Diaper-related:
(1) soiled clothing and diapers accessible to (within reach of) children, often associated with improper disposal
(2) diapered children played with nondiapered children
Sharing of resources between children of different ages:
(1) playground
(2) playroom and toys
(3) toilets
(4) classes
(5) supplies
Handwashing:
(1) supplies not within reach of children
(2) not supervised by an adult
(3) lack of formal training of staff in proper handwashing techniques
Family-related:
(1) failure to comply with screening with stool culture
(2) resistance to exclusion criteria (not allowed to return until stool negative) if the child was asymptomatic
(3) failure to comply with treatment
Other:
(1) use of a kiddie pool during the outbreak
(2) presence of volunteers assisting at the center (possibly due to the lack of training in handwashing)
I would add:
(1) poor hygiene in the diaper changing area
(2) failure to wash hands before eating and drinking
(3) handling of pacifiers or toys placed in the mouth
