Child Care Facilities
Presented by Amy Gammel
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Overview of Department
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General Review of Sanitizing and Disinfecting
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History of Bleach Use
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Using Bleach to Sanitize
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Using Bleach to Disinfect
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Alternate Solutions
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Determining Approval for Disinfectants
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Determining Approval for Sanitizers
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FAQ’s
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Questions
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Colorado Department of Public Health and Environment (CDPHE)
“The Department” is the regulatory authority for the Rules and
Regulations Governing Health and Sanitation of Child Care
Facilities.
The child care program is housed in the Division of
Environmental Health and Sustainability (DEHS), Delegated
Programs Unit (DPU). Therese Pilonetti is the program manager.
Amy Gammel is the lead Environmental Protection Specialist.
The DPU unit also implements the retail food establishment and
schools programs.
CDPHE delegates authority to local public health agencies to
enforce regulations with the exception of counties where the
local program does not do inspections.
Child Care
Facilities in
these counties
are inspected
by CDPHE and
not the local
agency.
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Sanitization: reduces bacterial count,
including pathogens, to a safe level.
◦ Use on food contact surfaces, tables, toys etc.
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Disinfecting: eliminates most or all
pathogenic microorganisms.
◦ Use on diaper tables, surfaces contaminated with
high hazard body fluids (urine, feces, blood, vomit,
sputum, mucus)
Sanitizing
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Toys: Weekly*
Bedding, Mattresses etc.:
Weekly* or between use
of another child
Water Tables: Daily and
between groups of
children
Food Contact Surfaces:
per RFE regulations
Disinfecting
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Diaper Tables: after
each use
Toilet Seat Inserts:
after each use
Surfaces Contaminated
w/ HHBF: immediately
*When items are placed in mouth or contaminated, they shall be
sanitized prior to use by another child. If contaminated with a HHBF,
item shall be disinfected.
RFE: Retail Food Establishment
HHBF: High Hazard Body Fluid
Sanitizers
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Test strips are required
for sanitizing solutions
Sanitizing solutions shall
be made and/or tested
daily
Sanitizing solutions
obtained in a ready to
use solution do not
require testing
Disinfectants
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Disinfectants shall be mixed
daily in facilities that have
children in diapers, unless
obtained in a ready to use
solution
Daily testing is acceptable
in lieu of daily mixing
In other facilities that do
not have children in
diapers, disinfectants can
be made as needed
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All secondary containers of sanitizers &
Disinfectants must be labeled with the
content and intended use:
◦ Sanitizer/chemical name for Tables/Toys
◦ Disinfectant/chemical name for bathrooms
** Solutions shall be readily accessible to caregivers
and inaccessible to children
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Historically most child care providers have used household
bleach as a sanitizer and disinfectant.
Before Clorox was a registered pesticide, it was still
acceptable as a sanitizer and disinfectant because it was
deemed as safe and effective. This was the only chemical
sanitizer/disinfectant that did not need to be EPA
approved.
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Providers wanting an alternative to bleach have typically
used a quaternary ammonium solution for a sanitizer.
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Providers have rarely used any bleach alternates for
disinfecting due to long contact times of products.
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When Clorox registered household bleach
with EPA, the instructions for use as a
disinfectant conflicted with previous guidance
issued and what is stated in the regulations.
The Department had to issue new guidance
because the regulations also state that all
products have to be used according to EPA
registered labeled instructions.
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A guidance sheet intended for child care
providers was distributed by the Department.
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An interpretive memo was issued by the
Department and distributed to local health
agencies.
Environmental health inspectors were made
aware of changes and are providing education to
child care providers.
Department is a resource to child care providers
in direct service counties, agencies that work
with child care providers, and local health
agencies.
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Bleach is an approved sanitizer if mixed and used
according to the labeled instructions
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For sanitizing the solution shall be maintained
between 50-200 ppm
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Most bleach solutions are now manufactured with
8.25% sodium hypochlorite (active ingredient)
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Determine the % of hypochlorite:
Active Ingredient:
Sodium Hypochlorite……….…8.25%
OTHER INGREDIENTS…….91.75%
TOTAL……………………….100%
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If a bottle contains 5.25% or 6% hypochlorite, refer to
label for mixing instructions or previous guidance
Most bleach that is sold today contains 8.25%
hypochlorite, refer to table below for mixing
instructions
Concentration
Amount of Bleach
(8.25%)
Amount of Water
100 ppm
1 tsp
1 gallon (128 oz)
100 ppm
¼ tsp
1 quart (32 oz)
100 ppm
1/8 tsp
1 pint (16 oz)
Mixing instructions were obtained from EPA registration
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There were no changes to the USE of bleach
as a sanitizer
The only change was the amount of bleach to
mix if using an 8.25% hypochlorite product
Sanitizers are to be tested daily
If inspectors see a violation related to the use
of bleach as a sanitizer it will be marked as a
violation
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Bleach is an approved disinfectant if mixed and used
according to the labeled instructions
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Refer to labeled instructions on bottle used by facility
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Contact time and rinsing if required must be followed
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Most measurements on the label are calculated per
gallon
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Not all establishments mix this quantity and my need
help determining mixing instructions for smaller
batches
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Example: Bottle instructs to mix ½ cup
bleach to 1 gallon water. Provider may only
use 1 quart (32 oz) or 1 pint (16 oz)
containers and may need help with the
conversion.
Amount of Bleach
Amount of Water
½ Cup
1 gallon
2 Tbsp
1 quart
1 Tbsp
1 pint
**This chart is for example purposes only and not a
standardized recipe for disinfecting solutions. Follow
instructions on label for mixing instructions.
Liquid measurements helpful in making conversions:
1 Tbsp=3 tsp
1 oz= 2 Tbsp
1 cup= 8 oz
1 pint=2 cups= 16 oz
1 quart= 4 cups= 2 pints= 32 oz
1 gallon= 4 quarts= 8 pints= 16 cups= 128 oz
Tip: Covert everything into the same measurement (ex. Ounces)
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At the first inspection, inspectors may take an
educational approach
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If a provider wishes to use bleach, it shall be used
according to the labeled instructions moving forward
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Assistance should be given to providers in
determining the % of hypochlorite and reading the
label
At corresponding inspections if the bleach is not used
according to the labeled instructions, it will be
marked as a violation
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Changes to the use of bleach as a disinfectant
may not have an impact on child care programs
with preschool age children and older
This change may have a larger impact on
programs with infants and toddlers
Program changes can be made to accommodate
contact times such as additional diaper tables,
scheduling, staffing etc.
There are alternate products with lower contact
times and no rinse step
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There are other products approved for use
aside from household bleach
Most common active ingredients include
sodium hypochlorite, hydrogen peroxide and
quaternary ammonium
More child care providers are moving toward
using green products
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Disinfectants
◦ Is the product EPA registered? What is the number?
◦ Is it a hospital grade disinfectant?
 Effective against
 Salmonella choleraesuis(enterica);
 Staphylococcus aureus; and,
 Pseudomonas aeruginosa
◦ Is the chemical used in accordance to the EPA labeled
instructions including:
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Concentration
Contact Time
Method
Surfaces
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Product labels contain valuable information needed to determine
approval but do not rely solely on the label
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Always cross reference the National Pesticide Information Retrieval
System: http://state.ceris.purdue.edu/ for the EPA registration
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Look for key words such as: for use in schools, daycare centers,
hospitals etc.
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Look for keywords such as: use on diaper tables, exam tables, medical
devices (items that normally have contact with skin)
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Note: There is no requirement for contact time, however the product
must be used according to the label. Is this contact time practical?
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Use your judgment, does the use seem practical ?
◦ Examples: product may meet criteria but it is intended for toilet bowls, product has a
10 minute contact time etc.
Click on Colorado
Search by EPA Reg no, product name, company, or
active ingredient. Note, if the product is not
registered in Colorado it will not be displayed and is
not permitted to be sold in the state.
Provides EPA
Registration
Provides label if
submitted to CDA
electronically
Click on the Company Label ID to view the label.
Click on the
most recent
approval date
when viewing
registrations
This is the cover
page of the EPA
registration. Scroll
through document
to find information
needed. The
document can be
printed or saved as
a pdf if desired.
These products have been evaluated by DEHS and are approved to be used as a
disinfectant in child care facilities. The list of products does not represent
endorsement by CDPHE.
This list is intended as a resource for child care providers inquiring about
alternate disinfecting solutions. This is not intended for mass distribution.
The instructions on a product label or EPA registration supersedes any
information listed here.
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Sanitizers
◦ Is the product EPA registered? What is the number?
◦ Is the active ingredient listed in 40 CFR 180.940
“Approved Sanitizers”?
◦ Is the chemical used in accordance to the EPA
labeled instructions including:
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Concentration
Contact Time
Method
Surfaces- food contact surfaces
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Look at the “directions for use” on the label for information needed to determine
approval but do not rely solely on the label
Cross reference the National Pesticide Information Retrieval System:
http://state.ceris.purdue.edu/ for EPA registration
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Look for key words such as: use in restaurants, food establishments, deli’s etc.
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Look for keywords such as: use on food contact surfaces
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Refer to 40 CFR 180.940 (search for electronic copy) to verify the active ingredient
is an approved sanitizer
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Note: A rinse step can not be required for a sanitizing product to be approved
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Note: Household bleach used can not contain a scent
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Note: Products intended for residential use only (with the exception of household
bleach) are not approved sanitizers for food contact surfaces
Quaternary Ammonium (QA): There are several products with the active
ingredient of a quaternary ammonium compound that are approved for
food contact surfaces.
Places to purchase quaternary ammonium products:
•Restaurant supply stores
•Companies that distribute chemicals to restaurants
(Autochlor, Eco Lab etc.)
Concentration: It is critical that the concentration on the label is
followed because there are different compound variations of this
chemical. Example: If the directions state the concentration
needs to be 200 ppm, this is what needs to be followed. If the
directions state the concentration needs to be between 150-400
ppm, this is what needs to be followed.
Test Strips: The test strips can be purchased in the same location
as the product. Note: chlorine test strips will not work for QA
products.
Sanidate Ready To Use is a product that has been evaluated by the
Department and meets approval criteria for sanitizers for food contact
surfaces.
Active Ingredient: Hydrogen Peroxide
EPA Registration No: 70299-9
Colorado Registration No: 50465
Testing: This is a ready to use product and does not require testing.
Note: There are directions for residential use and commercial use, follow
directions for commercial use of food contact surfaces.
**Sanitizers not listed in this presentation should
be reviewed by the regulatory agency prior to use.
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Can I purchase 3% hydrogen peroxide and mix it with water to create a
sanitizer and/or disinfectant?
No. To date over the counter hydrogen peroxide is not EPA registered.
Instructions are relevant to first aid.
Is ozone an approved sanitizer and/or disinfectant?
No. The device that mixes ozone to make an aqueous solution is
registered but the solution is not. This product has not gone through
efficacy testing and is not listed on 40 CFR 180.940 (approved sanitizers)
The only approved use for ozone at this time is as an antimicrobial produce
wash.
Is the new guidance for disinfectants applicable to norovirus outbreaks in
child care facilities?
For norovirus outbreaks refer to “Infectious Diseases in Child Care and
School Settings.” This document can be found on CDPHE’s website.
Is Benefect Decon 30 Disinfectant an approved sanitizer and/or
disinfectant?
This product meets the approval criteria as a disinfectant but has a 10
minute contact time. For a sanitizer, this has not been determined. The
active ingredient Thymol is not listed in 40 CFR 180.940 as an approved
sanitizer for food contact surfaces. The directions for use are a little vague.
The label and EPA registration have been forwarded to FDA for evaluation.
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Are household Clorox wipes acceptable for sanitizing?
Any product intended for household or residential use is not
approved for commercial use. Typically these products have a
very high concentration of quaternary ammonium that exceeds
the limit for a food contact surface.
What qualifies as a secondary rinse after disinfecting?
Rinsing with water is sufficient. This could be done by spraying
water on surface and allowing it to air dry or wiping with it away
with a paper towel. This could also be accomplished by taking a
wet paper towel and wiping the surface. A cloth towel would
not be acceptable for this use.
Do door handles or similar fixtures require a rinse/wipe step?
If the direction on the label state a rinse step is required then
this would apply to all surfaces the solution is being applied to.
Has anyone identified an affordable alternative to bleach as a
disinfectant?
Boulder County Public Health has done a cost analysis on Oxivir
TB (EPA reg. no. 70627-56) and found that it costs .12 per
ounce.
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Household bleach is still an approved
chemical, when mixed correctly, for sanitizing
and disinfecting.
The product label of any chemical used must
be followed.
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Rules and Regulations Governing the Health and
Sanitation of Child Care Facilities are scheduled
to be revised in 2015. If you would like to be on
CDPHE’s stakeholder list please contact Amy
Gammel at [email protected] or
(303)692-3644
In the message, please indicate what type of
stakeholder you would like to be:
◦ Active involvement in process (includes attending
meetings and completing assigned work)
◦ Notification list (will receive updates throughout process)
Contact Information:
Colorado Department of Public Health & Environment
Division of Environmental Health & Sustainability
4300 Cherry Creek Drive South
Denver, CO 80246
(303)692-3645- Main
http://www.colorado.gov/cdphe/dehs
Thank you for your participation!