Rules Governing The Sanitation of Child Care Centers 15A NCAC 18A .2800

Disinfecting Solution Concentration
Click the card to flip 👆
1 / 150
Terms in this set (150)
hand washing time procedurerub hands with soap for 15 seconds and rinse for 10 seconds.Hermetically sealed containers allowed?yes, as long as they were prepared in a commercial food processing establishment.Can prepared food sent from home be shared with other children?yes, only if it is a non-potentially hazardous baked good.Dry milk productsshall be used for cooking purposes only (ex: pudding desserts, flavored hot beverages, etc). Unless prescribed by a physician.Prohibited foods?Steamed and uncooked shellfish, raw eggs and products containing raw eggs (raw cookie dough, cake batter, brownie mix, milkshakes and ice cream).Pasteurized egg productsmay be substituted for raw eggsBreast milk, formula and other bottled beverages sent from home shall be...?Fully prepared, dated and identified for the appropriate child at the child's home.Breast milk, formula and other bottled beverages sent from home shall be?returned home or discarded at the end of the day.Frozen breast milk storage?Stored up to 7 days; with date received and date thawed for use. (Previously frozen breast milk shall be refrigerated and may be stored for no more than 24 hours). (Previously frozen breast milk may not be refrozen for storage).Bottle warming equipment?No microwaves used to warm or thaw bottles. No crockpots. Inaccessible to children when in use. Emptied, cleaned and sanitized daily.Opened jars of baby food?covered, dated, refrigerated and used within 2 days. (do not feed child from jar unless the uneaten portions are discarded).Fresh Garden fruits and vegetables grown at facility.Are allowed to be consumed, so long as they are washed before being served.Opened food storage?opened food stored in clean, tightly covered storage containers (or resealable bags). (label dry goods).Unless classroom is equipped with a food prep area....?only individually prepackaged foods are allowed in the classrooms.Food storages, requirements:Off the floor, not stored under sewer lines, not stored in laundry rooms or restrooms.PHF Temps?Under 45F or above 140FRefrigeration units/ hot hold units shall have a thermometer accurate to _____F.+/- 3 FMetal stem type thermometers shall be provide and accurate to ______F.+/- 2 FServed leftovers or milk products?shall not be served again unless package is intact and food is not PHF. Milk dispensed out of a container is considered poured and served and shall be discarded when finished.children shall not be in the kitchen except?If they are supervised during an activityReheating foods:Do not use steam tables, warmers, and similar hot food holding units are prohibited for reheating PHF's. Microwave reheats shall be heated an additional 25 style eating:Prohibited only during an outbreak and investigation of communicable diseases. Otherwise allowed as long as children are supervised.Kitchen specification requirements:Shall have: ~A two comp sink, with drainboards or countertop space of adequate size ~adequate refrigeration equipment ~(when needed) adequate cooking equipment. ~Domestic or commercial kitchen equipment shall be used.Childcare facilities using multi-service articles shall provide:A dishwasher. (In lieu of a dishwasher and two-comp sink being used, a three comp sink of sufficient size and depth may be used).Handwash sinks required to be:Are required at food prep areas. If the dish-washing area is separate from the food prep area, an additional lavatory shall be required.Child Care centers (13 Children or less/located in a residence): Domestic refrigeration equipment requirements:- (besides thawing) PHF shall not be prepared prior to the day they are served. - heated PHF shall not be reheated or placed in refrigeration, they should be discarded. -Protein salads (chicken, tuna, egg, meat, etc) shall not be prepared on site.Frying Food:-To cook over direct heat in hot oil or fat (this includes the oil or fat that is generated by the food or added to the cooking utensil.)Frying food requirements:A commercial hood shall be installed when frying is used for food preparation on site.Food prep in classrooms:-If food is prepared in a classroom, a food prep area shall be provided. -Water from handwash lavatory shall not be used to prepare formula, mix dry cereals or other foods. -Toy cleaning and sanitizing may also be conducted in this food prep area.Food prep equipment (utensils, food contact surfaces, tables, etc):-Out of reach of children. -All equipment cleaned at least daily -All multi-use articles shall be cleaned and sanitized in kitchen after each useCleaning and sanitizing equipment and utensils specifications:-After April 15, 1998: Drainboards or countertop space shall be no less than 8 Sq Ft. -A domestic dishwasher may be used to provide the equivalent of 4 square ft of drainboard space and other designated areas may be utilized to meet drainboard space (as long as it is opposite of wash basin of the sink with soiled equipment).3rd compartment sink sanitize methods:-One minute immersion in hot water at least 170 F. -two minute immersion in 50-200 ppm chlorine/water solution of at least 75 F. -two minute immersion in at least 12.5 ppm iodine, and having a pH not higher than 5.0 at a temperature of at least 75 F. -two minute immersion in 200-400 ppm of quaternary ammonium products at a temp of at least 75F (water hardness levels must be checked on MSDS sheet, to insure product will work). -other sanitizing products may be used as long as they are non-toxic to children and effective as those above.Mechanical cleaning (dish machine)-Additional sanitizing is not required when a domestic dishwashing machine with a sanitizing cycle is used according to manufacturers instructions. -When commercial dish machine is used a temp indicating device accurate to +/- 2 F, shall be provided.Mechanical cleaning (Large equipment).-if equipment is too large to fit in a sink or dish machine. A spray on or wipe on sanitizer of sufficient chemical strength shall be used. -These should be prepared daily and kept on hand. -Test strips must be available at facility at all times.Multi-service articles:- shall be washed, rinsed and sanitized after each use (high chair feeding trays).Non-food contact items:shall be cleaned to keep equipment free of accumulation of dust, dirt, food particles and other debris.Child care facility on a well:-Any center using groundwater supply that serves 25 or more ppl shall provide documentation from the public water supply that the well meets the requirements. -water samples shall be collected annually and sent for bacteriological analysis.Water supply:-water pressure must be sufficient. -No cross connections, backflow or vacuum breaker devices installed where needed.Hot water temps-Hot water in kitchen/laundry: 120F (minimum). -Water in areas accessible to children shall be tempered between 80-110F. -Handwash lavatories used exclusively by school-age children, the 80 F minimum temp shall not apply. -Child care centers serving only school age children are not required to provide hot water in areas accessible to children.Water fountains:-If provided, shall be separate from handwash lavatories and kept clean with pressure regulated.Lead poisoning hazards:-Areas accessible to children shall be kept free of identified lead poisoning hazardsToilet rooms and fixture (requirements):-Toilet tissue at each toilet room. -adjacent to a hand wash lavatory -easily cleanable and in good repair. -shall be child sized, adapted adult toilets or potty chairs. -Free of storage and kept in good repair. -soap and paper towels shall be available to each hand wash sink.Toilet fixtures should be cleaned and ___________ _____________?Cleaned and disinfected at least daily.If cleaned with bleach, these toilet fixtures shall be sprayed glistening wet for __________?and left to air dry, or can be dried after 2 minutes.Products registered with the U.S. Environmental Protection Agency as hospital grade germicides or as disinfectants for safe use in schools, child care, etc are approved disinfectants provided...:the manufacturers material safety data sheets are kept on file at the child care center and the instructions are used and followed.If potty chairs are used:-They shall be located and stored in a toilet room equipped with a spray-rinse toilet or a utility sink. - emptied, rinsed, cleaned and disinfected after each use.Any Lavatory can be used as a hand wash sink, except for?A flush rimmed sink and those with an attached, operable drinking fountain.Change of use?lavatories shall be cleaned and disinfected with each change of use, as needed and at least daily.For centers licensed for fewer than 13 children and located in a residence for diaper changing area for school age children they are required to have a hand wash sink...?In or next to the diaper changing areaDiaper changing surface shall be:-easily cleanable -non-absorbant -smooth and intact -nothing shall be placed on diapering surface except for the items needed.Diaper changing cleaning procedure:-Spray with soapy water wipe off then spray with disinfectant, let disinfectant air dry or can wipe off after 2 minutes.What should be kept at each diaper changing station?-cleaning and disinfecting solutions in separate and labeled bottles.Bleach disinfecting solutions shall be administered from?a hand pump spray bottle. -No cloths or sponges shall be used on diapering surfaces.Diaper changing procedure (11):1. Gather supplies prior to placing child on table. 2. Put on disposable gloves (if needed). 3. Wipe child front to back with disposable towelette or moistened paper towel. 4. Dispose of gloves, soiled towelette and diaper in a plastic lined covered receptacle. 5. Wipe both (employee and child) hands with disposable towelette or moistened towel. 6. Slide clean diaper under child, apply diapering products (if needed) using facial or toilet tissue. 7. Fasten diaper, place clothing on child. 8. Wash child's hands (if child is unable to support their head, their hands can be cleaned with a disposable towelette or moistened paper towel). 9. Spray entire diapering surface with detergent solution and wipe clean (with disposable towels). 10. Spray diapering surface with approved disinfecting solution and allow to remain on surface for 2 minutes or air dry. 11. Wash hands (even if disposable gloves were worn).Gloves must be worn during diapering process if:Employee has cuts, sores or chapped hands.Diapering disposal:-You may dispose of feces in diapers in the toilet. -Do not rinse soiled cloth diapers, training pants or clothes. (put these soiled items in a tightly closed plastic bag or other equivalent container (or send to diapering service). Stored out of reach of children and sent home daily). -Empty diaper receptacles daily.Important posted signage:-Diaper changing procedures (at each diaper changing area). -hand washing signs (at each hand wash sink).Storage space in the facility:-Adequate space provided for equipment, furniture, toys, clothes, linens, cots, etc. -Shelving provided and constructed to facilitate cleaning. -Separate containers for clean and dirty laundry.Chemical storage: Stored in locked storage room or cabinet?- All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes and any product under pressure (aerosol). - any substance which may be hazardous to a child if ingested, inhaled, or handled (kept in original container or labeled container).Adequate locking devices for chemical cabinets?-combination locks -electronic or magnetic device -key lock -equivalent lock to above devicesUnlocking devices for locks should be stored?-Out of reach of children and shall not be stored in the lock.Toxic substances shall be stored __________?-below or separate from medications and food.Any product labeled "Keep out of reach of children" shall be:-kept inaccessible to children when not in use (not required to be locked up).Inaccessible means?-when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of 5ft above the finished floor.Ex. of warning labels:-Keep out of reach of children -flammable -do not ingestHow many warning labels to be kept in locked storage?2 or more warning labels.Chemical storage: non aerosols-sanitizing, disinfecting and detergent (soapy water) solutions, hand sanitizers and hand lotions. -not required to be locked up, but must be kept out of reach of children. -Hand soap is ok to be accessible unless it is a bulk container.Storage: Medications-prescription and non-prescription items -stored in a locked cabinet or other locked container -not stored above food. *(designated emergency medications shall be stored out of reach of children, but not required to be kept in locked storage ex: inhaler, epi pen, etc.)Storage: medications (diaper creams)-non-prescription diaper creams and sunscreen shall be kept out of reach of children when not in use. (not required to be put in locked storage).Storage: Personal, individual (cubbies):-Individual cubicles, lockers or coat hooks shall be provided for storage of coats, hats, or similar items. -Coat hooks, not in individual cubicles or lockers, shall be spaced at least 12 horizontal inches apart. -combs: labeled and stored separately. -toothbrushes: identified, allowed to air dry and protected from contamination. -toothpaste: when used for multiple children, dispensed onto intermediate surface (wax paper).Storage: employee personal items-purses and other personal effects kept out of reach of childrenStorage: Beds, cribs cots-good repair -stored to prevent contamination -cleaned and sanitized between usersMattress size for cribs and play pens?2 inches thickAssigning beds, cots, or mats:-assigned an labeled for each individual child -equipped with individual linens.Mat thickness and storage?-2 inches thick -waterproof, washable material -stored so floor side does not touch the sleeping sideWhen in use: cribs, cots, mats and playpens shall be placed:-at least 18 inches apart or separated by partitions which prevent physical contact.Cot, mat or crib: linens-kept clean in good repair -stored with the individual mat or cot or stored individually for each child in designated area. -large enough to cover the sleeping surface.linen cleaning schedule:-Laundered between users, when soiled and at least once per week. -In rooms where children are less than 12 months old, linens shall be changed and laundered at least daily.Wash clots, bibs, and burping cloths...-shall not be used more than once until laundered and shall be laundered when soiled and at least daily.Toys, equipment and furniture...-kept clean and in good repairIn rooms designated for children not toilet trained, toys and other mouth contact surfaces...-shall be cleaned and then sanitized at least daily by: 1. scrubbed in warm, soapy water (use brush to reach crevices). 2. rinse in clean water 3. submerge in sanitizing solution for at least 2 minutes; or sanitized with approved sanitizing solution. 4. Air dried * (toys and surfaces not designed to be submerged shall be washed and rinsed in place, sprayed with a sanitizing solution and allowed to air dry). * (hard, plastic toys may be washed and rinsed in a dish washer and cloth toys may be laundered and mechanically dried without requiring sanitizing).Toy, furniture, cribs accessible to children shall be free of?-peeling, flaking or chalking paintWater Play Centers:-filled just prior to each water play session -water emptied after each session (or more often if visibly soiled) -Play centers and toys involved shall be cleaned and sanitized at least daily. *water play is prohibited during the outbreak and investigation of communicable diseases at the site. *wading pools are not considered water play centers.Personnel requirements: (full time, part time and volunteer)-employees and their clothing shall be clean -shall keep fingernails clean -Tobacco use in any form is prohibited in any part of a child care center (except in a designated area) *Smoke outdoors, inside with separate ventilation, separate from outdoor environments, etc.Flooring:-non-absorbent, easily cleanable in all food prep, food storage, utensil-washing, toilet rooms and laundry areas. -Easily cleanable in sleeping and play areas. -In areas accessible to children shall be kept free of peeling, flaking and/or deteriorating paint. -all floors kept clean and maintained in good repair.Carpeting: construction-shall be of closely woven construction, properly installed and easily cleanable.Carpeting: vacuuming-Vacuumed daily when children are not present in the room (except to clean up spills). -Can vacuum when children are present if using a HEPA (high efficiency particulate air) filter vacuum. -Vacuum bag changed when children are not in the room. -Central vacuums that exhaust to the outdoors away from children may be used in lieu of HEPA vacuum cleaners to meet the daily vacuuming requirements (.2832)HEPA filter requirements:-99.97% efficient at 0.3 micron dust particle size. -sealed to prevent leakage around connection points.Wall to wall carpet cleaning:-Shall be cleaned using extraction methods at least once each 6 months. -Cleaning materials including surfactants, solvents and water shall be removed from the carpet before the space is reoccupied. -When hot water extraction is used, carpet shall be completely dry within 12 hours of cleaning.Walls and ceilings:-(walls, ceilings, doors and windows)- of all rooms and areas shall be kept clean, free of visible fungal growth and in good repair. -All walls and ceilings shall be easily cleanable and free of peeling, flaking, chalking or otherwise deteriorating paint. -*Walls and ceilings in rooms where food is stored, handled, prepared, utensil-washing rooms and toilet rooms shall be non-absorbent. -Acoustic and other ceiling material may be used where ventilation precludes the possibility of grease and moisture absorption.Child care centers licensed for fewer than 13 children and located in a residence: ceiling construction.-ceilings of residential construction are acceptable if kept clean and in good repair.Lighting:-50 FC at work surfaces (kitchens & Diaper Changing areas, children's work tables, desks and easels). -10 FC (30 inches above the floor) in all other areas, including storage rooms.thermal:-all rooms shall be heated, cooled and ventilated. -Ventilated= operable windows (screened), or mechanical ventilation to the outside. -temp. between 65-85°F. *(outdoor storage areas are exempt from electrical wiring or heating and air).Thermal & lighting: cleanliness-windows & window treatments kept clean and in good repair. -All ventilation equipment: air supply diffusers (heating and cooling vents) and return grilles, fans and all other equipment kept clean and in good repair.Communicable diseases and conditions:-children who become ill and can no longer participate in routine group activities shall be separated from the other children until the child leaves the center. -Each child care center shall have a designated area for a child who becomes ill.Designated sick area requirements:-area shall be equipped with a bed, cot or mat and a vomitus receptacle. -thermometers and materials in area shall be cleaned and sanitized after each use. -Linens and disposables shall be changed after each use.Designated sick area room requirements:-If a separate room is not available, it shall be separated from space used by other children by a partition, screen or other means. -located in an area where staff will not disrupt other staff or children with health and sanitation measures.Communicable disease: employees-Employees with communicable disease or condition shall be excluded from situations in which transmission can be expected to occur -Boils, sores, burns, infected wounds or other potentially draining lesions on exposed skin shall be bandaged to eliminate exposure to drainage. (If bandaging obstructs handwashing, employee shall be excluded from food prep and caregiving while condition exists).Wastewater:-Disposed of in publicly owned wastewater treatment system or approved on site wastewater system. -Septic systems shall be sized to accommodate anticipated children and staff for all shifts.Solid Wastes:-Food scraps, other putrescible materials shall be placed in plastic lined, cleanable, covered container. (emptied at least daily). -paper, cardboard boxes, etc. shall be stored in containers or designated areas.Solid waste: Facilities-Facilities shall be provided for the washing and storage of garbage containers and mops for child care centers ***(for facilities licensed for fewer than 13 children and located in a residence, this does not apply).***Solid waste: Cleaning Facility requirements (can wash)-Shall include a faucet with a threaded nozzle and water of at least 80°F in either a designated utility sink or above a cubed impervious pad (sloped to drain into waste water treatment system). ***(Can wash facilities approved before 7/1/91, shall be approved if in good repair).***Solid waste: Dumpsters-kept clean and covered -Facilities shall be provided for cleaning either on-site or off site through a contractual agreement. -Solid wastes shall be disposed of to prevent insect breeding and public health nuisances.Animal and Vermin Control:-Unrestrained animals shall not be allowed in a child care facility or outdoor learning environment (unless it is used in supervised activity or pet therapy program). -When animal is on premises a copy of vaccination records shall be available for review. -Animals shall not be allowed in or kept at the entrances to food prep areasChild care facility: pets owned by facility-any animals kept as pets shall be examined by Vet. to determine they are free from vermin, such as mites, lice, fleas, and ticks, and pathogens that could adversely affect human health. -Pets kept outside shall be in designated areas that are maintained and separate from outdoor area used by children.Excluded animals (not allowed in facility)-Turtles, iguanas, frogs, salamanders and other reptiles or amphibians are not allowed to be kept as pets on premises.Animal Cages:-Kept clean, waste materials shall be bagged, sealed and immediately disposed of in the exterior garbage area in a covered container.Insects/rodents and vermin: exclusion-effective measures shall be taken to exclude vermin out of child care centers an to prevent breeding or presence on premises. -traps shall be inaccessible to childrenVermin exclusion: Food prep areas-Only fly traps, pyrethrin based insecticides or a fly swatter shall be used for extermination of flying insects. -use product as manufacturer recommends. -Insecticides shall not come in contact with raw or cooked food, utensils or equipment used in food prep and serving or with any other food contact surface.Vermin exclusion: pesticides-only pesticides registered with US EPA and NC Dept of Agr. and consumer services shall be used. -Used in accordance with the directions on the label and shall be stored in locked storage room or cabinet, separate from foods and medications. ***do not apply pesticides when children are present***Chromated Copper arsenate (CCA) Pressure treated wood:-CCA shall not be used for: Decks, fences, playground equipment and other products constructed or installed after September 1, 2006 (unless approved by EPA)CCA treated wood: sealant application-If accessible to children, wooden structures installed prior to January 1, 2005 (or where EPA allowed the use of CCA wood). The wood shall be sealed at least once every 2 years.CCA: types of sealant-oil based, semi-transparent sealant -oil based clear stain -water based clear stainCCA treated wood: prior to sealant or after more than two years has passed since sealant was applied (soil)-soil under such wood shall be: removed and replaced with similar material; covered with at least 4 inches of soil, gravel, sand, sod, or other vegetation; otherwise made inaccessible.Composting areas:-kept covered and maintained (to prevent vermin harborages) -worm bins shall be kept covered.Gardens:-Grass, fruit, vegetable gardens, vines on fences, and other vegetation shall be maintained (to prevent vermin harborages)Outdoor learning environment and premises:-kept clean and drained to minimize standing water, free of litter and hazardous materials. -All debris, broken play equipment and dilapidated structures shall be removed.Wells, can wash, cisterns, grease traps:-made inaccessible to childrenOut door play equipment:-sand toys, water tables, etc that can collect standing water shall be emptied and stored to prevent standing water. -Equipment in good repair, free of peeling, flaking, chalking paint and free of rust and corrosion. -sandbox shall be constructed to allow for drainage and covered when not in use & kept clean.Air quality report--Code ORANGE= unhealthy for sensitive groups. Children shall not be outside in physical activity between 12pm-8pm, for more than 1 hour. --Code RED= unhealthy forecast. Children shall not be outside in physical activity between 12-8pm for more than 15 minutes. --Code PURPLE=very unhealthy. No physical activity permitted between 12-8pm at all. ***Provisions shall be made to allow children with diagnosed asthma, coughing or wheezing symptoms to participate in physical activities INDOORS on days with a code Orange, red, or purple***Outdoor activity area: Food service-food shall be protected, stored, prepared and served the same as inside food prep -hands will be washed -tables will be cleaned or covered prior to use.Outdoor activity area: Diaper/toilet facilities-facilities shall be maintained -employee and child shall wash handsOutdoor storage areas:-kept clean for toy storage -kept free of hazardous materials if accessible to children -lighting requirements shall be met by opening doors, windows, sky lights, battery operated light, flashlight or electric lighting. **Spare batteries shall be available for battery operated light fixtures and flashlights**Water Play:-Flow through water play systems shall be designed to minimize standing water -employees and children shall wash hands before and after water playSwimming and wading pools: exclusions-portable wading pools, natural bodies of water and other unfiltered, nondisinfected containments of water shall NOT be utilized for recreation activities. (Pools shall follow .2500 rules)Request for sanitation inspections by child care operator or Division of Child Development shall be conducted by local health dept...-within 30 daysUnannounced inspections shall be made by the dept. at least....-once each six-month period.Inspection report form:-Sanitation standards evaluation form for child care centers.An original and two copies of the form go to?-The original shall be submitted to the Division of Child Development -The child care center operator and the Department shall each retain a copy (.2834)Child care form ratings and point value:--SUPERIOR= 0-15 demerits (no 6 point demerit) --APPROVED= 16-30 demerits (no 6 point demerit) --PROVISIONAL= 31-45 demerits, (or any 6 point demerit) ***{The provisional classification period shall not exceed 7 days unless construction or renovation is necessary to correct any violation, so dept may specify a longer provisional classification period}*** --DISAPPROVED= 46+ demerits, or failure to improve provisional classification. ***{Dept shall immediately notify the division of child development by faxing a copy of the inspection form}***A summary classification of disapproved shall be issued and forwarded to the ?-Division of Child Development when the right of entry to inspect is denied or when an inspection is discontinued at the request of the operator or administrator unless the decision to discontinue the inspection is mutual.A summary classification of disapproved shall also be issued and forwarded to?-The Division of Child Development when a water sample is confirmed positive for fecal coliform, total coliform or other chemical constituents.The child care center's compliance is indicated by the....-number of demerits on the Child Care Sanitation Inspection Form.Issuing a license to a new operator: process-A Child Care Sanitation Inspection Form shall be forwarded to the Division of Child Development only when the child care center can be granted a superior classification. ***If children are not in attendance during this inspection the same form shall still be forwarded however, the Sanitation Classification placard shall not be posted.*** (Another sanitation inspection shall be conducted when children are in attendance within 30 days of opening and the placard shall then be posted)Change of ownership: temporary license-If center continues to operate the operator shall request an inspection from the department within 14 days. (Placard shall be posted after each inspection during temp license).If Dept determines conditions found at child care center (during inspection or visit) are dangerous the the health of the children?-The dept shall immediately notify the division of child development by verbal contact. (The original inspection form or documentation of dangerous conditions shall be sent to the division of child development within 2 working days following the inspection).The dept may conduct an inspection of any child care center:-As frequently as necessary in order to ensure compliance with the rules.Mildly Ill Children (.2836):-Prior to starting a program for mildly ill children, the child care operator shall request an inspection from local health dept.Mildly Ill children: Rules-Drinking fountains not used. -toilet fixtures, potty chairs, sinks, tubs, showers, etc cleaned and disinfected after each use. -lavatories shall be of "hands free" design or equipped with single lever faucets. -cloth diapers shall not be used. -Individually moist towelettes for each child in diapers (labeled). -Caregivers shall wear gloves when diaper changing. -Moist towelettes shall not be used in lieu of handwashing for children who cannot support their heads. -36" separation shall be maintained or partitions shall be placed between beds, cots, mats. -Non absorbent furniture. -Thermometers, mouthable toys, soft toys shall be cleaned and sanitized between uses by different children. (soft toys may be brought from home if labeled.). -Caregivers for mildly ill children shall not prepare food in the kitchen or serve food to well children. -Family style food service prohibited. -Carpeted floors prohibited. (throw rugs may be used if laundered when contaminated and at least weekly). ***Floors contaminated by body fluids shall be cleaned and disinfected immediately***Child to teacher ratios:--(0-12 months) 1 staff / 5 children {Group size:10} --(12-24 months) 1 staff / 6 children {Group: 12} --(2-3 years) 1 Staff / 10 children {Group: 20} ***No child care center shall care from more than 25 children in one group. If 26 or more children, center shall provide 2 or more groups according to the ages of the children and provide separate supervisory personnel and separate identifiable space for each group*** PRESCHOOL AGED CHILD ENROLLED ***center is 6-12 children*** --(0-12 months) 1 staff / 5 preschool children plus 3 additional school age children --(12-24 months) 1 staff / 6 preschool children plus 2 additional school aged children.