Child Care Centres and COVID-19

Public Health aims to promote the health and wellbeing of children and staff to ensure that child care centres operate in the safest and healthiest way possible. In addition to the requirements set out in the Child Care and Early Years Act, 2014 and its regulations, as well as the Occupational Health and Safety Act, child care centres are also required to follow the advice and direction of Public Health Sudbury & Districts. Public Health Sudbury & Districts expects the child care sector  ( Government of Ontario) to put measures in place to stop the spread of COVID-19.

COVID-19

Visit our COVID-19 page for information on symptoms, self-isolation, and where to get tested for COVID-19.

Outbreaks in Child Care Centres

Public Health will post information about outbreaks of COVID-19 in licensed child care centres when they are declared. This information is updated as it becomes available.

What’s on this page

• Screening
• • Child Care workers
  • Children
• Attendance recording
• Cleaning and disinfecting
• Handwashing
• Physical distancing
• Mask and Personal protective equipment
• COVID-19 Symptoms in children
  • If a child develops symptoms at home
  • If a child develops symptoms while at child care centre
• COVID-19 symptoms in staff
  • If a staff develops symptoms while at work
• Close contact definition in child care settings
• Reporting
• Summer FAQ for licensed child care centers and day camps

Screening

Child care workers

All individuals must self-screen every day before arriving at the child care centre. If you are a child care worker and have symptoms of COVID-19, immediately self-isolate (learn how), notify your employer or occupational health and safety department, and seek testing for COVID-19. Staff can use the COVID-19 school and child care screening tool every morning before attending work. It is also recommended to complete the screening tool on weekends, especially if symptoms develop. Child care centres must have a process in place to validate the daily self-screening of staff, placement students and visitors. At minimum, daily confirmation of having self-screened (i.e., proof of completed paper copy, mobile application indicating a “pass”) is required prior to and upon entry.

Staff presenting with new symptoms compatible with COVID-19, including atypical symptoms, must be rapidly identified, investigated and managed, including ensuring access to testing. Staff awaiting test results should not attend work and must remain in self isolation until results are received. Those with symptoms should contact their assessment centre to book an appointment.

Children

• Providers should develop procedures that support physical distancing and separate groups of children as best as possible – ideally separate entrances and exits (i.e., children of one room enter door A and children of another room enter door B), or staggered entrance times. You may want to review the Checklist on COVID-19 Preparedness and Prevention in Elementary and Secondary Schools(Public health Ontario) , for helpful considerations
• Pick up and drop off of children should occur outside if operationally feasible. As much as possible, parents should not enter the premises.
• Parents and/or guardians must screen their children for symptoms of illness every day using the COVID-19 school and child care screening tool.
• In the event that an individual is not screened prior to arriving at the child care setting, active (in-person) screening should be available when necessary.
• Consider dedicating one to two staff to be screeners. Have one staff screening and have another staff available to bring the child(ren) to their designated room(s).
  • For screening individuals at the child care setting and when escorting children to the program, precautions including maintaining physical distance of 2m, being separated by a physical barrier, the use of personal protective equipment and hand hygiene must be in place.
  • Deny entry to anyone who fails the screening. Anyone with new or worsening symptoms that may be due to COVID-19 should be advised to seek medical assessment/guidance for testing from their primary health care provider.

Attendance recording

• In addition to attendance records for children attending child care, maintain daily attendance records of all individuals entering the child care centre/home daycare. This includes, but is not limited to, maintenance workers, cleaning/environmental staff, food service workers and government agency employees (e.g. public health inspectors, fire inspectors).
• This record should include the following information: name, company, contact information, date, time of arrival/departure, reason for visit, rooms/areas visited and confirmation of screening.
• Non-essential visitors must not be permitted to enter the child care centre.
• Monitor attendance records for patterns or trends (for example, children and child care staff in the same group or group absent at the same time or over the course of a few days).
  • Attendance records must be available on-site at all times and must include all individuals entering the building (e.g. maintenance workers, cleaning/environmental staff, food service workers and government agency employees (e.g. public health inspectors, fire inspectors). Public Health may request the attendance records; this will need to be provided within 24 hours.

Cleaning and disinfecting

Frequently touched surfaces must be cleaned and disinfected at least twice daily. Frequently touched surfaces include, but are not limited to toilet fixtures, faucets, doorknobs, light switches, handles, phones, keyboards, handrails etc. Keep a log of when cleaning occurs. Centres should also refer to the Ounce of Prevention Manual (PDF) for recommendations on cleaning and disinfecting in child care centres.
Provide only toys that can be cleaned and disinfected. Where possible have designated toys and equipment for each group. Where toys and equipment are shared, they must be cleaned and disinfected between groups. Where outdoor toys are shared, these too should be cleaned and disinfected between groups. Large play structures do not require cleaning and disinfecting, however, hand hygiene after outdoor play and after the use of shared play structures is essential.
Other frequent cleaning steps include, but are not limited to:

• Disinfecting cots and cribs after each use
• Washing linens between children’s use
• Cleaning and sanitizing eating surfaces and multi-use utensils after use

Hand hygiene

Handwashing ( Public health Ontario) is one of the best way to prevent the spread of infection. Proper handwashing significantly reduces the spread of germs. When you wash your hands, you wash away the germs that you may have picked up from other people or from surfaces.

When hands are not visibly soiled, the use of an alcohol-based hand rub with a concentration of at least 60% alcohol is acceptable. However, hand washing using soap and water is recommended over alcohol-based hand rub for children. Staff and children need to wash their hands thoroughly and often so that handwashing becomes a lifelong habit. For handwashing resources and videos for child care centers visit our resources page.

Perform proper hand hygiene (including assisting children with hand hygiene) especially:

• Upon entering and leaving the child care centre
• Before and after touching the face or blowing the nose
• After sneezing and coughing
• Before and after preparing, serving, or eating food
• Before and after giving medication
• After using the washroom
• After handling frequently touched items
• After playing outside
• Whenever hands are visibly dirty

Physical distancing

While it is recognized that physical distancing may be challenging in child care settings, physical distancing of at least 2 meters must be maintained between groups and, where possible, should be encouraged between children within the same group. Here are some helpful considerations:

• Staggering lunch time and outdoor playtime.
• Incorporate independent activities.
• Avoid handshakes, high fives, and hugs.
• Increase the distance at naptime (if space is tight, children can be placed head to toe or toe to toe).
• When possible, children should practice physical distancing while eating and during sit down activities. Tables and chairs should be placed to optimize space between children.

Recognizing that physical distancing is difficult with small children and infants, additional suggestions include:

• Planning activities that do not involve shared objects or toys;
• When possible, moving activities outside to allow for more space

Masks and personal protective equipment (PPE)

Expectation for adults:

• All staff, home child care providers, visitors and students are required to wear a medical mask and eye protection (i.e. face shield or goggles) while inside a child care setting, including in hallways and staff rooms (unless eating – but time with masks off should be limited and physical distance should be maintained).
• All other adults (parents/guardians and visitors) must wear a non-medical mask or face covering (for example, a homemade cloth mask) while inside the premises.
• Gloves must be worn when it is anticipated that hands will come into contact with mucous membranes, broken skin, tissue, blood, bodily fluids, secretions, excretions, contaminated equipment, or environmental surfaces.
• The use of a medical mask is required outdoors when a distance of 2 metres cannot be maintained
• Child care operators must provide personal protective equipment (PPE) for use by staff.
• It is strongly recommended that child care operators maintain a one- to two-week supply of PPE at all times.
• Staff providing coverage for a group that is not their group (break or lunch coverage for example), should consider the use of a gown if they will be holding young children.

See Public Health Ontario for information on how to properly wear and take off PPE.

Expectations for children:

• All children in grades 1 and above are required to wear a non-medical mask or face covering while inside a child care setting, including in hallways.
• The use of a non-medical mask or face covering is required outdoors when a distance of 2 metres cannot be maintained.
• Younger children are encouraged, but not required to wear a face covering while attending child care.
• Parents/guardians are responsible for providing their children with a mask or face covering and should be reminded that children will require a way to store their mask when not in use.

Children under the age of two should not wear a mask/face covering

Reasonable exceptions to the requirement to wear masks are expected to be put in place by licensees. Exceptions to wearing masks indoors could include circumstances where a physical distance of at least 2 metres can be maintained between individuals, situations where a child cannot tolerate wearing a mask, reasonable exceptions for medical conditions, etc. (See our Frequently Asked Questions on Face Coverings).

COVID-19 Symptoms in children

If a child develops symptoms at home:

• Parents are encouraged to use the COVID-19 school and child care screening tool on a daily basis, and follow the guidance provided in the tool.

• Parents should notify the child care centre of the child’s symptoms.

If a child develops symptoms while at a Child Care Centre:

This document “What to do: if a child is ill during school or day care hours” provides a step-by-step road map on the steps child care centres should take if a child is ill during day care hours.

• Notify the supervisor and Identify a staff member to supervise the child.
• Identified staff member should immediately separate the symptomatic child from others in a supervised area until they can be picked up by a parent or guardian.
• When possible, the identified staff member should maintain a 2-meter distance from the ill child. If that is not possible, wear eye protection, a medical mask and a gown. The child should also wear a medical mask only if above the age of two and if they can tolerate it.
• Contact the child’s parent or guardian to pick them up right away and advise them to follow directions from the school and child care screening or their primary health care provider.
• Remember to practise hand and respiratory hygiene. Tissues should be provided to the child for respiratory etiquette, along with proper disposal of the tissues.
• Environmental cleaning and disinfecting of the centre should be conducted once the child has been picked up.
• Advise caregiver the child should be tested for COVID as soon as possible.

Symptomatic children awaiting test results must self-isolate at home away from other household members. Note that if the sick child is young and cannot isolate apart from other household members, a parent or caregiver must also isolate with the child away from other household members.

COVID-19 symptoms in staff

All staff members should self-screen every morning before attending the child care centre.  Staff member can use the COVID-19 school and child care screening tool.  If a staff develops symptoms at home, staff should:

• Follow the guidance provided in the COVID-19 school and child care screening tool
• Notify their supervisor at the child care centre of their symptoms.
• Contact their nearest assessment centre to schedule testing.
• Symptomatic staff awaiting test results must self-isolate at home away from other household members.

If a staff develops symptoms while at work:

• Staff must go home and self-isolateas soon as possible.
• Staff should be referred to the nearest assessment centre for testing for COVID-19.
• Environmental cleaning and disinfecting of the centre should be conducted once the staff has left.

Symptomatic staff awaiting test results must self-isolate at home away from other household members.

Close contact definition in child care setting

In the context of child care settings, it is important to apply these definitions conservatively in order to prevent the spread of COVID-19. Although exceptions may apply, in general the following applies in these settings:

• When a child is the confirmed case, any close contact of the case (while they were symptomatic and up to 48 hour prior to symptom onset) include:
  • all staff and children within the same group;
  • all staff or children outside of the group who provided care for or spent time with ill child with proximity to child is 2 metres or less for any duration of time;
  • any siblings of the confirmed case at the child care centre who may be in different groups would also be considered close contact.

• When the staff is the confirmed case, any close contact of the case (while they were symptomatic and up to 48 hours prior to symptom onset) include:
  • all children or other staff within the same group;
  • all staff or children outside of the group who spent time with the ill staff within a proximity is 2 metres or less.

Public Health will make direct contact with those identified as being close contacts of a case.

Testing and Test results

Children or staff with at least one symptom of COVID-19 should be tested.

Asymptomatic individuals do not need to be tested (with exceptions). Learn more about who is eligible for testing

Negative test result or testing not recommended:
Children or staff who test negative for COVID-19 and have not been identified as a close contact of a COVID case or if testing is not recommended and/or an alternative diagnosis is provided, may return to school/daycare if they meet the following criteria:

• They do not have a fever (without using medication); AND
• Their symptoms have been improving for at least 24 hours (or at least 48 hours if their symptoms were vomiting/diarrhea); AND
• They were not in close contact with someone who currently has COVID-19.

Please note that mild symptoms known to persist in young children (e.g. runny nose or mild cough that may persist following infections) may be ongoing at time of return to school/child care if other symptoms are resolved.

Close contacts can discontinue self-isolation if .

Positive test result:
Those who test positive for COVID-19 must be excluded from child care centre until clearance has been received from public health. of this person must continue to self-isolate and monitor for symptoms for 14 days from last known exposure and notify public health should symptoms develop.

Public Health will provide further advice about information that should be shared with other staff and parents or guardians in the event there is a case or outbreak of COVID-19 in the child care centre.

Testing recommended, but test not obtained:

If testing is recommended by your health care provider and/or the COVID-19 Screening Tool for Children in School and Child care and testing is not done, the child/staff member must stay home and self-isolate away from other household members for 10 days from when their symptoms started. They may return to school/daycare after 10 full days since the symptoms started as long as they do not have a fever and their symptoms have been improving for at least 24 hours (or 48 hours from last episode of vomiting and/or diarrhea).

Reporting

In general, daycares should not report all instances of ill individuals in the child care setting to Public Health.  They should call Public Health Sudbury & Districts at 705.522.9200, ext. 553 if:

• they are in the opinion that an individual may have COVID-19 (e.g. awareness of child being diagnosed with COVID-19, exposed to a case of COVID-19, having traveled outside of Canada or to a COVID-19 impacted area in the last 14 days)
• they have concerns about child-related absences or attendance concerns within their daycare community
• they have questions about the management of individuals with symptoms (or environmental cleaning or other measures)
• there are concerns about multiple ill individuals in a group

Summer FAQ for licensed child care centers and day camps

If you are a daycare or summer camp operator, you may have some questions about how COVID-19 regulations impact your summertime activities. Get answers in our Frequently Asked Questions (PDF, 617 KB).

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This item was last modified on July 13, 2021