Infection Prevention, Control and Management
Reporting Diseases to Public Health
The A-Z List of Diseases of Public Health Significance can be printed and posted in the centre for staff to see.
Report a Disease of Public Health Significance
To report a disease of public health significance to public health, please contact our Infectious Diseases Control Team 519-663-5317, or after-hours at 519-663-5317, option 2.
Be prepared to supply the following:
- name of the child and parent
- date of birth
- address
- telephone number
- physician’s name
- name of hospital if child is admitted
- immunization information
Outbreaks
When several children and/or staff become ill in a 48-hour period, notify the Infectious Disease Team immediately at 519-663-5317. Health unit staff will help identify if there is an outbreak and may also assist in managing the outbreak.
Be aware of any children in the childcare centre who are immuno-compromised, these children may need special attention.
Refer to the Guide to Common Childhood Infections for exclusion guidelines.
Infection Prevention Measures:
- regular hand washing by children, staff, and volunteers
- cleaning and disinfection practices of entire centre, toys and equipment
- up-to-date immunization for children and staff
- exclusion and isolation of ill children, staff and volunteers
- proper respiratory etiquette (i.e., teaching children to sneeze or cough into their elbows)
Routine Practices
Routine practices protect you by stopping the spread of blood-borne infections. These practices should be used whenever there is a risk of exposure to blood or body fluids. Body fluids include vomit, feces, and fluids from coughing or sneezing.
Handwashing
- wash hands after touching blood, body fluids, and contaminated items, even when gloves are worn
- use alcohol-based hand rubs unless hands are visibly soiled
Gloves
- wear gloves when touching blood, body fluids and contaminated items
- remove gloves right after use, before touching other items and surfaces
- wash your hands right after removing gloves
PPE – Personal Protective Equipment
- wear eye protection and gowns if there is a chance of blood or body fluids splashing
Cleaning and Disinfection
- clean and disinfect items or surfaces soiled with blood and body fluids
Handwashing
Handwashing is an important infection prevention measure. There are some considerations that may be more specific to childcare centres:
Moments for hand hygiene:
- when children, staff and volunteers arrive
- after using the bathroom or changing diapers
- after coughing, sneezing or blowing your nose, or assisting a child
- after contact with someone who is sick
- before eating and preparing food
- before touching your, or a child’s mouth, eyes, nose or open cuts
- after touching animals, their waste (poop), their food or treats
- anytime hands look dirty
Special considerations for hand hygiene of children:
Educators should assist with handwashing for young children. For older children:
- tell them how to wash hands correctly
- show how to wash hands
- remind that washing hands will help them from getting sick
Alcohol-Based Hand Rub (Hand Sanitizer)
Alcohol-based hand sanitizers are an effective tool when hands are not visibly soiled, and soap and water is not available.
Soap and water should always be used:
- before preparing food
- after handling raw meat products
- after using the washroom
- when hands are heavily contaminated
- in between diaper changes
Cleaning and Disinfecting
Toys, play equipment and surfaces can be an excellent reservoir for pathogenic microorganisms that are present in saliva, respiratory secretions, feces and other bodily fluids (IPAC, 2016).
Follow Proper Cleaning and Disinfection Steps:
- Clean items with soap and warm water to remove contaminants and visible dirt or debris.
- Rinse with clean water.
- Use an approved sanitizing solution (see below) according to dilution and contact time requirements, or along with manufacturer’s instructions.
- Allow sanitizer to remain wet on surfaces for a minimum of 45 seconds to allow proper disinfection.
- Rinse with clean water.
- Allow items to air-dry before storing.
Implement the Following Practices:
- policy and written procedure outlining routine cleaning and disinfection practices
- new/temporary staff and volunteers provided with training on practices (IPAC, 2016)
- cleaning and disinfection logs ensure consistent cleaning and disinfection practices
- store soiled toys and equipment separately (i.e., dirty/used toy bin) until they can be cleaned and disinfected (IPAC, 2016)
To reduce the risks associated with sanitizing solutions, all chemicals must be stored in a locked cupboard, out of reach of children and away from food products.
Use Approved Disinfectants:
Toys, equipment and surfaces must be disinfected using an approved process with proper dilution and contact times, or according to manufacturer’s instructions. Commonly used sanitizing solutions include:
- Chlorine (bleach)
- Quaternary ammonium
- Accelerated hydrogen peroxide
- Test strips ensure adequate concentrations
- mechanical/chemical dishwashers can be used for some toys
- In an outbreak situation, cleaning and disinfection practices may be subject to change
Cleaning and Disinfection Frequency
Using these resources ensures consistency in infection prevention and control practices for Child Care Centres in Ontario:
Reducing Spread of Infection and Illness
The Daily Observation of Children section in the Child Care Licensing Manual discusses best practices for illness.
- Staff should note signs/symptoms of illness
- Policies and procedures should be clear around isolating child with illness, notifying parents/guardians and receiving medical attention if needed
- Policies around exclusion from the centre (i.e. fever-free for 24 hours)
Our Guide to Common Childhood Infections has information that will help determine appropriate exclusion criteria.
Management of Human Bites at Your Facility
Biting incidents can be distressing for all children involved, parents/guardians as well as childcare staff. Child bites are no longer reportable to MLHU. For information on risks associated with bites, contact MLHU Infectious Disease Control team at 519-663-5317 or visit your healthcare provider.
Administration of Drugs or Medication
Childcare centres are not required to administer medication to children. If a centre does choose to administer medication to children, specific requirements must be met. For further information, visit O. Reg. 137/15, section 40, and Childcare Licensing Resources.
This is different from requirements for an Anaphylactic Policy. This is not optional.
Animal Management
Animals can provide invaluable learning opportunities, but consideration should be taken for:
- cleanliness
- transmission of infections
- safety (bites and scratches)
- allergies
Proper policies and procedures around different types of animals can help mitigate some of these risks. Refer to Recommendations for the Management of Animals in Child Care Settings (Ministry of Health and Long-Term Care) for more information.
GENERAL, O Reg, 137/15. Retrieved from: https://www.ontario.ca/laws/regulation/150137
IPAC Canada. (2016). Infection Prevention and Control (IPAC) Program Standard. Retrieved from: https://ipac-canada.org/wp-content/uploads/2025/03/IPAC_PROGRAM_STANDARD_2016-1.pdf
Public Health Ontario: Provincial Infectious Diseases Advisory Committee. (2018). Best practices for environmental cleaning for prevention and control of infections in all health care settings, 3rd edition. Retrieved from: https://www.publichealthontario.ca/-/media/Documents/B/2018/bp-environmental-cleaning.pdf?rev=5dfe8f638f01400ea2640910902d789d&sc_lang=en&hash=36853FC2FDC3434AA7632BF9018EA48F
Public Health Ontario: Provincial Infectious Diseases Advisory Committee. (2014). Best practices for hand hygiene in all health care settings. Retrieved from: https://www.publichealthontario.ca/-/media/documents/b/2014/bp-hand-hygiene.pdf