See Managing Infectious Diseases in Child Care and Schools, 4th Edition available at https://shop.aap.org for more information. In PA, please send your health and safety request with your name and phone number to This email address is being protected from spambots. You need JavaScript enabled to view it..

Correct hand hygiene is important in all seasons. Use information on the Centers for Disease Control (CDC) website to remind everyone about how and when to do it.

Use the CDC posters and the information from the CDC website to make your own posters with photos of the children, drawings or magazine clippings. Here is some wording adapted from the CDC web-site to use on posters in child care programs:

  • The flu virus can live on surfaces such as door knobs and tabletops for up to 24 hours. Routine cleaning of surfaces and proper hand hygiene may reduce the spread of flu.
  • Washing hands with soap and water is the best way to reduce the number of germs (microbes) on them in most situations.
  • If soap and water are not available, adults and children older than 24 months of age who are close-ly supervised by adults can use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situa-tions, but sanitizers do not eliminate all types of germs. Hand sanitizers may not be as effective when hands are visibly dirty or greasy.

WHEN to perform hand hygiene:1

  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing diapers, soiled pull-ups or underwear, or cleaning up a child who has used the toilet (Before changing diapers too, if hands touched body fluids before the change)
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling pet food or pet treats
  • After touching garbage

HOW to perform hand hygiene:2 Washing hands with soap and water is the best way to reduce the number of germs in most situations. If soap and water are not available, use hand sanitizer with at least 60% alcohol. Hand sanitizers do not eliminate all types of germs.

  • Wet your hands with clean, running water (warm or cold), and apply liquid soap. (Let the water run if you can’t turn it off without touching the faucet with soiled hands.)
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds or as close to 20 seconds as possible. Need a timer? Hum or sing "Happy Birthday" or “Row, Row, Row Your Boat” from beginning to end twice. Make up words to sing about hand washing with these familiar song tunes.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air dry them. Use a paper towel to turn off the wa-ter if the taps do not shut off automatically.

1 http://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html
2 http://www.cdc.gov/handwashing/when-how-handwashing.html

Handwashing is a your best defense against germs.  Use this poster developed by the North Carolina Division of Public Health as a reminder about the importance and steps for handwashing.  Click here to access the poster.  Reviewed and reaffirmed 6/2018.

This form guides collaborative problem-solving involving those who are affected, those with authority, and those with expertise. The form encourages documentation of who is involved, the tasks planned, who is responsible, and checkpoints for follow-up. The attachments include a blank copy of the form and a sample of the completed form to address the problem of a 2 year old child who is biting other children.

Brochure that describes the role of a sanitarian or food safety consultant for early education and child care programs. Reviewed and reaffirmed 11/2012

This online professional development opportunity is for directors and administrative staff in centers that serve 25 or more children and who are new users (subscribers) using the WellCareTrackerTM Internet application software, available from ECELS. The professional development experience involves working with the user-friendly internet application on any computer connected to the Internet to review children's health records, identify and track gaps in the children's required preventive health services. WellCareTrackerTM software uses the dates of preventive health care services entered for each child at any time thereafter to report whether the child is currently up to date, overdue or will be due in the next three months for specific services. In addition to reports for individual children that can be given to parents, the system produces a report for all the children entered. This report makes it easy to  track needed services and follow-up with families. Currently, the PA Department of Health is doing random audits of the immunization records that state regulations require child care programs keep on file to show children are up to date. The health reports should give information about screening tests and special needs too. WellCareTrackerTM lets staff make sure children have received all the services that they need to be healthy and ready to learn. In addition to being protected against vaccine preventable infectious disease, they need to be free of treatable conditions such as hearing and vision problems, anemia or lead poisoning. Look for the detailed description of the self-learning module on the left pane of the WellCareTracker(TM) home page at www.wellcaretracker.org under "ECELS - Self Learning Module." PA child care practitioners may submit completed work for review for credit by scanning the pages and attaching them to an e-mail, sending them by fax or by surface mail to ECELS. Be sure to follow the instructions in the “Important Reminders” box next to the list of self-learning modules on this webpage. (ECERS-ITERS: Personal Care Routines, Program Structure. K7-C3-78 or K8-C3-91. 6/2017

Steps for child care facilities to prevent illness. This approach is for all facilities, but will be especially helpful to those who want to meet the Pennsylvania standards for STARS. 

See Managing Infectious Diseases in Child Care and Schools, 4th Edition available at https://shop.aap.org/ or search www.healthychildren.org for more information. In PA, please send your health and safety request with your name and phone number to This email address is being protected from spambots. You need JavaScript enabled to view it..

Deciding when to exclude a child who is ill from early learning and education programs can be confusing for staff. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, clarifies the decision-making process. A child who is ill but does not require immediate medical attention should be excluded if the staff member determines the illness:
a. Prevents the child from participating comfortably in activities as determined by staff
b. Results in a need for care that is greater than the staff can provide without compromising the health and safety of other children
c. Poses a risk of spread of harmful diseases to others based on the list of specific excludable conditions
If any of the above criteria are met, the child should be excluded, regardless of the type of illness.

Immunization is a key component of early childhood development and health. Remember – early childhood and school readiness begin with good health! It is important for early childhood education staff to make immunization a priority. Foster an environment of health with:
• Immunization tracking
• Staff education and adult vaccination as needed
• Parent education
Early childhood education (ECE) programs are prone to disease outbreaks. Recent outbreaks of measles, flu and pertussis (whooping cough) have occurred in ECE settings. Unvaccinated children are at increased risk for disease and can spread disease to others. Babies are at high risk since they are too young to be fully vaccinated.

Learn how to check immunization records for children in your care. View online videos and learn about vaccines on the website of the Vaccine Education Center of The Children's Hospital of Philadelphia. The instructions include a link to the website of the National Immunization Program of the Centers for Diseases Control and Prevention (CDC) and CDC's FREE handy software tools to check vaccine records for individual children in your care and adults who care for the children.   Pennsylvania child care practitioners may earn professional development credit by submitting your answers to questions about what you learned with your evaluation of vaccine records for at least 5 children in your care. Follow the instructions in the "Important Reminders" box beside the list of self-learning modules for ECELS to review your work to award professional development credit.  (ECERS-ITERS: Program Structure. K7-C2-78. 6/2017