Activity 5:
Let's Have a Picnic

Purpose: This activity helps participants identify proper food handling practices to prevent the spread of disease.

This activity is particularly helpful for food service workers, classroom staff, and parents involved in food preparation. You will need:

• Five pieces of flip chart paper and five markers
• Handout E-4: Food Handling Checklist (for trainer only)

Step 1: Explain that this activity involves planning a picnic. Participants will pay special attention to safe food handling to prevent the spread of disease.

Step 2: Say: It's a great day for a picnic-sunny and warm. The menu for the picnic is fried chicken, potato salad, melon, and milk. Infants will drink formula and eat baby food.

Step 3: Divide participants into five groups. Assign each group a topic: food selection, storage, preparation, serving, and cleanup.
 
Give each group a flip chart paper and marker. Ask the groups to spend 5-10 minutes listing some important considerations for their topic in planning this picnic. (For example, under "Preparation": "Cook the chicken thoroughly, until the juices run clear.")

Step 4: Bring the groups back together. Allow each group a few minutes to present its list. Ask the other participants to add any points that they feel are important.
 
Use Handout E-4: Food Handling Checklist as a guide to the main points to elicit.

Step 5: Ask:

• Over the past few years in your program, have you had any foodborne illnesses or unexplained outbreaks of vomiting and diarrhea that might be associated with unsafe food handling?
• What have you observed about food safety practices in your Head Start program—picnics, cooking projects, snacks, lunches, potluck meals, conferences, and fundraisers?
• How might these food safety principles apply to food activities at your program?
• How can Head Start home visitors use this information when they visit families, observe the facilities and practices in the homes, and discuss food safety with parents?
• What are some strategies for teaching proper food handling to children?

Points to Consider:

• Food is a source of health and well-being; but it can also be a source of illness when handled improperly.
• Most often foodborne illness result from using poor hygiene (e.g., not washing hands, preparing food when ill), not cooking meat and poultry sufficiently, and letting "perishable" foods (e.g., meat, fish, poultry, milk, eggs, mayonnaise) sit out at room temperature.
• Foodborne illness spreads in Head Start programs because of hygiene practices both in the centers and in homes.
• To prevent foodborne illness, programs must ensure that food vendors, staff, parents, and children conduct all aspects of food handling-selection, storage, preparation, serving, and cleaning-in a safe and sanitary manner (see Background Information).

 Activity 6:
Promoting
Fresh Air

Purpose: This activity helps participants develop strategies to improve air quality in the program in order to reduce the spread of illness in Head Start.

For this activity, you will need:

•  A copy of Handout G: Air Quality, for each participant

Step 1: Explain that this exercise explores policies to improve air quality and reduce the spread of illnesses in Head Start.

Step 2: Divide participants into three groups. Instruct participants to take on roles for the exercise:

• Group 1 members are directors of programs
• Group 2 members are teachers
• Group 3 members are parents

Step 3: Distribute Handout G: Air Quality. Explain that public health authorities recommend these policies to improve the air quality and reduce the spread of diseases in early childhood programs.

The directors would like to incorporate all of these air quality standards into the health policy for their program. Review each point.

Step 4: Ask teachers: What are some of your concerns?

If the teachers don't raise any concerns, give a few examples:

• When it's 68 degrees in the center, it feels a little cold?
• When I go on my break, I feel that I need a cigarette. Why can't I smoke at school?
• I like to have the children all playing next to each other, so they're easier to supervise.
• I'm afraid to let children play outdoors because there have been some drive-by shootings nearby.

 Ask the directors to respond to the teachers' concerns.

Step 5: Ask the parents: What are some of your concerns?

If the parents do not raise any concerns, give a few examples:

•  Don't the babies catch colds if there's a draft?
•  I don't like my child playing outdoors so much because she skins her knees and gets her clothes dirty.
•  I'm worried about the children playing outdoors when it's hot out; they'll get sunburned and overheated.
•  Kids can't play outdoors when it's cold and rainy; they'll get wet and chilled and catch pneumonia.

 Ask the directors to respond to the parents' concerns.

Step 6: Ask participants ("directors," "teachers," and "parents"):

• Given the concerns among staff and parents, what steps should the program take to implement the policy on air quality?
• What strategies might be helpful for teaching children about the importance of fresh air and addressing some of their concerns (e.g., being too cold, wet, or sick)?
•  How might this process be useful for implementing other health policy changes?

 Points to Consider:

• Although research has shown that fresh air is healthy, many Head Start staff, parents, and children have fears and concerns about cold air.
• Fresh air is one example of a health issue that can raise concerns among staff, parents, and children. For this, and for all health issues, programs should maintain open communication and be sensitive to the concerns of staff, parents, and children.
• Programs can use staff-parent meetings, health workshops, and classroom activities to provide information and address concerns.

 Next Steps:
Ideas to
Extend Practice

Teaching Children to Prevent the Spread of Germs

Set up activities to teach children to prevent the spread of germs:

• Have them rub cooking oil on their hands then sprinkle on cinnamon to represent germs that we can't see. Practice scrubbing hands all over with soap and water to wash away all of the "germs." Remind them that this is how we all need to scrub our hands every time, even when we can't see the germs.
• Teach children to catch their coughs and sneezes in their elbows.
• Teach them to share food without sharing germs. At snack time, practice sharing food in different ways:
• Food in individual units (e.g., carrots, crackers): Touch only the one that you take.
• Food to be divided into portions (e.g., casserole, rice, pudding):

Use a clean knife/spoon to cut and serve onto individual plates.
• Liquids (e.g., milk, oatmeal, soup): Pour or ladle into individual cups or bowls.

 Promoting Immunizations for Younger Siblings

While Head Start programs ensure that enrolled children receive the necessary immunizations, many families have younger siblings at home who are not adequately immunized. Head Start staff can play an important role in helping families get siblings immunized to protect the children from serious diseases and prepare them for entry into Head Start.

Show the video, Before It's Too Late, Vaccinate (available in English and Spanish) at staff and/or parent meeting. Discuss the importance of mmunizations, the challenges to obtaining immunizations, and strategies for maximizing immunization rates among families.

•  Do you know anyone who became very sick, disabled, or died from a disease that we can now prevent by vaccines (e.g., polio, measles, HIB meningitis, or whooping cough)?
• What difficulties have you faced in getting yourself or your own children immunized?
• How can all Head Start staff help promote immunization of children, families, and staff? For example, what could a director, health coordinator, teacher, health aide, family service worker, or busdriver do?

 Assessing the Program's Infection Control

Using the infection control checklists (Handouts E: 1-4), assess the program's facilities and procedures in hand washing, diapering, cleaning/ disinfecting, and food handling. Also observe the handling and storage of toothbrushes. You may get assistance from health consultants or your local health department.

Identify the main infection control problems and develop a plan to improve them. Determine what policies are needed. Target training to specific issues of concern. For example, if hand-washing practices are inadequate, show the videos ABCs of Clean and Hooray for Handwashing. Set a timeline for the changes. Follow up six months later.
 
Having a Picnic

Have the picnic that you planned in Activity 6. You may use the menu listed or develop your own menu. Plan the picnic, paying special attention to safe food handling to prevent illnesses caused by spoiled food. Consider food quality, storage, preparation, serving, and cleanup (see Handout E-4: Food Handling Checklist).
 
Promoting Fresh Air

Review your program's policies concerning air quality (see Handout G: Air Quality). Work with your management team, Health Services Advisory Committee and Policy Council to draft policies to improve air quality and reduce the spread of illnesses in your program. Organize a staff-parent meeting, as in Activity 6, to discuss the policy. Take steps to implement the policy. Do follow-up interviews of staff and parents six months later to evaluate the new policy.

Handout C: Hand Washing

    Handout D: Gloving     Handout E-1: Hand Washing Checklist

For any items checked NO, write your plan for change in the "Comments" column.
 
 

Do staff, children, and parents wash hands...	Yes	No	Comments
Before and after...
Preparing and serving food? Eating/drinking?
Taking or giving medication?
Doing mouth/eye care and medical procedures?
After...
Toileting, diapering, assisting a child at the toilet and handling soiled clothes?
Touching blood, skin lesions, eye discharge, saliva, vomit, urine, stool, and mucus (including wiping noses)?
Playing or working outdoors?
Handling animals?
Cleaning up?
When hand washing do you?
Have the following facilities and supples
Sink with running water within reach of diapering, toileting, and food preparation?
Soap (preferably liquid)?
Disposable paper towels?
Trash can?
Handwashing posters?
Use the following procedures
Lather with soap and water?
Scrub all surfaces with hands for at least 10 seconds?
Rise off under running water?
Turn off faucet with paper towel?
Discard paper towel in trash?

 
 Handout E-2: Diapering Checklist
 

When changing diapers, do you...	Yes	No	Comments
Use a diaper-changing surface that is...
Elevated and sturdy?
Waterproof (e.g., formica, metal or plastic diaper pad)?
Guarded by a railing? (Don't use a strap)
Withing reach of a hand-washing sink?
Away from the food preparation and serving area?
Not used for any other purpose?
Have the following supplies on hand:
Disposable, non-porous paper to cover the surface?
Clean, disposable diapers and /or cloth diapers and waterproof diaper covers?
Disposable diaper wipes?
Disposable latex or vinyl gloves?
Plastic bags?
Covered, foot-pedal-operated trash can with disposable plastic liner?
Saop and water sloution?
Disinfectant solution?
Disposable paper towels?
Use the following procedures:
have a routine for when to check and change diapers?
Cover the diapering surface with disposable, non-porous paper?
Always keep at least one hand on the child?
Wear disposable gloves if blood in the stools or oozing rash are present?
Seal soiled clothes in a plastic bag to send home?
Wipe from front to back and use a clean wipe for each pass?
Discard disposable diapers, diaper wipes, gloves, and paper in a covered, foot-pedal-operated trash can?
Change both the dirty cloth diaper and diaper cover together?
Wipe your hands with a diposable diaper wipe before putting a clean diaper on the child?
Wash the child's hands with soap and running water afterward?
Clean visible soil off the diapering surface with paper towel, soap, and water?
Spray the diapering surface with paper towel, soap, and water?
Wash your hands with soap and running water afterwards?

Handout E-3: Cleaning & Disinfecting Checklist
 

Do you clean and disinfect...	Yes	No	Comments
After each use or occurrence
Diapering surface?
Kitchen counter?
Utensils, dishes, cups, bottles, nipples?
Dining table, high chair, feeding table?
Mouthed toys?
Spills of food or drink?
Surfaces, bedding and clothess oiled with stool, urine, blood, or other body fluid?
Daily...
Diapering surface?
Toilets and bathroom area?
Sinks and faucets?
Drinking fountains?
Kitchen counters?
Telephone receiver?
Floors (carpet vacummed)?
Trash cans?
Freqeuntly-handled toys and play tables?
Door knobs?
Weekly...
Low shelves?
Cribs, mattresses, and bedding?
Cloth toys?
Refrigerator?
Montly...
Carpets?
Walls?
All shelves?
With the flollowing supplies:
Bleach solution or other approved disinfectant?
Opaque spray bottle?
Disposable paper towels?
By the following procedure:
If you use bleach, do you:  Make a frewsh solution every day? Mix 1 tablespoon bleach in 1 quart water? or 1/4 cup bleach in 1 gallon water?
Wash surfaces by:  cleaning off visible soil with soap and water? spraying on disinfectant, wiping with paper towel, and air-drying?
Wash plastic toys in  dishwater with detergent? or basin of soap/water; then rinse in disinfectant and air-dry?
Wash cloth toys in laundry with detergent?

 
Handout E-4: Food Handling Checklist
 
 

Do you...	Yes	No	Comments
Select food that is...
Fresh and unspoiled?
From government-inspected meat and food suppliers?
Pasturized milk products?
Not from bulging, damaged, or home cans?
Store food by...
Keeping refrigerators under 40 degrees F; freezers under 0 degrees F?
Refrigerating or freezing perishable food?
Cooking meat, fish, and poultry within two days?
Sealing non-perishable food in containers?
Prepare food by...
Using a separate area from diapering, toileting, play, and animals?
Using staff members who have no illness or open skin lesions?
Using staff members who do not change diapers?
Washing hands first?
Using clean and disinfected counters, cutting boards, and utensils?
Defrosting food in refrierator, microwave, or by cooking (not at room temperature)?
Washing fruits and vegetables prior to use?
Cooking meat/poultry thoroughly until juices run clear?
Washing hands, cutting boards, and utensils after handling raw meat/poultry?
Serve and eat foods...
After washing hands?
Keeping hot foods hot, cold foods cold?
On clean and disinfected tables?
On clean or disposable plates, cups/bottles, and utensils?
For infants...
Using individual, labeled bottles?
Using clean, disinfected bottles/nipples?
Warming bottles under running water, in pan on stove, or crockpot (not microwave)?
Shaking/mixing well and testing temperature?
Never giving honey?
Serving baby food in  bowl/cup (not jar)?
Clean up by...
discarding uneaten food from plates, bottles/cups, and perishables in family-style bowls (after two hours)?
Refrigerating leftovers immediately?
Discarding disposable plates and utensils?
Washing dishware in dishwater or hot water/detergent then disinfecting?
Cleaning ans disinfecting counters, cutting boards, and tables?

 

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