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					  Health and Child Care Newsletter
Volume 5 Issue 2                                                                           Fall 2006


                                                          It’s not too late to get your Flu shot!
                                                          Call your health department for a
                                                          location nearest you! For
                                                          information about the flu, visit
 In this Issue:                                           http://www.cdc.gov/flu/
       Sanitizing with Bleach…….1
       Disposal of Medications…2
       Caring for a child with
           diabetes…2
       Immunization Update….4
       What’s New with Healthy Child
           Care Virginia?....4
                                                   certain areas that have high concentrations
                                                   of germs. We recommend bleach as the most
The beginning of the school year is a good         effective and economical method of
time to review important cleaning and              sanitizing.
sanitation issues. Starting off the year with
proper classroom hygiene will mean a               Why use bleach?
healthier year for all. We hope the                Household bleach (not industrial) mixed
information and resources included in this         appropriately with cold water is highly
issue will prove useful as you strive for a safe   recommended as a sanitizer because it kills
and healthy classroom. We also want to keep        the widest range of bacteria, fungi
you will informed about some items of              and viruses. Diluted bleach also has the
interest. The recent outbreak of mumps,            shortest required contact time and is
questions regarding the care of children with      economical and safe when used properly.
diabetes in childcare, and the proper disposal
of medications are all areas we have received
questions from child care providers. Please
feel free to contact our office if you would
like additional information.


         Sanitizing with Bleach
One of the most important steps in reducing
the spread of infectious diseases among
children and child care providers is cleaning      The bleach recipe
and sanitizing surfaces. There is a difference     Above is a recipe for a bleach solution. (One
between cleaning (removing visible soil),          tablespoon household bleach per one quart of
sanitizing (reducing the number of germs),         water, OR one-fourth cup household bleach
and disinfecting (removing all germs). In child
                                                   per one gallon of water.) It is easy to mix,
care programs the focus is on sanitizing
                                                   nontoxic and safe if handled properly, and it
Volume 5: Issue 2                                 2                                        Fall 2006

kills most germs that cause infectious                        Disposal of Medications
diseases. It is appropriate for surfaces that         Healthy Child Care Virginia has received many
have been cleaned and rinsed in bathrooms,            inquiries requesting the proper procedure for
diapering areas, for countertops, tables, toys,       disposing of unused medications. Best
floors, and surfaces contaminated by body             practice recommends that the provider give
fluids. The recipe should be followed exactly         the remaining medication or empty container
using measuring devices—more is not better!           back to the parent or guardian. However, if a
                                                      provider is left to dispose of the medication
How to work with bleach                               and/or container, the following should be a
Guidelines for the safe use of bleach as a            policy for the child care program:
sanitizer can be found in Caring for
Our Children: National Health and Safety               Left over or expired medication should be
Performance Standards (Appendix I)                    disposed of one of the following ways:
http://nrc.uchsc.edu/CFOC/index.html                       Dissolve down the sink
                                                           Flush down the toilet
Here is an overview:                                  Or, in the case of non soluble medications,
• Solutions of bleach and water lose their            such as expired epipens, empty nebulizer
strength over time, and are also weakened by          vials, and used insulin syringes, all shall be
heat or sun, so they must be mixed fresh              disposed of in a closed impenetrable
every day.                                            container. A heavy duty Tupperware® type
• Prepare and pour bleach solutions in a room         container that is taped securely with duct
which is separate from the children. Work             tape is an appropriate sharps container. Once
near an open window for ventilation.                  taped securely, the container can then be
• When preparing the bleach mixture, wear a           thrown in the trash.
plastic apron, gloves and glasses to protect          A heavy duty Tupperware container that is
against splashes of full strength bleach              taped securely with duct tape is an
during mixing.                                        appropriate sharps container.
• Do not mix household bleach with any other
chemicals that could produce hazardous
gases.
• Clearly label the spray bottles with the
words “bleach sanitizer” and keep them out of
the reach of children at all times.
• After you spray the bleach solution on an
item or surface, do not wipe off the surface.
The solution needs about two minutes of
contact time, and is most effective if the            Caring for Children with Diabetes
total surface is lightly covered and allowed to                 in Child Care
air dry.                                              Diabetes is one of the most common chronic
• Be sure children are at a safe distance while       diseases of childhood. In the U.S.,
cleaning and sanitizing.                              approximately 13,000 new cases are
                                                      diagnosed annually in children. About 125,000
                                                      individuals younger than 19 have diabetes in
                                                      the U.S. The majority of these children
Volume 5: Issue 2                                  3                                        Fall 2006

attend school and/or some type of day care                   What accommodations to the program
and need knowledgeable staff to provide a                     are needed (flexibility of snack/meal
safe school environment. Both parents and                     times, exercise activities,
the health care team must work together to                    personalized snacks from home,
ensure child care programs have the                           medical equipment storage and use)
information and training they need to allow                  Arrange staff training on caring for a
children with diabetes to participate fully and               child with diabetes. This should be
safely in their programs.                                     coordinated with the child’s primary
Under Federal laws, diabetes has been                         physician and should be facilitated by
determined to be a disability, and it is illegal              a certified diabetic educator. All
for child care programs to discriminate                       staff who are in contact with the child
against children with diabetes. Any school                    should receive this child specific
that receives federal funding or any facility                 course. This should include signs and
considered open to the public must reasonably                 symptoms of hypo and hyperglycemia
accommodate the special needs of children                     as well as instructions on performing a
with diabetes. The required accommodations                    glucose test (“finger prick”). Insulin
should be provided within the child's usual                   injections should be given by the
school setting with as little disruptions to the              parent/guardian prior to arrival and/or
school's and the child's routine as possible                  after dismissal. (Unless parent,
and allowing the child full participation in all              physician and provider have made
school activities. Federal law requires an                    other arrangements.)
individualized plan of care for any child with               A written care plan of how to care for
diabetes.                                                     the child. This shall include what to
Despite these protections, children in the                    do, who to call in the event of a
schools and day care setting still face                       medical emergency as well as the daily
discrimination. For example, some child care                  care of the child.
centers have refused admission to children
with diabetes. Children in those classrooms            For additional information on Caring for a
have not been provided the assistance                  child with diabetes, contact the following:
necessary to monitor blood glucose and/or              American Diabetes Association
have been prohibited from eating needed                www.diabetes.org or call 1-800-DIABETES
snacks. Appropriate diabetes care in the child         (1-800-342-2383)
care setting is necessary for the immediate            Children with Diabetes
safety of the child and for the child's long-          www.childrenwithdiabetes.com for
term well being. Child care staff must have an         comprehensive information on caring for
understanding of diabetes and its                      children with diabetes in a school setting,
management to appropriately care of the                click on the “school” tab on the top of the
child with diabetes.                                   page. A guideline for developing a specialized
                                                       care plan is available. You may also request
What needs to be done prior to a child with            free printed materials.
diabetes enrolling in a program?
Any child with a special health need requires
a specialized plan of care. Included in this
plan is:
Volume 5: Issue 2                                4                                        Fall 2006

          Immunization News                          and to create safe physical environments for
                                                     children.
                                                     Please visit our newly remodeled website for
The recent Mumps outbreak in many states
                                                     information on child care health consultation,
last spring is a good reminder for both staff
                                                     how to find quality trainings, and how to
and parents to keep immunizations current.
                                                     contact a child care health consultant to
Not only should all children be vaccinated
                                                     assist you in providing a safe and healthy
according to the 2006 Immunization Schedule
                                                     child care environment. The website address
(http://www.cdc.gov/nip/recs/child-
                                                     is:
schedule.htm#printable ), but staff should
                                                     http://www.vahealth.org/childadolescenthealt
take care to receive all recommended
                                                     h/healthychildcare.asp . Also available on the
immunizations as well. This includes all
                                                     website are back editions of the Health and
childhood vaccinations, booster shots and
                                                     Child Care Newsletter. Just click on the
seasonal flu shots. For comprehensive
                                                     “Publication and Newsletters” tab on the left.
information on vaccines, visit the National
                                                     Contact vacchcs@aol.com or (804) 864-7685
Immunization Program (NIP) at
                                                     for additional program information.
http://www.cdc.gov/nip/default.htm

The latest change to the Immunization
Schedule is the addition of a second dose of
varicella (chickenpox) vaccine for children
                                                     DON’T MISS IN THIS MAILING!
four to six years old to further improve
protection against the disease. The first dose
of varicella vaccine is recommended at 12 to         The Virginia Department of Health,
15 months old.                                       beurea of STD/AIDS has updated its
We recommend you visit the NIP site often            brochure “ABC’s of Day Care
for news, updates and useful resources.              Attendance for Children with
                                                     HIV/AIDS”.

                                                     The Virginia Department of Health and
                                                     the Virginia Department of Social
                                                     Services are happy to include a brand
                                                     new poster, “CHANGING A DIAPER
                                                     THE SAFE WAY”. If you would like to
                                                     request additional copies please call
     Healthy Child Care Virginia                     (804) 864-7685. Leave name, mailing
          Program Update                             address and number of posters.

The goal of the Healthy Child Care Virginia
program is to promote the healthy
development of all children in child care,
including those with special health needs, to
increase access to preventive health services,