, and add to dust loading in rooms. On metal surfaces, the metallic color should be visible. The presence of water or stains indicate a moisture problem that may result in mold or bacteria growth. Standing water can be sprayed into the ducts. When the a/c is on water should quickly drain away from cooling coils, onto the pan, and out the drain line. Odors may be caused by microbial growth, chemical storage, roofing work, chemical treatments, recent renovation, or nearby outdoor sources. Proper belt tension and alignment is important for the efficient delivery of outdoor air. Excess vibration may affect fan speed and hasten deterioration of the mechanical equipment. Gaps around the mechanical unit may affect the air distribution and ultimately the amount of fresh air delivered to rooms. B.7 What is the MERV rating or dust spot efficiency of filters in the heating and ventilation systems? Check filters in furnace and ventilation equipment: • not accessible • overloaded • filter type not pleated or bag • gaps or tears allow air bypass • water or stains Use filters that have the highest MERV rating or dust spot efficiency compatible with your heating or ventilation equipment (check with equipment manual, manufacturer, or ventilation contractors). • Install access panels, if possible. • Replace filters more frequently and create a filter replacement schedule and attach to units. • Switch to pleated or bag filters. • Remove by-pass by changing filters and/or making repairs to the filter housing. • Correct moisture problem and clean any microbial growth OK See Notes 6 Interior insulation of ducts near the mechanical unit should be removed because these areas tend to collect moisture and dust, which may lead to mold growth. Filters remove particles including outdoor asthma triggers such as pollens, molds, and vehicle pollution. In addition, some indoor allergens (e.g., cats, dogs, other furry mammals) are carried on fine particles that remain airborne for enough time to be returned to the mechanical unit where they may be removed by filtration. Filters vary a lot in their ability to trap particles. More particles are removed by filters that have higher MERV or dust spot efficiency ratings B.8 Check in and around outdoor air intakes of ventilation equipment and around windows that are frequently opened: • feathers/bird droppings, insects • grass clippings, leaves, etc • covered by snow, no protection against wind-driven rain/snow • plants touching • odors • buses/trucks idle <100 ft • plumbing exhaust or dumpster <30 ft • dampers broken, closed, different from computer setting B.9 Are exhaust fans present and regularly used in the kitchen and in bathrooms? Check exhaust fans in bathrooms, chemical storage rooms, by copier, attached to clothes dryer, above oven, etc: • not present • doesn't draw air (hold a layer of tissue paper against the exhaust vent—it should be drawn to the vent) • not being used • not ducted to outside (check attic) Clean leaves, grass clippings, and plant debris routinely from air intakes. Change landscaping activities to prevent organic matter from collecting in the air intake (for example, directing grass clippings away from the building during mowing). Hire a pest eradicator to remove pests in the ventilation system. Clean feathers and bird droppings according to NIOSH guidelines (see www.cdc.gov/niosh/docs/2005-109/). Prevent birds from entering intake by installing or repairing bird screens Keep air intakes free from snow drift--check weekly and after large snowfalls for snow blocking the outdoor air intake during the winter and remove as needed. Protect intake from wind-driven snow and rain. The quality of air in a building is affected by the quality of outdoor coming into a building, which is greatly dependent on the conditions in and around the air intake and open windows. Organic matter, pests, water intrusion, garbage, and idling vehicles are some of the common problems in and near these areas can lead to contaminants entering the building. Dampers are metal flaps that control the amount of fresh air that enters buildings that have mechanical ventilation equipment. Under most conditions, dampers should be about 15-20% open, to allow for fresh air to enter the building which is critical to remove odors, chemicals, and dust. Ventilation computer settings can be obviously inconsistent with the actual damper position. Trim trees and shrubs away: • Investigate odor sources and correct problems. • Move parking and idling zones at least 100 feet away from the outdoor air intake and post signs asking drivers to turn engines off. • Move the plumbing exhaust at least 30 feet away from the air intake. • Keep the air intake dampers partially open at all times, unless there is a specific concern with extreme cold weather that may cause freezing in the system. Repair broken dampers and damper controls. OK See Notes Operate kitchen exhaust fans during cooking, washing dishes, and mopping floors. Operate bathroom exhaust fans all day or at least during hand-washing, using bathrooms, and mopping floors. Operate chemical storage room exhaust fans all day. • Install exhaust systems in all bathrooms, kitchens, chemical storage rooms, copiers, and clothes dryers. • Repair, clean, or re-connect to the electrical grid. • Instruct all staff to use the bathroom exhaust ventilation unit; consider placing a note by the switch or using a timer that turns on with the lights and runs at least 20 minutes after lights are off. • Install ducting to the outdoor air. OK See Notes 7 Working exhaust ventilation removes contaminants to the outdoors. It is necessary in various areas and by certain equipment. In bathrooms, kitchens, and storage room, there can be humidity, odors, chemicals, and particle pollution in the air. In addition, equipment, such as copiers, clothes dryers, gas space heaters, ovens, and fireplaces need exhaust ventilation to direct contaminants to the outdoors. Ideally, bathrooms should have automated exhaust systems that either run during business hours or are at least on a 20+ minute timer connected to the light switch. This ensures the equipment are used in bathrooms. Storage rooms should have continuous exhaust ventilation during the day. You may want to tape a piece of tissue paper against the vent for an easy visual indication that specific vents are working. B.10 Do you have a working carbon monoxide detector in each room that has a fuel-burning appliance (non-electric), such as gas furnace, water heater, oven, space heater, dryer, etc? C. Smooth Floors C.1 How often are smooth floors mopped thoroughly? Thorough mopping means all the floor area that is accessible, including under tables, chairs, play areas, and objects that can be easily moved. Check rooms for dirty smooth floors. C.2 How often are room smooth floors wet mopped thoroughly? Thorough means all the floor area that is accessible including under tables, chairs, play areas, and objects that can be easily moved. C.3 How do you deal with spills and tough soiling that occur during the day? Install carbon monoxide detectors in each room that has a gas or other fuel-burning appliance. Replace batteries and check the alarm siren twice a year. OK See Notes Clean smooth floors thoroughly with a dust mop (slightly wetted with mopping oil) daily. OK See Notes Mop floors thoroughly with a liquid cleaner at least once a week. OK See Notes Spot mop spills and significant soiling that need immediate attention during the day. Spot mop (as needed) areas at the end of the day that need extra attention (e.g. heavy use areas, obvious spills, for visible debris). The use of a carbon monoxide detector may alert you to a release of pollutants from a fuelburning appliance. These pollutants can irritate airways and may trigger asthma attacks. When the alarm sounds, be sure to take proper measures. For details, see www.health.state.mn.us/divs/eh/indoorair/co/ind ex.html Routine thorough floor cleaning is necessary to remove allergens present in floor dust, such mold spores, pollen, bacteria, pet dander, dust mites, and pest droppings. A dust mop (i.e., push mop) is the easiest way to pick up dust and other dry debris. Sticky residues and wet spills should be spot cleaned with a wet mop. Routine wet mopping should be done in addition to dry mopping, to remove allergens and sticky residues that may provide nutrients for mold and bacteria. Bodily fluids, crumbs, and liquid spills need to be cleaned immediately during the day and at least at the end of the day. This helps to prevent mold, bacteria, and pests. Disinfect areas contaminated with bodily fluids immediately. Instruct staff to inform building maintenance about large spills and messes that need immediate attention, cleaning, or drying. C.4 Is a separate mop used for kitchen, classrooms, hallways, and bathrooms? If the same mop is used to clean all floors, what is the order that rooms are mopped? C.5 Are vinyl tile floors stripped, sealed, and/or refinished according to manufacturer guidelines? OK See Notes Use separate color-coded mops for different areas of the building, or mop floors in the following order: • kitchen • classrooms • bathrooms OK See Notes Follow the guidelines of the floor, stripping, and waxing chemical manufacturer--generally this should be done at least yearly. OK See Notes 8 Mold, bacteria, and viruses should not be spread to sensitive areas (kitchens, classroom) from areas with higher concentrations of the contaminants (bathrooms). Periodic restorative maintenance adds a smooth impermeable finish to smooth floors, which helps in the proper cleaning of dust and allergens from the floor. It also reduces the likelihood of mold growth in cracks. Every type of smooth flooring has different guidelines for restorative maintenance. C.6 Do waxing, sealing, and stripping chemicals have a low concentration of volatile organic chemicals (VOCs) (such as a Green Seal or Green Guard chemicals)? Talk to your vendor about selecting chemicals that have the lowest volatile organic chemical content (usually reported as percent by volume VOC), without significantly affecting performance. OK See Notes D. Carpets, Area Rugs, and Entry Mats Vacuum all accessible carpeted floor and area D.1 rugs surfaces thoroughly at the end of every day. How often are carpeted floors and area rugs vacuumed OK See Notes thoroughly? Thorough means all the floor area that is accessible including under tables, chairs, play areas, and objects that can be easily moved. Check room for dirty carpets and area rugs D.2 Do you use your manufacturer’s approved deep carpet cleaning method? Deep cleaning means shampoo, steam, or other deep cleaning method. D.3 After deep cleaning carpets, rugs, and walk-off mats are rapid drying practices used to assure they are dry within 24 hours? D.4 How often are all carpets and rugs thoroughly deep cleaned? Thorough means all the floor area that is accessible including under desks, chairs and objects that can be easily moved. D.5 Is wall-to-wall carpeting present in rooms that are below ground (e.g., basement)? Consult the manufacturer or your vendor Some information is available at the Carpet and Rug Institute website at http://www.carpetrug.org, and click on “Care and Cleaning” and then “Manufacturer-Recommended Deep Cleaning Methods and Service Providers” OK See Notes Dry floor coverings within 24 hours after deep cleaning, using rapid drying methods such as commercial grade dehumidifiers and carpet fans. Also, use the ventilation system and open windows and doors (if outdoor humidity is fairly dry). OK See Notes Follow the manufacturer’s recommendations-typically deep cleaning should be done twice a year. OK See Notes Replace carpet with a floor covering that is breathable (such as tile, textured concrete, terrazzo) and use area rugs. If carpeting must be used, then install it on a raised sub-floor. OK Stripping, waxing, and other restorative floor maintenance products may off-gas a very large amount of VOCs. Environmentally preferable products emit lower levels of VOCs. See Notes 9 Carpets can be the single largest collector of dust and allergens in a building. Thorough and frequent cleaning of carpets can remove most of these contaminants The proper restorative deep cleaning of carpets can ensure efficient cleaning of allergen and soiling, prevent moisture problems in carpeting that may result in microbial growth, and avoid chemical reactions that damage the carpet and produce odors. Carpeting that is not effectively dried within the first 24-48 hours can develop mold or bacteria growth. Opening windows and doors on very humid days may actually slow drying compared to using the air conditioning system. Routine deep cleaning of carpets is necessary to remove allergens that cannot be removed by vacuuming and stains that can become nutrients for mold and bacteria. Professional deep cleaning using high temperature steam should provide much better results than rental equipment. Carpets below grade are more prone to problems because moisture may collect under the carpet along with a large amount of dust. This may lead to mold or bacteria growth. D.6 Do you have a policy to phaseout carpeting and replace it with smooth floors? Check rooms, entrance areas, and hallways for carpets. When flooring is replaced, install smooth flooring, preferably hard mineral flooring (terrazzo, mineral tiles, textured concrete). If this is not possible, then resilient flooring (vinyl tile, linoleum, rubber, etc.) is still preferable over carpet. Area rugs can be installed over the smooth floor, if desired. Smooth floors are preferable to carpeting. Carpet tends to collect more dust and allergens. Hard mineral floorings are the best for indoor air quality because they last a long time, need the least maintenance, and allow for humidity to evaporate from underneath. Hallways should be the first place carpeting is removed, because a lot of dirt, chemicals, and moisture is tracked in on people’s shoes. Remove carpets from hallways first. D.7 How do you deal with cleaning daily spills and tough soiling on carpets that can’t be removed by wiping or vacuuming? OK See Notes Vacuum dry spills and significant soiling that need immediate attention. For liquid spills and tough soiling, purchase and use a wet carpet extraction vacuum immediately after they occur. Both dry and wet spills need to be extracted as soon as possible, before the particles and liquids adhere to carpet fibers and create conditions favorable to mold or bacteria growth. In addition, such staining makes dust removal more difficult during routine vacuum cleaning. Spot vacuum and deep clean areas at the end of the day that need extra attention (e.g. heavy use areas, obvious spills/messy areas, for visible debris). Staff should immediately inform building maintenance about large spills and messes D.8 Are carpet cleaning chemicals free of unnecessary fragrances? D.9 How often are building entrance mats: • vacuumed? • deep cleaned? Check exterior next to entrances: • muddy, standing water/snow. Check every building entrance for entry mats: • absent • less than 5 steps • dirty OK See Notes Ask your carpet cleaning company or your maintenance product vendors for fragrance-free chemicals. OK See Notes Vacuum entry mats daily Follow the manufacturer’s recommendations for deep cleaning—if manufacturer is vague, then deep clean walk-off mats at least weekly. This should include cleaning underneath the mat, wet mopping smooth mats, picking up and shaking mats outdoors, empting dirt collecting areas, and/or using wet extraction vacuum. Make landscaping changes to keep mud and water away from entrances. Keep snow and rain away from building entrances, by shoveling and/or adding an overhang at the entrance. Place a mat at every entrance that extends at least 5 steps. Vacuum entry mat daily and perform deep cleaning according to manufacturer recommendations. OK See Notes 10 Fragrances are often added to cleaning products, but may not be needed for the extraction of dirt and stains. They may cause respiratory irritation in sensitive individuals. Walk-off mats remove most the dirt, moisture, mold spores, pollen, pesticide residues, and other contaminants that would otherwise be tracked into buildings. When tracked on to flooring, these can later become airborne and possibly cause symptoms. Proper maintenance will ensure they are effective at preventing these contaminants from being deposited in rooms. Sand and grit can also damage flooring, making these surfaces harder to clean. Entry mats should be long and fairly clean, to minimize the amount of dirt and moisture that gets tracked into the building. E. General Cleaning Activities E.1 Are brooms and feather dusters used to clean floors, shelves, and other surfaces? Check storage rooms and areas for brooms and feather dusters. E.2 How often are the following surfaces cleaned: • blinds, • curtains, • bookshelves and their tops, • cupboard shelves and their tops, • ventilation supply and return diffusers. Check rooms for significant visible dust, crumbs, and staining of furniture and vents. E.3 How often is upholstered furniture cleaned by vacuuming? This includes couches, armchairs, bean bags, and cushions. Check upholstered furniture for dustiness and stains. E.4 At what temperature are fleecy items laundered (e.g., stuffed toys, cushions, blankets, play clothes, etc.)? E.5 How often are: • blankets, sheets, and pillow covers washed? • pillows washed? • play dress-up clothes washed? • dolls, toys, and the like washed or sanitized? Don’t use brooms and feather dusters. Clean surfaces with cleaning tools that trap and hold dust, such as dust push mops, wet mops, vacuum cleaners, microfiber cloths, and damp cloths. OK See Notes Clean these surfaces at least every three months by vacuuming or wiping with a damp cloth, preferably using a microfiber cloth. OK See Notes Clean upholstered furniture by vacuuming at least weekly. OK See Notes Raise the temperature for the laundry water to at least 120 °F; if possible, to 130 °F while keeping the hand washing water at 120 °F Instruct parents to wash and dry bedding at the highest temperature settings. OK See Notes Launder blankets, sheets, pillow covers, and the like at least weekly, whenever they are wet or soiled, and when a new child is given the sleeping area (use a disinfectant when soiled with bodily fluids). Launder pillows twice a year in the hottest water temperature possible. Launder dress-up clothes weekly in the hottest water temperature possible, when the clothes are being used. Launder or sanitize dolls, toys and the like every three months in the hottest water temperature possible (sanitize these items when mouthed or soiled). OK See Notes 11 Brooms and feather dusters flick dust into the air. The other cleaning tools do a better job of collecting and holding dust. These surfaces are often neglected. They collect significant amounts of dust and allergens. The dust on these surfaces can become airborne and the particles are inhaled from time to time, for example, when air flows across the area and when objects are moved. Also, food crumbs tend to collect in areas were food is stored, which can attract pests. Upholstered furniture tends to collect a lot of dust, including pet allergens, mold spores, dust mites, pollen, and other contaminants. If cleaning is neglected, these surfaces may actually have higher levels of allergens than other surfaces. Dust mites, which are commonly present in these items, are only effectively killed at high temperature (preferably 130° F). Pet allergens, mold spores and other asthma triggers are more effectively extracted at high wash temperatures. Hand washing water cannot exceed 120° F, under Minnesota Rules for child care centers. Bedding, clothes, and stuffed toys are a breeding area for dust mites, and can collect large amounts of pet allergens attached to children’s clothes. These items may also become contaminated with viruses and bacteria. Pillows can have high levels of mold, bacteria, and dust mites, and should be washed periodically. The bedding cleaning frequency is required under Minnesota Rules for child care centers. E.6 How often are kitchen floors, counters, refrigerator, and oven cleaned? Check kitchen cleanliness: • floors and counters • carbon build-up inside oven • cleanliness around the sides and back of oven and refrigerator. E.7 How often are hallways cleaned thoroughly? Check hallways: • dusty and stained surfaces • wet or muddy • shoes on carpet Clean kitchen floors, counters, and other areas daily that collect crumbs and have spills using a sanitizer. Clean the interior and behind the stove and refrigerator yearly, including the refrigerator drain pan. OK E8 How often are bathrooms cleaned? See Notes Clean hallways daily, by wet or dry mopping smooth floors and vacuuming carpets. Perform spot cleaning to remove spills and tough soiling. Store shoes on a smooth, easy to clean surface, such as a container, cubby, or a smooth floor. OK See Notes Clean bathrooms daily, by mopping floors, disinfecting toilets and seats, and sanitizing fixtures. Check bathrooms for dusty and OK See Notes stained surfaces. E.9 Remove garbage daily from rooms and when full. How often is trash removed from the building? Store garbage away from the building, in a covered container. Check trash containers in rooms: Place plastic liners in every garbage container. Replace the liner as needed when waste adheres • overflowing trash to the liner. • no plastic liner. • contaminated under Check under the liner daily. Clean soiled surfaces the liner and replace the liner when soiling is evident under the liner. OK See Notes E.10 Clean chalkboards, white boards, and the ledges How often are the chalkboards, with a damp cloth at least twice a week. white boards, and their ledges cleaned? OK See Notes Check boards in rooms. E.11 Where are chalkboard and whiteboard erasers cleaned? E.12 At what time of day is routine cleaning typically done (except for spot cleaning for spills)? Clean erasers outside. OK See Notes Perform all mopping, vacuuming, and dusting after children have left or on weekends, except to spot clean during the day. OK Food crumbs and standing water attract pests, and can encourage mold or bacterial growth. Grease and carbon build-up on the interior of an oven can produce fine particle pollution as it is burned off during oven operation. See Notes 12 Hallways are high traffic areas that need daily cleaning, to control the accumulation of dust, moisture, and allergens. Dirt, mud, and water that is present in front of entrances will increase the amount of dirt brought into the building and reduce the effectiveness of walk-off entrance mats. This may contribute to higher levels of mold and bacteria throughout the building. Shoes that are removed should be placed on a smooth cleanable surface that doesn’t absorb water or dirt. Daily cleaning will help to control the spread of viruses. It should also help to remove any bacteria or mold that can grow in damp and dirty areas. Minnesota child care center rules require daily bathroom cleaning. Moisture and rotting food can collect under plastic liners and around the waste basket. This will result in mold or bacteria growth and it may attract pests. Chalk dust as well as the chemicals in markers may irritate the throat and lungs of asthmatics. The boards and ledges should not have a thick layer of chalk or marker dust. When erasers are cleaned indoors, a lot of dust is released. This dust may trigger symptoms at that moment. The dust from chalkboard and whiteboard erasers will settle in the room, and then later get back into the air. Cleaning pushes dust into the air and cleaning products may release chemicals into the air. This may cause discomfort and health symptoms in sensitive individuals. F. Disinfection and Sanitation F.1 For disinfection purposes, what type of chemical does the staff use? Mix bleach chlorine plus water or use an equivalent product or process approved by the center’s health consultant If a bleach is used, mix as follows: • For 5.25% chlorine bleach, use ¼ cup plus water to equal a gallon • For 6.25% chlorine bleach, use 3 and 1/3 tablespoons plus water to equal a gallon. F.2 How often are toilets, seats, and training chairs washed with soap and water and then disinfected? Check cleanliness of toilets and urinals. F.3 Are pillows, toys, and equipment that are likely to be mouthed by infants and toddlers made of a material that can be disinfected? F.4 How often do you clean and disinfect toys and equipment that are likely to be mouthed? F.5 How often are floor mops soaked in a disinfectant? F.6 How often are the following areas cleaned with a disinfectant: • door, toilet, and cabinet handles • hand-washing sinks, soap dispensers, faucet handles, and the bathroom counters F.7 For sanitation purposes, what type of chemical does the staff use? Disinfectants such as bleach and equivalent products kill viruses, bacteria, and mold spores. Respiratory infections, mold, and bacteria can trigger asthma symptoms. State rules require disinfection of these areas with bleach or an equivalent product or process. OK See Notes When soiled or at least daily wash toilets and seats with soap and water and then disinfect. After each use, empty toilet training chairs, wash with soap and water, and then clean with an approved disinfectant. OK See Notes Replace items that cannot be disinfected. This may include fleecy toys and pillows. OK See Notes When mouthed, soiled and at least daily, clean toys and equipment and then disinfect with bleach or a method approved by the health consultant. OK See Notes Disinfect the mop(s) between rooms and before storing away, by soaking in a disinfectant and squeezing it out (do not use ammonia containing cleaners when using a disinfectant containing chlorine such as bleach). Wipe door, toilet, cabinet, and faucet handles daily with a disinfecting cleaning solution. Clean hand-washing sinks, soap dispensers, faucet handles, and the bathroom counters daily with a disinfecting cleaning solution. OK See Notes Mix bleach chlorine plus water or an equivalent product or process approved by the center’s health consultant at the following ratios: • For 5.25% chlorine bleach, use 1 tablespoon plus water to equal a gallon • For 6.25% chlorine bleach, use 2 teaspoons plus water to equal a gallon. OK See Notes 13 Disinfection of floor mops between rooms may limit the spread of viruses from one area of the building to another. Disinfection before storage will help to kill bacteria, viruses, and mold in the mop, and prevent mildew in the mop head. Areas that are touched frequently by occupants tend to have the highest levels of viruses and bacteria. If the area is visibly dirty, it should be first cleaned and then disinfected. These surfaces ought to be cleaned and disinfected regularly to reduce the spread of viruses and bacteria, which may contribute to asthma symptoms. In addition to required disinfection procedures, sanitation of other surfaces provides control of microbes, without the overuse of large amounts of bleach or other harsh chemicals. F.8 How often are food contact surfaces sanitized (chair seats, table tops, high chair trays, countertops used for food preparation, eating utensils)? Check rooms for dust, stains, and food crumbs on tables, counters, and chairs. G. Pests and Pesticides G.1 What pest control methods are used indoors? May include sealing entry points, removing accessible food and moisture, baits, traps, powders, and sprays. Check boiler, storage areas, and rooms for pesticide brought by staff (e.g., lice, insect, bought, lawn care products). Wipe table tops, high chair trays, chair seats, and countertops used for food preparation daily with a sanitizer and a cloth. Soak and wring out the table wiping cloth in a sanitizer after each table is wiped. OK See Notes Use integrated pest management to control pests such as sealing entry points, removing food and moisture, baits, traps and powders. See www.mda.state.mn.us/ipm/ipminschools.html Avoid pesticide sprays – use them as a last resort. Remove all pesticides from rooms such as store bought aerosol sprays, lice and insect pesticides, and restricted use pesticides. Staff should report all pest problems to the director—the director should coordinate pest management efforts. OK See Notes G.2 When spray pesticides must be used, at what times are they applied? Apply pesticides on weekends or vacations, when the building is unoccupied. G.3 When dealing with large pest problems, do you hire a professional pest controller? Is this person licensed by the state for the specific type of pesticide used? Large pest problems should be handled by a professional pest controller, licensed by the MN Department of Agriculture for the particular pesticide application. To verify a license, check the Minnesota Department of Agriculture licensing information system website: www2.mda.state.mn.us/webapp/lis/pestappdefau lt.jsp Place powder, baits, and traps in areas that cannot be reached by children, such as cracks and holes. G.4 If pesticide powders, gels, or baits are used, where are they applied? OK OK See Notes See Notes 14 People and food touch these areas routinely, which may allow for transmission of viruses. Also, these surfaces collect pet allergens deposited from people’s clothes. Moreover, food crumbs can attract pests. To ensure that the table-wiping is reducing levels of bacteria and viruses, it is best to soak and squeeze the cloth in a sanitizer. Pests such as cockroaches and rodents deposit allergens in the building that may trigger asthma symptoms. Pests should be managed through prevention, by sealing entry points into the building, removing food and water sources, removing harborage areas, and carefully applying baits, traps, and powders. Spraying pesticides releases chemicals into the air, which may be inhaled and irritate people’s airways. In some cases, too much of the spray is used or the product does not target the pest. Spray pesticides are merely a temporary solution as pests will return when the chemicals wear off. Restricted use pesticides should never be used in a center—they may not be approved for indoor use or residential applications. Lice should not be eradicated by spraying—washing, vacuuming and cleaning are recommended. Pest problems can be much bigger than is visually apparent. A coordinated effort is necessary to eradicate pests. Large pest problems should be quickly and aggressively dealt with, to minimize allergy, asthma, and other health risks. To learn more about the laws and licensing requirements, contact Jeanne Ciborowski at Minnesota Department of Agriculture ([email protected] or 651-2973217). Pesticide powders may be toxic if sniffed or eaten, which may trigger respiratory problems. Childcare rules require toxic chemicals to be kept out of children’s reach. G.5 Have you had cockroach, bee, wasp, rat or mice problems in the past year? Manage these pest problems by hiring a statelicensed pest controller, and following Department of Agriculture recommendations (see www.mda.state.mn.us/ipm/ipmpubs.html). Check boiler room, storage areas, building doors, food storage areas, under sinks, building exterior for: • droppings • rat runs (smears along wall) • gnaw marks. • openings in building exterior Thoroughly clean affected areas after eradicating the pest population, G.6 Check rooms for food containers that are not metal or hard plastic. Store food in hard plastic or metal containers with tightly sealed lids. G.7 Do children play near utility poles, or near any other areas where pesticides may be applied (including landscaping herbicides)? G.8 Are parents routinely notified about the application of pesticides? Keep children clear of areas where pesticides are applied. Continue vigilance of this problem; remind staff to look for pest problems and report them to building management. OK OK OK Check products in rooms, bathrooms, storage rooms, boiler room: • not “green” • accessible to children. • cracked or leaking • aerosol spray can See Notes See Notes For all-purpose, glass, and bathroom cleaning, purchase environmentally preferable products such as “Green Seal” certified products or products that meet the 12 specifications listed under the product formulation section of the state contract “Cleaning Supplies and Floor Care Products C-252(5)”. Contact product vendors, for free samples, help in selecting the right products, and directions for proper use. See the Appendix A “Environmentally Preferable Cleaning Product Distributors” Provide every room one all-purpose cleaning product. Move products to an area not accessible to children. Remove leaking products. Replace aerosol can with liquid or pump spray alternatives. OK Food crumbs can attract pests. Many pests can chew through cardboard and plastic wrappers, even if sealed. Pests such as cockroaches and rodents produce allergens, which may trigger asthma symptoms. Insecticides and herbicides may contain chemicals that are toxic to children, and exposure should be avoided. See Notes Notify parents at least once a year, to give them an opportunity to provide comments that may help protect children’s health. OK H. Chemicals H.1 Do you use “green” cleaning products, meaning chemicals that are better for human health and the environment? See Notes Many insects are generally harmless, and the use of pesticide sprays is an unnecessary and excessive measure when there are only a few insects present. However, certain pests are more significant to allergies and asthma. Cockroach droppings are potent allergy and asthma triggers. Mice, rats, and other rodents leave behind allergens in their dander, feces and urine. Some insects and their stings may also trigger allergic reactions and possibly asthma attacks. These types of pest problems should be dealt with more aggressively than other pest problems. Cleaning should be done after pests are eradicated because allergens can linger for many months. See Notes 15 Many parents are concerned about children’s exposure to pesticides. Some parents would like to be aware of pesticide applications so that they may provide constructive suggestions to protect their children from both pests and pesticides. Cleaning products emit chemicals into the air during cleaning and maintenance work, which may irritate the airways of some people. Products should be selected that contain lower concentrations of these chemicals, without sacrificing cleaning performance. Environmentally preferable products are usually better for human health and the environment, compared to other products. These products should be used for most routine cleaning of floors, shelves, vents, window ledges, and the like. Sanitizers should be used for food prep, eating areas, door handles, and sleeping areas. Disinfectants should be used in toilets, diapering areas, and other soiled and mouthed materials and areas. H.2 Do you specifically purchase art supplies that: • meet the ASTM D4236 standard for “non-toxic” products, or • have the ACMI labels “AP” “CP” or “HL Non-toxic”? Check chemical products in rooms and storage areas: • label has warnings • label lacks CP, AP, or HL Non-toxic • powder art supply • solvents • aerosol can • cracked or leaking • chemicals accessible to children (excluding chalk and crayons) H.3 Do staff use any personal products with strong odors inside the building, such as perfumes, fragranced fabric softeners, nail polish and remover, hairspray, or air fresheners? Check rooms for these products. H.4 Are only liquid or foam soap and paper towels or blow dryers used for hand cleaning (not bar soap and cloth towels)? H.5 Are chemicals periodically inventoried to see which ones are not used or center purchased and to remove problem products? Remove products that have any of the following statements on the label: “CL”; “HL Health Label”; “Warning”; “Caution”; “Risks if not properly used”; or “Inappropriate for children” Purchase products that have the ACMI labels “AP (approved product)”, “CP (certified product)” or “HL Non-toxic” Also, remove products that are: • in aerosol spray cans • scented • contain permanent or solvent based adhesives, paints, dyes • in a powder formulation. • leaking or cracked • accessible to children. OK See Notes Remove perfumes, fragranced fabric softeners, nail polish, nail polish remover, hairspray, air fresheners, static control sprays, and other products with fragrances and strong odors. OK See Notes Provide fragrance-free liquid or foam soap at every sink Replace cloth towels with paper towels or blow dryers. OK See Notes Once a year, inventory chemicals in custodial closets and in classrooms (check under sinks, in closets, drawers). Identify and discard chemicals that are rarely used, unnecessary, or inappropriate. In classrooms, replace the assortment of specific cleaners and sanitizers with an all-purpose cleaner spray bottle (not aerosol can). See Ref. “Chemicals in Cleaning” for vendors that sell environmentally preferable cleaners. If staff demand specialized chemicals, have them check out specialized chemicals (e.g., mark remover, stainless steel polish, solvents) from a central location at the end of the day. OK Many art supplies contain chemicals that may be irritating to the respiratory system. The fragrances and chemicals in art products are emitted into air as they’re being used and sometimes while they are stored. Staff often bring their own products to the center. Even if certain products are used infrequently or staff say they are used after hours, there is a risk that children will use these products inappropriately or other staff will use the products around children. See Notes 16 Personal products with fragrances and strong chemical odors may irritate the airways of some people. Air fresheners often cover-up odors that should be investigated and addressed through other means (removing the source or better ventilation). Using liquid soap and paper towels should help limit the spread of viruses and bacteria. Using paper towels or blow dryers is more sanitary than sharing cloth towels. Minnesota rules for child care centers require sinks to have liquid soap, not bar soap. Products can be brought into the center, such as solvents and pesticides, which may irritate sensitive individuals’ airways even when used according to manufacturer guidelines. I. Construction and Renovation (building additions, replacing flooring, applying paints and finishes, applying panels, erecting walls, installing insulation, new roofs, installing large new furnishing, restoring smooth floors and the like) I.1 Schedule all construction and remodeling The best way to prevent exposure during When are construction or projects outside child care center hours (e.g., construction and renovation is for occupants to renovation projects performed, weekend and vacations) and complete projects be away from the work site, preferably out of the including stripping and waxing during unoccupied times building when feasible. Putting up plastic sheets floors? and using other containment and engineering Schedule extra time to ensure delays don’t cause methods may not be sufficient to prevent dust the projects to continue during occupied times. and odors from spreading throughout the building. Air out the building before re-occupancy. I.2 Are air vents and work areas sealed off with plastic and tape during renovations and remodeling? I.3 Do you increase housekeeping during and after projects to clean dust that may have settled in adjacent areas? I.4 Are outdoor air intakes closed off near or downwind during roofing work? I.5 Is the building flushed out with fresh air for at least 3 days after construction or renovation projects are completed? OK See Notes During renovations, isolate work areas using engineering controls. This could include installing temporary barriers (polyethylene sheeting), covering vents and fire alarms, and providing local exhaust (for example, window fans pointing outward from the area). OK See Notes Perform careful cleaning in nearby rooms and areas served by the same ventilation system, including damp wiping of all horizontal surfaces, mopping floors, and vacuuming carpets and fleecy materials. OK See Notes Shut outdoor air intakes and windows near or downwind from roof work (approximately 100 feet or less). OK See Notes Allow three days of outdoor ventilation to air out the building before it is occupied again. Where feasible, air out the building by opening windows, running fans, and running the ventilation system at maximum outdoor air (if this can be done without creating moisture or temperature problems). OK I.6 Are durable and low chemical emitting materials used in renovation and construction projects? Materials of interest include flooring, paints, adhesives, panels, insulation, and furniture. See Notes Talk to your vendor about environmentally preferable products, such as: • Green Label (carpet) • Green Guard (furniture, building materials) • Green Seal (paints, coatings) • ANSI A208 (pressed wood and particle board) OK See Notes 17 Dust and chemical fumes can be irritating to the airways. Even if the building is unoccupied during renovation, the dust and chemicals will spread through the building, settling in ducts and other building surfaces. These contaminants can be released into the air at a later time. A large amount of dust may settle in adjacent areas. These should be cleaned so the dust doesn’t become resuspended in air. The gas and particles released from roofing work can enter buildings through openings such as outdoor air intakes and open windows. This may irritate the air ways of some individuals. Many building materials and coatings contain chemicals, which off-gas into air after application. Typically, levels are acceptable for most people after the area has been aired out for 72 hours. However, particle board furniture and some building materials, tend to off-gas more slowly and it may be necessary to air out the building for several months (as weather permits). Care should be taken when increasing your mechanical ventilation because moisture problems may occur during very warm or cold days. Many building materials, furnishings, and coatings emit significant levels of volatile organic chemicals. Selecting products that have low emissions is an effective way to prevent exposure to chemicals that may irritate the airways of some individuals. The products should balance low volatile organic chemical emissions, quick curing time, durability, ease of cleaning, and ease of application. I.7 Check the building exterior and interior for renovation needed in walls, floors, windows, ceiling. • cracks, tears, or openings • stained areas, water damage, peeling paint • weeps missing/ weeps touching soil • vegetation touching building • wetted by sprinklers Replace worn and torn carpeting and smooth flooring. Repair walls and windows. Seal cracks and openings. Worn flooring collects more dust and is more difficult to clean compared to flooring in good condition. Correct moisture problems and staining. Paint walls and correct any moisture causing peeling. Gaps and cracks in the walls and windows can allow cold air in and create condensation that may lead to mold or bacteria growth. In addition, these openings may allow pests to enter the building. Install weeps or other feature to drain water. Move weeps off the ground or snow. Trim back plants and shrubs Direct sprinklers away from the building. OK See Notes Staining may indicate a water problem, such as gutter, faucet, downspout, and flashing problems. Moisture problems should addressed following MDH or EPA best practices (see www.health.state.mn.us/divs/eh/indoorair/mold/i ndex.html) Weeps are ropes that stick out of brick walls, and should be present to move water out of the wall cavity. Plants and shrubs should not touch the building exterior. This can contribute to dampness in the building wall and provide harborage and cover for pests that can enter the building. Sprinklers directed against buildings for prolonged periods may cause moisture problems in walls. I.8 Check the building roof top, if accessible, for: • standing water • roof doesn't slope to drain or gutter • apparent water infiltration, roof disrepair • ice dams • plumbing exhaust blocked Change the grading of the roof to ensure water drains off the roof. Check the roof drainage every three months to see if water drains away properly. Repair roof, patch or replace roof. Improve roof insulation to prevent ice dams. Where possible, make repairs or modification to ensure ventilation and exhaust stacks/pipes don’t get obstructed with debris, leaves, snow, and the like. Remove snow and debris as needed. OK See Notes 18 Minnesota rules require that areas used by children must be free from debris, loose flaking, peeling, or chipped paint, loose wallpaper, or crumbling plaster, litter, and holes in the walls, floors, and ceilings. Water infiltration through the roof is one of the most common causes of mold in buildings. It can be caused by poor drainage, damage from ice dams, and disrepair. Plumbing exhausts need to be unobstructed, to allow for sewer gases to leave the plumbing system. J. Furnishing, Products, and Materials J.1 Only install new or re-conditioned furniture Is second-hand furniture present (professionally deep-cleaned). in the center, such as couches, cushions, and area rugs? When purchasing upholstered furniture buy furniture made of a smooth material (such as Check rooms for: microfiber, vinyl, or leather). Consider replacing all existing fleecy furniture. • used furniture • fleecy curtains, Replace fleecy window treatments (e.g., furniture, wall curtains) with a preferable non-fleecy option that coverings does not collect dust (e.g., vertical blinds) Second-hand furniture may have a lot of pet allergens, mold growth, and dust mites. In general, fleecy furnishings and decorations collect a lot of dust and are difficult to clean. When these items are disturbed, the dust becomes airborne, which may then be breathed and irritate the airways of asthmatics. Furniture should be easy to clean and should not trap or collect dust. Remove fleecy wall coverings and large decorative objects that collect dust. J.2 Is separate bedding provided for each child that is never shared with other children? OK See Notes Provide each child with their own designated bedding (i.e., pillow, sheets, blanket, sleeping bag, and the like) Mark items with the children’s names or some other identifier Sharing these materials may allow disease causing viruses and bacteria to spread from one person to another. Also, pet allergens are rubbed off from clothing onto bedding. State rules require each child has their own bedding. Store each set of bedding separately, in plastic bags or other type of containers. J.3 Check rooms for mattresses and cots that are waterproof. J.4 Check rooms for: • many stuffed toys on display • feather-stuffed toys • general clutter (games, books, boxes) OK See Notes Replace mattresses that have an absorbent surface with a water-proof mattress or attach a waterproof cover. Reduce the number of soft toys on display. Keep remaining soft toys stored away in covered containers. Replace feather-stuffed toys with items that are stuffed with a synthetic material. OK See Notes 19 Mattresses will probably get wet, which can contribute to mold, bacteria or dust mites. Water-proof mattress or cots are required under state rules. Soft toys collect dust and can contain lots of dust mites due to the skin cells and humidity that collect inside. Limiting the number of toys on display will reduce the amount of dust and dust mites in the toys. Defining “too many toys” depends on the size of the toys. If the toys are not regularly cleaned, then too many could be three or more large toys, five or more medium toys, nine or more small toys, or some combination of different sizes. Feathers can trigger allergy symptoms in some people. Clutter collects a lot of dust which requires cleaning, but these items are rarely cleaned or difficult to clean. J.5 Check diaper changing areas • in food prep area • no disposable paper • not smooth surface • plumbing handles require hand use • no foot operated, covered disposal container Move the diaper changing area to a location away from the food prep area. Use disposable paper to cover diaper surfacing area Replace the diaper changing surface with one that has a smooth impermeable surface. These precautions will limit the spread of viruses that may cause respiratory infections and bacteria. Both viruses and bacteria may trigger asthma symptoms. Minnesota state rules for child care require these conditions. In addition, in newly constructed centers or those undergoing major remodeling to the plumbing system, foot or wrist operated sinks must be provided in the diaper changing area. Replace the plumbing handles with one that can be operated with the wrist or foot. Replace the diaper disposal container with one that is foot operated and covered. J.6 Are there ozone generating air cleaners in the center? OK See Notes Remove and prohibit ozone generating air cleaners in the center. OK Check rooms for ozonegenerating “air cleaners”. J.7 Are there portable humidifiers in the center? Remove and prohibit area humidifiers in the building. OK J.8 Check rooms for chalkboards being used. See Notes See Notes Replace chalkboards with whiteboards; if both are present, instruct staff to only use whiteboards. OK Humidifiers add moisture to the air, which can result in condensation on cold surfaces (such as around windows, in poorly insulated walls and ceilings, and in closets against exterior walls). This may encourage mold growth. In addition, mold and bacteria can grow inside the water reservoir of poorly maintained humidifiers. Chalk dust can irritate the airways of asthmatics. See Notes K. Plants and Animals (if animals and plants are never permitted, skip this section) K.1 Only allow animals for educational or Do you only permit animals for developmental purposes. educational or developmental purposes, and not merely as Remind staff to check with the director before pets? bringing pets. Check rooms for • problem or not approved pets • signs pets visit (cages, food, bowls) • dirty animal habitats (for approved animals). Ozone is an irritant that may trigger asthma symptoms. It is federally regulated in outdoor air. It also masks odors preventing staff from investigating and correcting the source of the problem. Check health records to ensure nobody has a sensitivity to the animal. Animal dander, urine, feathers, and saliva may trigger allergies and asthma in sensitive individuals. Also, pet habitats, including reptile terrariums and fish aquariums, can develop mold or bacteria if not maintained carefully. The benefits of having animals need to be periodically weighed against the health risks to specific children. Give preference to animals without fur or feathers. Keep approved animals in proper containment, in a location inaccessible to children. The responsible staff must clean the containment daily Allow service animals. Ask parents not to bring their pets into the building when they drop off or pick up their child. K.2 If pets are permitted, are parents OK See Notes Inform parents about the presence of animals at the time of enrollment. 20 Notifying parents may help center staff and parents take appropriate precautions to informed about the presence of pets at the time of enrollment? K.3 Are animals permitted to roam around the classroom? OK See Notes Keep animals on tabletops, and away from flooring and fleecy materials. accommodate the health needs of children with allergies. This is required under Minnesota rules for child care centers. Animals will deposits dander and other allergens in areas that they roam. Fleecy items, such as carpets and furniture are difficult to fully clean. The table should be immediately wiped with a disinfectant after returning the animal to the cage. K.4 Check for plants in rooms: • more than 3 potted plants • plants moldy or overwatered • flowers present OK See Notes Limit plants in center to up to three per room. Remove moldy plants. Plants can contain mold in the soil. They may be over-watered causing mold in and around the pot. In addition, flower pollen and plant odors may trigger allergy and asthma symptoms. Instruct staff to limit watering or place tags with watering instructions. Prohibit all flowers and flowering plants Place plants away from the reach of children. Make teachers and staff responsible for maintaining their plants. OK L. Smoking L.1 Does anyone ever smoke indoors? L.2 When staff go outside to smoke, do they wear a coat that is only worn during smoking and not during other times? See Notes Never permit smoking indoors. OK See Notes Staff should use a specific coat that is used for smoking only and stored away from the children. OK See Notes 21 Under the Minnesota Clean Indoor Air Act, smoking is prohibited in child care premises, during and after hours. Smoking is also prohibited in day care homes, during operating hours. Smoking that occurs when rooms are unoccupied can still cause exposure to tobacco contaminants. Smoke odors and particles will settle on surfaces. These contaminants can become airborne later. Tobacco smoke clings to clothing. Children may breathe these pollutants when they come close to the coat. M. Moisture and Mold M.1 Has water or sewage ever entered or leaked into the building? Check all areas for water leaks or entry seasonally: • sinks • toilets • air conditioning unit • boiler • windows • walls • roof • attic • basement, crawl space • closets • pipes Investigate and address the underlying cause of water problems. Look for mold or bacteria growth in areas with water problems (odors, spots, stains) Prevent ice dams by improving attic insulation and sealing air by-passes around pipes, recessed lighting, hatches, and other penetrations to unconditioned spaces under the roof. Address dampness due to condensation. Depending on the problem, this can be achieved by improving insulation, increasing air circulation, raising the room temperature, keeping the closet door open, moving furniture, and/or making sure adjacent bathroom and kitchen exhaust vents are used during water use. OK M.2 When water comes into the building, is the area dried and cleaned within 48 hours? See Notes Begin drying surfaces within the first 48 hours using shop vacuums, dehumidifiers, and commercial grade fans. After areas are dry, clean surfaces with soapy water if the flood water was clean. Moisture problems can contribute to mold, bacteria and dust mite problems. Sources of moisture include plumbing leaks, roof leaks, window leaks, ground water infiltration, and moisture use without ventilation. Sewage water contains bacteria, viruses and mold that may cause illnesses and irritate the airways of sensitive individuals. Ice dams can form when warm air moves through the roof, causing snow to melt, and then refreeze at the edge of the roof. This ice can eventually damage the roof. Roof damage can allow for entry of water. Moisture can condense in walls and on windows when these surfaces are colder than the air, due to inadequate insulation, limited air circulation, and/or low room temperatures. This could occur during cold or warm times of the year It is critical to begin drying materials immediately, within the first 48 hours, to prevent mold and bacteria growth. Areas contaminated with sewage need to be disinfected to kill microorganisms, but disinfection is excessive in areas that were soaked with clean water. Disinfect surfaces that came in contact with sewage water. Discard items that become moldy, where possible. M.3 Are there any areas that have smelled musty or earthy? OK See Notes Musty/earthy odors should be investigated for mold or bacteria growth that may be in hidden areas Address moisture problems and clean mold according to MDH guidelines: www.health.state.mn.us/divs/eh/indoorair/school s/mold.html M.4 Is there any visible mold in the center? Check for stains or mold growth in rooms, hallways, storage areas, bathrooms, crawl space, closets, attic areas (examine around sink and toilets, walls, around window, ceiling, above ceiling tiles). OK See Notes Remove the mold, during unoccupied hours, following MDH guidance www.health.state.mn.us/divs/eh/indoorair/school s/mold.html • Remove porous moldy materials, such as carpet, sheetrock, and insulation • Clean and disinfect semi-porous and non-porous moldy materials, such as concrete, solid wood, glass, and tile Investigate and correct the underlying moisture problem. (such as roof leaks, plumbing leaks, condensation on cold pipes, poor site drainage). OK See Notes 22 Musty or earthy odors usually indicate mold growth. Mold can trigger allergies or asthma. Hidden mold growth may be found behind furnishings, under carpets, in utility tunnels, in attics, behind walls, in ventilation ducts, in a/c units, in crawlspaces, etc. No amount of visible mold should be tolerated. Mold growth may trigger allergy or asthma symptoms. Large mold problems should be remediated with additional precautions. M.5 Are all porous materials (such as carpeting, sheet rock, ceiling tile, insulation, etc.) that are wet for more than 48 hours replaced? M.6 Have you ever seen standing water within a few feet of the building? Check building exterior and below grade areas for drainage problems: • gutter/downspout blocked short, missing • standing water by wall or ground not sloping away • snow piled against wall • water damage in utility tunnels / below grade areas N. Hand Washing N.1 Do center staff monitor and assist children with hand washing? N.2 Is each child and staff member’s hands washed after diaper changing, use of a toilet, and before eating or handling food? N.3 Do staff and children wash their hands when they first arrive at the center? N.4 Do staff and children wash their hands after handling or cleaning bodily fluids? N.5 Do staff and children wash their hands after handling pets and animals? N.6 Do children wash their hands after coming in from outdoors? N.7 When soap and water are not available, do staff and children Carpeting and other porous materials that have stayed wet for more than two days should be replaced. Porous materials can develop mold or bacteria after staying wet for 2 days. It can be difficult to see mold growth in these materials or to clean them when they do have visible mold. The underlying cause of the problem should be addressed. OK See Notes Repair or install gutters and downspouts so water is moved off the roof and dumped at least 4 feet away from the building. Change the grade of the landscaping, sidewalks, and other adjacent surfaces to ensure they move water away from the building so it slopes down 1 foot for every 10 feet across Poor site drainage can cause damp basements and foundation, which may lead to mold growth. Water should not pond at the base of the building or drain directly down the side of the building. This may allow moisture in walls, windows, or through the foundation. Chronic moisture may result in mold or bacteria growth. Even with dehumidification, there may still be sufficient moisture to cause microbial growth. Move snow to a location away from the building. Remove water from utility tunnels after heavy precipitation. Consider other methods of water proofing the below grades areas, such as a sump system. OK See Notes Staff should monitor children and ensure children lather their hands and rub them together for at least 15 seconds. OK See Notes Each child and staff member’s hands should be washed after diaper change, use of toilet, and before eating. OK Bacteria and viruses can be transmitted from hand contact Exposures to bacteria and viral infections may trigger asthma symptoms in some individuals. Thorough hand washing with soap is necessary to remove a significant amount of bacteria and viruses. Minnesota rules for child care centers require hand washing after these activities. See Notes Each child and staff member should wash their hands when they first arrive at the center. OK See Notes Each child and staff member should wash their hands after handling bodily fluids, including sneezing, nose wiping, coughing, and blowing noses. OK See Notes Each child and staff member should wash their hands after handling pets and animals. OK See Notes Each child and staff member should wash their hands after coming in from the outdoors. OK See Notes When soap and water are not available, purchase and use a hand-sanitizer that is moisturizing, fragrance-free, and at least 60% alcohol. 23 People may bring asthma triggers to the center on their hands, such as respiratory viruses, pet allergens, food allergens, bacteria, etc. Transmission of respiratory infections can be limited between by washing hands after handling or cleaning bodily fluid and contaminated materials. Animal dander, urine, and saliva, contain allergens. Also, animals can shed bacteria and viruses. Individuals may inhale the allergens by hand to nose contact. Children may come into contact with bacteria, mold, and pollens when playing outside. Individuals may inhale these contaminants through hand to nose/mouth contact. When children are on field-trips, such as to petting farms, they will come in contact with bacteria, viruses, and molds. These should be clean their hands with a handsanitizer that is moisturizing and fragrance-free. OK See Notes O. Outdoor Pollutants and Allergens O.1 Check air quality conditions daily, either by Do you receive email alerts for reading the daily newspaper or signing up for air air quality problems or check quality alerts at www.pca.state.mn.us/air/aqithe newspaper regarding subscribe.html outdoor air pollution conditions? OK See Notes O.2 Check outdoor allergen conditions daily from Do you receive email alerts for spring to fall, either by reading the daily outdoor allergen levels or check newspaper or signing up for daily email the newspaper regarding notification at pollen.com allergen levels? OK See Notes O.3 Discuss with parents of asthmatic children the Are precautions taken--in appropriate actions to take when there are air consultation with parents--to quality alerts and high outdoor allergen levels. protect vulnerable children Actions could include monitoring the child when there are air quality alerts during physical activity, limiting the duration of for outdoor air pollution? activity, and/or keeping the child indoors. O.4 Are windows closed during outdoor mowing or raking near windows? Check for nearby pollutant sources: • industry • construction • animal confinement • pesticides application • marsh/swamp • busy highway O.5 Check outdoor activity area for possible hazards: • rubbish • chemicals • plant matter (grass clippings, compost, leaves) O.6 Check loading areas for no idling signs. OK See Notes Keep windows closed and run air-conditioning or ventilation during outdoor mowing, raking near windows, and when odors and pollutants are elevated. Evaluate whether any actions can be taken to reduce exposure to pollutants from nearby sources. This could involve keeping windows closed and scheduling outdoor activity at certain times of day or week, depending on winddirection. OK • • See Notes Remove items from activity area. Check area prior to children going outside every day. OK See Notes Post no idling signs and send letters to companies that park vehicles in receiving areas. OK See Notes 24 removed from hands, to avoid hand to mouth exposure. The Minnesota Pollution Control Agency issues daily outdoor air quality conditions and provides warnings when levels may cause respiratory problems in sensitive individuals such as asthmatics. Tree, weed, grass, and mold allergens increase at different times of year. Knowing when specific allergens are high can help you take precautions to protect children allergic to these allergens (such as keeping windows closed, monitoring activity, and other measures). Possible precautions should be first discussed with parents. Precautions should not be excessive since physical activity should generally be encouraged Also, precautions may not be necessary if the sensitive child is receiving proper medical treatment that prevents symptoms even when outdoor asthma triggers are high. Activities and conditions near the center can contribute to contaminants that enter the building through the ventilation system, doors, and windows. Allergens become airborne during yard-work, which may trigger asthma symptoms in sensitive individuals. Contaminants associated with agriculture, industry, and traffic can also cause respiratory health problems. During the summer, keeping windows closed and running air conditioning will help to reduce the amount of outdoor pollution that enters the building. In addition, exposure can occur during outdoor play times. Identifying when contaminants are low can help you take precautions to protect children. Organic matter or chemicals present in the activity area may trigger asthma symptoms. According to Minnesota rules for child care centers, the activity area must be free of various hazards. Idling vehicles emit fine particles and gases. These enter the building through doors, windows, and ventilation air intakes. Particle pollution, especially from vehicles, is a significant cause of respiratory health problems including asthma symptoms. Appendix A. Environmentally Preferable Cleaning Product Distributors The two tables in this appendix list companies (“distributors”) that sell cleaning products in Minnesota. This list of distributors was compiled using the companies on the state of Minnesota cleaning product purchasing contract as well as a few other individual recommendations from colleagues at the MN Pollution Control Agency. All the distributors were contacted by mail and asked to participate in the following manner: 1. Provide cleaning products to the centers, when contacted by the centers or their property management staff. Products should include at least one same of general purpose, bathroom, and glass cleaners. 2. Provide samples that are ready-to-use in areas used by the center (rooms, bathrooms, hallways, etc). 3. Provide guidance to help center staff pick the proper products for the needs of the center, and to ensure products are used safely and properly. 4. Only provide products that either: a. meet all 12 specifications for general cleaning supplies listed under the product formulation section of the state contract “Cleaning Supplies and Floor Care Products C-252(5)”, OR b. are Green Seal certified. 5. Do not encourage replacing the center’s disinfectant, unless the center director explicitly indicates that they have approval from their health consultant to use a new product. Minnesota regulations require that bleach or a product approved by the center’s health consultant must be used to disinfect the following surfaces: a. diapering surfaces; b. toys and equipment that are likely to be mouthed by children; and c. toilet training chairs, toilets, and toilet seats. Six representatives responded to the letter. They are shown in the first table below. These companies are very interested in promoting their products to child care centers. The companies listed in the second table may also be willing to work with you, but they did not respond to our letter. We encourage you to contact one or more of these companies to find new environmentally preferable cleaning products for your center, to replace your existing products. Cleaning Product Distributors that Have Volunteered to Participate Product Distributor Contact Person Address Manufacturer Brulin & Company, Brulin & Mark Siefkin 2920 Dr. Andrew J. Brown Inc. Company, Inc. Avenue, PO Box 270, Indianapolis, IN 46206 Chemical Chemical Fran Elliott 901 North Newkirk Street, Specialties MFG Specialties MFG Baltimore, MD 21205 3M Company 3M Company Michael E. Stewart Commercial Care Division, 3M Center-Bldg. 223-2N-21, St. Paul MN 55144 3M Company Dalco Enterprise, Joni Miklya 300 5th Avenue West, New Inc. Brighton, MN 55112 Restore Cleaning Restore Linda Hanson 79 13th Ave. NE, Suite 209, Products Minneapolis, MN 55413 Dalco Enterprise, Dalco Enterprise, Mark Miller 300 5th Avenue NW, New Inc. Inc. Brighton, MN 55112 25 Phone Email 651-5018908 [email protected] om 800-6387370 800 917 1937 felliott@chemspec world.com 651-2516614 612-3313605 651-6042966 joni.miklya@dalco online.com linda@restoreprod ucts.com mark.miller@dalco online.com Other Known Cleaning Product Distributors in Minnesota (these did not respond to our solicitation letter) Product Distributor Contact Person Address Phone Email Manufacturer Dalco Enterprise, Dalco 300 5th Avenue NW, New 651-251jeff.madsen@dalco Inc. Enterprise, Inc. Jeff Madsen Brighton, MN 55112 6651 online.com 651-293Ecolab, Inc Ecolab Inc. Kathleen Hall 370 Wabasha Street, St. Paul 2291 Brissman 296 East Pennsylvania Avenue, St. 800-327Ecolab, Inc Dione Johnson Kennedy Paul MN 55101 3528 9001 Wyoming Avenue North, 763-488Ecolab, Inc Unisource Steve Elert Brooklyn Park, MN 55445 7200 810 South 48th Street, Grand 800-289Ecolab, Inc Lystads Paul Niffenegger Forks, ND 58201 7837 Heartland Paper 808 West Cherokee, Sioux Falls, 800-843SD 57104 7922 Ecolab, Inc Company Dwight Dexter Brissman 296 East Pennsylvania Avenue, St. 800-3273M Company Dione Johnson Kennedy Paul MN 55101 3528 Heartland 808 West Cherokee, Sioux Falls, 800-843Paper 3M Company Company Dwight Dexter SD 57104 7922 3001 17th Street South, Moorhead, 218-2333M Company Stein's Bob Remark MN 56560 2727 Naturally 1926 South Glenstone Avenue 417-889Naturally Yours Shelly Gervais Yours #406, Springfield, MO 65804 3995 Premium 343 Maple Island Road, 612-386chuck.holien@hot Envirox Chuck Holien mail.com Products Burnsville, MN 55306 5748 jefff@ecoconcepts 2450 Northeast Miami Gardens 888-326EcoConcepts EcoConcepts Michelle Supraski Drive Suite 100, Miami, FL 33180 6278 usa.com [email protected] 274 Apollo Drive, Lino Lakes, MN 800-950Hillyard Hillyard John Dalman 55014 7660 om 26 Primary References The following references were relied upon the most for developing the Best Practices to Prevent Environmental Asthma Triggers in Child Care. 1. Greater Minneapolis Day Care Association, Healthier Housing Survey. 2. California Childcare Health Program. Health and Safety Policies Checklist. Available at http://www.ucsfchildcarehealth.org/. 3. Colorado State Board of Health. Rules and Regulations Governing the Health and Sanitation of Child Care Facilities. 2005 Available at http://www.tchd.org/pdfs/childcare_sanitary_standards.pdf. 4. Ohio Department of Health. Managing Asthma in Ohio Child Care Facilities. Available at http://jfs.ohio.gov/cdc/Training.stm. 5. Minnesota Department of Human Services, Child Care Center Rule 9503. Available at http://www.revisor.leg.state.mn.us/arule/9503/ 6. Dautel, P.J., et al., Asthma Triggers in the Elementary School Environment: A Pilot Study. Journal of Asthma, 1999. 36(8): p. 691-701. 7. U.S. Environmental Protection Agency, Indoor Air Quality Tools for Schools Action Kit. 2nd ed. 2000, Washington, D.C. 8. Washington State Department of Health, School Indoor Air Quality Best Management Practices Manual. 1995, Washington State Department of Health, Environmental Health Programs: Olympia. 9. Minnesota Department of Education, Indoor Air Quality Operations and Maintenance Manual. 1997. 10. U.S. Environmental Protection Agency, Building Air Quality: A Guide for Building Owners and Facility Managers. 1991. Available at http://www.epa.gov/iaq/largebldgs/baqtoc.html 11. Tranter, D.C., Indoor Allergens in Settled School Dust: A Review of Findings and Significant Factors. Clinical and Experimental Allergy, 2005. 35: p. 126-136. 12. Minneapolis Public Schools, Acceptable Indoor Air Quality for School Construction Projects. 1997 Minneapolis. Available at http://www.health.state.mn.us/divs/eh/indoorair/schools/plan/appdxg.pdf 13. Minnesota Department of Health. Indoor Air Quality Management Plan Development Package. 2001 Available at http://www.health.state.mn.us/divs/eh/indoorair/schools/plan/index.html. 14. Connecticut Department of Public Health, Managing Asthma in Connecticut Schools: A Resource Manual. 2002. 15. Minnesota Department of Health Indoor Air Unit, Model School Environmental Asthma Management Plan: A New Tool to Evaluate and Improve the School Environment. 2005: St. Paul. Available at http://www.health.state.mn.us/divs/eh/indoorair/schools/plan/asthmaplan.htm Rev 8/07 27
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