(CBS SF) — Parents may be feeling inclined to send their kids back to school with an extra box of Kleenex and a whole lot of hand sanitizer.

A survey by OpenWorks found that most parents are concerned about their children’s school cleanliness.

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From the more than 300 working parents surveyed, half said they pack lunch for their kids because they think the cafeteria is “unclean” or “unsanitary.”

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One in three parents said they won’t let their kids ride the bus because they think it’s not clean.

Despite these behaviors, nearly half of surveyed parents said they feel pressured to send their kids to school in these conditions — even if they’re sick — because they can’t miss work.

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“The survey shows parents believe schools aren’t making the grade when it comes to keeping facilities clean, creating unhealthy environments for students ” says David Bosley, OpenWorks Executive Vice President.