Purpose: Over 75% of children use non-parental child care nationally. Children attending child care centers (CCC) have more upper respiratory infections and diarrheal illness than children who stay at home exclusively. Children in CCC are also substantial contributors to the spread of illness into the community. The American Academy of Pediatrics (AAP) provides guidelines for the routine cleaning, sanitizing, and disinfecting of CCC facilities, but studies on cleaning practices are lacking. We partnered with our local county’s consortium of CCC directors to examine current centers’ practices and protocols for cleaning, sanitation, and disinfection of facilities during illness outbreaks so that future studies and interventions studies can be optimized to decrease spread of illness. Methods: We partnered with Washtenaw County Early Childhood Director’s Association, a network of CCC directors to distribute a written anonymous survey of 18 questions at their monthly educational seminar. Survey questions obtained center and director demographics with an emphasis on cleaning protocols, practices, and availability of support for child care health consultants. Survey was developed based on Caring for Our Children National Health and Safety Performance Standards (3rd ed). Only one response was obtained from each center. Descriptive statistics were used to summarize responses. Results: Of 27 directors, 25 directors completed the survey (Table 1). Centers had an average child to staff ratio of 3.75:1. Most centers reported using bleach (n=21; 84%), followed by soapy water (n=13; 52%), hydrogen peroxide (n=7; 28%), and a “three step process” consisting of washing with soapy water, water, and then bleach in sequence (n=6; 24%) for inside cleaning. Most centers used paper towels (n=; 76%) as the primary cleaning material, with washcloths, disposable wipes, and microfiber cloths each used in less than one-third of centers. Bathrooms, changing tables, and non-machine washable toys were most reported as the most difficult areas/objects to clean. Figure 1 depicts local CCC directors’(n=23) perceived effectiveness of cleaning methods during an outbreak, with only 34% of centers reporting that practices were “effective” or “very effective”. Conclusion: Our survey of child care centers in a single county revealed substantial practice variability for cleaning, sanitizing, and disinfecting, with few centers consulting child care health consultants. Knowledge about AAP Caring for Our Children guidelines as a resource for cleaning guidance appears limited. There is an urgent need for the dissemination of infection cleaning strategies based on AAP guidelines and further research on determining optimal cleaning strategies tailored for the child care center environment.

Table 1

Director Demographics and Cleaning Information among 25 Child Care Centers in Washtenaw County, MI

Table 1

Director Demographics and Cleaning Information among 25 Child Care Centers in Washtenaw County, MI

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Figure 1

Perceived Effectiveness of Cleaning Protocols to Prevent Outbreaks Among Child Care Center Directors in Washtenaw County

Figure 1

Perceived Effectiveness of Cleaning Protocols to Prevent Outbreaks Among Child Care Center Directors in Washtenaw County

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