1. (1) Early learning providers must comply with the following handwashing procedures or those defined by the United States Center for Disease Control and Prevention, and children should strongly be encouraged to:

   1. (a) Wet hands with warm water;
   2. (b) Apply soap to the hands;
   3. (c) Rub hands together to wash for at least twenty seconds;
   4. (d) Thoroughly rinse hands with water;
   5. (e) Dry hands with a paper towel, single-use cloth towel, or air hand dryer;
   6. (f) Turn water faucet off using a paper towel or single-use cloth towel unless it turns off automatically; and
   7. (g) Properly discard paper single-use cloth towels after each use.
2. (2) An early learning provider must wash and sanitize cloth towels after a single use. Soiled and used towels must be inaccessible to children.
3. (3) To prevent children from being burned, air hand dryers must have a heat guard (barrier that prevents user from touching heating element) and turn off automatically.

4. (4) Early learning providers must wash their hands following the handwashing procedures listed above:

   1. (a) When arriving at work;
   2. (b) After toileting a child;
   3. (c) Before and after diapering a child (use a wet wipe in place of handwashing during the middle of diapering if needed);
   4. (d) After personal toileting;
   5. (e) After attending to an ill child;
   6. (f) Before and after preparing, serving, or eating food;
   7. (g) Before preparing bottles;
   8. (h) After handling raw or undercooked meat, poultry, or fish;
   9. (i) Before and after giving medication or applying topical ointment;
   10. (j) After handling or feeding animals, handling an animal's toys or equipment, or cleaning up after animals;
   11. (k) After handling bodily fluids;
   12. (l) After using tobacco or vapor products;
   13. (m) After being outdoors;
   14. (n) After gardening activities;
   15. (o) After handling garbage and garbage receptacles; and
   16. (p) As needed or required by the circumstances.

5. (5) Early learning providers must direct, assist, teach, and coach, children to wash their hands, using the steps listed above:

   1. (a) When arriving at the early learning premises;
   2. (b) After using the toilet;
   3. (c) After diapering;
   4. (d) After outdoor play;
   5. (e) After gardening activities;
   6. (f) After playing with animals;
   7. (g) After touching body fluids such as blood or after nose blowing or sneezing;
   8. (h) Before and after eating or participating in food activities including table setting; and
   9. (i) As needed or required by the circumstances.

6. (6) Hand sanitizers or hand wipes with alcohol may be used for adults and children over twenty-four months of age under the following conditions:

   1. (a) When proper handwashing facilities are not available; and
   2. (b) Hands are not visibly soiled or dirty.

7. (7) Children must be actively supervised when using hand sanitizers to avoid ingestion or contact with eyes, nose, or mouths.

   1. (a) Hand sanitizer must not be used in place of proper handwashing.
   2. (b) An alcohol-based hand sanitizer must contain sixty to ninety percent alcohol to be effective.

[WSR 18-15-001, recodified as § 110-300-0200, filed 7/5/18, effective 7/5/18. Statutory Authority: RCW 43.215.070, 43.215.201 and chapter 42.56 RCW. WSR 18-14-079, § 170-300-0200, filed 6/30/18, effective 8/1/19.]