Ensuring Drinking Water Quality in Child Care Facilities During and After Extended Closures 3Ts: TRAINING, TESTING, TAKING ACTION Developed in collaboration with the signatory agencies and organizations of the Memorandum of Understanding (MOU) on Reducing Lead Levels in Drinking Water in Schools and Child Care Facilities: https://www.eDa.gov/ qround-water-and-dririkinq-water/mou-reducinq-lead-levels-drinkinq-water-schools-arid-child-care. The purpose of this factsheet is to: 1) provide guidance to child care facilities on maintaining drinking water quality during extended closures, and 2) recommend start-up procedures when reopening to ensure that drinking water is safe for consumption. When a child care facility closes for an extended period (i.e., one week to several months), the water in the building's plumbing will become stagnant. The water may become unsafe for drinking, cleaning, cooking, or other purposes. Stagnant water in plumbing may: Support growth of bacteria, such as Legionella, or other microorganisms that can cause disease, and Have higher levels of metals, such as lead and/or copper, from the building plumbing components. This factsheet is part of EPA's 37s for Reducing Lead in Drinking Water in Schools and Child Care Facilities (3Ts) Toolkit, referenced in Important Resources. It also includes considerations for lead sampling after extended closures. This factsheet is intended for child care facilities specializing in early care and education programs, which include center-based and family child care homes, pre- kindergarten programs as weli as Head Start and Early Head Start Programs. Additional considerations are included for home-based child care facilities, child care facilities that are non-community water systems (NCWSs), and child care facilities served by a private well. INFORMATION ABOUT EXTENDED CLOSURES FOR CHILD CARE ADMINISTRATORS AND MAINTENANCE STAFF What can child care facilities do while they are closed to maintain water quality? Completing the following steps during closures may help to avoid more complicated start-up procedures when reopening. Many of these steps are routine procedures that should be part of normal operations. Work with the owner or landlord to ensure proper water system maintenance if you do not own your building. It is important to perform these steps before using building tap water to reconstitute infant formula EPA's 3Ts Toolkit Module 6 includes additional information about establishing routine practices. See Important Resources Qv Know Your Plumbing To maintain water quality, you need to know how water enters and flows through your facility. EPA's 3Ts Toolkit Module 4 provides examples of building plumbing configurations. Additionally, the U.S. Centers for Disease Control and Prevention (CDC) Water Management Program Toolkit provides guidance on how to understand and describe your building's water system. See Important Resources for links to both toolkits. 1 ------- f Consider Contacting a Water Professional The instructions in this factsheet are necessary for the health and safety of children, staff, and other building occupants. However, they include technical content. Consider speaking with a water professional for assistance. Visit your water provider's website for more information or contact them to find out if your facility may be served by a lead service line. Closures also present a good opportunity to have a qualified plumber inspect the plumbing. For example, a qualified plumber can: Help you determine your plumbing configuration, Ensure that the plumbing is functioning properly and in good condition, Confirm that there are no cross-connections between your drinking water system and water that is not safe to consume, or non-potable water, Check for lead or galvanized service lines, and Identify any older faucets that are more likely to contain lead. ijjjpl Flush Your Plumbing System Routinely flush all water outlets used for drinking or food preparation. This is particularly important after weekends and during long vacations. The longer water has been sitting in pipes, the more lead it may contain. "Flushing" involves opening valves and letting faucets run long enough to remove standing water in the interior pipes and/or the outlets. It is important to know your plumbing, as described above, because flushing times vary based on the plumbing configuration in your facility. EPA's 3Ts Toolkit Module 6 provides flushing best practices and guidance for developing a flushing plan. In addition, EPA's Guidance on Buildings with Low or No Use addresses flushing. See Important Resources. [f=1 Document Actions c:® Any steps taken to prevent standing water and maintain water quality in the child care facility should be documented. This will help determine if and what steps are needed when reopening. Documenting actions may also be useful in communicating actions to parents and staff upon reopening. Consider Developing a Water Management Program CDC provides a toolkit on creating a water management program (WMP) to reduce the risk of Legionella growth. Developing a WMP specific to your child care facility can help maintain drinking water quality in your plumbing system. See Important Resources Maintain Water System Components Cleaning faucets and drinking water fountains should be a routine practice that continues during extended closures. Refer to your local health department or licensing agency for more guidance on appropriate cleaning materials. The following activities should be conducted to maintain water system components: Remove and clean all aerators (or faucet screens) and drinking water fountain strainers often and before flushing, Replace any worn or damaged aerators with new ones before placing them back on outlets after cleaning or flushing, Maintain any water treatment systems in use, which may include point-of-entry or point-of-use filters or water softeners, Maintain filters per manufacturer's instructions as routine practice (for more information on selecting filters, please see EPA's consumer tool referenced in Important Resources), and Keep cold water cold and hot water hot. CDC recommends keeping water outside the range for Legionella growth, which is 77°F to 108°F. It is important to maintain water heaters at appropriate temperatures while following local and state anti- scald regulations. See Important Resources for CDC's guidance on Legionella. 2 Considerations for Home-Based Child Care Facilities Many child care facilities are operated within homes. The procedures for facility closures may not apply if the homeowner is present during the closure. EPA has guidance on reducing lead in drinking water at homes. The National Center for Healthy Housing (NCHH) has a Lead-Safe Toolkit for Home-Based Child Cares See Important Resources ------- EPA and CDC both have guidance on restoring water quality after extended closures. See Important Resources. What drinking water start-up procedures should child care facilities conduct when reopening after an extended closure? Some child care facilities may not be able to conduct the best practices described above during extended closures to maintain water quality. These facilities should conduct the following steps to prepare the drinking water system before water is used by children, staff, and others who occupy the building. Child care facilities that were able to conduct the best practices described above during extended closures may not need to conduct all of the following steps. These steps provide additional precautions when reopening. It is important to perform these steps prior to using building tap water to reconstitute infant formula. ( Check Local Requirements Contact your local health department for any steps they might require before reopening. Your local health department and water supplier may have information on additional water testing for bacteria and/or lead. Conduct Facility-Wide Flushing Flushing removes stagnant water before anyone drinks it. The EPA recommends flushing after extended breaks to maintain or restore water quality. Before flushing, the plumbing should be inspected, and water treatment systems should be maintained. Follow the steps in the previous section above: Know Your Plumbing, Flush Your Plumbing System, and Maintain Water System Components. Consider Additional Actions You should review the potential impact of poor water quality caused by the extended closure on children, staff, and other building occupants. You may want to consider taking additional actions. These may include limiting access to certain outlets, contacting a water professional, or developing a WMP. Factors to consider include outlets used for consumption and past issues with the plumbing system. EPA's Guidance on Buildings with Low or No Use and 3Ts Toolkit Module 6 provide guidance for recommended additional actions. See Important Resources [1=1 Document and Communicate Actions c:® If any issues arise with the child care facility's water system or water quality communicate with parents, staff, and other building occupants. You should also consider sharing actions taken to maintain or restore water quality. CONSIDERATIONS FOR CHILD CARE FACILITIES THAT ARE N O N-CO M M U N IT Y WATER SYSTEMS (NCWSs) A NCWS is a type of public water system that is a building, campus, or other entity with its own water supply and is regulated (usually by the state environmental or public health agency). If you pay a water bill or pay a landlord for water, you are NOT a NCWS. If your child care facility is a NCWS, contact your state for other required steps for start-up. This includes disinfecting the water system and collecting samples for bacteria and disinfectant residual. EPA's Revised Total Coliform Rule (RTCR) State Implementation Guidance and Template Factsheets for Primacy Agencies provides examples of these actions See Important Resources CONSIDERATIONS FOR CHILD CARE FACILITIES SERVED BY A PRIVATE WELL In addition to the activities described above, child care facilities served by a private well may want to consider testing for bacteria before reopening as part of the start-up procedures. EPA provides resources on private drinking water wells. See Important Resources 3 ------- LEAD SAMPLING CONSIDERATIONS Water that has been sitting for weeks or months may have higher levels of metals, such as lead and/or copper from the building plumbing components. The most common sources of lead in drinking water are lead pipes, faucets, and fixtures. There is no safe blood lead level in children. The best way to know if there is lead in drinking water is to test for it. Starting in 2019, states began receiving federal funding under the Water Infrastructure Improvements for the Nation (WIIN) Act to conduct a voluntary program to assist with testing for lead in drinking water at schools and child care facilities. See Important Resources for EPA's WIIN Lead Testing Grant Program. Test your water for lead. If you are served by a water utility they may test your water upon request. You may also contact laboratories certified to test for lead in water. See Important Resources below for information on how to find these laboratories. Perform sampling at appropriate locations and times. EPA's 3Ts Toolkit Module 4 recommends collecting lead samples that represent water typically consumed by children, staff, and other facility occupants. Water that has been sitting stagnant tor weeks or months (i.e., during extended periods of closure) is not considered representative of typical drinking water. Do not conduct sampling immediately after an extended closure or immediately after flushing your facility's plumbing. These samples would not represent typical water consumption. Ensure that you plan ahead to sample at an appropriate time before serving water to children, staff, and other facility occupants. EPA's 3Ts Toolkit Module 5 provides information on lead sampling and understanding results. See Important Resources below. IMPORTANT RESOURCES (in order of appearance) This factsheet builds on EPA's continued efforts to provide proactive steps to protect children's health. More guidance on actions "building water systems" can take to minimize water stagnation during prolonged shut down of operations can also be found on the EPA and CDC coronavirus websites. EPA's 3Ts Toolkit for Reducing Lead in Drinking Water in Schools and Child Care Facilities (Modules 1-7): https://www.epa. gov/ground-water-and-dr inking-water/3ts-reducing-lead-drinking-water-tool kit Modules 4, 5, and 6 are referenced in this factsheet. The link provided will bring you to the 3Ts Toolkit homepage where you can navigate to the 3Ts Manual and the individual modules. CDC Water Management Program Toolkit: https://www.cdc.gov/legionella/wmp/toolkit/index.html EPA's Information on Maintaining or Restoring Water Quality in Buildings with Low or No Use: https://www.epa.gov/ coronavirus/informat ion-ma inta in ing-or-restoring-water-quality-bui Id ings-low-or-no-use EPA's Consumer Tool for Identifying POU Drinking Water Filters Certified to Reduce Lead: https://www.epa.gov/water- research/consumer-tool-identifying-pou-dr inking-water-fi Iters-certified-reduce-lead CDC Guidance on Legionella for Building and Healthcare Facilities Owners and Managers: https://www.cdc.gov/legionella/ wmp/overview/growth-and-spread, html EPA Guidance on Reducing Lead in Drinking Water in Homes: https://www.epa.gov/ground-water-and-drinking-water/ basic-information-about-lead-dr inking-water#reducehome National Center for Health Housing Lead-Safe Toolkit for Home-Based Child Care: Lead in Drinking Water: https://nchh.org/ tools-and-data/technical-assistance/protecting-chi Id ren-from-lead-exposures-in-chi Id-care/toolkit/in-drinking-water/ CDC Guidance for Reopening Buildings After Prolonged Shutdown or Reduced Operation: https://www.cdc.gov/ coronavirus/2019-ncov/php/bu ilding-water-system.htm I EPA's RTCR Implementation Guidance: https://www.epa.gov/dwreginfo/total-coliforrm-rule-cormpliance-help-prirmacy- agencies Template Factsheets for Primacy Agencies (Requirements for Seasonal Systems): https://www.epa.gov/dwreginfo/total- coliforrm-rule-cormpliance-help-prirmacy-agencies EPA's Resources on Private Drinking Water Wells: https://www.epa.gov/privatewells EPA's Water Infrastructure Improvements for the Nation Act Lead Testing in School and Child Care Program Grant: http:// www.epa.gov/safewater/grants EPA's National Accredited Laboratory List: https://www.epa.gov/lead/national-lead-laboratory-accreditation-program-list Office of Water (4606M) EPA 810-F-21-003 March 2021 ------- |