Other sanitary facilities

PF24 Tempering valve

Criteria

§ A tempering valve or other accurate means of limiting hot water temperature is installed for the requirements of criterion HS13 to be met.

HS13 Temperature of hot water from taps children can access

Rationale/intent

The criterion aims to uphold the safety of children by removing the risk of hot water scalding. The criterion also aims to ensure that water is kept at a comfortable temperature to encourage hygienic handwashing practices.

Guidance

You will only need a tempering valve if the centre has a hot water cylinder.

Because stored hot water (that is, inside a hot water cylinder) must be kept at 60°C to prevent Legionella bacteria from growing, a tempering valve is currently the only safe and effective means of ensuring that water accessible by children is delivered at a temperature of no more than 40°C. A tempering valve is a safety device fitted by a plumber designed to provide water to taps at a consistently controlled temperature. It works by mixing hot and cold water between the hot water source and the outlet.

If the centre’s hot water supply is produced by a continuous flow gas hot water system, it must be set to deliver water at no more than 40°C wherever the children have access. See HS13 Temperature of hot water from taps children can access.

HS13 Temperature of hot water from taps children can access

These systems are electronically controlled and can be installed with up to 3 temperature controllers for different water outlets. Be aware that all continuous flow hot water heaters come with a factory set temperature of 55°C, so you will need to reset them for water outlets accessible by children to less than 40°C.

PF25 Nappy change facilities

Criteria

§ There are safe and stable nappy changing facilities that can be kept hygienically clean. These facilities are located in a designated area near to handwashing facilities and are adequately separated from areas of the service used for play or food preparation to prevent the spread of infection. The design, construction and location of the facilities ensure that:

• they are safe and appropriate for the age/weight and number of children needing to use them
• children's independence can be fostered as appropriate
• children's dignity and right to privacy is respected; and
• some visibility from another area of the service is possible.

Rationale/intent

The criterion aims to uphold the health, safety and wellbeing of children by ensuring that appropriate facilities are available for children wearing nappies. Nappy changing in an early childhood centre is a high-risk activity from a number of perspectives. For example, hygiene (as there can be large numbers of children using the facilities) and safety (risk of falls for the child, risk of back injury for adults). Nappy changing is also a personal-care routine that by definition makes the young child vulnerable.

Guidance

The design and layout of the nappy changing facilities need to be appropriate to the ages and number of children attending. The nappy changing area in a sessional service with only older children attending does not need to be the same as those in an all-day service with high numbers of infants/toddlers.

Hygiene

All surfaces on and around the change area should be smooth, impervious to moisture and able to be easily wiped clean and disinfected. Any change mat or pad must have a non-porous covering or be disposed of after each child is changed. See HS3 Nappy changing procedure.

HS3 Nappy changing procedure

Location

Regional Public Health requires that nappy change facilities are located in a designated area that is separate from play and food preparation areas. Thought should be given to where the change area is in relation to doors or viewing windows. This will help preserve the child’s right to privacy, while ensuring some visibility into the nappy changing area. The change area must also be located near handwashing facilities.

Design, strength and durability

If using changing tables, check their strength to ensure they are sturdy enough to cope with the number and weight of children using them – a folding table designed for domestic use is not appropriate. Fold down tables need to be able to be locked in both the up and down positions to prevent injuries to both adults and children. For older, heavier children, a low plinth or a change mat on the floor may be more appropriate than a changing table.

Children’s independence and dignity

The nappy changing area can be designed so mobile children are able to get themselves onto the table to be changed under adult supervision. This fosters a child’s sense of personal control.

Things to consider

Accessibility

You may want to consider wheelchair access and a suitable space for older children who require nappies.

Health and safety of adults

Adults in some services can spend a large proportion of their time changing children’s nappies. A poorly designed changing area that requires adults to engage in excessive heavy lifting, hunching over or kneeling may result in injury.

See the ACC website for more information on preventing injuries at work.

Preventing injury – Accident Compensation Corporation

PF26 Body wash facilities

Criteria

§ Ø There are suitable facilities provided for washing sick or soiled children and a procedure outlining how hygiene and infection control outcomes will be met when washing sick and soiled children.

Documentation required

A procedure outlining how the service will ensure hygiene and infection control outcomes are met when washing sick and soiled children.

Rationale/intent

The criterion aims to uphold the health and wellbeing of children by ensuring that there are suitable facilities and practices for washing children who vomit or soil themselves while attending the service so that the risk of cross infection is reduced.

Guidance

Sometimes children at the centre will need to have all or part of their bodies washed. This might be necessary, for example:

• at nappy change time – if wipes are not enough to ensure the soiled child is cleaned thoroughly
• if a child has vomited over themselves
• if a child has had a toileting accident
• if children become very dirty during play.

Services need suitable facilities for the children being washed. Services need to ensure the facilities and procedures foster children’s independence as appropriate and protect children’s dignity and right to privacy.

A shower, shub or bath is likely to be the most suitable facility depending on the age and size of the child. The need to occasionally wash or bathe older children is usually best met with a shower rather than a tub, using a hand-held shower head with warm water. It is normally only needed for toileting accidents or if a child has been sick.

If a plumbing fixture is not available, service providers will need to consider how they will ensure sick or soiled children are washed easily and hygienically.

Things to consider

Specific considerations should include the following:

• How readily can adults provide for the safe and comfortable washing of a sick or soiled infant, toddler or child?
• Will your procedure or facility ensure the child’s right to privacy and dignity is protected and promoted while they are being washed?
• How will you ensure your procedure/facility maximises adult health and safety?
• How will body waste and wastewater be disposed of safely and hygienically?

This is a criterion where health expertise can provide guidance on hygienic practices and the control of infection. Service providers are also reminded that under Regulation 55, the Ministry of Education may require a service provider to obtain a report from a public health unit in order to assess whether the facilities and procedures used at the centre are adequate to prevent the spread of infection.

New services or services considering renovations should be aware of the requirements of the New Zealand Building Code.

Building Code compliance – Building Performance

PF27 Isolation area

Criteria

Ø § There is space (away from where food is stored, prepared or eaten) where a sick child can:

• be temporarily kept at a safe distance from other children (to prevent cross-infection)
• lie down comfortably; and
• be supervised.

Rationale/intent

The criterion aims to uphold the safety and wellbeing of children by ensuring that there are comfortable and safe facilities for the isolation of a sick child.

Guidance

When a child becomes unexpectedly ill at a centre, there needs to be somewhere for their care to make the sick child feel comfortable, as well as to keep other children from becoming ill until the sick child can be collected and taken home. The child must be able to be supervised. If the child is isolated in a separate room with an adult, the service must maintain adult to child ratios.

Some centres might be in a position to have a separate ‘sick room’, but this is not a requirement. However, there must be an area where sick children can lie down away from other children. For practical purposes, an office or staff room may be the best room for this. Some centres use a couch (with a vinyl sheet and linen that they put down when needed), while others have a bed (either portable or permanently set up) for this purpose. See HS26 Response to infectious illnesses for additional guidance.

HS26 Response to infectious illnesses

PF28 First aid kit

Criteria

There is a first aid kit that:

• complies with the requirements of Appendix 1
• is easily recognisable and readily accessible to adults, and
• is inaccessible to children.

Appendix 1: First aid kit requirements for criterion PF28

Rationale/intent

The criterion aims to uphold the safety of children by ensuring that:

• there are adequate provisions available for the treatment of minor injuries
• adults can easily find the necessary provisions for administering first aid
• children cannot access any hazardous materials themselves.

Guidance

Contents and quantity

A list of first aid kit contents can be found in Appendix 1: First aid kit requirements for criterion PF28.

Appendix 1: First aid kit requirements for criterion PF28

The quantity of first aid items you will need to store in your kit will depend upon:

• the number of children attending your centre
• the number of kits you choose to have.

There must always be 1 first aid kit at the centre, and having a second kit to take on excursions will be necessary if some children remain at the centre during excursions.

Centres with large outdoor areas may also consider securing an additional first aid kit in an outdoor storage area for quick access.

First aid kit maintenance

Items in first aid kits will need to be replaced as they are used, and regular checks should be made to ensure that any perishable items are not past their use-by date (once a month or term is a good idea). Having a minimum stock list of frequently used items as well as a staff roster for checking your first aid kit(s) will help to ensure perishable items and frequently used items are renewed as needed.

First aid kit identification

First aid kits need to be easily recognisable – so that when an accident happens, any adult at the centre can identify it.

First aid kit placement

First aid kits must be stored in a container, so it is readily available to adults but is secure and out of reach of children. If the first aid kit, or cupboard or container in which it is stored, is locked, make sure the key is kept within easy reach of adults and all staff know where it is. A sign nearby letting any adult know where to find the key in an emergency is a good idea.