Administrative health policies and procedures help child care centres to ensure staff are trained and aware of infection prevention and control (IPAC) measures specific to the child care centre and how they apply to their daily activities.
- A policy sets out general directions on a specific matter (describes who, what and why) but does not detail how to perform certain tasks.
- A procedure describes the step-by-step instructions for tasks that should be done in order to fulfill a policy.
When creating policies and procedures:
- Be specific to the individual child care centre.
- Child care centre operators may refer to site-specific surveillance data (e.g., reports of illness, attendance records) and credible sources such as professional practice guidelines, standards, and legislative requirements.
- Ensure they are kept up-to-date with the most recent evidence and best practices.
- Ensure they are reviewed by child care centre staff annually, and when updates are made.
- Provide staff with education and training on all policies and procedures.
- Maintain policies and procedures in a written format and make them easily accessible for child care centre staff.
- Child care centre operators may also contact Toronto Public Health (TPH) and speak with a public health inspector for guidance.
Public health inspectors at TPH conduct IPAC inspections within child care centres. As part of this inspection, the inspector focuses on several criteria, including reviewing written policies and procedures, outlined below.
Submitting Floor Plans
The Ministry of Education license application process for licensed child care centres and prospective licensees may require the submission of floor plans to Toronto Public Health. Learn more about submitting floor plans for review.
These policies and procedures relate to how a child care centre monitors, manages and responds to common communicable diseases, and must include:
- Actions the centre will take to monitor and recognize illness.
- This includes daily health checks, monitoring and screening for illness. For example, observing children for signs of illness upon arrival and throughout the day, recording symptoms, or noting absences after outings or special events.
- How the child care centre will recognize when there is an increase in illness among children and/or staff.
- When an outbreak is suspected, start 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, individual symptoms, and their room number or type (e.g., infant or toddler room).
- Maintain attendance records to help monitor absenteeism. This includes recording instances of illness or absences, and monitoring for any increase in baseline levels of absenteeism. Baseline incidence is the normal level of illness in a given place and time.
- How the child care centre will respond when a child or staff becomes ill while at the centre.
- This includes identifying a designated isolation area, supervising the child, calling the child’s parent/guardian to pick them up, and keeping ill children and staff cohorted.
- Identifying symptoms or illnesses that require exclusion from the child care centre.
Reporting Diseases & Outbreaks
These policies and procedures relate to how child care centres will report diseases of public health significance (DOPHS) or outbreaks to Toronto Public Health, and must include:
- Who, when and how the centre report DOPHS or outbreaks to TPH. See the list of diseases that must be reported.
- TPH contact information. Report DOPHS to TPH immediately by calling the Communicable Disease Notification Unit (CDNU) at 416-392-7411.
- Information on recognizing signs and symptoms of reportable diseases.
These policies and procedures relate to how child care centres will manage outbreaks and must include:
- How the centre responds to a suspected outbreak.
- This includes ensuring child care centre staff are trained to recognize a suspected outbreak, report it, and implement measures to help prevent the spread of illness.
- Additional IPAC measures that will be implemented during an outbreak.
- This includes enhanced hand hygiene and respiratory etiquette, enhanced cleaning and disinfection, and pausing sensory play.
- How the centre will communicate with families and staff regarding outbreaks or illnesses.
- This may include posting Outbreak Notification signs, sending out an Outbreak Advisory template letter, or obtaining consent from parents/guardians to submit specimen samples to the Public Health Ontario Laboratory (PHOL). Note: The privacy and confidentiality of the ill individual(s) must always be maintained when communicating with families or staff.
Cleaning & Disinfection
These policies and procedures relate to cleaning & disinfection IPAC measures a child care centre will implement and should include:
- Step-by-step instructions on cleaning and disinfecting procedures.
- This includes outlining who will be responsible for cleaning and disinfecting, what products will be used for cleaning and disinfecting, and how the products will be prepared and used safely.
- A cleaning and disinfecting schedule for every room.
- This schedule should clearly identify the areas and objects that are to be cleaned and disinfected and how often cleaning and disinfection is required.
Infection Prevention & Control
Child care centres must have policies and procedures in place outlining IPAC measures. Examples include (but are not limited to):
- Routine practices
- Monitoring for illness (disease surveillance) and isolating sick children
- Hand hygiene and respiratory etiquette
- Managing exposure to blood and bodily fluids
- Diapering and toileting practices, including procedures to be posted at each diaper changing station
- Cleaning and disinfection, including environmental cleaning and disinfection, toy cleaning and disinfection and laundering
- Sensory and outdoor play activities, including how often sensory materials are to be changed and step-by-step instructions for cleaning and disinfection
- Pets and animals
- Food and water safety
- Pest control
- Occupational health and safety, including routine practices, risk assessment and the use of PPE
- Immunization requirements for staff and children
Emergency preparedness is everyone’s responsibility. Because emergencies may arise at any time, it is important that child care centres be informed and prepared, with a plan in place.
Child care centres should have and maintain an emergency preparedness plan in place outlining what to do in different emergency situations such as fires, severe weather conditions, or pandemics. The plan should include specific procedures for child care centre staff to follow. The plan should be shared with families and with local emergency service providers.
Child care centres must not operate under the following conditions:
- Fuel/Natural Gas Leak
- Sewage Back-up
- Water Disruption or Drinking Water Advisory
- Any other health hazards as advised by the local Medical Officer of Health
In the event that an emergency takes place during operating hours, child care centre operators must first ensure the safety of children and staff. Determine if whole or partial dismissal of the centre is required and notify relevant service providers (e.g. Toronto Fire Services) depending on the type of emergency.