Administrative health policies and procedures assist child care centre operators in ensuring that staff are trained and aware of infection prevention and control (IPAC) practices specific to the child care centre and how they apply to their daily activities.
- Polices set out general directions on a specific matter (describes who, what and why).
- Procedures describe the step-by-step instructions for tasks that should be done in order to fulfill a policy.
Refer to site-specific surveillance data, professional practice guidelines, standards and pertinent legislative requirements when developing policies and procedures. Child care centre operators can also contact Toronto Public Health (TPH) and speak with a public health inspector about child care IPAC policy and procedure development.
Policies and procedures:
- should be specific to the individual child care centre
- should be reviewed by child care centre staff
- must be maintained in a written format to serve as a resource for providers responsible for their implementation
- should be practical to implement
- should be reviewed and updated annually, or as necessary, to incorporate the most current evidence, data and best practices
- should be included as part of staff training
Required Administrative Health Policies & Procedures
Child care centres require individualized policies and procedures that at a minimum cover the management of communicable diseases, infection prevention and control and outbreak management.
Managing Communicable Diseases
Each child care centre must develop, maintain and implement a policy and procedure on the management of communicable diseases that at a minimum, include the following components:
Management, Surveillance and Reporting of Diseases Policy and Procedure
This policy and procedure relates directly to how a child care centre identifies, manages, responds to and reports diseases of public health significance. At a minimum, the following components must be included in the policy and procedure:
- Surveillance (e.g., observing children for illness upon arrival, recording symptoms, absences after outings, special events etc.).
- Monitoring for an increase from baseline illness levels among staff and children. Baseline incidence is the normal level of illness in a given place and time.
- Methods and contact information for reporting diseases of public health significance to Toronto Public Health (TPH).
- Reference to the Exclusion and Isolation/Cohorting Policy and Procedure.
Exclusion and Isolation/Cohorting of Ill Children & Staff Policy and Procedure
This policy and procedure outlines the steps a child care centre will take to:
- isolate/cohort children and staff who become ill while attending the child care centre until they can be picked-up
- exclude ill children and staff from the child care centre
At a minimum, the following components must be included in the policy and procedure:
- Signs and symptoms of reportable diseases (diseases of public health significance).
- A designated room or area to isolate/cohort ill children until they can be picked up.
- Exclusion criteria (e.g., illness that prevents child from participating in activities; greater need for care than the staff can provide; illness poses a serious health risk if spread to others).
- Reference to Guidelines for Common Communicable Diseases.
Infection Prevention and Control (IPAC) Policies and Procedures
Each child care centre must develop, maintain, and implement policies and procedures for each applicable component of the IPAC program. Examples of such policies and procedures include, but are not limited to:
- hand hygiene
- diapering and toileting
- communication (with parents and staff with respect to IPAC practices)
- environmental cleaning and disinfection
- toy cleaning and disinfection
- pest control
- care and handling of resident and visiting animals
- prevention of occupationally acquired infections, including disease surveillance and management
Management of Outbreaks
Child care centres must develop, maintain and implement a policy and procedure on outbreak management that at a minimum includes the following components:
- Isolating/cohorting ill children in a designated room/area until they can be picked up
- Notifying parents or emergency contacts to pick up ill children as soon as possible
- Maintaining a line list of ill children and staff by recording name(s), the date and time children and staff became ill, date(s) of birth, gender(s), individual symptoms, and their room number or type (e.g., infant room or toddler room)
- Enhancing cleaning and disinfection:
- Changing the disinfectant or dilution concentration
- Ensuring appropriate disinfectant contact times
- Increasing the frequency of cleaning and disinfection of high touch surfaces
- Reference to the chlorine bleach information sheet
- Reporting possible gastrointestinal outbreaks to Toronto Public Health’s Communicable Diseases Surveillance Unit at 416-392-7411
- Distributing outbreak advisory letters to parents/guardians
- Posting outbreak notification sign(s) at entrances to the child care centre
- Obtaining permission from parents to submit specimen samples to the Public Health Ontario Laboratory