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Guidelines for Child Care Facilities During a Boil Water Advisory

Water for drinking
  • Post “Do Not Drink” signs at all water taps at all sinks.
  • Take special measures to prevent young children who cannot read a sign from consuming water directly from a tap.
  • Only boiled or bottled water should be used for drinking. Boiled water is water that has been brought to a rolling boil for at least one (1) minute and then cooled and stored in clean, covered containers until served.

Handwashing and teeth brushing

  • Enforce frequent thorough handwashing with disinfected water for all staff and children and ensure children are supervised when handwashing
  • Alcohol–based hand disinfectants, containing more than 60% alcohol may be used after washing hands with soap or in situations where water is not available
  • Use only boiled or bottled water for teeth brushing and make sure that children are supervised during this activity
Food preparation
  • Review and follow guidelines for food premises if full service kitchen.
  • Discard all foods and beverages made with untreated or potentially contaminated water.
  • All water that is used to wash, rinse or soak foods (i.e. fruits and vegetables) must be commercially bottled or boiled. Children and staff should not consume raw foods rinsed with water that has not been disinfected. 
  • Commercial dishwashers that use hot water at 60C (or 140F) with a hot water sanitizing rinse of 82C (or 180F) for 10 seconds would be considered satisfactory.  Where parasitic contamination is suspected, "low" temperature dishwashers using chemical sanitizers may not be effective. 
  • Dishes may be hand washed by using a three compartment sink (for washing, rinsing, and sanitizing respectively), provided that they are rinsed in the second sink in water at a temperature not lower than 43C (109.5F) and sanitized in the third sink by immersing dishes in a chlorine solution of 100 parts per million of available chlorine.  Other methods of sanitizing can be used as described in the Ontario Food Premises Regulation. Single-use, disposable dishware and utensils may also be used. 
Exclusion with diarrhea
  • Exclude all children or staff reporting diarrhea until symptoms have subsided for at least 24 hours. 
  • Use disposable gloves, alcohol/gel rinses and disposable moistened towelettes when diapering children.
  • Use disposable paper to cover diaper-changing areas.
  • Clean children’s hands with the gel after diapering and ensure staff wash their hands after each diaper change.
  • If face cloths are used, ensure they are moistened with non-contaminated water then laundered after each use.
  • Use over-clothes or diapers capable of retaining liquid feces.
  • Disinfect diaper changing areas after each child has been changed with a chlorine solution of 100 parts per million (or a solution of equivalent disinfection capability).
  • Ensure clear separation of diapering and food-handling areas and responsibilities.
  • Ensure separation of diaper changing areas from children’s play areas. 
Water play stations
  • Stop the use of water play tables during this time. Drain all water play tables or play areas containing water.
  • Discourage activities/crafts which utilize water and where there is a risk that children may consume a product (for example hand painting, baking and pasting with glue made from flour and water). 
Washing toys
  • Wash cloth toys or dress up clothes in a washing machine and heat dry them in a clothes dryer for 30 minutes.
  • Disinfect toys in a disinfectant solution ensuring adequate contact time. Toys may also be cleaned in a dishwasher if the machine uses a hot water wash at 60° C (or 140° F) with a hot water sanitizing rinse of 82° C (or 180° F) for ten seconds.  
Launder dish cloths, bedding, bibs and facecloths in a standard washing machine and using a sanitizing rinse or hot rinse cycle. Items should be dried in a standard dryer for a minimum of 30 minutes.
Communication to parents
Inform parents of the boil water advisory, symptoms of enteric illness (gastrointestinal illness caused by contaminated food or water), the need for exclusion, reporting requirements, risk of severe illness in immunocompromised persons, and necessary control measures.
When a boil water advisory is rescinded
Once the boil water advisory has been lifted, all water-using fixtures or pieces of equipment should be restarted, flushed and sanitized.
  • Run cold faucets for one minute before using the water.
  • Run drinking fountains for one minute before using the water.
  • Backwash pool filters and change media or water as warranted.
  • Drain and refill hot water heaters set below 45° C (113 ° F).
  • Drain, sanitize and refill all water play stations.

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