Home Study Course in

Child Care
Please note:
This course is based on generally accepted practices in Alberta. Please consult your
public health inspector to make sure you are following Alberta health regulations.

This course will be updated regularly. Please make sure that you are reading the most
current version by printing the course directly from our website at:
[Link]/[Link] click on education courses and then click on
Homestudy Course in Childcare. Please also print the test from the website to make
sure you complete the most recent version, as only this version will be marked.

4EPHE-13-003
Created: Jan/01
Revised: May/14

2
 Alberta Health Services
Health Protection
Environmental Public Health

Home Study Course in Child Care

Table of Contents

Introduction………………………………………………………………………………………. 4

Section 1: Institutions Regulation………………………………………………………….. 5

Building construction, ventilation and lighting, plumbing, garbage disposal,

sleeping and resting areas, crib safety, maintenance, first aid, emergency
preparedness, food facilities

Section 2: Food Safety………………………………………………………………………... 9

Food poisoning, clean, separate, cook, chill, feeding infants, picnic safety,
home prepared food, dishwashing

Section 3: Infection Control…………………………………………………………………. 19

Handwashing, hand sanitizer, cleaning up body fluid spills, diapering,

when to exclude children, pets in daycares

Section 4: Health and Safety Concerns……………………………………………………. 26

Playground safety, sun safety, winter safety, arts and crafts safety, toys, dress up,
playdough, water play, sandboxes, displays, chemical safety

Test package ………………………………………………………………………………….. 36

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 Home Study Course for Child Care Providers
This course was designed by Environmental Public Health to assist you and your staff in providing
a safe and healthy environment for the children under your care.

There are four sections:

Section 1 - Institutions Regulation

Section 2 - Food Safety
Section 3 - Infection Control
Section 4 - Health and Safety Concerns

The course is structured so that you may study the material at your own pace and complete the
attached exam when you are ready.

The test has a total of 25 multiple-choice questions. The passing mark is 80%. Once you pass the
test, you will be awarded an Alberta Health Services Home Study Course Certificate, which is
valid for three years. This certificate is not to be confused with certificates awarded from other
agencies or schools.

Thank you for your participation. We feel that your time will be well spent, and the information you
learn will make for a healthier and safer child care setting.

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Section 1: Institutions Regulation

The purpose of the Institutions Regulation is to protect the health of individuals who are under the
care of a daycare, a day home, a nursery school, or an institution. Public Health Inspectors ensure
that strict health and safety standards are met in establishments where individuals are cared for. To
help prevent illness, compliance with the Institutions Regulation and Public Health Act is expected at
all times. Official copies of Alberta legislation such as:

Institutions Regulation 143/1981

Alberta Food Regulation 31/2006
Public Health Act

are available in print and electronic format from:

Alberta Queen’s Printer

Main Floor, Park Plaza, 10611 – 98 Avenue
Edmonton, Alberta T5K 2P7
Phone: 780-427-4952 Fax: 780-452-0668
Email: qp@[Link]
Internet: [Link]

Alberta Health Services also publishes Health and Safety Guidelines for Child Care Facilities, that
can be used as a reference tool. The document is available at:
[Link] Click on Social Care Facilities.

What kind of child care settings does the Institutions Regulation cover?

The Institutions Regulation regulates all child care facilities, which include day care centres,
family day homes, and nursery schools.

The regulation sets out the following requirements for child care settings:

Building construction

The building shall be built in a manner which makes it safe and sanitary.
Adequate space shall be provided for all activities within the facility.
Every room used for sleeping or resting shall have a space of not less than 2.5 square metres
per child who is under the age of ten, or not less than 5 square metres for each person over the
age of ten.
The facility shall ensure that it does not exceed the maximum occupancy.
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Ventilation and lighting

Every room shall be maintained at a minimum temperature of 20°C.

All surfaces shall be smooth and easy to clean.
20°C
The facility shall be well ventilated.
The facility shall be well lit.
Curtains or shades shall be provided to cover windows.

Plumbing

The facility shall be equipped with an appropriate number of washrooms

that are connected to an approved sewage disposal system.
An adequate supply of hot and cold, running, potable (safe to drink)
water shall be available.
Soap and either:
paper towels,
an electric hot air dryer, or
individual towels to be laundered after one use
shall be provided for handwashing. In a private child care
facility or home, individual towels may be provided.
Toilet paper shall be provided in dispensers.
Garbage cans shall be provided in the washroom.

Garbage disposal

Garbage shall be kept in fly proof and water proof containers.

Garbage shall be properly stored and disposed of at least once a week.

Sleeping and resting areas

A clean and sanitary cot, bed, or sleeping mat shall be provided

for every child under care.
Every crib and bed shall be equipped with a mattress and
protected with a moisture resistant cover.
Every cot and sleeping mat shall have washable covers.
All bedding shall be kept clean and dry and labeled with the
child’s name.
No bedding shall be used for more than one child without
laundering between uses.
All sheets and pillow cases shall be laundered at least once a
week.
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Crib safety

Cribs used shall be built after 1986.

Crib sides shall have secure locking devices and sides
locked in the highest position.
Cribs shall be in good repair and in a safe location.
Warning labels shall be intact.
Crib slats shall be no more than 6 centimetres apart.
There shall be no more than 3 centimetres of space
between mattress and bed frame.
Mattresses shall be no thicker than 15 centimetres.
Check all requirements on Health Canada’s website - crib
safety.

Maintenance

The facility shall be kept in a clean and sanitary manner at

all times.
All equipment used indoors and outdoors shall be
constructed and designed so that it may be used in a safe
and sanitary manner.
All paint shall be lead-free and non-toxic when dry.
All medical supplies, corrosive agents and other chemicals
shall be labeled. These shall be stored in a locked cab-
inet, and stored and used according to the directions on
the label.
Individuals shall be protected from hazards such as
radiators, water pipes, electrical outlets, and toxic plants.
Furnishings and equipment shall be in good repair, free
from sharp, loose or pointed parts.

First aid

A first aid kit for emergency treatment prescribed by the

Alberta Occupational Health and Safety Act (Schedule 2 in
the Code) shall be readily available.

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Emergency preparedness

Children’s emergency information should be accessible to all staff at all times.

The facility must comply with all fire regulations. Check with your local municipality. Fire pull
alarms shall be child proof.
A non-coin, landline telephone should be accessible with emergency numbers posted by the
phone.

Food facilities

If the facility is responsible for the care of more than ten children, then the facility shall meet the
requirements of the Alberta Food Regulation. A copy of the regulation is available from Alberta
Queen’s Printer.
Food shall be prepared, stored and served under sanitary conditions.

For care of children under 19 months of age:

Supplies for bathing the children shall be available.

A diaper change table or surface shall be available, separate from food areas, and next to a
handwashing sink.
The change table surface shall be non-absorbent and easily cleaned and sanitized.
The top of the change surface must be covered with a fresh diapering service (e.g. disposable
covering such as paper towel) for each child.
Soiled disposable diapers shall be disposed of properly in sealed containers.
Cloth diapers provided by the parents, when soiled shall be sent home in a sealed container.
Staff must wash their hands after each diapering of a child, even when using gloves.
Staff must ensure that personal belongings, soothers and bottles are properly identified so that
they are not exchanged between
children.

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Section 2: Food Safety
Millions of people get sick each year from the food they eat. Symptoms may include stomach
cramps, diarrhea, nausea, vomiting, fever or a combination of these symptoms. Many think they
have the so-called ―stomach flu‖, when the real problem is poisoning from the food they ate a few
hours or a few days ago. In more severe cases, food poisoning may cause nerve disorders,
paralysis and even death.

INFANTS AND CHILDREN ARE AT HIGH RISK

A healthy adult’s immune system is usually able to fight off infection but children are not always able
to fight disease very well because their immune systems are not well developed. Some harmful
bacteria can be killed by natural stomach acid, but infants and children produce less acid in their
stomachs, making it easier for them to get sick. Other groups that are at higher risk of getting sick
include pregnant women, the elderly and the sick or those with weakened immune systems.

WHAT CAUSES FOOD POISONING?

A majority of food poisonings happen because harmful bacteria or their toxins (waste products
produced by some bacteria) are present in food. Bacteria are very small organisms that can only be
seen with a microscope. They are everywhere and can easily be spread on the food we eat, in the
water we drink, on our hands, in the air, on the kitchen counter and on dishes and utensils. Some
bacteria are helpful in making foods like cheese, yogurt, sauerkraut, pickles and vinegar, but some
other bacteria are harmful and can make people sick. Examples of harmful bacteria that cause food
poisoning are E. coli, Salmonella and Listeria. The bacteria or their toxins that cause illness do not
change the appearance, colour, texture, odour or taste of the food so you can’t tell when food has
harmful bacteria or toxins in it.

The best way to control harmful bacteria and toxins in food is by

controlling the temperature of the food. Potentially hazardous food,
which is food that can support the growth of bacteria (like meat or dairy),
needs to be kept out of the temperature danger zone. This is the
temperature range between 4°C and 60°C (40°F to 140°F), where
bacteria grow rapidly. Bacteria grow the fastest between 30°C and 45°C.

A common virus that can cause food poisoning is norovirus. The best
way to control spreading harmful viruses like norovirus in food or on
surfaces is to practice good personal hygiene, and not coming to work
when sick.
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FIGHT BAC: FOUR SIMPLE STEPS TO FIGHT BACTERIA

CLEAN – Wash hands. Wash utensils and surfaces with hot soapy water
before and after making food. This is especially important after handling
potentially hazardous foods such as meat, poultry, eggs or seafood. Wash
food contact surfaces such as countertops and cutting boards with warm
water and soap, rinse and then use a sanitizing solution of bleach and water
on food contact surfaces.

Sanitizer: mix 1/2 teaspoon of household bleach into one litre of water.

SEPARATE – Avoid cross contamination which allows bacteria to be

transferred from food to food, hand to food or equipment to food. Do this by
keeping raw meat, poultry, eggs and seafood and their juices away from
ready-to-eat foods. Store cooked and ready-to-eat foods on the top shelf of
the cooler, and store raw meats on the bottom shelf. Use separate cutting
boards for raw and cooked foods. Colour-coded cutting boards are
recommended (e.g. a red plastic cutting board for meat and green for
vegetables). Never place cooked food on an unwashed plate that previously
held raw meat, poultry, eggs or seafood.

COOK – Cook food to the proper internal temperatures and check for
doneness with a food thermometer. Cook eggs until both the yolk and white
are firm.

CHILL – Refrigerate or freeze potentially hazardous foods, prepared foods

and leftovers within two hours. Make sure the refrigerator is set between 0ºC
(32ºF) and 4ºC (40ºF) and the freezer unit is set at about -18ºC (0°F).
Refrigeration and freezing will not kill bacteria in food. Refrigeration will only
slow down the growth of bacteria. Freezing will eventually stop bacteria from
growing, but bacteria will start multiplying again during thawing. Watch a
short video on the four Fight Bac steps by clicking here.

18 children in an Alberta daycare ended up in the emergency room

with Staphylococcus aureus food poisoning from eating chicken and
rice that was left at room temperature for several hours. - 2001

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COOK FOODS WELL DONE

Meats, fish and poultry

When using a thermometer, ensure that it does not touch any bone or the
bottom of the pan. Take the temperature in the thickest part of the food.
Cook fish to an internal temperature of 70°C (158°F).
Cook pork to an internal temperature of 71°C (160°F).
Cook solid cuts of red meat to an internal temperature of at least 63°C.
(145°F) (medium rare). Ground beef must be cooked to at least 71°C.
Cook whole poultry to an internal temperature of 85ºC (185°F).
Check the temperature with a thermometer in the thigh. Cook poultry pieces to 74°C (165°F).
Cook casseroles and leftovers to an internal temperature of 74°C.

Custard-filled baked goods linked to at least 73 illnesses including 30 hospitalizations

The source of the contamination remains unknown but raw eggs often used in custards can carry Salmonella.
Pasteurized eggs should be used as a safe alternative.

February 2011 Click here for a food safety information sheet on this outbreak

Milk and eggs

Only buy and serve pasteurized milk. Raw (unpasteurized) milk from
cows and goats may contain harmful bacteria. It is illegal to sell or
buy raw milk.
Raw eggs may also contain harmful bacteria. Refrigerate eggs and
egg-containing foods because refrigeration slows down bacterial
growth. Do not use cracked eggs.
Cook eggs until the yolk and white are firm, not runny. Cook scrambled eggs until firm.
Recipes for homemade mayonnaise, salad dressing, ice cream and eggnog that call for using
raw eggs are not safe to eat. This is because the eggs will not be cooked before consuming
them. Buy and use store-bought products which are made with pasteurized eggs for these rec-
ipes instead.
At home, tasting while baking is tempting, but licking a spoon or tasting raw cookie dough or oth-
er batter that contains raw eggs can be risky. Wait until the batter is baked.

Three children contract Salmonella after licking a spoon used in baking with raw eggs.
April 2010 Click here for a newspaper article on this incident

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CONTROL THE TEMPERATURE OF FOOD

CHECK — Keep refrigerators and coolers at 4ºC or colder and freezers

at -18ºC or colder. Use a thermometer to ensure that correct
temperatures are maintained. Check and record temperatures on a
daily basis.

THAW — Thaw food in the refrigerator or microwave, never at room

temperature, like on the kitchen counter. If you defrost food in the
microwave oven, only use a microwave safe dish, and cook the food
immediately after thawing. Food can also be thawed in a sink under cold
running water.

HOLDING AND SERVING — If not eating prepared food right away,

keep hot foods hot (60ºC or hotter) and cold foods cold (4ºC or colder)
until service.

COOL — It is best to serve food immediately after cooking. If food is not

going to be served right away, divide large amounts of food into smaller
portions. Place food in uncovered shallow containers, and cool in the
refrigerator. Food should be placed in the refrigerator to cool as soon as
possible after cooking. Do not cover food or containers until the food has
cooled. Label and date containers, and use leftovers within 2-3 days.

REHEAT — Reheat foods thoroughly to a minimum internal temperature

of 74ºC. Note that when you are using the microwave oven to reheat
foods, heating may result in ―cold spots‖ inside or on the surface of
foods. Rotate dishes, stir food and let food stand for five minutes to
allow the heat to spread evenly. Bring soups, sauces and gravies to a
boil when reheating.

DISCARD — Remember the two-hour rule: Do not leave potentially

hazardous foods at danger zone temperatures for more than a total of
two hours. This includes transportation, preparation and serving time
added together. When in doubt, throw it out!

Keep potentially hazardous foods out of the

Danger Zone!
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FEEDING INFANTS

Formula

Label each child’s bottle. Bottles should not be shared.

Sterilize bottles and nipples for infants up to five months of
age. Place bottles and nipples in boiling water for five
minutes to sterilize. Do not use a microwave oven to
sterilize.
Remember to use boiled water that has been cooled for
infants up to six months old for drinking and preparing formula.
Baby milk has different storage times. Powdered formula prepared with boiled water should be
used within 24 hours. Once a can of concentrate or ready-to-eat formula is opened and placed
in bottles, it should be used within 48 hours. Expressed breast milk should also be used within
48 hours.
Keep prepared formula in the refrigerator, not in the diaper bag or on the kitchen counter. If you
are going away, keep it cold in an insulated thermos bottle, carry it in an insulated container with
an ice pack to keep the formula cold, or bring along an unopened can of ready-to-eat formula.
Throw away any leftover formula after feeding. Never save partially used bottles for another
feeding. This is because when a baby drinks from a bottle, bacteria move from the baby’s mouth
into the bottle. Saving the bottle for another feeding allows time for the bacteria to grow in the
formula, even if it is in the refrigerator.

Baby food

Remove some of the baby food from the jar and put in a bowl or on a plate. Close the jar and
refrigerate any unused portion.
To prevent burns, always check the temperature of heated food before serving.
Throw away uneaten food on a child’s plate because it may contain bacteria. If uneaten food is
kept, the bacteria have a chance to grow and contaminate the food.
Feed each child from a separate plate or bowl, with a separate spoon. Using the same dish or
utensil could pass bacteria from one child to another.
Never feed infants unpasteurized apple juice, juice blends that contain unpasteurized apple juice
or unpasteurized apple cider.
Never feed children under four years old foods that pose a high risk of choking, such as whole
hot dogs, hot dog ―coins‖, whole grapes, peanuts, hard candies or raw carrots.
Never feed honey to infants under one year old because the honey may be contaminated with
the bacteria that causes infant botulism.
Never prop up a baby bottle to feed an infant. Always hold the bottle to feed the baby. 13
PICNIC SAFELY

Planning the picnic

Plan to take only the amount of food you think you will use.
Make sandwiches ahead of time and wrap each one by itself. Put all the wrapped
sandwiches in a big plastic bag and freeze them. Simple sandwiches freeze best.
Try using cheese, sliced meat or poultry.
Foods that are not potentially hazardous are great for picnics. Good examples
include fresh, canned or dried fruit, raw vegetables, hard cheese, canned or dried
meats or fish, dry cereal, bread, crackers, or cookies. Do not use canned foods
that are bulging or dented, have mould or off-odours.
Freeze small containers of juice, yogurt or applesauce. They will thaw by lunch.
Gather a supply of safe drinking water for drinking or mixing with food.
Freeze gel packs or buy bags of ice.

Packing the picnic

Pack the food right from the fridge or freezer.

Pack all food in clean plastic wrap or sandwich bags.
Pack food in your cooler in reverse-use-order. Pack the food first
that you are likely to use last. All perishable foods such as lunch
meats, fried chicken, potato or pasta salads should be kept in a
cooler.
Include ice packs or freezer gel packs in the cooler. Keep the ice
bags in plastic bags to prevent leakage.
Pack cold infant formula in an insulated cooler with an ice pack to keep it cold.
Keep hot food hot by using a thermos or an insulated dish.

Enjoying the picnic

Always wash your hands (and children’s hands) before preparing and
eating food. If safe, running drinking water is not available, take along
disposable sanitizing wipes.
Keep all coolers out of the sun with the lid closed. With a proper cooler
and ice, most foods are safe for several hours.
Keep food out of danger zone temperatures. Do not let food sit out for
very long. Serve food quickly and put unused portions back in the
cooler. Throw out any leftover perishable food.
Cook foods thoroughly. Bring a food thermometer to make sure that
meat and poultry have reached a safe internal cooking temperatures.
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HOME PREPARED FOOD

Many child care settings provide children with two snacks and one meal a day. However, some
child care facilities only provide snacks, and lunch must be provided by the parents. If this is so,
ensure that:

Each child’s lunch brought from home is clearly labeled with the child’s name.
The food is stored at an appropriate temperature until eaten. Potentially hazardous foods are
stored in the refrigerator.
The food brought from one child’s home is not fed to another child.

Parents may want to provide a food treat to share with other children on special occasions such a
child’s birthday. Encourage parents to bring only cakes, cupcakes, or other ―party‖ food that have
been purchased from a store or restaurant that is routinely inspected and approved by the health
department. Many outbreaks of food poisoning have been linked to eating home-prepared foods.
There is often a greater risk of cross contamination occurring in homes because they are not
inspected or approved to provide food for the public. There is usually very little control over pets,
children and infected individuals in private homes. Let parents know that the child care’s policy aims
to protect all the children in its care from foodborne illnesses.

Special Note:

Many child care facilities require any food products included in lunches or brought to share are nut
free. Some children may have a severe allergic reaction if exposed to nuts.
For more information on allergies, click here.

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DISHWASHING

There are two different systems for cleaning dishware, pots, pans and other utensils.

1. Mechanical system: washing dishes using a dishwasher.

2. Manual system: washing dishes by hand.

The system selected will be influenced by the size of the facility and the type of operation.

General dishwashing procedures

Whether dishwashing is done by machine or by hand, there is a basic procedure that is common to
both. Steps should be carried out in the following order:

1. Scrape – to reduce food particles before cleaning and sanitizing. It may be necessary to soak
flatware, cutlery and small utensils in hot water and detergent for 10 to 15 minutes.
2. Sort and Rack – to ensure items of the same size and shape are washed together.
3. Wash – to remove grease and food particles using detergent and clean water.
4. Rinse – to remove detergents and remaining food particles that interfere with the sanitizing
process.
5. Sanitize – to reduce the number of microbes to a safe level using hot water or chemicals.
6. Air Dry – to remove the moisture that allows bacteria and other microbes to survive. Only clean
hands should handle clean dishes and utensils. Do not dry with a towel which can contaminate
clean dishes and utensils. Do not touch the ―business ends‖ (i.e. the part of the utensil, dishware
or glassware that touches the mouth).

Approved Chemical Sanitizers:

Chemical Concentration Dilution

Chlorine Bleach 100 ppm* Using unscented household bleach, mix a 1/2
teaspoon of bleach in 1 litre of water.

Quaternary Ammonium 200 ppm Follow manufacturer’s instructions.

Compound (Quats)
Iodine 25 ppm Follow manufacturer’s instructions.

* ppm = parts per million

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MECHANICAL DISHWASHING USING A COMMERCIAL DISHWASHER

There are 2 types of commercial dishwashers:

High temperature dishwashers use heat to sanitize dishes.

The wash water temperature should be 60°C. Ensure the
―booster heater‖ is turned on well in advance of using the
machine. The machine’s water temperature during the
sanitizing cycle (also called final rinse) should reach 82ºC to
properly sanitize the dishes.
Low temperature dishwashers use chemicals instead of hot
water to sanitize. The wash water in these machines should
be at least 48°C. Use a test paper to ensure that the proper
chemical strength, or concentration, is reached after running
one load.

Domestic dishwasher

The use of domestic dishwashers is discouraged in child care centers

because it is difficult to accurately determine the wash and sanitize
water temperature. Unless your facility has 10 or fewer children and
the facility is exempt from the Alberta Food Regulation, a commercial
dishwasher or a 3 compartment sink is required.

Test strips are very sensitive to

ultraviolet light and moisture.

MANUAL DISHWASHING USING THREE-COMPARTMENT

They should be replaced every
A
six months.
SINK

When washing dishes by hand, use a three compartment sink and follow the approved dishwashing
procedure. Make sure to use an appropriate test paper to verify the concentration of the sanitizer in
the third sink. A picture of the proper manual dishwashing procedure is on the next page.

17
Manual dishwashing procedure using a two compartment sink

If your facility has been approved to use a two compartment sink for dishwashing, or if a two
compartment sink is available as a backup when the dishwasher is not working, use the
procedure outlined below:

Follow the wash, rinse and sanitize procedure for clean in place items such as countertops,
tables and larger kitchen equipment.

18
Section 3: Infection Control
HANDWASHING

Hands are warm and moist and provide a perfect environment

for bacteria to live. Hands are constantly touching things so
they pick up bacteria as well as spread them. Young children
are often seen putting things in their mouths, sucking their
thumbs or rubbing their eyes. Infants between six to 30
months have been observed putting their hands in their
mouths every one to three minutes.

Hand sinks need to be available in the diapering area and in

washrooms. These sinks must not be used for washing dishes Fake germs glowing on hand under an
ultra violet light.
or for preparing food.

Handwashing is the single most effective way to control communicable disease. It reduces
in half the number of diarrhea outbreaks in child care centres.1

When should hands be washed?

After arriving at the centre.

After using the toilet, after changing diapers or after helping a
child use the toilet.
After touching pets in the centre or during and after field trips to
farms or petting zoos.
After smoking.
After touching raw meat, poultry, fish or eggs.
Before preparing and before eating food.
Whenever hands come into contact with body fluids such as
vomit, saliva or runny noses.
Whenever hands come in contact with soiled or dirty items.

1
RE Black et al., ―Handwashing to prevent diarrhea in day-care centers,‖ American Journal of Epidemiology, 113(4) (1981):445-51.

19
Correct handwashing procedure

Wet hands with warm water.

Use soap, lather and scrub well (a nail brush is recommended).
Rinse.
Dry hands, preferably with paper towels. Other single-use toweling or hot air dryers are also
acceptable.

This procedure takes a minimum of 20 seconds. Observe the proper technique and teach the
children in your care good habits. By practicing good personal hygiene, you provide a good
example to the children under your care. Remember that wearing gloves does not replace
handwashing in the kitchen. Hands must be washed and dried before putting gloves on; putting
gloves on with dirty hands will contaminate the outside of the gloves. Hands must also be washed
after taking gloves off.

Hand sanitizer

Hand sanitizers do not replace handwashing. Hands should be washed

with soap and warm water, dried and then hand sanitizer used. There
are different types and brands of hand sanitizer available. The most
common type uses alcohol to kill germs on your hands. The alcohol
content should be at least 60%. In order for hand sanitizer to work
properly, follow these rules:
Use sanitizer only on hands that are visibly clean.
Use enough sanitizer to cover all parts of your hands and wrists.
Rub hand sanitizer into your hands, knuckles, fingers, thumbs,
nails and wrists. Keep rubbing your hands until the sanitizer is dry.
Don’t rinse your hands, or dry them with a towel.
Hand sanitizer is not recommended for infants and toddlers, as they
may put their hands in their mouths before the alcohol has evaporated. Hand sanitizer is not considered
as effective as washing hands
Make sure that hand sanitizers are kept out of reach of young children. with warm water and soap.

Hygiene tips for child care providers

Stay home when you are sick.

Avoid touching your face, rubbing your eyes or putting your fingers in your mouth unless your
hands are clean.
Keep nails short and clean. Avoid wearing nail polish or artificial nails.
Wear minimal jewelry.
Cough and sneeze into your sleeve. If you cough or sneeze into your hands, wash your hands
immediately.
Click here to watch ―Why don’t we do it in our sleeves‖ video.
20
Procedure for cleaning up body fluids (blood, vomit, feces)

1. Separate the injured or sick child from other children and isolate the affected area.
2. Put on gloves. Avoid contact with your mouth, eyes or ears while cleaning up the body fluid.
3. Check whether other children had contact with any of the body fluid. If yes, put on clean gloves
and cleanse the affected area of the child. If fluid, particularly blood, came in contact with another
child’s mouth, eyes, or broken skin, call the local Public Health Office for direction.
4. With gloves on, wipe up all fluids and any other debris with paper towel, or another absorbent
material. Dispose of waste in a plastic garbage bag.
5. Sanitize any contaminated surfaces (floor, furniture, toys etc) with a bleach solution (add 1 part
bleach to 9 parts water).
6. Allow the bleach solution to sit for at least 10 minutes.
7. Wipe up any excess bleach solution.
8. Soiled items such as mops and scrub brushes should be disinfected with the bleach solution and
then allowed to air dry.
9. Remove and dispose of gloves in garbage bag with other contaminated materials. Double bag,
seal and throw it away.
10. Wash hands thoroughly with warm water and soap.

21
DIAPERING PROCEDURE

Because feces are full of bacteria, the correct diapering procedure is critical in preventing the
spread of disease during diaper changing. You are not only protecting other children, you are also
protecting yourself and your family. Follow the proper steps for each child:

1/2 tsp (2.5 ml) bleach per

litre of water
(This makes a 100 ppm concentration solution)
22
WHEN TO EXCLUDE CHILDREN

Children can become sick quickly. It is important that a caregiver quickly recognizes the signs and
symptoms of illness. Know what to do when a child becomes ill, and know which symptoms will
require removing the child from a child care setting. Designate an isolation room before the parent/
guardian picks up the child, and disinfect all bedding (sheets/cot) and toys after they leave.

It is recommended that child care facilities create an ―Exclusion for Illness‖ policy, which is a clearly
written policy for excluding sick children from the day care centre. The written policy should clearly
outline the procedure for reporting and recording any unusual illness or injury.

Proper surveillance is the key. Watch children closely for signs and symptoms of illness.
If the following symptoms are present, contact the parents to have the child picked up as soon as
possible and continue observing the child for other symptoms:
Fever combined with sore throat, rash, vomiting, diarrhea, earache, irritability or confusion.
Diarrhea (runny, watery or bloody stools).
Vomiting two or more times within a 24-hour period.
Body rash with fever.
Sore throat with fever and swollen glands.
Severe coughing – where the child gets blue or red in the face and/or makes high-pitched
whooping sound after coughing.
Eye discharge such as thick mucus or pus draining from the eye or pink eye.
Yellowish skin or eyes.
Irritable, continuous cry, or requires more attention than a caregiver can provide without affecting
the health and safety of other children in the day care.

If you strongly suspect that there may be an outbreak in the child

care facility because several children are suffering from similar
symptoms of runny, watery, or bloody diarrhea or frequent vomiting,
inform your supervisor immediately and contact the local public
health office or phone HealthLINK at 1-800-408-5465.

Encourage parents to take their children to the doctor. The doctor

may ask parents to submit the child’s ―stool‖ (poop) sample. By
analyzing the stool, it can be determined if and what type of harmful
germ is causing the vomiting or diarrhea.

There are specific guidelines for cleaning and disinfecting during an

outbreak that must be followed in order to control the spread of
illness. This information is provided in the Alberta Health Services
Health and Safety Guidelines for Child Care Facilities. 23
PESTS OF CONCERN TO DAYCARES

Children do not need to be excluded if they or their home are having issues with pests such as bed
bugs or lice. These common nuisances are described below:

Bed bugs

Adult bed bugs are visible to the naked eye. They range in size from
one to seven millimetres. They like to hide in the seams of mattresses
and in cracks and crevices, like in a headboard or behind baseboards.
They come out at night and crawl and feed on sleeping people to have
a blood meal. Some people react to the bites, with symptoms of itchy
red bumps, while other people may not react to the bites as much. The
good news is that bed bugs are not known to transmit disease.
Photo courtesy CDC.
Unfortunately there is a world-wide resurgence of bed bugs, and they
can be found anywhere. They are not an indicator of poor hygiene.

If a child or staff member at the daycare had bed bugs at home, there is no need to exclude that
person from the daycare. Bed bugs do not fly, but travel in people’s belongings from place to place.
Therefore, it is important to keep personal belongings (e.g. coats, backpacks) separate. Using
cubbies or individual lockers is the best method for separation. If it’s suspected that some items may
have come into contact with bed bugs, place those items in a clothes dryer on the hottest setting for
at least 30 minutes. If you suspect bed bugs may have entered your daycare, call a pest control
company.

Read a bed bug fact sheet from My [Link] here. You may print and distribute to others who
would like more information on bed bugs.

Head Lice

Head lice are very common amongst young children, and can spread
easily. Head lice spread from person to person through things like
hairbrushes or hats. Like bed bugs, lice are not a sign of poor hygiene,
nor do they transmit disease. Children that have head lice do not need
to be excluded from the daycare; however, the family should be actively Photo courtesy CDC.

treating the lice infestation. Keep children’s belongings separate.

Discontinue dress up play and remove dress up items from rooms when lice have been detected.
Wash all washable items in hot water and hot dryer before putting them back into the rooms.

Read a fact sheet from MyHealthAlberta about lice diagnosis, symptoms and treatment here.
24
PETS IN CHILD CARE CENTRES

ACCEPTABLE NOT ACCEPTABLE

Small rodents—such as gerbils, guinea Cats and dogs—increase the risk of

pigs and hamsters are allowed. communicable disease, bites, and
allergies in child care centres.
Rabbits— are acceptable. However, be
aware that most rabbits do not like to be Parrots and pigeons—harbor
picked up and cuddled. Chlamydia psittaci, a bacterial species
that can kill the bird and transmit
Small birds—such as budgies, canaries, diseases to humans. Larger birds tend
finches and lovebirds are allowed provided to bite and their bites may be more
they are healthy and monitored by serious.
veterinarians on a regular basis. Birds must
be caged and not permitted to fly freely. Reptiles—such as garden snakes, anole
Cages must be cleaned daily. lizards, native bull frogs, newts and
salamanders can harbour bacteria such
Fish—should be kept in covered as Salmonella and fungi.
aquariums to minimize the risk of
transmitting Salmonella. Turtles—such as Pseudemys,
Graptemys, Chrysemys and the Red
Ant farms—are allowed if they are totally Earred Slider (Trachemys scripta) are
contained and are a non-biting species. associated with the transmission of
Salmonella.

Chinchillas, ferrets, poisonous

snakes, constrictor type snakes,
amphibians and endangered
species—are not acceptable.

11 children and 2 adults contract E. coli O157:H7

Remember that getting a pet is a commitment from Vancouver petting zoo
and that animals like birds and rabbits can live
September 2009
for ten years or more. Rodents, rabbits and birds
can also bite and scratch. You may want to
67 ill in UK outbreak linked to petting farm
discuss with a vet before getting a pet for your
daycare. September 2009
Click here for more information on both stories

25
Section 4: Health and Safety Concerns
PLAYGROUND SAFETY

Each year thousands of children suffer from playground injuries ranging

from abrasions and cuts to broken limbs and concussions. In Canada, it
is estimated that 28,500 children under the age of 15 are treated in
hospital emergency rooms for injuries related to playground equipment
and roughly 1,700 must stay in the hospital because they are badly hurt. 2
These injuries can even cause death. In order to help prevent these
injuries:

1. Ensure that playground equipment and surfacing meet Canadian

Standard Association Standards and has been inspected by a licensed
playground inspector.
2. Ensure daily checks of the play area.
3. Ensure children are wearing safe and appropriate clothing.
4. Ensure proper supervision of the area.

Playground equipment and surfacing needs to meet the Canadian

Standards Association Standard. The CSA Standard provides detailed
information about materials, installation, strength of the equipment,
surfacing, inspection, maintenance and performance requirements. It
also provides information on access to the playground, play space
layout, and specifications for each type of equipment.

The Parachute website provides information on playground surfaces.

Click here for more information. All surfaces must be certified by the
manufacturer for the necessary fall height. Before the playground is open
for use, a Certified Playground Inspector should complete a thorough
inspection of the area.

Every day before children play on the equipment, staff should take
a few minutes to visually inspect the playground for broken or
vandalized equipment, broken glass, needles or other hazardous
materials, garbage, animal droppings, ropes tied to equipment,
depth of surfacing and any other hazards.

2
Safe Kids Canada, ―Facts on Playground Injury,‖ Safe Kids Canada, [Link]
Safe%20Kids%20Canada/Safe%20Kids%20Canada%20-%20Facts%20on%20Playground%[Link] (accessed July 8, 2011).
26
When children are ready to go and play, staff should ensure that
appropriate and safe clothing is being worn. Past tragedies have
involved strangulation when clothing is caught on equipment. It is
recommended that drawstrings, cords and scarves are securely
tucked inside snowsuits and coats.

Helmets can also be a safety concern in playgrounds. Children

should not wear bike or other sport helmets at the playground. A
child wearing a helmet may fall and be caught dangling by the
helmet in a space large enough for a child to fall through.
A loose scarf and drawstring can be
hazards in playgrounds.

7 year old girl in Saskatchewan dies when her bicycle helmet became trapped in
playground equipment.
September 1997

A key way to ensure ongoing safety in play areas is to properly supervise children at all times. While
children should be challenged and allowed to test their limits during outdoor play, keeping a
watchful eye on the children and potential hazards can prevent or reduce injuries without sacrificing
play value.

Additional playground safety information can be found on the Parachute website as well as in the
Playground Safety Manual developed by Alberta Health Services Kids Safe program.

Young girl falls from playground equipment, hits her head and dies.
August 2010 Click here for more information

27
Playground Checklist

This checklist assists childcare operators in assessing the safety of their playground equipment. It
should not be considered a complete list and does not replace the need to have the playground area
inspected by a Certified Playground Inspector.

 Play space is away from dangerous activities or areas.

 The space between equipment is sufficient to prevent children from colliding into equipment
(generally six feet or about 1.8 metres).
 Foreign objects and obstructions have been removed from fall zones under and around fixed
equipment.
 Equipment is smoothly finished and in good repair (no sharp edges, loose or broken parts).
 All worn S-hooks, chains and bolts have been replaced on swings. All S-hooks are tightly closed.
 The end portion of the slide is at least 11 inches long (28 cm).
 Slides have large decks and handrails at the top and no small spaces that can catch drawstrings
or cords.
 Play structures with closed spaces allow air to circulate sufficiently to control temperature.
 The play space has varied and appropriate surface materials. For example, approved
shock-absorbing surface material is located beneath raised equipment and is the appropriate
depth.
 Most of the play area and equipment is in deep shade between 11 am and 2 pm.
 Health hazards from animal contamination are minimized (sandbox sand raked or sterilized,
hands washed after outdoor play).
 The playground is free of areas where standing water or other debris can collect.
 Wooden play structures are preserved with non-toxic materials.
 Climbing areas, where children could fall, are less than six feet high (1.8 m).
 There are no areas where a child could get caught. For example, there are no openings 3.5
inches to 9 inches (9 cm to 23 cm) wide that can entrap a child’s head.
 Children are closely supervised.

Adopted from: Resource Sheet #32 published by The Canadian Child Care Federation

28
WEATHER CONSIDERATIONS

Sun Safety

The cumulative effect of excessive sun exposure, especially sunburn in young children, can produce
skin cancer in later years. According to the Canadian Dermatology Association, over 75,000
Canadians develop skin cancer annually. The good news is that skin cancer is almost completely
preventable.
Canada Sun Guide

Schedule outdoor physical activities when UV rays are at their weakest –

Minimize sun
before 11:00 am and after 4:00 pm, especially between the months of April
exposure
and October.
Always keep children under the age of one out of the sun.
Remember that skin does not have to be hot to burn, so don’t be fooled by
cloudy or overcast weather. Also, water, snow, sand and concrete can
reflect and increase the sun’s burning rays.

Seek natural shade from trees and buildings. Plant

Seek and create
shade trees in the school yard and other play areas. Use
shade, umbrellas, or create other forms of shade if
natural shade is not possible. Keep playpens, strollers
and carriages in shaded areas.

Eighty percent of skin cancers occur above the neck.

Cover up Cover children’s heads, necks and ears with a broad
brimmed hat when outdoors. Protect arms and legs
with tightly woven, loose fitting, cotton clothing.
Children can also wear UVA/UVB protective sunglasses.

The use of sunscreen is not recommended for infants under six months old.
Use sunscreen
Have children use a broad spectrum sunscreen (protects against both UVA
and UVB rays) with a sun protection factor (SPF) of 15 or more.
Apply sunscreen generously before all outdoor physical activities such as
swimming, biking or even walking. Remember to apply sunscreen at least
20 minutes before sun exposure. Reapply often, as perspiration will reduce
the effectiveness of the sunscreen.

Adopted from an article on Sun Safety published by Canada Safety Council.

29
Winter Safety

Cold weather, snowfall advisories and wind chill warnings are a regular winter occurrence in
Alberta. Child care providers have a responsibility to ensure children are safe and protected from
winter elements. This includes assessing whether it is safe to play outside, modifying play and
following safe outdoor winter play practices. Childcare providers must remind parents and caregivers
to bring the correct winter wear for their children

Assess whether it is safe to play outside

Check the weather forecast. Remember weather conditions can change dramatically
throughout the day. Is there precipitation expected? Wind-chill? Humidity?
Consider the age of the children. Toddlers and infants bodies are smaller and more
vulnerable to cold exposure.
Consider the type of activities children will be doing. When you move, your body generates
heat that gets trapped under your clothes and makes you feel warm. Stand still and you are
more likely to get cold.

Modifying Play

Based on your assessment, decide what is best for the children. You may decide to:
Keep children inside until the weather changes or keep younger children inside but allow old-
er children time outside if they are properly dressed and monitored.
Allow all children to play outdoors but modify the time spent outside. For example, instead of
one thirty minute session, break it into two fifteen minute sessions.

Winter Play Practices

When playing outside, measures to protect children include:

Dress children in layers of clothing, with a wind and water proof outer layer.
Ensure children have hats, mittens, warm boots and neck warmers.
Monitor children to ensure they are not removing or losing items of clothing during play.
Keep children moving but avoid activities that will lead to children sweating, since perspiration
will cool children off.
Monitor children for wet clothes, chilling, frostbite, fatigue and signs of hypothermia.
Remember toddlers may not be able to effectively communicate that they are cold, or have
painful tingling or burning sensations (early signs of frostbite).
Don’t ignore shivering, an important first sign that the body is losing heat.
Teach children the signs of frostbite and hypothermia and the importance of dressing warmly.

Additional information on winter safety can be found here. 30

ARTS AND CRAFTS SAFETY

For many children, taking part in art and craft projects is an enjoyable and popular
activity. However, some art materials contain hazardous substances that can cause
permanent health damage and even death. Research has shown that children are
more susceptible than adults to toxic substances, which can be inhaled, ingested or ―Approved
Product‖ Seal.
absorbed through the skin. Therefore, children should only work with materials and
processes known to be safe. It is important to check the labels of art and craft
supplies to ensure they are non-toxic and safe for use. Look for the Approved
Product Seal by the Art & Creative Materials Institute. Products with the Cautionary
Label Seal should not be used with young children. The following is a list of safe
and unsafe materials:
―Cautionary
Label‖ Seal.
AVOID USE
Powdered clay. It is easily inhaled and contains Talc-free, premixed clay. After using clay, wet
silica and possibly asbestos. Do not sand dry clay mop or sponge surfaces thoroughly.
pieces or engage in other dust-producing
activities.

Ceramic glazes or copper enamels. Water-based paints instead of glazes. Adults

may waterproof pieces with shellac or varnish.

Cold-water, fibre reactive dyes or other chemical- Vegetable and play dyes (such as onion skins, or
based commercial dyes. tea) as well as food dyes.

Instant papier mâchés, which create inhalable Make papier mâché from black and white
dust and may contain lead or asbestos. newspapers and library or white paste.

Powdered tempera paints, which create inhalable Liquid tempera paints or paints an adult
dust and may contain toxic pigments. premixes.

Pastels, chalks or dry markers that create dust. Oil pastels, crayons, or dustless chalks.

Solvents such as turpentine, toluene and rubber Water-based products only.

cement thinner and solvent-containing materials.

Aerosol sprays. Water-based paints with brushes or spatter

techniques.
Epoxy, instant glue, airplane glue or other solvent- Water-based white glue or library paste.
based adhesives.

Permanent felt tip markers which may contain Water-based markers only.
toxic solvents.

Casting plaster. Besides creating dust, casting Adults can mix plaster in ventilated area or
body parts can result in serious burns. outdoors for sand casting and other safe projects.

Adopted from: Resource Sheet #21 published by Canadian Child Care Foundation 31
SAFETY DURING PLAY
Toys

Toys should be appropriate for the child’s age group.

Avoid toys that can cause choking in young children such as toys that are less than 4 cm (1.6‖)
in diameter and 5.7 cm (2.2‖) long. Some examples of these toys include balloons, marbles and
beads. Styrofoam objects should be avoided as well since pieces may break off and be eaten.
All children’s toys should be washed and sanitized at least once a week, except for infant toys,
which should be washed and sanitized on a daily basis. If a bleach solution is used to sanitize
the toys, ensure that the concentration of the bleach solution is 100 ppm (1/2 teaspoon of
household bleach/one liter of water). If toys are visibly dirty, sticky or stained, they should be
washed and sanitized before use. Some toys such as plastic balls can be run through the
dishwasher.
Toys that are mouthed by infants and toddlers should be immediately placed in a marked
―mouthing/dirty toy bin‖ and cleaned and sanitized as soon as possible.

Dress-up activity

Clothing used in dress-up activities should be washed at least once a week.

Hats and other headgear should be washable.
Discontinue all dress-up activities during a lice outbreak.

Playdough

Ensure children wash their hands before and after playing with playdough.
If using homemade playdough, salt or other preservatives should be used to prevent bacterial
growth. Store in fridge after use and discard after one week.
Discontinue playdough activity during a diarrhea outbreak.

32
Water play

Ensure children wash their hands before and after playing at the water
play table.
Water temperature at the sink taps should not exceed 54ºC to prevent
scalding. The maximum temperature at a bath tub tap is 49°C.
Teach the children to turn on the cold water tap first before the hot.
When using water play tables, fill the table with clean, potable water
and change the water at least twice daily. At the end of the day, drain
the water and disinfect all the toys and the table.
Discontinue water play activity during a diarrhea outbreak.

Sandboxes

Outdoor sandboxes
Outdoor sandboxes provide a suitable environment for the growth of bacteria. Parasites can also
be transmitted when animals defecate in the sandboxes. However, outdoor sandboxes can still
provide safe play if they are covered properly when not in use. If the sand box cannot be
covered, it should be fenced. Sand should be turned over a depth of 18 inches each year.
Sand play areas should be checked on a daily basis prior to play. Garbage, glass pieces, sharps,
fecal matter, etc. should be removed.
Supervise the children, and teach them not to put hands in their mouths.
Wash hands after use.

Indoor sandboxes
Do not use unsieved or unprocessed sand, since these may
contain fine dust. Exposure to these fine textured products for
prolonged periods may cause lung damage, get lodged in the
eyes and are difficult to remove.
Use sand that has been bagged and labeled ―washed play sand.‖
These have been washed, heat-treated or dried and are composed
of larger sand granules. Play sand should be replaced at least eve-
ry two years.
Cereal products such as pasta, rice or beans as an alternative to
sand, are not recommended as they may attract pests.

33
Wall and ceiling displays

To avoid possible injury when displaying or securing items on a

wall or ceiling, do not use thumb tacks or staples. Instead, use:
T-Bar hooks to be used with T-bar ceilings
Regular or eye hooks
―Fun Tack‖ or ―Hold It‖ which is similar to gum or putty
Velcro
Magnetic bulletin boards (do not use small magnets
as children can swallow/choke on them)
―Scotch Magic Tape‖ that does not dry or peel paint

Other safety points

Place protective covers on all electrical outlets or install

child proof outlets.
Remove any hanging cords or loose wiring that
may cause strangulation or other injury.
Ensure blind cords are child safe with any loops
removed and always out of reach of children.
For more information on blind and curtain cord
safety click here.

CHEMICAL SAFETY
Storage

All chemicals such as detergents, disinfectants, cleaning

compounds and aerosol products must be stored off the floor,
away from children, and separated from food, toys and med-
ication.
Chemicals should be kept in their original containers or
properly labeled containers. Food containers should not be
used to store chemicals.
In general, chemicals should be kept in locked cabinets or in
an area that children have no access to, or at a height of at
least 1.5 metres.
Always follow manufacturer's recommendations when using
any chemical.

34
Medical supplies

Medical supplies should be stored in a locked cabinet away from other chemicals and food
products. If medication requires refrigeration, it should be locked in a container and then placed
in the refrigerator.
Prescription drugs and other medicines should be in their original containers with the original
label.
Acquire a written consent from the parent or guardian to dispense medication to a child.
Keep a written log of the date and time that the medication was given to the child.

Online resources:

Public Health regulations—Alberta Queen’s Printer: [Link]

Is Your Child Safe? Sleep Time—Health Canada:

[Link]

First aid kit requirements—Alberta Occupational Health and Safety Act (Schedule 2 in the Code):
[Link]

Food safety information and outbreaks: [Link]

Food safety video clip: [Link]

Food allergies information—Health Canada: [Link]

―Why Don’t We Do It in Our Sleeves‖ video: [Link]

Bed bug information—[Link]:

[Link]

Lice—My Health Alberta: [Link]

Playground safety and surfacing information—Parachute:

[Link]

Canadian Standards Association: [Link]

Sun safety information and video—Health Canada: [Link]

Is Your Child Safe (blind cords)—Health Canada:

35
[Link]
 Home Study Course in Child Care - TEST

Instructions for Completing the Test

The test has a total of 25 multiple-choice questions. Choose the most correct answer based on the
information from each section. To choose your answer, check the box with the corresponding letter on the
answer sheet provided.

Complete the personal information and answer sheet. Please print clearly or use the fillable answer sheet
available at [Link]/publichealth/envhealth/education/edmonton_courses.htm. We
would also appreciate it if you would complete the evaluation form.

When you are finished, mail, fax or email the personal information, answer sheet and the evaluation form to
Alberta Health Services. Use the contact information for the area of Alberta where you live.

Edmonton and Calgary, Red Deer and

OR
Areas North of Red Deer Areas South of Red Deer

Alberta Health Services Alberta Health Services

Environmental Public Health Environmental Public Health

HSBC Building 10101 Southport Road SW

Suite 700, 10055-106 Street Calgary, AB T2W 3N2

Edmonton, AB T5J 2Y2 Attn: Health Educators

Attn: Health Educators

Fax: 780-735-1802 Fax: 403-943-8056

[Link]@[Link] [Link]@[Link]

Upon successful completion of the test, you will be awarded a Home Study Course Certificate, which is
valid for three years. The passing mark is 80%.
Home Study Course in Child Care
Personal Information and Answer Sheet

First and Last Name:

Mailing Address:

City: Province: Postal Code:

Phone Number (home): Phone Number (business):

Email:

Current Employer:

Current Position:

Check the correct answer

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9. a b c d 18. a b c d Revised: May/14

Edmonton, Areas North of Red Deer

Phone: 1-855-247-3433 Fax: 780-735-1802 HSBC Building, Suite 700, 10055-106 St, Edmonton AB, T5J 2Y2
[Link]@[Link]
Calgary, Red Deer and Areas South of Red Deer
Phone: 1-855-247-3433 Fax: 403-943-8056 10101 Southport Rd SW, Calgary AB, T2W 3N2 [Link]@[Link]
If you receive less than 80% on the test, you will not receive a certificate. Please contact our office for more information.

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Home Study Course in Child Care
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Home Study Course in Child Care - TEST
Questions

1. What minimum temperature should be maintained in every room in a day care centre?

(a) 10°C
(b) 15°C
(c) 20°C
(d) 25°C

2. How often should sheets and pillowcases provided for each child be laundered?

(a) Daily
(b) Once a week
(c) Twice a week
(d) Three times a week

3. Which of the following can cause serious illness?

(a) Eating undercooked hamburger

(b) Eating undercooked poultry
(c) Drinking unpasteurized milk
(d) All of the above

4. Which of the following groups in the general population are considered to be at high risk?

(a) Teenagers
(b) Adults under 50 years of age
(c) Children
(d) None of the above

5. The transfer of bacteria from one food to another can occur by:

(a) Using separate cutting boards for raw meats and for ready-to-eat or already cooked foods.
(b) Covering all foods stored in the refrigerator.
(c) Washing your hands thoroughly before handling food.
(d) Cutting cooked chicken on the same cutting board as raw chicken

6. What is the maximum time persishable foods may be left at room temperature?

(a) 1 hour
(b) 2 hours
(c) 4 hours
(d) 6 hours

7. Which statement is true?

(a) Unsafe food always tastes spoiled.

(b) Unsafe food does not always have a changed appearance, colour, texture, odour or taste.
(c) Unsafe food always looks discoloured or mouldy.
(d) None of the above.
8. Perishable food shall be kept in a cooler or refrigerator at a temperature of °C or colder:

(a) 0°C
(b) 4°C
(c) -18°C
(d) 60°C

9. When sanitizing dishes and utensils in a three compartment sink, what concentration should the
chlorine solution be in the sanitizing sink:

(a) 25 ppm
(b) 50 ppm
(c) 100 ppm
(d) 400 ppm

10. Use leftovers within:

(a) Six hours

(b) 2-3 days
(c) 6-7 days
(d) Using leftovers is not acceptable in a day care

11. Symptoms usually associated with food poisoning include:

(a) Skin rashes or hives

(b) Abdominal cramps, vomiting and diarrhea
(c) Sneezing and coughing
(d) Migraines and heart palpitations

12. Which statement is true?

(a) Sterilize bottles and nipples by immersing in boiling water for 5 minutes.
(b) Use prepared powdered formula within 24 hours of preparation.
(c) Discard expressed breast milk after 48 hours even if refrigerated.
(d) All of the above

13. What is the most effective way to control communicable disease?

(a) Wearing gloves

(b) Excluding animals from the day care
(c) Frequent handwashing
(d) Using sanitizing wipes

14. When must day care employees wash their hands?

(a) After changing a child’s diaper

(b) After using the toilet
(c) Whenever hands are dirty
(d) All of the above
15. Which statement is true?

(a) You should use your hands, instead of an applicator, to apply ointment while changing a
child.
(b) Use bleach or an other approved sanitizer to disinfect diapering change tables and
other soiled areas or equipment.
(c) The use of cloth or re-usable diapers is not acceptable in a day care.
(d) You don’t always have to wash your hands if you’re using gloves.

16. What is the best way to store chemicals in a day care centre?

(a) In a locked cupboard or cabinet

(b) In the laundry room
(c) On a shelf in the food storage room
(d) In a cupboard under the sink

17. Which statement is true about dispensing medication to children?

(a) Like other chemicals, all medication and prescription drugs should be stored in a
locked container or cabinet.
(b) A separate refrigerator is required for medication that requires refrigeration.
(c) Medication can be given to a child provided verbal consent is received from the
parent.
(d) Medication does not have to be in its original container provided it is clearly
labelled.

18. Which disinfectant or sanitizer is acceptable for use in a day care centre?

(a) Bleach
(b) Vinegar
(c) Quaternary ammonium compounds
(d) a & c only

19. Which pets are acceptable in a day care centre?

(a) Ferrets
(b) Hamsters and gerbils
(c) Cats and dogs
(d) Newts and salamanders

20. To prevent injuries during outdoor play in a playground:

(a) Ensure that drawstrings, cords and scarves are securely tucked inside children’s
snowsuits and coats.
(b) Ensure that there are no sharp edges, loose or broken parts on equipment.
(c) Ensure that children are closely supervised.
(d) All of the above.
21. How often should children’s toys be washed and sanitized?

(a) Daily
(b) Twice a week
(c) Once a week
(d) Once a month

22. What concentration of bleach solution is effective in sanitizing toys and other surfaces in the day
care?

(a) 50 ppm
(b) 100 ppm
(c) 1000 ppm
(d) 800 ppm

23. How do we prevent children from getting too much sun exposure, skin damage or skin cancer during
outdoor activities?

(a) Have children wear a wide-brimmed hat and use a broad spectrum sunscreen.
(b) Limit exposing children to the sun between 11 a.m and 4 p.m.
(c) Apply sunscreen at least 20 minutes before sun exposure.
(d) All of the above.

24. What product can be used safely in a day care for securing or displaying items on the wall or on the
ceiling?

(a) Velcro
(b) Staples
(c) Thumb tacks
(d) All of the above

25. Which art material should children avoid using?

(a) Water based white glue

(b) Water-based markers
(c) Powdered tempera paints
(d) Oil pastels and crayons

4EPHE-13-003
Created: Jan/01
Revised: May/14