NC Childcare Sanitation Rules Pt 2

.2800 Childcare Rules Part 2

.2815 Water Supply

(a) A child care center's water supply shall meet the requirements of 15A NCAC 18C or 15A NCAC 18A .1700, as applicable.
The operator of a child care center using a groundwater supply that serves 25 or more people shall provide the local health department serving the county in which the child care center is located with documentation from the Department of Environmental Quality, Division of Water Resources, Public Water Supply Section that the well meets the requirements of 15A NCAC 18C.
In child care centers that use a non-community water supply, a water sample shall be collected by the Department once a year and submitted to the North Carolina State Laboratory of Public Health or other laboratory certified by the North Carolina State Laboratory of Public Health under 10A NCAC 42C .0102 to perform bacteriological examinations.
The Department may collect additional samples for tests of water quality, as indicated by possible additional sources of contamination.

(b) Water under pressure shall be provided to meet the child care center's needs of cooking, cleaning, drinking, toilets, and outside uses.

(c) A child care center's water supply plumbing shall not include cross-connections as set out in 15A NCAC 18C .0102(c)(8). If the potential for back siphonage or backflow conditions exist, an atmospheric vacuum breaker or backflow prevention device shall be installed.

(d) Water heating equipment shall be provided to meet the hot water requirements set forth in this Rule.
The capacity and recovery rates of water heating equipment shall be based on number and size of sinks, capacity of dishwashing machines, capacity of laundering machines, diaper changing facilities, and other food service and cleaning needs for child care centers not located in a residence.
Child care centers licensed for fewer than 13 children and located in a residence shall be allowed to use an existing water heater, or the equivalent replacement, if the water temperature requirements set forth in this Rule are met.
Hot and cold water under pressure shall be provided in all rooms where food is prepared, rooms in which utensils or equipment are washed, and other areas where water is required for cleaning and sanitizing, including diaper changing areas

(e) Hot water used for cleaning and sanitizing utensils and laundry shall be provided at a minimum temperature of 120 degrees Fahrenheit at the point of use.
Water in areas accessible to children shall be tempered between 80 degrees Fahrenheit and 110 degrees Fahrenheit.
Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children.
For handwash lavatories used exclusively by school-age children, the requirement to provide water tempered between 80 degrees Fahrenheit and 110 degrees Fahrenheit shall not apply.
In the event of the loss of hot water at the child care center, the operator shall immediately notify the local health department that serves the county in which the child care center is located.

(f) Drinking fountains, if provided, shall be separate from handwash lavatories and kept clean.
The water pressure of a drinking fountain shall be regulated so that an individual's mouth does not come in contact with the nozzle and so that water does not splash on the floor. Other devices used to dispense drinking water shall be kept clean.

(g) Outdoor drinking fountains shall be constructed to protect the spout from contamination by hazards and shall be kept clean.

Multiple Choice

Hot water in the kitchen and laundry for cleaning and sanitizing shall reach a minumum of...

• 110F

• 80F

• 120F

• 140F

.2816 Lead Poisoning Hazards in Childcare Centers

(a) In child care centers, areas accessible to children shall be free of identified lead poisoning hazards as defined under G.S. 130A-131.7(7).

(b) The following actions shall be taken to ensure that drinking water in child care centers is free of identified lead poisoning hazards as defined under G.S. 130A-131.7(7)(g).

(1) Child care operators, as defined under G.S. 110-86(7), shall test, once every three years, all water outlets used for drinking or food preparation.

Samples shall also be collected and tested within 30 calendar days of completion of any renovations or repairs that may impact the facility's drinking water infrastructure, such as repair or replacement of all or part of drinking water service lines or faucets, at impacted outlets.

The operator shall provide documentation of testing results for review by the Department during each unannounced routine sanitation inspection under Rule .2834(b) of this Section.

(2) For child care centers that submit an application for licensure in accordance with 10A NCAC 09 .0302 after the effective date of this Rule, initial samples shall be collected by the child care operator and tested in accordance with Subparagraph (b)(4) of this Rule during the license application process

(3) For all other centers, initial samples shall be collected by the child care operator and tested in accordance with Subparagraph
(b)(4) of this Rule within one year of the effective date of this Rule.

(4) The child care operator shall collect samples and submit them for testing in accordance with guidance specified by the United States Environmental Protection Agency in its publication, 3Ts for Reducing Lead in Drinking Water in Schools and Child Care Facilities, which is incorporated by reference with subsequent changes or amendments and available free of charge at https://www.epa.gov/ground-water-and-drinking-water/3ts-reducing-lead-drinking-water.

Notwithstanding the guidance, samples may be collected with a stagnation period of up to 72 hours.

Samples shall be analyzed by a laboratory certified by the North Carolina State Laboratory of Public Health to analyze for lead in drinking water.

(5) When a water sample is analyzed for lead content by a laboratory under this Rule, the laboratory shall notify the Department of the test results by electronic submission in accordance with G.S. 130A-131.8.

(6) When a child care center receives test results from a laboratory indicating that a water sample collected by the child care operator contains a lead concentration at or above the lead poisoning hazard level defined in G.S. 130A-131.7(7)(g), the child care operator shall:

(A) restrict access to any water outlet(s) used for drinking or food preparation that have lead concentrations at or above the lead poisoning hazard level; and

(B) ensure that all children and staff have access to water free of cost that does not contain lead concentrations at or above the lead poisoning hazard level for drinking and food preparation.

(7) When notified of a water lead level at or above the lead poisoning hazard level, the Department shall conduct sampling at the water outlet identified to have a water lead level at or above the lead poisoning hazard level within 10 business days of notification.

(8) If a water sample collected by the Department reveals a water lead level at or above the lead poisoning hazard level, the child care operator shall continue to follow Subparagraph (b)(6) of this Rule until the Department determines the water outlet(s) are not producing water lead levels at or above the lead poisoning hazard level and notifies the child care operator and the Division of Child Development and Early Education in writing of this determination.

(9) Failure to comply with Paragraph (a) of this Rule or any Subparagraph of this Paragraph, shall be deemed a violation of this Rule subject to demerits under Rule .2834(c)(20) of this Section.

(10) Within five business days of receiving the test results of the Department's water analysis that shows a water lead level at or above the lead poisoning hazard level, the child care center operator shall provide written notification of the test results to the parents or legal guardians of the children attending the child care center and the staff of the child care center, in accordance with the United States Environmental Protection Agency guidance specified in Subparagraph (b)(4) of this Rule.

(11) Within five business days of receiving the test results of the Department's water analysis that shows a water lead level at or above the lead poisoning hazard level, the child care center operator shall make the test results available to the public, free of charge.

The child care center operator may post test results to the child care center's website to satisfy the requirement to make the test results available to the public.

.2817 Toilets

(a) In child care centers, toilet tissue paper shall be provided in each toilet room and stored in a clean, dry place.

The toilet room shall include or be adjacent to a handwash lavatory.

Storage in toilet rooms shall be limited to toileting and diapering supplies.

All toilet fixtures shall be kept clean and in good repair.

Toilet fixtures shall be child-sized, adult-sized toilets that are adapted to accommodate children, or potty chairs.

(b) Toilet fixtures shall be cleaned and disinfected daily and when visibly soiled.

(c) If potty chairs are used, they shall be located and stored in a toilet room equipped with a spray-rinse toilet or utility sink.

Potty chairs shall be emptied, rinsed, cleaned and disinfected after each use.

(d) When cloth diapers are used and emptied, the diaper changing area shall be located next to a toilet room.

Multiple Choice

True or False: Items other than toileting and diapering supplies can be stored in toilet rooms if in waterproof containers.

• True

• False

.2818 Lavatories

(a) In child care centers, lavatories shall be kept clean and in good repair and shall not be used for storage.

Lavatories shall be mounted at an appropriate height to accommodate children or otherwise made accessible to children.

Water from a handwash lavatory shall not be used for consumption.

Lavatories with flush-rimmed sinks or with an attached operable drinking fountain shall not be used for handwashing

(b) Lavatories shall be equipped with hot and cold water or tempered water provided through mixing faucets or pre-mixing devices which provide water in the temperature range specified in Rule .2815(e) of this Section

(c) Lavatories shall be cleaned and disinfected with each change of use, when visibly soiled, and at least daily.

Change of use occurs when a handwash lavatory is used outside of its original intent.

Change of use includes, but is not limited to, a classroom handwash lavatory used for rinsing toothbrushes, a food preparation handwash lavatory used for toy cleaning, or a classroom handwash lavatory used for diaper changing handwashing.

(d) Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area.

(e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 of this Section.

Open Ended

Describe change of use in regards to lavatory use.

.2819 Diapering and Diaper Changing Facilities

(a) In child care centers, children in diapers shall be changed at stations designated for diapering or toileting.

Each diaper changing station shall include a handwash lavatory.

For child care centers licensed for fewer than 13 children and located in a residence, and for diaper changing areas designated for school age children, a handwash lavatory shall be in or next to the diaper changing area.

(b) Diapering surfaces shall be made of smooth, intact, nonabsorbent material and shall be kept clean and in good repair.

Nothing shall be placed on the diapering surface except for those items required for diapering and the child whose diaper will be changed.

If diapering is performed on the floor in a toilet room, then a smooth, intact, nonabsorbent barrier that is clean and in good repair shall be placed on the floor to minimize cross-contamination.

(c) Diapering surfaces shall be disinfected using an approved disinfectant. Approved disinfectants and detergent solution shall be kept in separate and labeled bottles at each diaper changing station.

Approved disinfectants that are chlorine disinfecting solutions shall be stored in hand pump spray bottles.

No cloths or sponges shall be used on diapering surfaces.

(d) Child care center employees shall change a child's diaper as follows:
(1) gathering supplies before placing child on diapering surface; (2) donning disposable gloves (if needed); (3) using disposable towelette or moistened paper towel to clean child, wiping front to back; (4) disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle; (5) wiping the child care center employee's hands and the child's hands each with a separate disposable towelette or moistened paper towel; (6) sliding a clean diaper under the child, applying diapering products if needed, using facial or toilet tissue, and discarding the tissue in a plastic-lined, covered receptacle; (7) fastening the diaper and placing clothing on child; (8) washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support the child's head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area; (9) spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels; (10) spraying entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and (11) washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the child care center employee.

(e) Vinyl or latex disposable gloves shall be used by child care center employees during the diaper changing process if the employee's hands have cuts, sores, or chapped skin.

(f) Child care center employees may dispose of feces from diapers in the toilet, but shall not rinse soiled cloth diapers, training pants, or clothes.

Soiled cloth diapers, training pants, or clothes shall be sent to a diaper service or placed in a sealed plastic bag or other sealed container, stored out of reach of children, and sent home with the child on the same day to be laundered.

(g) Receptacles containing soiled disposable diapers shall be emptied in a garbage area located outside the child care center building daily.

(h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area.

Multiple Select

Diapering surfaces shall be...

• nonabsorbent

• soft

• smooth

• intact

Multiple Select

Disinfectant shall remain on diapering surface for...

• 2 minutes

• 1 minutes

• no time is specified

• as specified by manufacturer