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Infection Prevention and Control in Childcare Settings (Day Care and Childminding Settings)
- Stella Underwood
- 2 years ago
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1 Infection Prevention and Control in Childcare Settings (Day Care and Childminding Settings) Supported by March 2011
2 . Infection Prevention and Control in Day Childcare Settings. Health Protection Scotland, Glasgow, Published by, Clifton House, Clifton Place, Glasgow G3 7LN. is a division of NHS National Services Scotland. First published February 2011 Version 2 published March 2011 The Health Protection Network (HPN) has supported the development of this document. HPN is a network of existing professional organisations and networks in the health protection community across Scotland. It aims to promote, sustain, and coordinate good practice. The HPN supports a systematic approach to development, appraisal and adaptation of guidelines, seeking excellence in health protection practice has made every effort to trace those who hold copyright in original material and to get permission to use it in this document and the associated quick reference guide. If we have accidentally used copyrighted material without appropriate permission, we would appreciate if the copyright holders contacted us so that we can acknowledge their copyright as soon as possible. This document can be photocopied for the purpose of putting into practice. All other requests to reproduce large extracts should be addressed to: 1 Cadogan Square Cadogan Street Glasgow G2 7HF. Phone: +44 (0) Designed and typeset by: Graphics Team,
3 Table of amendments to version March 2011 as at 12 October 2011 Pages Glossary and when referred to throughout document Amendment Where disinfectant is mentioned in the document the approved disinfectant type is a Chlorine releasing agent (e.g bleach) unless otherwise stated. 9. Section 5.3, Table 2 For nappy changing the PPE should be Disposable aprons and non-plastic gloves.
4 Contents Abbreviations Glossary 1. About this Document 1 Members of the Guidance Development Group 1 2. Introduction Risk Assessment Infection Risk Actions to prevent spread of infection Early warning signs and symptoms of infection 3 3. Outbreaks of infection in childcare settings 4 4. Spread of infection How germs spread Some basic facts about germs 6 5. Standard Infection Control Precautions (SICPs) Hand hygiene Respiratory Hygiene/Cough Etiquette Personal Protective Equipment (PPE) Environmental cleanliness Dealing with spillages of blood and body fluids Equipment cleanliness Management of waste Linen/Laundry Food and kitchen hygiene Milk for babies Other sources of food and kitchen hygiene information The National Care Standards Supporting Bodies Health Protection Teams Environmental health services 17 References 18 Appendices 20 Appendix 1 Using this guidance as local policy 21 Appendix 2 How hands should be washed 22 Appendix 3 Example of a cleaning schedule 23 Appendix 4 Keeping toys and equipment clean 24 Appendix 5 Sample letter to parents when their child joins childcare setting 27 Appendix 6 Farm visits or contact with animals 28 Appendix 7 Checklist of standard infection control precautions 29 Appendix 8 Example of a checklist of measures to use during an outbreak of infection (for example, vomiting or diarrhoea) 30 Appendix 9 Toilet, potty and nappy changing 31 Appendix 10 Health Protection Teams contacts in NHS Boards 32 ii iii i
5 Abbreviations BS BSI CE COSHH EHS HACCP HPS HPT MSDS NCS NHS NSS PPE SICPs British Standard British Standards Institution The initials CE do not stand for any specific words but are a declaration by the manufacturer that his product meets the requirements of the relevant European directives Control of Substances Hazardous to Health Environmental Health Services Hazard Analysis Critical Control Point Health Protection Team Material Safety Data Sheets National Care Standards National Health Service National Services Scotland Personal Protective Equipment Standard Infection Control Precautions ii
6 Glossary Blood and body fluids Chain of infection Childcare settings Children vulnerable to infection Communicable disease COSHH Regulations Diarrhoea Disinfectant Enforcement role Exclusion period Food business Food handler GP HACCP Blood and body fluids such as urine, faeces (bowel movements), vomit or diarrhoea can all cause infection. You should only handle them when wearing personal protective equipment (PPE) (for example, disposable gloves). A series of steps that describes how infection spreads. Any setting, except schools, where children are cared for, for example nurseries, day-care centres and children s centres, playgroups, crèches, childminders, pre-school, after-school care. Some medical conditions make children more vulnerable to infections that would not usually be serious in most children. Children vulnerable to infection include those being treated for leukaemia or other cancers, on high doses of steroids by mouth, and with conditions which seriously reduce their immunity. A disease that can be spread from one person to another. Using chemicals or other hazardous substances at work can put people s health at risk. By law, employers must have controls in place to prevent their staff from becoming exposed to hazardous substances, including infectious agents (for example, germs). See Three or more loose or liquid bowel movements in 24 hours or more often than is normal for the individual (usually at least three times in a 24-hour period). A chemical that will reduce the numbers of germs to a level at which they are not harmful. The responsibility for using legal powers (including gathering evidence of offences, serving notices, taking samples and, where appropriate, reporting offences to the Procurator Fiscal) to protect the public health. The period of time that a person with an infectious disease must be excluded from, for example childcare settings, to limit the risk of the infection being passed on to other people. Any business, whether for profit or not and whether public or private, that carries out any of the activities related to any stage of producing, processing and distributing food. Food also includes drinks, chewing gum and any substance, including water, intentionally included in the food when it is made, prepared or treated. Someone who directly touches food or surfaces that will come into direct contact with food. This stands for General Practitioner (your family doctor). Hazard Analysis and Critical Control Point (HACCP) is a system used to identify and remove risks from food processing to protect those who eat the food. iii
7 Hand hygiene The process of cleaning your hands by washing them thoroughly with liquid soap and warm water and then drying them thoroughly or using alcohol based hand-rub solutions. Health Protection Team (HPT) The team of health professionals whose role it is to protect the health of the local population including staff and children in childcare settings and limit the risk of them becoming exposed to infection and environmental dangers. Every NHS board has a HPT. Outbreak When there are two or more linked cases of the same illness or when there are more cases than the number expected. Outbreaks can happen anywhere, including in nurseries, in hospitals, on cruise ships and so on. Personal Protective Equipment Equipment a person wears to protect themselves against one or more risks (PPE) to their health or safety, including exposure to infections. In a nursery setting this would include single-use disposable gloves and disposable aprons. Respiratory droplets Standard Infection Control Precautions (SICPs) Small particles of fluids expelled during coughing, talking, sneezing etc. Germs for example flu, can be transferred from one person to another by droplets travelling small distances and landing on the mouth, nose or eyes of others or in their environment. A set of control measures which are designed to reduce or remove the spread of germs to people or within the environment. They include effective hand hygiene, using PPE, how to clean the environment and equipment, how to clean up spills of blood and body fluids and how to deal with waste and linen safely. iv
8 1. About this Document This document does not apply to schools, children s residential settings or outdoor nurseries. This guidance covers all day care facilities for children including nurseries, day-care centres, playgroups, crèches, children s centres, childminders, after-school clubs and holiday clubs. Day care facilities for children in this document also refers to those based in schools. This document provides guidance and advice on preventing and controlling infection for staff who work with children in childcare facilities (day-care) and childminding services in Scotland. All people who care for children in childcare settings have a duty of care to provide a safe environment for children in their care. The Scottish Commission for the Regulation of Care (known as the Care Commission) was set up under the Regulation of Care (Scotland) Act 2001 ( the Act ) to register and inspect all services regulated under the Act. The Care Commission must take account of the National Care Standards, Early education and childcare up to the age of 16 (revised September 2009) when registering and regulating these service types. On 1 April 2011, the functions of the Care Commission relating to childcare services will be transferred to Social Care and Social Work Improvement Scotland (SCSWIS). For further information on SCSWIS, please visit In addition to this document, guidance on exclusion criteria is available via the HPS website www. hps.scot.nhs.uk/haiic/ic/publicationsdetail.aspx?id= This is updated regularly based on available scientific evidence. Local NHS Board Health Protection Teams (HPTs) will also advise on exclusion criteria. Members of the Guidance Development Group This document was developed by a working group led by (HPS) and formed by representatives from the health protection community in Scotland, stakeholders and key users, who considered current scientific evidence and expert opinion. The HPS Infection Control team retains the evidence notes on which this document is based for scrutiny. The working group also secured public involvement through consultation with parents whose children attend childcare day settings. The Health Protection Network (HPN) has facilitated and coordinated the final stages of its development, its adherence to agreed criteria of validation, and its completion. 1
9 2. Introduction 2.1 Risk Assessment This guidance is based on the Standard Infection Control Precautions (SICPs), a set of prevention and control measures designed to reduce the spread of germs to people or within the environment. (www.hps.scot.nhs.uk). Appendix 7 has a checklist of standard infection control precautions to check practice in your childcare setting. Infection control safety is a legal requirement under the Health & Safety at Work Act For details of this visit Infection control in childcare settings involves carrying out risk assessments and putting measures in place to control any risks identified e.g. the potential risk from contaminated equipment, the environment, blood and body fluid spills, waste, used linen and children and staff who may have infectious disease. For more information on risk assessment, visit 2.2 Infection Risk Infection risk in the childcare setting can be reduced by; Training all staff in the childcare setting in standard infection control precautions Reviewing and updating infection prevention and control risk assessments regularly Ensuring staff and /or children with symptoms of an infectious disease do not attend the childcare setting Planning ahead when arranging special days out or activities e.g. see appendix 6 Farm visits or contact with animals Seeking advice from your local HPT on infection prevention and control issues e.g. exclusion policies. Excluding a child from a childcare setting when not necessary can be a burden on parents or guardians. However, failing to exclude an infected child (with signs or symptoms of infection) could lead to an outbreak of infection in the childcare setting. 2.3 Actions to prevent spread of infection It is important that you know the children in your care and whether they are at special risk of getting or spreading an infection. Some medical conditions make children more vulnerable to infections that would not usually be serious in most children. It is therefore important that you ask parents/guardians whether their children have any specific health issues. For an example of a letter you can send to the parents/guardians when a child joins your childcare setting, see appendix 5. Vulnerable children include those being treated for leukaemia or other cancers, on high doses of steroids and with conditions which seriously reduce their immunity, these children are particularly vulnerable to infections such as chickenpox or measles. If a child is exposed to either of these, tell the parent or carer quickly so they can get medical advice. N.B. Shingles is caused by the same virus as chickenpox and so anyone who has not had chickenpox is potentially vulnerable to the infection if they have close contact with a person who has shingles. Providing posters and leaflets promoting immunisation will help give parents and guardians information. The website at: can provide more information for parents, guardians and staff. 2
10 If a pregnant employee comes into contact with a child or adult in the childcare setting who has an infectious disease (such as chickenpox, measles, slap cheek (parvovirus) or German measles), or if they develop a rash, they should tell their midwife or GP as soon as possible. 2.4 Early warning signs and symptoms of infection Staff must report immediately to the person in charge if any child has the following signs or symptoms: Diarrhoea (this is defined as three or more very loose or liquid bowel movements within 24 hours) Blood in their faeces Vomiting Continuing or severe stomach pain Any kind of rash Flu-like symptoms a fever (temperature of 38 C or higher) and two or more of the following cough, sore throat, runny nose, limb or joint pain, and headache. Appears unwell (feels hot or looks flushed). If any one child has any of these signs or symptoms, staff should Keep the child safe and away from other children if possible Ask the parent / guardian to collect the child and suggest they visit the GP if symptoms continue or get worse Put in place the appropriate infection control measures as described in appendix 8. If more than one child has any of these signs or symptoms, staff should contact their local HPT for advice. (see appendix 10 for contact details for HPTs) Remind adults in childcare settings to report their own illnesses as well as illnesses in children in their care. If you wish to know which Local Authorities covers your local area, the following website might be of assistance: 3
11 3. Outbreaks of infection in childcare settings An outbreak is defined as two or more linked cases of the same illness (for example, E.coli O157, scarlet fever); or more cases than expected; or a single case of a serious disease (for example, measles or diphtheria). Actions: 1. Assess the situation (see section 2.4) 2. Make sure the adults in your childcare setting: Know and understand what the infection control precautions are Understand how to apply these precautions Have the resources they need for example, PPE (disposable gloves and disposable aprons) Sign and date documents to record they know and understand the infection control precautions in place. Appendix 7 has an example checklist of infection control measures you can use during outbreaks of an infection. 3. It is vital that someone is responsible for checking staff are keeping to these measures. It is important to keep an up-to-date list of the following: The names of those children / staff who are ill The symptoms, if known (for example, vomiting and diarrhoea) When the children / staff became ill and when first noticed or reported (if known) The date they last attended the childcare setting When you contacted the parents What time the child was collected Who you have informed about the outbreak The advice you have received. You should also keep the following, until you are told otherwise: Recent menus Food prepared but not eaten Raw food, if it is possible that those who are ill ate some cooked portions of the same food Samples of any other food items (labelled with the date) that the people who were ill might have eaten Keep sealed in bags, cling film or containers, and place all samples of bagged and sealed foods in your freezer. 4
12 Alert everyone who needs to know: Alert your local HPT, who will: Carry out appropriate investigation Provide advice for parents and staff on appropriate control measures (for example, exclusions and increased infection control precautions) Inform other healthcare-services e.g. local GPs Inform other organisations e.g. Environmental Health Deal with media enquiries. Contact the parent/guardian of any child who becomes ill and ask them to take the child home as soon as possible. Inform the Care Commission if there is an outbreak. From the 1 April 2011 it will be a legal requirement for childcare services to notify Social Care Social Work Improvement Scotland (SCSWIS) of the above occurrences. Have a test run of these procedures at least once a year to make sure everyone knows what to do. 5
13 4. Spread of infection 4.1 How germs spread It is very important that you know how germs can spread so you can help stop children becoming sick. Children should be taught how germs spread and how to stop this e.g. by washing their hands. 4.2 Some basic facts about germs Not all germs are harmful Some germs live harmlessly on us and in us and help us to digest food and stop other more harmful germs from making us ill However harmful germs can grow quickly on surfaces that are not kept clean and dry. The chain of infection can be broken by a number of ways e.g. excluding children with symptoms of an infection from your childcare setting, effective hand hygiene and environmental cleaning. The following sections give you more information. 6
14 Diagram 1. How do germs spread? For germs to cause disease, six steps in a chain must all happen. This is called a 'chain of infection'. 6. Person at risk This is someone who is likely to develop the illness if they are exposed to germs. For some infections (like, Norovirus), many people will be at risk, while,for other infections, our own immune system will stop us getting sick. However, babies and young children are more likely to get infections because their immune systems are still developing. 1. Harmful germ - Respiratory germs like colds and flu viruses -Stomach bugs E. coli almonella (like, Norovirus, O157, S ) - Germs that cause rash illnesses such as measles or chickenpox. 2. Source These harmful germs can come from a source where they can live and multiply (like, humans, raw food, animals or pets and water). Once people are infected, harmful germs can live and multiply in various places such as the stomach, nose and lung (respiratory tract). 5. Way in To cause illness, the germs now need to find away into the next person. For example, germs from coughs and sneezes can find a way in by landing on another person's eye, nose or mouth, or through the person putting unwashed hands in their mouth or touching their eyes or nose after changing nappies or touching toys or equipment, for example. 3. Way out Harmful germs need to find a way out of the source. Stomach bugs can get out by causing vomiting or diarrhoea (or both). Germs that cause colds, flu and rash illnesses can cause people to cough and sneeze. This leads to droplets containing germs to spread through the air to other people and surfaces (like, furniture, toys, door handles, hands and so on). 4. Spread of germs These harmful germs now need to spread to the next person they are going to infect. Germs can spread on hands, from surfaces, shared food, toys and so on. Some germs can survive on surfaces for a long time. 7
15 5. Standard Infection Control Precautions (SICPs) 5.1 Hand hygiene Good hand hygiene will help prevent the spread of common infections such as colds, flu and stomach bugs. Children need to understand why it is important to wash their hands and taught how to wash their hands correctly. Scotland s National Hand Hygiene Campaign was launched in January 2007 and as part of this campaign, a pack was designed specifically for children between the ages of three and six. The contents of the pack are available to view and to download for use at com/the-campaign/childrens-pack.aspx. Good hand hygiene practise: Use warm running water Do not share water in a communal bowl when washing hands Use liquid soap (there is no need to use soaps advertised as antibacterial or antiseptic) Dry hands thoroughly using paper towels (childminders may use kitchen roll or a designated hand towel, which should be washed every day or more often if visibly dirty) When going on outdoor trips, continue to promote good hand hygiene. N.B. If you have cuts or grazes on your hands, cover them with waterproof plasters. Table 1 When should you wash your hands? Children and adults should wash their hands: Before and after eating or handling food or drink After using the toilet, potty or changing a nappy After blowing your nose, coughing or sneezing After touching animals or animal waste After contact with contaminated surfaces (e.g. food-contaminated surfaces, rubbish bins, cleaning cloths). See appendix 2 for how hands should be washed. 5.2 Respiratory Hygiene/Cough Etiquette To stop respiratory germs spreading, children and adults should cover mouth and nose when coughing and sneezing. If using a tissue put it in the bin immediately after and then wash your hands You should always wash your hands after coughing and sneezing Adults should teach children what to do after coughing and sneezing. 8
16 5.3 Personal Protective Equipment (PPE) The term PPE includes single-use disposable gloves and single-use disposable plastic aprons. Whether you need to use PPE will depend on you coming into contact with blood and body fluids. Table 2 When should PPE be worn? Level of contact with blood PPE recommended and body fluids No contact (for example, None playing with child) Possible contact e.g. cleaning toys & equipment e.g. nappy changing Risk of splashing (for example, nose bleeds, cleaning up spillages of body fluids e.g. blood, vomit, urine) Household gloves e.g. marigolds or disposable non-plastic gloves Disposable non-plastic gloves Disposable non-plastic gloves and disposable apron Always wash your hands before putting on and after taking off PPE. 5.4 Environmental cleanliness There are many areas in childcare settings with a high risk of germs being present e.g. toilets and kitchens. To cut down the spread of germs, the environment must be kept as clean and dry as possible. Table 3 Easy steps to make sure your childcare setting is clean and safe for children 1. All childcare settings should have a cleaning schedule which: lists each room in the building used to provide the care service has a signed, dated record of cleaning records who is responsible for the cleaning says how and when the fixtures and fittings should be cleaned includes areas that are cleaned less often than each day and when they are due to be cleaned A sample cleaning schedule is shown in appendix 3 2. Do a cleanliness check every day before the children arrive 3. Check and clean areas that are touched often (for example, toilets, hand-wash basins, taps, door handles) 4. Encourage staff and parents to raise their concerns about cleanliness 5. Have a procedure for what to do if fixtures / fittings break or can no longer be cleaned Routine environmental cleaning Use of a general-purpose detergent and hand-hot water (prepared according to the manufacturers instructions) is usually enough to make sure the environment is clean and safe Disinfectants don t usually need to be used as part of your routine cleaning (with the exception of toilets), but may be required during an outbreak of infection, as directed by your HPT Keep all cleaning equipment well maintained e.g. check and change vacuum cleaner filters regularly. 9
17 5.5 Dealing with spillages of blood and body fluids All staff must be trained in how to safely clean up spillages of blood and body fluids i.e.: Deal with blood and body fluid spillages as quickly as possible Keep the children away from the spill Wash your hands and ensure all cuts and grazes are covered with waterproof dressings Put on PPE (i.e. disposable gloves and disposable apron) Prepare a solution of general-purpose neutral detergent and a solution of disinfectant (prepared according to the manufacturers instructions) Use paper towels (or kitchen roll), to soak up the spillage then place into a disposable, leakproof plastic bag Apply the disinfectant solution to the spillage Wipe off any disinfectant solution left after cleaning up the spillage Wipe down area with paper towels (or kitchen roll) soaked in detergent solution then wipe dry with paper towels (or kitchen roll) Remove PPE and put into the plastic bag, seal the bag and place it in the waste bin Wash your hands. N.B. Do not use chlorine-based disinfectants e.g. household bleach directly onto urine spillages (to prevent a release of chlorine gas), soak up urine with paper towels before using a disinfectant Always check that disinfectants are suitable for use on carpets and other soft furnishings as they may cause damage/discolouration. In these circumstances clean with neutral detergent and handhot water, then leave the area to dry Use COSHH sheets, material safety data sheets (MSDS) and manufacturers instructions to make sure all cleaning products are used and stored safely. 5.6 Equipment cleanliness Toilets, potties and nappy-changing mats will all become contaminated with germs when used. To prevent germs spreading: There must be a hand wash basin with warm running water, liquid soap and disposable paper towels in all toilets and areas where nappies are changed or potties used If you work in a childcare setting where paper towels are not used (for example, if you are a childminder), you can use a hand towel that is easily identifiable as only for drying hands and washed each day, or more often if visibly dirty Areas where nappies are changed or potties are used must be separate from where food is prepared or eaten, and where children play. A full description of how to maintain toilet, potty and nappy hygiene is included in appendix 9. 10
18 If a child develops diarrhoea (Diarrhoea defined as when there are three or more loose or liquid bowel movements in 24 hours, or more often than is normal for the child.) Contact the child s parent or guardian, and ask them to collect the child as soon as possible. If the child has developed diarrhoea which is severe, or if there is blood in the child s faeces, tell the parent to contact their GP Remind the parent or guardian to wash their hands and their child s to stop germs from spreading Tell the parent or guardian that the child can return to your childcare setting after being free of symptoms (i.e. diarrhoea) for 48 hours. (If a definite infection has been identified, follow the advice from your local Health Protection Team.) As well as the standard cleaning described above, use a disinfectant to decontaminate the child s changing mat, potty, toilet seat or toilet. Follow the manufacturer s instructions carefully to prevent disinfectant causing harm to the equipment or the environment. All toys and equipment must be safe for use and well maintained to reduce the risk of spreading harmful germs. All toys must carry a BS, BSI or CE mark. Where possible buy toys and equipment that can be easily cleaned. Store toys in a clean container and don t let children take toys into toilet areas. See appendix 4 for advice on keeping toys and equipment clean. 5.7 Management of waste Waste created at your childcare setting (nappy waste) should be managed as follows: Make sure that that there are lined pedal bins in each of the areas where waste is produced e.g. food, nappies Make sure waste bins are never overfilled i.e. once three-quarters full, tie them up and put into the main waste bin Have a schedule for emptying the bins at the end of the day, and during the day if needed Keep the main waste bin in a secure area away from play areas (make sure animals cannot get into this area) All bins should be cleaned according to the specified cleaning schedule When collecting waste and emptying bins, wear PPE (i.e. disposable gloves and disposable apron) When you are finished, remove PPE and wash your hands. If you use sharp objects ( sharps ) i.e. needles within your childcare settings, you must: Dispose of them in an approved sharps container, made to British Standard 7320 Make special arrangements for having this kind of waste collected (discuss local arrangements with your Environmental Health Officer or HPT) Keep sharps containers away from children. 11
19 5.8 Linen/Laundry If you use uniforms or cotton tabards, you should change them every day and wash them using normal washing detergent at the hottest temperature specified on the garment. If the childcare setting uses linen then you must: Allocate bedding to each child and keep it in a named bag or drawer when not in use Wash bedding every week and when visibly dirty Wash face flannels after each use Keep clean linen in a clean dry area separate from soiled or used linen If linen or clothing has been dirtied by faeces carefully dispose of the faeces in the toilet Do not rinse dirty or wet clothing by hand. Put in a named, sealed plastic bag for the child s parent or guardian to collect. Tell the parent or guardian that the clothing is dirty Before washing, put dirty and used linen in an area that children do not have access to Wash all laundry at the hottest temperatures specified by the manufacturer. 12
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Most beautiful place?
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[Question] Most beautiful place?sigpic
�That's the way a lot of things happen... You think one person did something
but he was just the one to put the color on it." � Ken Anderson
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Re: Most beautiful place?
I think the most beautiful spot in Anaheim has to be Town Square. Especially at night. I love the popcorn lights and the way that the flowers are always (of course) in bloom. When you walk through the tunnel and that is the first thing you see.... simply gorgeous!"I do not like to repeat successes. I like to go on to other things." - Walt Disney
Re: Most beautiful place?
All of Disneyland when decked out for Christmas. But if I had to pick one or a few spots, one would be standing in front of and looking at small world, especially in the evening when the lights are on (and again especially at Christmas).
I also like the walkway between Big Thunder and Rivers of America, where the old tunnel is. If it weren't for the smoking section nearby, I could hang out there a bit.
And finally, when my kids go to play on Pirate's Lair, I love to find a quite bench and let the world go by. It's very peaceful over there.
Re: Most beautiful place?
The bottom floor of Hungry Bear way in the back watching the river traffic and feeding the ducks does it for me. So quiet and peaceful with the river and trees in front of you.
Pre-Tomorrowland 1998, one of the most beautiful places at night was on the rocket-jets, way up high watching the lights of the park spin past you."Greetings, Starfighter! You have been recruited by the Star League to defend the Frontier against Xur and the Ko-Dan Armada."
Re: Most beautiful place?
A few areas:
-Back behind Thunder Mountain, standing on the bridge, watching the (albeit fake) fish jump
-Under the big tree by the tea cups
-The extreme end of Critter Country, with all of the ferns
Re: Most beautiful place?
It's a typical answer, but I do really love Snow White's Grotto. Especially at night when it's all lit up. And all of New Orleans Square is just gorgeous to me.DLR AP � DLP 2002 � WDW 2007, 2013, 2015 � TDR 2009 � DCL 2014 � ABD 2016
Next: HKDL & SDL: November 2017!
GROUNDHOG DAY: WDW and DLR in the same day: 2/2/13
My Stay in the Disneyland Dream Suite
Re: Most beautiful place?
Probably the Castle Lighting during Christmastime.Fear of the unknown.
They are afraid of new ideas.
They are loaded with prejudices, not based upon any reality, but based on� if something is new, I reject it immediately because it�s frightening to me. What they do instead is just stay with the familiar.
You know, to me, the most beautiful things in all the universe, are the most mysterious.
Re: Most beautiful place?
I know you said not too, but while Disneyland is probably the best stateside Disney park, DCA is more beautiful. Disneyland is charming and graceful and quaint and attraction heavy, but it has no area as beautiful as parts of Carsland or Grizzly. For me, nature is just more beautiful than buildings. However, areas of The Jungle Cruise and in front of Haunted Mansion and Pirates, looking 360 degrees is pretty awesome.
Re: Most beautiful place?
Originally posted by Wall to Wall Creep View PostA few areas:
-Back behind Thunder Mountain, standing on the bridge, watching the (albeit fake) fish jump
-Under the big tree by the tea cups
-The extreme end of Critter Country, with all of the ferns
Re: Most beautiful place?
The courtyard in New Orleans Square.
Re: Most beautiful place?
�Here you leave today and enter the world of yesterday, tomorrow, and fantasy.�
Re: Most beautiful place?
Disneyland is really beautiful at night.
The front of the park inside the turnstiles. The Mickey Floral glows beautifully at night.
The teacups and their lanterns.
The Rivers of America, and the Golden Horseshoe.
Fantasyland, directly behind the Castle. Peter Pan's tower, the carousel, are just dazzling.
I think the Firehouse is beautiful at night. Town Square just glows at night time.
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University of Michigan President Mark Schlissel announced new leadership of the Athletic Department during a press conference where Schlissel said David A. Brandon, the university's athletic director since 2010, had submitted his resignation.
The president appointed James Hackett to serve as intereim leader of the university's Athletic Department while a search for an AD is launched. His appointment is pending approval in November by the university's Board of Regents.


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UK Dating
I met my wife on this site 2 years ago and we are very happy, we even have a baby girl. Thank you... more..
Other UK Dating Group Sites
Sarah Harding admits herself into rehab post break-upPosted on: October 12, 2011 17:11:09
UK singles using online dating sites may know what it is like to be left feeling down after a break up so could feel some sympathy for one pop star.
Girls Aloud singer Sarah Harding has been admitted to rehab after struggling to cope following her split from fiance DJ Tom Crane.
The No Good Advice songstress is said to have hit rock bottom after the couple split in September. A spokesperson for Sarah said: "Harding has entered a treatment centre for depression and alcohol addiction."
It was reported by the Sun that she turned to alcohol to help her through the painful period.
The couple had been dating since 2007 and had been engaged for nice months.
Sarah has been previously linked to Alex Zane and Callum Best.
Fellow Girls Aloud bandmate Kimberley Walsh admitted recently that she wants marriage and children with her long-term boyfriend Justin Scott.
Are you looking for love? Try online dating!
Related Online Dating News
Hong Kong Phil boss "dreams of working with Jackie Chan"Posted on: April 17, 2014 16:26:26
The musical director of one of Asia rsquo s most well-known orchestras dreams of bringing in some unorthodox talent to perform with his musicians Speaking to the South China Morning...
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Lee Ryan and Casey Batchelor steam up the CBB housePosted on: January 6, 2014 17:25:01
They may have been shackled together when they entered the house but Lee Ryan and Casey Batchelor have done anything but drift apart since they were set free In fact...
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The online dating racePosted on: January 6, 2014 16:22:05
New research has revealed how likely single people are to get a message from an online dating site throughout According to MailOnline age matters more to men than women as...
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Sweethearts get engaged after failures on reality TVPosted on: January 3, 2014 19:02:42
When Danielle Cornwall-Nash appeared on ITV s prime time dating show Take Me Out last year she hoped that she would find a new partner and maybe even a new...
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text: Raider TV is a student-produced live news program created using industry standard equipment that provides students with real-life experiences in media, communications, and leadership. The show airs every school morning at 7:55am. The broadcast includes the latest news and events at CMS, and it highlights varying aspects of school life. Students produce a special feature segment for each school day. On-demand videos are available of shows from the last two weeks for the convenience of students, parents, and faculty. The production is overseen by student-producer Luke Stum and assistant producer Brayden Conn. Current production staff members are Eli Adams, Emma Bayne, Joy Douglas, Landon Fella, Gilza Garcia, Kieran Hall, Luke Hunt, Grant Hurst, Anna Ingram, Dillon Linkous, Cole Morrison, Sheeko Ndegwa, Evan Rants, Jackson Ritzhaupt, Shaylee Rose, Skyler Stone, John Willis, and Bridger Yowarsky. RaiderTV has been recognized both locally and nationally for its high production value and professionalism in its broadcasts. RaiderTV is a class offered to 8th grade students at Cleveland Middle School, and students apply at the end of their seventh grade year. RaiderTV is part of a holistic curriculum at Cleveland Middle School under the umbrella of communications that focuses on oral, print, web, and video communication delivery systems.


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The Smart Cart Training System organizes your training equipment into a compact and easy-to-transport system. Using the timed rotational circuit, coaches will be able to train as many as 60 athletes in one hour with the equipment on the Smart Cart.
The complete set includes Smart Hurdles, Smart Agility Ladder, medicine balls, Lifeline C-Band resistance cables and Lifeline Power Jump Ropes for unlimited training options.
Non-marking wheels allow the Smart Cart to be wheeled to your training area, inside or out.
Hurdle heights range from 6" to 36" with a sturdy 3-point base that improves stability on all surfaces. Set-up is quick and easy; the support leg rotates in either direction and folds flat for storage.
Total Weight: 200 lbs
The Smart Cart Training System includes 49 pieces of equipment:
Also includes:


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|Reviews for Let's start again
| GOANDSONNYITUP chapter 4 . 11/18/2011
this is so good you should continue
| RosesInJamJars chapter 4 . 10/19/2011
Im not usually a fan of jack/Gwen, but . ! I lurve it, and the bit with the coffee machine brought a tear to my eye! Well, several, and I couldn't see the screen for a few minutes, but I loved it all the same!
| madcloisfan chapter 4 . 8/22/2011
Loved it
| Mewknight chapter 4 . 8/17/2011
Oh cute Anwen! XD Jack is letting her kiss him? XP Noo! Why have a replica of Ianto's coffee machine? D: Well anyways, can't wait for the next chappy! XD
| Lutherian chapter 4 . 8/16/2011
Fantastically well written.
| LokixSigyn chapter 4 . 8/15/2011
nice one hehe
| SkulduggeryCain chapter 4 . 8/13/2011
Wow this is great! Please update soon!
| Martin-J-Christopher-Freeman chapter 4 . 8/13/2011
please update soon :) luv it so far
| madcloisfan chapter 3 . 7/29/2011
Loved it
| Mewknight chapter 1 . 7/6/2011
Aww! This is so sweet! XD I liked Ianto's headstone, but it is so sad that he died! D: IANTO! You can't leave Jack! XP Well, can't wait for the next chappy! XD
| LokixSigyn chapter 3 . 6/23/2011
ohh I love it!
| FrostedFox816 chapter 1 . 6/22/2011
Holy crow this is amazing. This is just brilliant, this is exactly the Gwen I have in my head. So thoughtful. No one recognizes her empathy, there are too many people who hate her. I just want to show this to all the Gwen haters of the world, because really she is quite lovely.
| MaryMatthesen chapter 2 . 6/19/2011
Great start! Looking forward to more...!
| Amethyst Lynn Willow chapter 2 . 6/3/2011
I just love this story so far. I hope that you update soon.
| madcloisfan chapter 1 . 6/1/2011
Loved continue


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- 2.5"
Some manufacturers place restrictions on how details of their products may be communicated.
Be Careful 08/18/2013
This review is from: SAMSUNG 840 Series 2.5" 120GB SATA III Internal Solid State Drive (SSD) MZ-7TD120BW
This SSD was very good while it lasted. My boot times were between 10 and 12 seconds with it as my boot drive and it never gave me any problems in the first few months of ownership.
It died. I have now owned this SSD for a little over three months and it completely died. Not detected by my system and not able to be booted from. I cannot even re-install Windows on it. Be aware that this drive should last a lot longer than three months, I would be careful when buying this product.
Other Thoughts:
It really was a great SSD when it was working! The read/write speeds are above average!
3 people found this review helpful. Did you? Yes / No Thanks for the valuable feedback you provided!


text:
Sunday, December 4, 2011
Torani Syrup Review and Giveaway- #SSTorani - Ends 12-18-11
Have you ever used Torani's Syrup Flavors? You can use them in Italian Sodas, Cocktails, Coffee, Flavored Lemonades or Iced Teas. Torani has over 100 delicious flavors! For this review I received one bottle of Salted Caramel and one bottle of Peppermint, these flavors are delicious! I have used them in my coffee, Italian sodas and I have made cocktails with them. I would certainly recommend Torani's Syrups! I love all the flavors I have tried. They have some new holiday flavors out and they are awesome!
With the great Holiday flavors of Torani in your home, every drink you make can be inspired. Discover how their syrups can help you make truly creative flavored coffees, lattes, mochas, cocktails, and more. Their Holiday flavors range from Pumpkin Pie to Gingerbread and Peppermint and they offer a variety of recipes to help you play and explore.
Product Description:
Regular and Sugar Free flavored syrups that add flavor and enhance beverages.
Popular Drink Types for Syrups:
- Flavored Coffees/Espresso Drinks (Most popular drink type for flavored syrups)
- Italian Sodas
- Flavored Tea (Hot and Cold)
- Flavored Lemonades
- Flavored Sodas (Coca-Cola, Mountain Dew, etc)
- Cocktails
- Mocktails
- Flavored Energy drinks (Red Bull)
Torani flavored syrups are available in over 122 flavors, which include regular and sugar free varieties. Please go to www.Torani.com to see all flavors.
Distribution/Where to Buy Torani Flavored Syrups:
Torani syrups are primarily used at coffeehouses and restaurants in over 40 countries. Within the retail flavored syrup category, Torani has a dominant market share exceeding 60%. At US retail outlets, Torani is available at stores such as:
- Cost Plus World Market
- BevMo
- Walmart
- Smart and Final
- Most major grocery stores
- Amazon.com (wide assortment of flavors)
- Torani.com and Shop.Torani.com (widest assortment of flavors)
About Torani
|Use Code shespeaks to
get a 10% discount!
In 1957, the Torre's son-in-law, Harry Lucheta, took over the business and guided Torani's growth from a small local San Francisco business to a brand that is loved around the world.
Fast forward to the early 1990s when Torani was at the helm of a new flavor movement in coffee. While sitting in San Francisco's Caffe Trieste, coffee industry veteran (and friend of Torani) "Brandy" Brandenburger spied Torani behind the counter and brought a bottle home to experiment with espresso and steamed milk. Thus, the first flavored caffe latte emerged, changing the pages of espresso history forever.
Today, their Torani family legacy is continued by Paul Lucheta and Lisa Lucheta. They have over 100 team members, produce an extensive portfolio of flavorful products, and continue to innovate for success.
The popularity of specialty beverages and the support of cafés, restaurants and retailers have helped grow their brand for the last 80 years. Flavor seekers around the globe enjoy Torani in their favorite beverages everyday. Torani continues to stay on the creative edge with new product lines and ideas. After all, you never know where the next revolutionary flavor innovation will appear, but you can be sure Torani will be there.
***There are four Tweets you can do each day for 8 extra entries, but must be 3 hours apart!
A product sample was received for review. This review was provided by SheSpeaks and Torani. I was not paid in any form of cash for this posting. The opinions expressed are my own and were NOT influenced in any way.
Giveaway ends December 18, 2011 (12:01 AM EST)The giveaway is only opened to the United States.
One person per household may enter.
One person per household may enter.
You must be 18 or older. Free Sweepstakes and Contest
Posted by Bonny Sallee at 12/04/2011 02:20:00 AM
2 Awesome Comments! Thanks for visiting!:
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- 9:07 AM, December 04, 2011
- ~dab said...
ugh...here's my 2nd tweet today (5:57pm), I hit enter too soon https://mobile.twitter.com/simplydab/status/144188636714385408
- 3:19 PM, December 06, 2011
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text: Divalproex sodium ER is a prescription drug that is taken for migraines, epilepsy, and for the manic episodes associated with bipolar disorder. Divalproex sodium ER helps to prevent migraine headaches. It allows people to manage their bipolar symptoms. In cases of seizure or epilepsy, divalproex sodium ER is usually taken along with other seizure medications to limit an individual's seizures. There are some serious side effects and risk factors associated with divalproex sodium ER. So talk with your doctor before you begin taking divalproex sodium ER.


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Like many other media companies, Postmedia Network Canada Corp. is in a fierce battle to hold on to diminishing advertising revenues. Now, the country's largest newspaper chain is attempting to win over one advertiser with a simple message: We only get paid if you do.
On Monday, Postmedia announced an unconventional deal with Mogo Finance Technology Inc., an online provider of short-term loans that is looking to build a customer base among young people who shy away from traditional bank branches. The deal will give Mogo what Postmedia says is at least $50-million worth of advertising space in its newspapers and on its digital properties over three years. In exchange, rather than the usual transaction where the advertiser pays for that space, Postmedia will take a cut of Mogo's revenues, and will have the option to buy into Mogo's stock at current prices.
Essentially, Postmedia is making a bet that the company will be worth more in the coming years than the value of the advertising space it is giving up. It's not without risk: Mogo's stock price has fallen more than 65 per cent since the company went public last June. Currently, Mogo says it has just over 150,000 members.
So why take the risk? Startups such as Mogo are hesitant to advertise with legacy media, said Andrew MacLeod, Postmedia's chief commercial officer. This was a way to convince them that Postmedia was worth examining as an advertising vehicle.
"They were allocating the vast majority of their marketing budget to the new apex predators – as I lovingly refer to them – the Googles, the Facebooks, whatnot. … If we had just approached them with a vanilla, 'How much print would you like, how much digital would you like,' I would highly doubt we would have had much traction with that," Mr. MacLeod said. "It's a completely different way of looking at it."
The moment that the agreement comes into effect, Postmedia will begin drawing 4 per cent of Mogo's revenues. And there is a performance-based aspect: If Mogo makes more money, Postmedia will get 11 per cent of those "incremental" revenues.
Postmedia will also receive warrants giving it the right to purchase up to roughly 1.2 million common shares of the company over a five-year period, subject to various conditions.
If this experiment works, Postmedia may be open to other similar deals in the future.
"This is a new model where we can approach people and say we can both have skin in the game from a commercial perspective," Mr. Macleod said. "It's not necessarily something you want to do everywhere. We're co-mortgaging ourselves together and you want to pick the right players."
For Mogo, as a small company trying to build its brand, marketing is a big expense, which is part of the reason it has focused on cost-effective online advertising. Its advertising with Postmedia will include online ads, but could also encompass other Postmedia advertising such as print ads, newspaper inserts and what is known as "native advertising," or articles that are paid for by an advertiser with prescribed subject matter with which the advertiser wants its brand to be associated.
In media, there are also differences between the standard rates charged for ad space and the prices that big advertisers with long-standing relationships and deep pockets are able to negotiate. Postmedia has told Mogo that as it draws on its bank of ad space across Postmedia properties, it will receive rates that are consistent with other large advertisers.
"Because they really are incentivised to help us grow our business, that creates a more compelling partnership than a traditional media buy," said Mogo chief executive officer Dave Feller.
It's not the first time a media company has struck such a deal: In August, Metroland Media Group Ltd. took a minority stake in Nest Wealth Asset Management, an investing website. Metroland, a division of Torstar Corp., paid $1.5-million cash, but also included advertising support in the deal. At the time, Metroland president Ian Oliver said the more than 100 weekly newspapers in Ontario that Metroland publishes were not seeing much advertising revenue from so-called "robo-advisers."
Last week, Postmedia announced that it would cut 90 jobs as it merges competing newsrooms in cities where it publishes more than one newspaper. The company has been struggling under the load of more than $670-million in debt, while at the same time advertising revenues are falling.
"Our industry is in a difficult place," Mr. MacLeod said. "We need to be trying new things. We know what doing nothing will get us, extrapolating out the current trends. So there is an element of, it's okay to jump off the burning platform and try things. ... This industry genuinely has to transform. It's one plank in a larger transformative journey."Report Typo/Error
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Let us know when your receive great advice so we can thank our lawyers and point others with similar questions in the right direction.Got it!
I have been divorced for 10 years. We have joint legal custody, but I have primary physical custody. Our visitation schedule is "as both parties mutually agree". He makes no attempt to contact or see our children. He has gone as long as 5 years at a time with no contact. At this point it has been a year since he has seen or spoken to them. He is over $50,000 behind in child support. I have been offered a great fellowship for a doctoral program in Indiana and would like to move there with our children. After several attempts to contact him with no success I filed the appropriate court paperwork for a hearing request and have been granted a hearing where I have been instructed to submit a list of witnesses and evidence to the referee and have no idea what I need or should have. Please help.
For change of domicile, the court considers the following factors:
(a) Whether the legal residence change has the capacity to improve the quality of life for both the child and the relocating parent.
(b) The degree to which each parent has complied with, and utilized his or her time under, a court order governing parenting time with the child, and whether the parent's plan to change the child's legal residence is inspired by that parent's desire to defeat or frustrate the parenting time schedule.
(c) The degree to which the court is satisfied that, if the court permits the legal residence change, it is possible to order a modification of the parenting time schedule and other arrangements governing the child's schedule in a manner that can provide an adequate basis for preserving and fostering the parental relationship between the child and each parent; and whether each parent is likely to comply with the modification.
(d) The extent to which the parent opposing the legal residence change is motivated by a desire to secure a financial advantage with respect to a support obligation.
(e) Domestic violence, regardless of whether the violence was directed against or witnessed by the child." MCL 722.31(4)
You should present evidence to the court supporting these factors. Some documents you may want to consider are: acceptance letter for doctoral program; documents proving income; information relating to schools in the new state; information regarding your proposed new neighborhood; if there has been domestic violence, police reports.
Your witnesses would be anyone who can testify about any of these factors.
If your ex doesn't appear, your motion will probably be granted. However, I would suggest that you contact a lawyer in your area for assistance.
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|Reviews for Midnight Visit
| YeahYouWannaKnowMyName chapter 2 . 11/18/2010
Aww, they really are cute.
| DAngel7 chapter 2 . 4/2/2009
I enjoyed it! I really hope you will write another NejixHina.. I just like this pairing! :]
| LunaSeasMoonChild chapter 2 . 8/10/2008
Aww! Too bad this is fic only has 2 chappies!I wanted to read more! MORE!
It was a wonderful portrayal of the "freeing" of Hyuuga. It was too bad HIashi was one of the "evil" Main House. , But this was a great read! XD
| gaarabear666 chapter 2 . 8/3/2008
aww its so cute! and hell yeah for hinata, someone needs to teach those idiots a lesson, it should be her!
| kawaiis chapter 2 . 5/5/2008
I'm so glad you made it into a two shot. It does feel more complete that way :3
Super sweet and cute story!
| PandaDragon chapter 2 . 5/3/2008
wow very good! amazing genius! i loved it! great stuff please do write more!
| anlmoon chapter 1 . 5/3/2008
nice story , you did great with the charaters. there weren't out of charater at all. sibling fluff. cute
| MlleD chapter 2 . 5/3/2008
Aw. Hinata freeing the Branch members. That's not something you see in every story. Well done.
| Stephanie8D chapter 2 . 5/3/2008
This was very sweet and I love the friendship, honor given to Hinata by the Branch house. I really hope you write more stories.
| darklight8121 chapter 1 . 5/1/2008
Wow. Just wow. I was a little suprised at the emotion in this. I have come across writers that can write with feeling but this was FEELING in written word. Make any sense? Well it was a compliment regardless. Keep that muse please and finish this!
| Stephanie8D chapter 1 . 4/23/2008
This was so sweet, I really wish you would continue it, I love the story line, and the way you took it. Please think of lengthening it, and Thanks for the opportunity to read it.
| PandaDragon chapter 1 . 4/15/2008
AW! LOved it! continue? or more genius please!
| elizabeth chapter 1 . 4/15/2008
please contuine this story. what will the main branch do if they found out? and poor neji tring to make it up to Hinata and how far will her little sister and the branch family go to protect her?
| kat2009 chapter 1 . 4/15/2008
ah i can tell this story is going to be really cute! please update, ive never read any hinata neji stories but there's a first for anything, i like it!


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License plates can be renewed at your County Tag Office. If you have not received a renewal notice by the first week of your registration month or you received an uncalculated renewal notice, contact your County Tag Office. Even if a renewal notice is not received, the taxes and penalties still apply.
If your address has changed, have your address corrected on your Georgia driver's license or ID card first then have your address changed at your County Tag Office.
Online Registration
Online registration is available in some counties, your renewal notice will have information about online registration if your county participates. Requirements for online renewals are:
- You must live in a participating county.
- Your renewal notice must have a Renewal Identification Number (RIN).
- All registration fees, taxes, and convenience fees must be paid by debit card, credit care, or electronic check. (You will know the actual cost before completing the transaction and cancel at any time before the transaction is complete.)
- In counties requiring emission testing, your vehicle must pass inspection prior to renewing.
In-Person or Mail-in Renewal
Vehicle Registrations can be renewed at your County Tag Office. The following information is required:
- Renewal notice
Note: If your renewal notice has incorrect information, you will need a completed and signed Form MV-1 Title/Tag Application.
- When applying in-person, you must show your valid Georgia driver's license or Identification card.
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FORT WORTH, Texas -- The general manager of the new Cowboys Stadium has pleaded guilty to driving while intoxicated and has been sentenced to 15 days on a Tarrant County sheriff's labor detail.
The Fort Worth Star-Telegram reported that Jack Hill's attorney, Mark Daniel, confirmed Hill had pleaded guilty. Daniel said the 54-year-old Hill was sentenced Thursday after entering the plea.
Hill also was fined $925.
Hill was arrested for suspicion of driving while intoxicated early June 7 after an accident near the stadium.
Dallas Cowboys spokesman Brett Daniels said Hill remains the stadium's general manager.