Rationale 

GHC understands that infectious diseases can be prevented through appropriate hygiene and sanitation practices. Bacterial cultures of environmental surfaces in facilities, which are used to gauge the adequacy of sanitation and hygiene practices, have demonstrated evidence of fecal contamination. Contamination of hands, toys, and other equipment in the room has appeared to play a role in the transmission of diseases in child care settings. Regular and thorough cleaning of toys, equipment, and rooms helps to prevent transmission of illness.

GHC requires that posted signs regarding the proper steps to hand washing provide frequent reminders to staff and orientation for new staff. Education of caregivers/teachers regarding handwashing, cleaning, and other sanitation procedures can reduce the occurrence of illness in the group of children with whom they work.

Illnesses may be spread by way of:

1. Human waste (such as urine and feces);

2. Body fluids (such as saliva, nasal discharge, eye discharge, open skin sores, and blood);

3. Direct skin-to-skin contact;

4. Touching a contaminated object;

5. The air (by droplets that result from sneezes and coughs).

Since many infected people carry communicable diseases without symptoms, and many are contagious before they experience a symptom, caregivers/teachers need to protect themselves and the children they serve by carrying out, on a routine basis, standard precautions and sanitation procedures that approach every potential illness-spreading condition in the same way.

Handling food in a safe and careful manner prevents the spread of bacteria, viruses, and fungi. Outbreaks of foodborne illness have occurred in many settings, including childcare facilities.

GHC requires that all center-based programming and related programs conform to the applicable portions of the U.S. Food and Drug Administration model food sanitation standards and all applicable state and local food service rules and regulations for centers and large and small family child care homes regarding safe food protection and sanitation practices. If federal model standards and local regulations are in conflict, the health authority with jurisdiction should determine which requirement the facility must meet.

Kitchen & Food Prep Areas 

The food preparation area of the kitchen should be separate from eating, play, laundry, toilet, and bathroom areas and from areas where animals are permitted. The food preparation area should not be used as a passageway while food is being prepared. Food preparation areas should be separated by a door, gate, counter, or room divider from areas the children use for activities unrelated to food.

 Infants and toddlers should not have access to the kitchen in a center-based. Access by older children to the kitchen of centers should be permitted only when supervised by staff members who have been certified by the nutritionist/registered dietitian or the center director as qualified to follow the facility’s sanitation and safety procedures.

GHC does permit children to be in the center kitchen. Children of preschool age and older should be restricted from access to areas where hot food is being prepared. School-age children may engage in food preparation activities with adult supervision in the kitchen or the classroom. Parents/guardians and other adults should be permitted to use the kitchen only if they know and follow the food safety rules of the facility. 

The kitchen should be used only by authorized individuals who have met the requirements of the local health authority and who know and follow the food safety rules of the facility so they do not contaminate food and food surfaces for food-related activities. Under adult supervision, school-age children may be encouraged to help with developmentally appropriate food preparation, which increases the likelihood that they will eat new foods. 

Cleaning and Sanitation 

Areas and equipment used for storage, preparation, and service of food should be kept clean. All of the food preparation, food service, and dining areas should be cleaned and sanitized before and after use. Food preparation equipment should be cleaned and sanitized after each use and stored in a clean and sanitary manner and protected from contamination.

 Sponges should not be used for cleaning and sanitizing. Disposable paper towels should be used. If washable cloths are used, they should be used once, then stored in a covered container and thoroughly washed daily. Microfiber cloths are preferable to cotton or paper towels for cleaning tasks because of microfiber’s numerous advantages, including its long-lasting durability, ability to remove microbes, ergonomic benefits, superior cleaning capability, and reduction in the number of chemicals needed.

 Cutting boards should be made of nonporous material and should be scrubbed with hot water and detergent and sanitized between uses for different foods or placed in a dishwasher for cleaning and sanitizing. The facility should not use porous wooden cutting boards, boards made with wood components, and boards with crevices and cuts. Only hard maple or an equivalently hard, close-grained wood (e.g. oak) may be used for cutting boards. 

Washing Dishes in a Sink:

 Reusable food service equipment and eating utensils should be first scraped to remove any leftover food, washed thoroughly in hot water containing a detergent solution, rinsed, and then sanitized by one of the following methods:

1. Immersion for at least two minutes in a lukewarm (not less than 75°F) chemical sanitizing solution. Bleach may be used as a sanitizing solution when diluted according to the manufacturer's instructions. The sanitized items should be air-dried; or

2. Immersed in an EPA-registered sanitizer following the manufacturer’s instructions for preparation and use; or

3. Complete immersion in hot water and maintenance at a temperature of 170 °F for not less than thirty seconds. The items should be air-dried (1);

4. Or, other methods if approved by the health department.

Food Sanitizing and Cleaning  

Food thermometers must be sanitized with alcohol wipes before and after each use.   Food preparation surfaces will be washed, rinsed, and sanitized before and after use.  All equipment, utensils, and tableware will be washed, rinsed, and sanitized according to the required procedures after use.  Wiping cloths shall be cleaned and rinsed in a sanitizing solution. Disposable wiping cloths will not be reused and will be discarded daily.  The food-safe sanitizer should be utilized in kitchen areas and on lunch tables.   Daily, weekly, and monthly cleaning schedules are completed and recorded daily.  Garbage needs to be removed frequently and no trash may be left in the kitchen at the end of the working day. Garbage cans must be cleaned at least once a week or as often as needed. Health Aides will conduct internal inspections quarterly to assure compliance with Federal, State, and local standards. Evidence of compliance with all applicable Federal, State, and local food safety and sanitation laws will be available.

Food Service & Kitchen Equipment 

The design, installation, operation, and maintenance of food service equipment must follow the manufacturer’s instructions and meet the standards for such equipment to ensure that the equipment protects the users from injury and the consumers of foods prepared with this equipment from foodborne disease. The manufacturer’s warranty that the equipment will meet recognized standards is valid only if the equipment is properly maintained. GHC requires  Food service equipment should be designed, installed, operated, and maintained according to the manufacturer’s instructions and in a way that meets the performance, health, and safety standards of the National Sanitation Foundation or applicable State or local public health authority, or the U.S. Department of Agriculture (USDA) food program and sanitation codes, as determined by the regulatory public health authority. 

All surfaces that come into contact with food, including tables and countertops, as well as floors and shelving in the food preparation area, should be in good repair, free of cracks or crevices, and should be made of smooth, nonporous material that is kept clean and sanitized. All kitchen equipment should be clean and should be maintained in operable condition according to the manufacturer’s guidelines for maintenance and operation. GHC requires that each site and program maintain an inventory of food service equipment that includes the date of purchase, the warranty date, and a history of repairs.

 Ventilation

In centers using commercial cooking equipment to prepare meals, ventilation should be equipped with an exhaust system in compliance with the applicable building, mechanical, and fire codes. These codes may vary slightly with each locale, and centers are responsible for ensuring their facilities meet the requirements of these codes. All gas ranges in centers should be mechanically vented and fumes filtered prior to discharge to the outside. All vents and filters should be maintained free of grease build-up, and food spatters and in good repair.

Microwave Ovens

Microwave ovens should be inaccessible to all children, with the exception of school-age children under close adult supervision. Any microwave oven in use in a childcare facility should be manufactured after October 1971 and should be in good condition. While the microwave is being used, it should not be left unattended.

If foods need to be heated in a microwave:

1. Avoid heating foods in plastic containers;

2. Avoid transferring hot foods/drinks into plastic containers;

3. Do not use plastic wrap or aluminum foil in the microwave;

4. Avoid plastics for food and beverages labeled “3” (PVC), “6” (PS), and “7” (polycarbonate);

5. Stir food before serving to prevent burns from hot spots.

Food Preparations & Illness 

Food handlers who are ill can easily transmit their illness to others by contaminating the food they prepare with the infectious agents they are carrying. Frequent and proper handwashing before and after using plastic gloves reduces food contamination.

Caregivers/teachers who work with infants and toddlers are frequently exposed to feces and to children with infections of the intestines (often with diarrhea) or of the liver. Education of child care staff regarding handwashing and other cleaning procedures can reduce the occurrence of illness in the group of children with whom they work.

The possibility of involving a larger number of people in a foodborne outbreak is greater in child care than in most households. Cooking larger volumes of food requires special caution to avoid contamination of the food with even small amounts of infectious materials. With larger volumes of food, staff must exercise greater diligence to avoid contamination because larger quantities of food take longer to heat or to cool to safe temperatures. Larger volumes of food spend more time in the danger zone of temperatures (between 41°F and 135°F) where more rapid multiplication of microorganisms occurs .

Anyone who has signs or symptoms of illness, including vomiting, diarrhea, and infectious skin sores that cannot be covered, or who potentially or actually is infected with bacteria, viruses or parasites that can be carried in food, should be excluded from food preparation and handling. Staff members may not contact exposed, ready-to-eat food with their bare hands and should use suitable utensils such as deli tissue, spatulas, tongs, single-use gloves, or dispensing equipment. No one with open or infected skin eruptions should work in the food preparation area unless the injuries are covered with nonporous (such as latex or vinyl), single use gloves.

In centers and home visiting programs , staff members who are involved in the process of preparing or handling food should not change diapers. Caregivers/teachers who prepare food should wash their hands carefully before handling any food, regardless of whether they change diapers. When caregivers/teachers must handle food they must have a the required safe serve certification (annually) caregivers/teachers of infants and toddlers before the caregiver/teacher assumes other caregiving duties for that day. Aprons worn in the food service area must be clean and should be removed when doing other activities not related to food preparation.

Food Storage 

Storage of food off the floor in a safe and sanitary manner helps prevent food contamination from cleaning chemicals or spills of other foods and keeps insects and rodents from entering the products. Foods not requiring refrigeration should be stored at least six inches above the floor in clean, dry, well-ventilated storerooms or other approved areas . Food products should be stored in such a way (such as in nonporous containers off the floor) as to prevent insects and rodents from entering the products. 

Dry, bulk foods that are not in their original, unopened containers should be stored off the floor in clean metal, glass, or food-grade plastic containers with tight-fitting covers. All bulk food containers should be labeled and dated, and placed out of children’s reach. Children should be permitted to handle household-size food containers during adult-supervised food preparation and cooking activities and when the container holds a single serving of food intended for that child’s consumption 

Covering food protects it from contamination and keeps other food particles from falling into it. Hot food cools more quickly in a shallow container, thereby decreasing the time when the food would be susceptible to contamination. Foods should be covered only after they have cooled. Leaving hot food uncovered allows it to cool more quickly, thereby decreasing the time when bacteria may be produced. All food stored in the refrigerator should be tightly covered, wrapped, or otherwise protected from direct contact with other food. Hot foods to be refrigerated and stored should be transferred to shallow containers in food layers less than three inches deep and refrigerated immediately. These foods should be covered when cool. Any pre-prepared or leftover foods that are not likely to be served the following day should be labeled with the date of preparation before being placed in the refrigerator. The basic rule for serving food should be, “first food in, first food out”.

In the refrigerator, raw meat, poultry and fish should be stored below cooked or ready to eat foods.

Disposal of Food 

Served foods have a high probability of contamination during serving. Bacterial multiplication proceeds rapidly in perishable foods out of refrigeration, as much as doubling the numbers of bacteria every fifteen to twenty minutes.

The potential is high for perishable foods (food that is subject to decay, spoilage, or bacteria unless it is properly refrigerated or frozen) that have been out of the refrigerator for more than two hours to have substantial loads of bacteria. This time can be as short as one hour if the air temperature is above 90°F. When such food is stored and served again, it may cause foodborne illness.

Food returned from individual plates and family style serving bowls, platters, pitchers, and unrefrigerated foods into which microorganisms are likely to have been introduced during food preparation or service, should be immediately discarded.

Unserved perishable food should be covered promptly for protection from contamination, should be refrigerated immediately, and should be used within twenty-four hours. “Perishable foods” include those foods that are subject to decay, spoilage or bacteria unless it is properly refrigerated or frozen (1).

Hot food can be placed directly in the refrigerator or it can be rapidly chilled in an ice or cold water bath before refrigerating. Hot foods should be promptly cooled first before they are fully covered in the refrigerator. Prepared perishable foods that have not been maintained at safe temperatures for two hours or more should be discarded immediately. If the air or room temperature is above 90°F, this time is reduced to one hour after which the food should be discarded (2). “Safe temperatures” mean keeping foods cold (below 41°F) or hot (above 135°F) (4).