Sanitation Requirements

PURPOSE: This rule establishes the requirements for maintaining proper sanitation in license-exempt child care facilities. (1) The premises of facilities shall be clean and free of unsanitary conditions and observable insects, spiders, and rodents. (A) Floors in bathrooms and kitchens shall be clean. Carpet shall not be used in bathrooms. (B) Infant and toddler toys shall be kept clean and shall be sanitized after any contact with body fluids. (C) Sanitizers shall be used in appropriate concentrations. (D) If toothbrushes, combs, hairbrushes, or other personal care items are used, they shall be individually air-dried and labeled with each child’s name. (2) Bathrooms shall meet the following requirements: (A) Toilets, urinals, and handwashing sinks shall be clean and odor free; (B) Toilet and handwashing facilities shall be in working order and convenient for the children’s use; (C) Paper towels or a hot-air dryer that is installed and maintained properly, soap and toilet paper shall be provided and accessible so the children can reach them without assistance; (D) Potty chairs shall be located in the bathroom and shall be emptied, cleaned, and sanitized after each use; and (E) Bathrooms shall be enclosed with full walls and solid doors. (3) Diapering areas shall meet the following requirements: (A) Diapering supplies and a handwashing sink with warm, running water shall be in a location that allows the caregiver to maintain supervision of the children in care at all times; (B) Disposable tissues or wipes shall be used to clean the child at each time of diapering. Any diapering creams, powders, or other products applied at the time of diapering shall be approved or provided by the parent(s) and labeled with the child’s name; (C) The diapering surface, after each use, shall be cleaned and sanitized with a sanitizer approved by the department; (D) Diapers and wet clothing shall be changed promptly; (E) Wet or soiled disposable diapers shall be placed in an airtight disposal container located in the diaper change area and discarded daily. If cloth diapers are used, they shall be stored in airtight plastic bags and removed from the building daily; and (F) The diapering and handwashing areas shall be separate from food service areas and food-related materials. (4) Kitchens and meals shall meet the following requirements: (A) A kitchen shall be required for meal preparation if a provider serves meals, unless meals are catered from a source approved by a state or local health department; (B) A kitchen used for meal preparation shall have sufficient equipment to serve the number of children in care. Equipment shall include a stove, sink, hot and cold running water, a refrigerator, and storage space for food, dishes, and cooking utensils; (C) If meals are catered, a sink with hot and cold running water, a refrigerator, and storage space shall be provided; and (D) Floors shall be a hard, smooth surface, easily cleanable and in good repair. Facilities caring for ten (10) or less children may use carpet. (5) Food equipment and utensils shall meet the following requirements: (A) All food equipment, utensils, and food preparation surfaces shall be cleaned properly and sanitized with a sanitizer approved by the department; (B) Kitchen equipment that produces excessive heat and moisture shall be vented properly; (C) If a mechanical dishwasher is used, it shall have the capacity to sanitize all dishes and utensils used in meal preparation; (D) Facilities caring for more than twenty (20) children shall use a three- (3-) vat sink; single-service utensils, cups, and plates in conjunction with the sink; or a commercial dishwasher. Facilities caring for twenty (20) children or less may use a two- (2-) vat sink and a container large enough to sanitize the largest utensil used; (E) Sinks shall be equipped with hot and cold running water and an area for draining dishes. Approved dishwashing methods shall be used; (F) Facilities caring for more than twenty (20) children shall have separate handwashing sinks in food preparation areas equipped with hot and cold running water, hand cleanser, and paper towels; (G) Food preparation areas shall have adequate lighting; (H) An accurate thermometer shall be located in each refrigerator. Each refrigerator shall be maintained at a temperature of fortyone degrees Fahrenheit (41°F) or less; (I) Freezers shall keep foods in a frozen solid state; and (J) A metal stem bayonet-type thermometer for checking food temperatures shall be used to check temperatures. (6) Nonpublic water systems shall meet the requirements of section 256.600, RSMo. (A) Public water systems shall meet the requirements of sections 640.010 and 640.140, RSMo. (B) All water systems shall be free of cross-connections and threaded faucets shall have a backflow preventive device. (7) Sewage systems shall be designed for the capacity of the facility, operate properly, be nuisance free, and meet applicable laws and rules of the department and the Department of Natural Resources. (8) Adequate refuse disposal and storage shall be provided. A sufficient number of nonabsorbent containers and lids shall be available. (9) Providers shall observe the following food protection practices: (A) Cross-contamination of raw and cooked foods is prohibited. Hands shall not be washed in equipment washing vats; (B) Home-canned foods shall not be used; (C) All food shall be from an approved and inspected source, except fresh or frozen fruits and vegetables; (D) All food shall be in sound condition; (E) Catered food shall be from a caterer that is inspected and approved by a state or local health department and shall be received at the facility meeting all temperature requirements; (F) Adequate equipment shall be provided for on-site storing and serving of food; (G) Food items shall be covered properly or packaged and protected from contamination; (H) Food placed on the table family style shall be discarded if not eaten; (I) Food shall be thawed properly; and (J) Food shall be cooked, stored, and served at safe temperatures. Foods requiring hot storage shall have an internal temperature of one hundred forty degrees Fahrenheit (140°F) or above. Cool foods requiring refrigeration after preparation shall have an internal temperature of forty-one degrees Fahrenheit (41°F) or below. (10) Sanitation inspections of license-exempt facilities may be delegated to the Department of Health and Senior Services or local public health agencies if the standards employed for inspections are substantially equivalent to this rule. Fees, as provided for in section 192.300, RSMo, may be charged at the option of the local public health agency. AUTHORITY: section 161.092, RSMo 2016, and section 210.252, RSMo Supp. 2021.* This rule was previously filed as 19 CSR 4060.090. Original rule filed Dec. 1, 1994, effective July 30, 1995. Changed to 19 CSR 30-60.090 July 30, 1998. Emergency amendment filed March 1, 2000, effective March 11, 2000, expired Sept. 6, 2000. Amended: Filed March 1, 2000, effective Aug. 30, 2000. Moved to 5 CSR 25-300.080, effective Aug. 30, 2021. Amended: Filed Oct. 6, 2021, effective May 30, 2022. *Original authority: 161.092, RSMo 1963, amended 1973, 2002, 2003, 2013, 2014, and 210.252, RSMo 1993, amended 1999, 2019, 2020, 2021.