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Administering Healthy Programs: The Environment

Group care can pose the risk of illness spreading among children, youth, families, and staff. There are precautions you and your staff need to take to ensure that everyone can play and work in an environment that is healthy and safe.

  • Articulate the importance of maintaining a clean environment in keeping everyone healthy.
  • Identify management practices that decrease the risk of infectious diseases by maintaining a clean and healthy environment.



Have you ever gone to a restaurant and sat down at a sticky table or found dried food on your fork? Have you ever hesitated about picking up a pen at the bank or grocery store because the person in front of you had a cold? Have you ever put a public toilet seat down with your foot just to avoid touching it? Have you ever stayed in a hotel room that made you want to avoid touching the comforter or the remote control?

Most people have experienced some of these uncomfortable and stressful health-related situations. As adults, we can respond to such situations by visiting a different restaurant or hotel, or by washing our hands as soon as we leave the bank or restroom stall. We want to stay healthy and we want to believe that our environments are reasonably clean. Children and their families have these same desires. Child development and school-age programs must provide environments that are clean and that prevent the spread of infectious diseases. It is your responsibility to make sure children have a safe and healthy environment for play and learning.

Maintaining A Clean Environment

As a manager, it is your responsibility to ensure that your program's environment is clean at all times. When it comes to maintaining a clean environment, there are tasks that should happen daily, weekly, and monthly. Instruct staff on the use of required checklists and follow up to ensure that tasks are completed as required. This is an effective way of keeping everyone on top of cleaning responsibilities. Cleaning is not an activity that should happen occasionally, rather it should be an everyday habit. With that being said, you must emphasize to staff that cleaning should never distract them from supervising or engaging with children and youth.

Cleaning, Sanitizing, and Disinfecting

Knowing whether to clean, sanitize, or disinfect is critical, and doing it correctly is essential. Here are the differences:

  1. Cleaning means to remove dirt or debris from a surface and sometimes involves scrubbing or friction in order to remove the debris. For example, you spray a table with a mix of water and detergent to remove food products and debris after a meal.
  2. Sanitizing means to reduce germs on a surface. When you sanitize a surface, it meets most health regulations. Sanitizing products usually are not effective unless the surface has been cleaned first. After cleaning the table with detergent and water, you spray an approved mix of water and bleach to sanitize the table and kill germs.
  3. Disinfecting means to destroy most germs on a surface. Disinfecting a surface is often necessary when it has made contact with body fluids. Disinfecting usually requires a stronger bleach-water mixture. Changing tables, sinks, toilets, and countertops should be disinfected.

How Diseases Are Spread

Understanding how diseases are spread can assist you and your staff in efforts to decrease their transmission. Here is a quick refresher on infectious diseases. Infectious diseases are caused by organisms - such as bacteria, viruses, fungi or parasites (see for more information). Some infectious diseases can be spread from one person to another. The organisms that cause infectious disease, such as bacteria and viruses, often cannot be seen by the naked eye.

Diseases spread from one person to another in a number of ways:

  • Direct contact: Touching the fluid from another person's infection
  • Through the air: Spread through breathing in germs when someone sneezes or coughs
  • Fecal-transmission: Spread to a person's mouth via hands soiled with feces that touch food, surfaces or objects
  • Blood infections: Spread when blood or other body fluids enter the bloodstream of another person

Infectious Disease Prevention

The transmission of disease can be greatly reduced by using the following precautions:

  • Maintain a clean and sanitary environment
  • Follow proper hygiene
  • Conduct daily health checks
  • Enforce the exclusion of infected children, youth, and adults
  • Promote healthy habits

Supervise & Support

You and the trainers or coaches in your program play an important role in keeping children and youth healthy. For new staff members, it is important that you:

  1. Provide any products your program uses to clean, sanitize, or disinfect. You must ensure staff members know where cleaning supplies are located, how to mix solutions, when to use them, and how to use them. All supplies should be approved by the Environmental Protection Agency (EPA) to make sure they are safe.
  2. Show staff members how cleaning supplies are stored in your program. For example, cleaning materials should be stored in clearly marked containers. They must be secured and inaccessible to children, including school-age children.
  3. With trainers and coaches, ensure staff members know how to follow ratios when creating cleaning, sanitizing, or disinfecting solutions. Teach staff when fresh solutions need to be made. Make sure fresh solutions are prepared each day and labeled with the date. Talk with staff about roles and responsibilities in the program: who makes the solution each day?
  4. You may also need to provide staff members with calendars and tools to help them keep their environments healthy. For infant and toddler classrooms, it is especially important to provide boxes or bins for "soiled toys" (e.g., toys that have been in children's mouths). For all other settings, it is helpful to provide checklists or work with staff to create calendars. These tools can help staff remember when various surfaces were last cleaned.

Divide Tasks to Equitably Distribute Labor

It's important that staff are aware of their cleaning responsibilities, both as individuals and as members of the program team during the orientation process. Maintaining a clean environment cannot be the sole responsibility of one person. Classroom teams should divide tasks equally, alternating who does what on a regular basis to keep hard feelings to a minimum. If hard feelings develop because one person feels they are doing an unfair amount of work, especially when it comes to cleaning, it can damage their relationship as a teaching team.

A posted schedule for the cleaning of shared spaces should be utilized to ensure that cleaning tasks are equally shared by everyone who uses the space. For example, in an indoor large muscle area, every class would pick up after they use the space; the assigned class for that week would be responsible for wiping down all the equipment.

One final note when it comes to maintaining a clean environment - do not wait until it is time for an inspection to do a deep clean. Deep cleanings should occur at least quarterly, if not monthly. This is similar to the concept of preparing a large meal; it is easier to clean up as you go along instead of waiting to do it all at the end.

Management Practices That Support the Prevention of Infectious Disease

The chart below summarizes your key responsibilities when it comes to ensuring staff maintain a clean and healthy environment.

Management Practices


Staff Practices

I should always…

To ensure

Staff never…

Make certain that staff are trained on their responsibilities and our program's policies for maintaining a clean environment. Utilize the Virtual Lab School Healthy Environments Course for new staff.


Contribute to the transmission of infectious diseases because they aren't maintaining a healthy environment or adhering to our program's requirements.

Fail to clean, sanitize or disinfect appropriately because they don't understand when each is required, what products to use, or how to make solutions.

Monitor the sanitary conditions throughout the program daily and address concerns immediately.


Fail to follow policies for maintaining a healthy environment because performance concerns are not addressed.

Provide tools that support staff in the maintenance of a clean environment. Tools may include checklists, calendars, cleaning materials, and Environment Rating Scales.




Fail to fulfill cleaning responsibilities because they cannot remember timelines or expectations.

Communicate our program's policies for maintaining a clean environment verbally and in writing (staff handbooks, trainings, staff meetings).



Put children and youth at risk of becoming ill because they were not following written procedures.


Maintaining a clean environment is one of the most effective strategies you can use to decrease the transmission of communicable disease. Taking a systematic approach and supporting your staff to do the same is an important aspect of your job. Make sure staff know their cleaning responsibilities and have the necessary tools to complete them. When there are performance concerns, address them immediately and consistently; this will help keep everyone at your program healthier.

The video below shows how programs maintain a clean and healthy environment.

Maintaining Clean Environments

Your Best Defense is a Strong Offense

Completing this Course

For more information on what to expect in this course and a list of the accompanying Learn, Explore and Apply resources and activities offered throughout the lessons, visit the Management Healthy Environments Course Guide

To support the professional development of the direct care staff members or family child care providers you oversee, you can access their corresponding Course Guides:


Take some time to look over previous inspection reports. Were there non-compliances related to maintaining a clean environment? If so, what were they? See below Analyzing Previous Inspection Reports with a Focus on Maintaining Healthy Environments and use it to help understand the root cause of previous non-compliance issues and brainstorm solutions.


Consider how you could work with staff, trainers, coaches, children and perhaps even families to help maintain a healthy environment.  How can you help foster mutual responsibility and commend staff members, children and families who go above and beyond to help create and maintain a healthy environment that diminishes the spread of infectious diseases?  Read the article, Enhancing Staff Morale, available at Then use Brainstorm – Creating a Culture to Support and Sustain Healthy Environments to think about ideas you can generate to motivate staff to create and maintain clean environments.

The Guide to Cleaning, Sanitizing, and Disinfecting from Caring for Our Children is a reference for a schedule for cleaning, sanitizing, and disinfecting a variety of surfaces. Use this resource to communicate environmental policies to staff members. 


To remove dirt and debris from a surface or object
To destroy or remove most germs from a surface
Infectious disease:
A disorder “caused by organisms — such as bacteria, viruses, fungi or parasites…. Some infectious diseases can be passed from person to person. Some are transmitted by bites from insects or animals. And others are acquired by ingesting contaminated food or water or being exposed to organisms in the environment.” (Mayo Clinic, n.d.)
To reduce the germs on a surface or object so it meets health guidelines
An organized method of accomplishing something. A system for tracking information, according to the Program Administration Scale, includes tangible and concrete evidence, involvement from multiple individuals, and defined accountability


As you are greeting families you notice some water and dirty paper towels on the floor near a classroom door. What should you do?
Which of the following practices can help reduce the spread of infectious disease?
True or False? As a manager, it is your job to choose one person from each teaching team to be responsible for cleaning their classroom.
References & Resources

American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. (2015). Caring for Our Children: National health and safety performance standards; Guidelines for early care and education programs. (3rd ed.). Elk Grove Village, IL: American Academy of Pediatrics; Washington, DC: American Public Health Association. Retrieved from

Aronson, S. S., Bradley, S., Louchheim, S., & Mancuso, D. (2002). Model Child Care Health Policies. (4th ed.). Washington, DC: National Association for the Education of Young Children.

Harms, T., D. Cryer and R.M. Clifford. (2006). Infant/Toddler Environment Rating Scale, revised edition. New York Teachers College Press.

Harms, T., D. Cryer and R.M. Clifford. (2005). Early Childhood Environment Rating Scale, revised edition. New York Teachers College Press.

Harms, T., D. Jacobs and Romano. (1995). School Age Environment Rating Scale, New York Teachers College Press.

Health and Safety in Family Child Care Homes. (2010). Ohio Department of Job and Family Services.

Mayo Clinic (n.d.) Definition of Infectious Diseases. Retrieved from:

Ritchie, S. & Willer B. (2008). Health: A guide to the NAEYC early childhood program standard and related accreditation criteria. Washington, DC: National Association for the Education of Young Children.

Talan, T.N. and P. Jorde Bloom. (2011). Program Administration Scale: Measuring early childhood leadership and management, 2nd ed. New York: Teachers College Press.