(a)  In child care centers, children in diapers shall be changed at stations designated for diapering or toileting.  Each diaper changing station shall include a handwash lavatory.  For centers licensed for fewer than 13 children and located in a residence and for diaper changing areas designated for school age children, a handwash lavatory shall be in or next to a diaper changing area.

(b)  Diapering surfaces shall be smooth, intact, nonabsorbent, easily cleanable and shall be approved by the Department.  Nothing shall be placed on the diapering surface except for those items required for diapering.

(c)  A disinfecting solution as set out in 15A NCAC 18A .2801(7) shall be used to disinfect diapering surfaces.  A testing method shall be made available to ensure compliance with the prescribed bleach solution concentration.  To achieve the maximum germ reduction with bleach, the cleaned surfaces shall be left glistening wet with the bleach solution and allowed to air dry or be dried only after a minimum contact time of at least two minutes.  Products registered with the U.S. Environmental Protection Agency as hospital grade germicides or disinfectants or as disinfectants for safe use in schools, child care centers, institutions or restaurants are also approved disinfectants, provided the manufacturer's Material Safety Data Sheets are kept on file at the child care center and the instructions for use are followed.  Cleaning and disinfecting solutions shall be kept in separate and labeled bottles at each diaper changing station.  Bleach disinfecting solutions shall be stored in hand pump spray bottles.  No cloths or sponges shall be used on diapering surfaces.

(d)  Diaper changing procedures shall include:

(1)           gathering supplies before placing child on diapering surface;

(2)           donning disposable gloves (if needed);

(3)           using disposable towelette or moistened paper towel to clean child, wiping front to back;

(4)           disposing of gloves if used, soiled towelettes and diaper in a plastic-lined, covered receptacle;

(5)           wiping hands with disposable towelette or moistened paper towel;

(6)           sliding a clean diaper under the child, applying diapering products (if needed) using facial or toilet tissue, discarding the tissue in a plastic-lined, covered receptacle;

(7)           fastening the diaper and placing clothing on child;

(8)           washing child's hands in accordance with Rule .2803 of this Section, or, if child is unable to support her or his head, cleaning the child's hands with a disposable towelette or moistened paper towel, then drying the child's hands and returning the child to a supervised area;

(9)           spraying entire diapering surface with detergent solution and wipe clean, using disposable paper towels;

(10)         spraying entire diapering surface with approved disinfecting solution and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry; and

(11)         washing hands in accordance with Rule .2803 of this Section even if disposable gloves are used by the caregiver.

(e)  Vinyl or latex disposable gloves shall be used by caregivers during the diaper changing process if she or he has cuts or sores on her or his hands or has chapped hands. 

(f) Caregivers may dispose of feces in diapers in the toilet, but shall not rinse soiled cloth diapers, or training pants or clothes.  Soiled cloth diapers, training pants or clothes shall be sent to a diaper service or placed in a tightly closed plastic bag or other equivalent container approved by the Department, stored out of reach of children, and sent daily to the child's home to be laundered.

(g)  Receptacles containing soiled disposable diapers shall be emptied in an exterior garbage area at least daily.

(h)  Instructions for caregivers on proper methods of diaper changing and handwashing shall be posted in each diaper changing area.


History Note:        Authority G.S. 110-91;

Eff. July 1, 1991;

Amended Eff. February 1, 1995;

Temporary Amendment Eff. April 15, 1998;

Amended Eff. July 1, 2006; January 1, 2006; April 1, 1999.