Sanitation in Classroom and Food Preparation Areas in Child Care Facilities in North Carolina and South Carolina [POSTER]

Introduction:  Approximately 60% of U.S. children age 5 and younger spend time in child care settings.  Such environments increase risk of enteric disease, including foodborne illness.

 

Purpose: To describe adherence to sanitation standards in classrooms and food preparation areas in child care facilities in the southeastern United States.  

Methods:  Site visits were conducted at 35 licensed child care facilities: 27 centers (77%) and 8 homes (23%). Data were collected in two classrooms at 16 facilities; thus, the sample size for classroom-level data was 51 (43 rooms for centers and 8 homes). Data collection methods included questionnaires, audits, observations, and environmental samples. Audits in up to two classrooms (an infant, toddler, and/or combined infant/toddler classroom) at each facility and the food preparation area were performed using a form similar to a regulatory inspection form. Audit data were used to calculate indices to describe adherence to sanitation standards based on the 2009 FDA Food Code and guidance from food safety experts.

Results:  The mean classroom sanitation index (0-8) was 7.7 (SD=0.7) and the mean food preparation area sanitation index (0-10) was 7.2 (SD=1.4). Items with low compliance included availability of a sanitizer test kit and use of hair restraints by food handlers. For classrooms with a refrigerator used to store food and beverages for children, 40% of centers and 75% of homes had refrigerators with ambient temperatures > 39°F. For facilities with a separate food preparation area, 48% of centers and 63% of homes had refrigerators with ambient temperatures > 39°F. 

Significance: Most facilities participating in this study adhered to sanitation standards within the classroom; however, improvements with regard to sanitation in food preparation areas and refrigerator operating temperature are needed.  These results, in conjunction with observational data and microbiological analysis of environmental samples, provide insight into risk factors for enteric disease transmission in child care facilities.