The three 'non-negotiable' health rules to look for when choosing a child care centre.

I still remember the time when my youngest daughter held her baby doll in her arms and told me that it was time to change her nappy.

“OK, you can change her on the couch,” I said. “I need gloves,” Milla replied, looking around the room in search for them. Initially I was confused. Why is she looking for gloves? But then I realised, yesterday she was at day care and the early childhood educators always use gloves when changing nappies.

So, the disposable gloves came out from the cupboard and my daughter changed the ‘dirty’ nappies of her doll. Although slightly frustrating that all my gloves had now been used on a plastic baby, the fact that my two year old was adopting these hygiene routines from her day care and then putting them into action at home was impressive.

It goes without saying that health and safety is the most important factor we consider when we have children. Ensuring that this is just as important at early childhood education centres when our kids are away from our supervision and home is critical when choosing a centre you trust.

From daily habits like handwashing and cleaning to preventative measures like immunisation, I asked two early childhood educators to take me through what they do in their centres. Elizabeth Bamford works for a not-for-profit organisation with three long day cares, and Jackie* is a highly experienced child care worker. Here is some of their advice about what to look for and ask about health and safety:

1. Personal hygiene: “Wash, wash!”

As I’ve seen with my daughter, personal hygiene is instilled from a young age – and it all starts with making it a ritual kids are happy to follow at childcare centres like Elizabeth’s.

“We empower our children to be in charge of their personal hygiene,” Elizabeth tells Mamamia. “Clearly young children are supported with proper hand washing procedures and nose wiping, but we endeavour to make this simple practice a key part of daily routines.

“Just today I had babies aged 15 to 18 months lining up to have their nappies changed as the most fun part of it for them is when they get to wash their hands once a clean nappy is on! These children don’t have much language yet but they can all say ‘wash, wash!’ as they wave their hands at us! The child-size sink and accessible soap dispensers are too good for them to refuse!”

At Elizabeth's centre, older children are treated as capable learners with the responsibility to take charge of their own personal hygiene and handwashing at all transitions, from nappy changes for toilet visits for the toilet trained.

"We have pictures in the bathrooms depicting the order of steps in the process, which aids our children from culturally and linguistically diverse backgrounds. And of course educators are always on hand for support," she tells me. "We teach the children to cough into their elbows and cover their mouths when they sneeze as well. They may not make it every time but they're pretty good. These strategies are more effective than people may think!"

2. What are the rules around immunisation?

For parents, in order to enrol your child into a child care or early learning centre they must be immunised or have an approved exemption, according to the NSW Government's enrolment requirements.

The good news is that 94 percent of kids in NSW are fully immunised, which also helps protect the vulnerable children and adults who can’t be vaccinated for medical reasons.

Childhood immunisation is important but being on time with their shots is just as crucial. Your child isn’t fully protected if their vaccination is overdue, even if they have always been up to date in the past.

Keeping on top of the NSW Immunisation Schedule is important. The free Save The Date To Vaccinate app makes it easy to keep your kids protected from serious, preventable diseases, because it reminds you when the next childhood vaccine dates are coming up.

For early childhood educators like Jackie, being immunised against preventable diseases is "non-negotiable" at her centre.

"Non-immunised staff and children may be excluded from the centre," she says. "The reality is that adults can be a 'silent' source of infection because they may carry diseases without suffering any symptoms, so diligence for staff to be up to date with immunisations is critical as well."

The requirements of the centre on immunisations for both children and staff should be readily available through the centre's policies and through the enrolment process.

At the centre where Jackie works, there is a list of vaccinations that all staff are recommended to be up to date with, abiding by Australian Government guidelines:

• whooping cough (pertussis) vaccine
• measles, mumps, rubella (MMR) vaccine (if non-immune)
• chickenpox (varicella) vaccine (if non-immune)
• hepatitis A vaccine
• influenza (annual)

Elizabeth agrees that even though she has a "pretty good immune system" from working with children, she gets the flu shot every year and makes sure her other immunisations are up to date

3. When sickness travels...

Every parent wonders what the centre will do if there is an illness or contagious outbreak among the kids. According to Elizabeth, if an illness is prevalent there's a strict game plan in place. Yes, that involves the correct forms, reports and procedures for duty of care - but it also involves managing how it impacts staff and the other kids.

"It's always a tricky situation when a staff member falls ill, and it puts pressure on educators," Elizabeth shares. "But we have a supportive management team who step in wherever needed to ensure we meet the legally required educator-to-children ratios."

"In the case of head lice or similar easily communicable diseases, a child is excluded from care until they have been treated and we advise all families at the service that a case has been reported. For privacy reasons we can't 'name and shame' but we provide information of symptoms or what to look for in the case of lice or worms so families can monitor their children and take appropriate action should it be needed."

So, in conclusion.

Choosing the right early childhood education centre is be a big step for you and your child! It is often the first time away from a parent and it is the beginning of your child's educational journey.

If you know that there are preventative measures in place, then you can feel safer overall about your child's health. All of the preventative measures above are incredibly effective and straightforward and a 'must' for anyone who is looking after our children.

And if they help your child change a doll's nappy the right way at home, well, that's a bonus.

This content was created with our brand partner NSW Health.

*Jackie's name changed for privacy reasons.