Key Takeaways
- Handwashing for 20 seconds is the #1 illness prevention method
- Follow proper diapering procedures with sanitizing between each child
- Know and post food allergies; never force eating
- Exclude children with fever 100.4°F+, vomiting, or diarrhea
- Use universal precautions when handling bodily fluids
Last updated: January 2026
Healthy Environment
Functional Area 2 focuses on promoting good health and nutrition and providing an environment that contributes to illness prevention.
Handwashing
Handwashing is the #1 way to prevent illness spread.
When to Wash Hands:
| Adults | Children |
|---|---|
| Before handling food | Before and after eating |
| Before and after diapering | After using the toilet |
| After handling body fluids | After nose blowing |
| After cleaning | Before and after sensory play |
| After removing gloves | After playing outside |
Proper Handwashing Steps:
- Wet hands with warm water
- Apply soap
- Rub for 20 seconds (sing "Happy Birthday" twice)
- Rinse thoroughly
- Dry with paper towel
- Turn off faucet with paper towel
Diapering Procedures
Follow these steps for sanitary diapering:
- Prepare: Gather supplies before getting child
- Place: Put child on clean surface; keep hand on child
- Remove: Take off soiled diaper; clean skin front to back
- Dispose: Put diaper in lined, hands-free container
- Clean: Wipe hands and child's hands
- Diaper: Put on clean diaper
- Dress: Return child to safe area
- Clean: Sanitize changing surface
- Wash: Wash your hands and child's hands
Nutrition Guidelines
For Infants:
- Breast milk or formula only for first 6 months
- Introduce solids around 6 months (as approved by family)
- No honey until age 1 (botulism risk)
- No cow's milk until age 1
For Toddlers and Preschoolers:
- Serve appropriate portion sizes
- Offer variety from all food groups
- Limit sugary and processed foods
- Make mealtimes pleasant and social
- Never force eating
Food Allergies:
- Know each child's allergies
- Post allergy lists in food prep areas
- Read all ingredient labels
- Have action plan for reactions
Common Childhood Illnesses
| Illness | Symptoms | Action |
|---|---|---|
| Common Cold | Runny nose, cough, mild fever | Can attend unless fever/discomfort |
| Strep Throat | Fever, sore throat, no cough | Exclude until 24 hrs on antibiotics |
| Conjunctivitis (Pink Eye) | Red, itchy, discharge | Exclude until treated or cleared |
| Lice | Itching, visible nits | Exclude until treated |
| Hand, Foot, Mouth | Sores, fever, rash | Exclude until fever-free |
Illness Exclusion Criteria
Children should stay home with:
- Fever of 100.4°F or higher
- Vomiting or diarrhea (within 24 hours)
- Undiagnosed rash
- Eye discharge
- Severe cough or difficulty breathing
- Illness preventing participation
Return Policy: Typically 24 hours fever-free (without medication) or with doctor's note.
Universal Precautions
Treat all bodily fluids as potentially infectious:
- Wear disposable gloves for contact with blood/fluids
- Clean spills with bleach solution (1:10)
- Dispose of materials properly
- Wash hands after removing gloves
Health Documentation
Keep records of:
- Immunization status
- Health history
- Allergies and special needs
- Incident/injury reports
- Medication administration
Test Your Knowledge
How long should children and adults wash their hands?
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Test Your Knowledge
At what temperature should a child be excluded from care due to fever?
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