Mike Rockett checked the temperature in Edie Lowes' refrigerator, looked for hazardous items in the sink, under the cabinets and checked to make sure the water coming out of the bathroom faucet wasn't too hot.
Rockett, an environmental public health specialist for the Cape Girardeau County Health Department, was conducting an inspection of Wonder Years, Lowes' home-based day care center in Cape Girardeau.
The Missouri Department of Health was already required to inspect and license child care centers, Head Starts, group homes, nursery schools, summer camps and other facilities. The sanitation inspection was added last year through a change in state law.
The county health department contracted with the state to perform the inspections. Each inspection is aimed at ensuring a safe environment for youngsters, Rockett said.
This year, the county health department will be inspecting 76 child care facilities: 44 home-based day cares, 25 commercial centers, six church-based day cares and one group home.
Many of the inspection criteria deal with food safety -- making sure the refrigerator is cold enough to keep food fresh, dishes and cooking utensils are sanitized with bleach or washed in a dishwasher where the water is hot enough to kill germs and food is cooked to the proper temperature.
"We see what procedures they go through as far as preparing meals," Rockett said, adding the kitchen has to be equipped with a two-compartment sink with hot and cold running water and hand soap and paper towels have to be readily available.
The kitchen is a tricky area. Day care providers can't feed children foods that have been home-canned or unpasteurized milk, and inspectors make sure commercially canned products are in good shape.
And no animals are allowed in the food preparation area.
Inspectors also will test the sanitizing solution -- water and chlorine bleach -- to make sure it is strong enough to kill germs on dishes, utensils and toys, but not strong enough to leave a residue.
If the day care is not on a public water system, inspectors will test the water supply and well construction to make sure the drinking water is safe.
In addition, inspectors look for asbestos and lead contamination, make sure there aren't any toxic plants in the areas used by children, look for signs of vermin and make sure trash is safely disposed of.
Most pets are acceptable as long as they aren't in the kitchen where they can get into the food. But reptiles and birds in the parrot family can transmit dangerous diseases, so they are prohibited from day cares.
If the inspectors find problems, they make recommendations on how to correct them -- covering lead paint, covering electrical outlets, cleaning up trash, proper dishwashing techniques -- and come back for a re-inspection.
Hand washing is a big concern, both for providers and their young charges. Dirty hands spread germs.
Day cares undergo three health inspections: the sanitation inspection carried out by the county, the fire safety inspection and the overall inspection by the state health department's Bureau of Child Care Safety and Licensure.
"Everything has to be compliance for all three of us before they're even issued a license," said Ann Hall, a child care specialist for the Missouri Department of Health's Bureau of Child Care Safety and Licensure.
If the day care participates in the federal food program, a fourth health inspection is added.
Lowes' day care passed the inspection with flying colors.
She wasn't worried about the inspection, because she had worked at a commercial center before opening her own business and knew what to expect.
"Most of it's common sense," Lowes said.
Rockett said inspectors only check the area of the home in which the day care center is located. They don't inspect private rooms.
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