AUSTIN (KXAN) – The Texas Health and Human Services Commission released new emergency rules for child care centers. 

Gov. Greg Abbott ordered the new rules Tuesday after a spike in the number of positive COVID-19 cases at child care centers across Texas. 

• READ: Child care center in southwest Austin reports 10 COVID-19 cases, including 1 child

It comes on the heels of the state lifting earlier safety measures about two weeks ago.

Those measures were repealed on June 12, which included screening and checking temperatures, as well as maintaining drop-off and pick-up outside only, and not serving family style meals. 

• RELATED: Governor scaling up safety at child care centers with emergency rules during pandemic

In the new order those safety precautions are back along with several new rules. 

All caregivers must now take required health and safety training related to COVID-19 through the Texas A&M AgriLife Extension. 

Employees 65 and older are encouraged to talk to their health care provider to assess their risk to determine if they should stay home. 

The emergency rules also require washing the child’s and caregiver’s hands before changing diapers and to wear gloves. All children and caregivers must now also have multiple changes of clothing in case they get soiled. 

Other requirements say operations should adjust the HVAC system to allow fresh air to enter, limit machine washable cloth toys to one person, and post signs describing handwashing steps near sinks.