Steering for Youngster Care Packages that Stay Open

Provides additional options for screening children on arrival to ensure children with a fever or other signs of illness are not admitted to the facility.
The additional options can be useful when personal protective equipment (PPE) is scarce.

These additional considerations are intended to guide a number of childcare programs, including:

Family childcare programs, also known as home childcare
Pre-K programs (pre-kindergarten) in private and public schools
Head Start and Early Head Start Programs
Private day care centers
Temporary daycare operated by municipalities for children of essential service providers such as first aiders, healthcare workers, transit workers and other industries where a parent cannot stay at home
Daycare centers that work with health care facilities to support health care workers who need childcare

This information is intended for Childcare programs that stay open and should be used in conjunction with CDC guidelines for administrators of childcare programs and K-12 schools. This guide does not replace any applicable federal, state, or local laws and guidelines for childcare programs.

General readiness and planning

As you are thinking about how your facility will deal with the effects of Coronavirus Disease 2019 (COVID-19), it is important to work with your local health authorities, school districts, childcare admissions agencies, childcare accreditation agencies and health counselors, and other community partners to identify the most appropriate plan and actions. This document is intended to help administrators create contingency plans and align them with the level of transmission in their community.

Regardless of the level of transmission in a community, every childcare program should have a plan in place to protect employees, children, and their families from the spread of COVID-19.

See the CDC guides for more information.

Prevent the spread of COVID-19

Plan ahead for adequate supplies to support hand hygiene behavior and routine cleaning of items and surfaces. If you are having difficulty obtaining these supplies, please contact your local Child Care Resource and Referral (CCR&R) agency to learn more about service organizations in your community that may have additional resources. You can find your local CCR & R agency under “Resourcesexternal symbol

Encourage employees to take preventative measures on a daily basis to keep respiratory diseases from spreading.

Wash your hands often with soap and water. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.
Always wash your hands with soap and water when the hands are visibly dirty.
Remember to supervise young children when using hand sanitiser to prevent ingestion of alcohol.
Clean and disinfect frequently touched surfaces.
Cover up your coughs and sneezes.
Cover your mouth and nose with a cloth if you must go out in public.
Babies and children under two years of age should NOT wear fabric face covers due to the risk of suffocation.

Sick children and employees have to stay at home.

Tell parents the importance of leaving children at home when they are sick.
Let employees know the importance of being alert for symptoms and staying in touch with facility management when they feel sick.
Establish procedures to ensure that children and staff who come sick or sick to daycare in your facility are sent home as soon as possible.
Keep sick children and staff separated from healthy children and staff until they can be sent home.
Sick employees should not return to work until they have met the home isolation criteria.

Have a plan if someone is or becomes sick.

Include an isolation room or area (such as a crib in a corner of the classroom) where a sick child can be isolated. For more information on isolation in related environments, see Home Isolation and Healthcare Isolation.
Follow CDC guidelines for disinfecting your building or facility when someone is sick.
If a sick child has been isolated in your facility, clean and disinfect the surfaces in your isolation room or area after the sick child goes home.
When COVID-19 is confirmed in a child or employee:
- Close areas used by the sick person.
- Open outside doors and windows to increase air circulation in the areas.
- Wait up to 24 hours or as long as possible before cleaning or disinfecting to allow breath droplets to settle before cleaning and disinfecting.
- Clean and disinfect all areas used by the sick person, e.g. B. Offices, bathrooms and public areas.
- If more than 7 days have passed since the sick person visited or used the facility, no additional cleaning and disinfection is required.
  - Continue routine cleaning and disinfection.

Monitor and plan absenteeism among your employees

Develop plans to cover classes in the event of increased staff absenteeism. Coordinate with other local childcare programs and reach out to substitutes to determine their likely availability if regular employees have to stay at home when they or their family members are sick.
Recommend those at higher risk of developing serious illnesses from COVID-19 (older adults and people of all ages with serious underlying illnesses) to see their doctor to assess their risk and determine whether they should stay home if they have an outbreak their community.

Review plans to implement social distancing strategies

Social distancing focuses on staying out of the community, avoiding mass gatherings, and keeping your distance from others when possible. Detailed instructions on implementing social distancing strategies in daycare centers and schools can be found here: Social distancing strategies

Assess group meetings and events

Follow the latest meeting and event guidelines.
Plan to restrict unneeded visitors and postpone or cancel the use of volunteers in the classroom.

When your childcare program stays open

Childcare programs that remain open during the COVID-19 pandemic should keep these additional considerations in mind:

Some schools, childcare programs, and service organizations support their communities by providing temporary or emergency childcare services for children from essential service providers such as first responders, healthcare workers, transit or grocery retailers, and unpaid people, not working from home or not having a family carer at home to have.

Social distancing strategies

Work with your local health authorities to identify a number of strategies that are appropriate for your community's situation. Keep using preparedness strategies and consider the following social distancing strategies:

If possible, childcare classes should include the same group every day and the same childcare facilities should stay with the same group every day. If your childcare program is still open, consider setting up a separate classroom or group for the children of healthcare workers and other first responders. If your program cannot create a separate classroom, consider only caring for the children of health care workers and first responders.
Cancel or reschedule special events such as festivals, holiday events, and special performances.
Consider changing or stopping daily group activities that can promote transmission.
- Keep each group of children in a separate room.
- Limit mixing of children, e.g. B. staggering playground times and separating groups for special activities such as art, music and exercise.
- Whenever possible, when napping, make sure that the children's lunch mats (or cribs) are as far apart as possible, ideally 6 feet apart. Consider placing children from head to toe to further reduce the potential for the virus to spread.
Consider staggering the arrival and drop-off times and / or have childcare workers come outside of the facility to pick the children up when they arrive. Your curbside drop-off and pick-up plan should limit direct contact between parents and co-workers and adhere to social distancing recommendations.
If possible, arrange for administrative staff to telework from home.

Delivery and collection by parents

Hand hygiene stations should be set up at the entrance to the facility so that children can clean their hands before they enter. If a sink with soap and water is not available, provide the hand sanitizer next to the parents' registration sheets at least 60% alcohol. Keep hand sanitizer out of the reach of children and monitor use. If possible, place registration stations outdoors and provide sanitary wipes to clean the pens between each use.
Consider staggering the arrival and drop-off times and plan to limit direct contact with parents as much as possible.
- Have child carers greet children outside when they arrive.
- Designate a parent to volunteer to bring all of the children to their classroom and, at the end of the day, to bring all of the children back to their cars.
- Small children could be transported in their car seats. Keep the car seat out of the reach of children.
Ideally, the same parent or specific person should drop off and pick up the child every day. If possible, elderly people, such as grandparents or those with serious underlying medical conditions, should not take in children as they are at a higher risk of developing serious illnesses from COVID-19.

Screen children on arrival (if possible)

Individuals with a fever of 100.40 (38.00 ° C) or more or other signs of illness should not be admitted to the facility. Encourage parents to look out for signs of illness in their children and to keep them at home when they are sick. If possible, check out the kids on arrival.

There are several methods that institutions can use to protect their employees when performing temperature tests. The most protective methods include social distancing (keeping within 6 feet of others) or physical barriers to remove or minimize exposures due to close contact with a child who exhibits symptoms during screening.

Examples of screening methods

Reliance on social distancing (example 1)

Ask the parent / guardian to take their child's temperature either prior to arrival at the facility or upon arrival at the facility. Upon arrival, stand at least 6 feet from the parent / guardian and child.
Ask the parent / guardian to confirm that the child does not have a fever, shortness of breath, or cough.
Do a visual inspection of the child for any signs of illness, which may include flushed cheeks, rapid breathing or difficulty breathing (without recent physical activity), tiredness, or extreme excitement.

You don't need to wear personal protective equipment (PPE) if you can keep a distance of 6 feet.

Reliance on barrier / partition controls (example 2)

Stand behind a physical barrier, e.g. B. a glass or plastic window or a partition that can be used to protect the face and mucous membranes of the employee from breath droplets that can arise when the child to be examined sneezes, coughs or speaks.
Do a visual inspection of the child for any signs of illness, which may include flushed cheeks, rapid breathing or difficulty breathing (without recent physical activity), tiredness, or extreme excitement.
Perform a temperature screening (follow the steps below).
- Perform hand hygiene
- Wash your hands with soap and water for 20 seconds. If soap and water are not available, use hand sanitizer with at least 60% alcohol.
Put on disposable gloves.
Check the child's temperature by reaching around the partition or through the window.
Make sure that your face always stays behind the barrier during the screening.
If you have a Temperature test with several peopleMake sure you a Clean each child with a pair of gloves and that the Thermometer has been cleaned thoroughly between each check.
If you are using disposable or non-contact (temporal) thermometers and have not had physical contact with the child, there is no need to change gloves before the next check.
If you use non-contact thermometers, clean them with an alcohol swab (or isopropyl alcohol on a cotton swab) between each customer. You can reuse the same cloth as long as it stays wet.

Reliance on personal protective equipment (example 3)

If social distancing or barrier / segregation controls cannot be performed during screening, personal protective equipment (PPE) can be used when the child is no further than 6 feet from a child. However, Reliance on PPE alone is a less effective control and more difficult to implement given the lack of PPE and training requirements.

When you arrive, wash your hands and put on a face mask, eye protection (goggles or disposable face shield that completely covers the front and sides of the face), and a single pair of disposable gloves. A dress might be considered if close contact with a child is expected.
Visually inspect the child for any signs of illness, which may include flushed cheeks, rapid breathing or difficulty breathing (without recent physical activity), fatigue, or extreme excitement, and confirm that the child is not coughing or having difficulty breathing.
Measure the child's temperature.
- If you have a Temperature test with several peopleMake sure you a Clean each child with a pair of gloves and that the Thermometer has been cleaned thoroughly between each check.
- If you are using disposable or non-contact (temporal) thermometers and have not had physical contact with a person, there is no need to change gloves before the next check.
- If you use non-contact thermometers, clean them with an alcohol swab (or isopropyl alcohol on a cotton swab) between each customer. You can reuse the same cloth as long as it stays wet.
Remove and dispose of PPE and wash hands after each screening.
Use an alcohol-based hand sanitizer that contains at least 60% alcohol or wash your hands with soap and water for at least 20 seconds.
If hands are visibly dirty, soap and water should be used before using an alcohol-based hand sanitizer.
If your employees have no experience with PPE:

Clean and disinfect

Care for our childrenexternal symbol

Intensification of cleaning and disinfection efforts:

Facilities should develop a schedule for cleaning and disinfecting. You can find an example herepdf icon
Regularly clean, disinfect, and disinfect surfaces and objects that are frequently touched, especially toys and games. This may include cleaning items / surfaces that are not normally cleaned on a daily basis, e.g. B. doorknobs, light switches, sink handles in the classroom, countertops, naps, toilet pots, desks, chairs, cubes and playground structures. Use the cleaners normally used in your facility. Instructions are available for selecting suitable disinfectants or disinfectantspdf icon
Use all detergents as directed on the label. Most EPA registered fragrance-free household disinfectants should be effective at disinfecting. A list of products that are approved by the EPA for use against the virus that causes COVID-19 can be found hereexternal symbol
Whenever possible, provide childcare workers and other staff with disposable EPA registered wipes so commonly used surfaces such as keyboards, desks, and remote controls can be wiped clean before use. If wipes are not available, please refer to CDC Disinfection Guide for Community Settings.
All detergents should be kept safe and out of the reach of children.
Cleaning products should not be used around children and personnel should ensure that adequate ventilation is available when using these products to prevent children from inhaling toxic fumes.

Clean and disinfect toys

Toys that cannot be cleaned and disinfected should not be used.
Toys that children put in their mouths or that are otherwise contaminated by body secretions or excretions should be set aside until they are hand-cleaned by a person wearing gloves. Clean with water and detergent, rinse, disinfect with an EPA registered disinfectant, rinse again, and air dry. You can also clean in a mechanical dishwasher. Think about things that are more likely to get into a child's mouth, like play food, dishes, and utensils.
Machine washable stuffed toys should be used by one person at a time or not at all. These toys should be washed before being used by another child.
Do not share toys with other groups of infants or young children unless they are washed and disinfected before being moved from one group to another.
Set aside toys that need cleaning. Place in a bowl of soapy water or in a separate container marked “dirty toys”. Keep the pan and water out of the reach of children to avoid the risk of drowning. Washing with soapy water is the ideal cleaning method. Try to have enough toys so that the toy can be rotated through cleanings.
Children's books, like other paper-based materials such as mail or envelopes, are not considered to be a high risk of transmission and do not require additional cleaning or disinfection procedures.

Clean and disinfect bed linen

Use bedding (sheets, pillows, blankets, sleeping bags) that can be washed. Keep each child's bedding separate and store them in individually labeled containers, cubes or bags. Cribs and mats should be labeled for each child. Bedding that comes into contact with one child's skin should be cleaned weekly or before another child uses it.

Care of infants and young children

Diapers

When diapersexternal symbol

Prepare (including putting on gloves)
Clean the child
Remove rubbish (dirty diapers and towels)
Replace diaper
Wash children's hands
Tidy up the diaper station
wash your hands

After diapering, wash your hands (even if you were wearing gloves) and disinfect the diaper area with a fragrance-free bleach registered by the EPA as a disinfectant or disinfectant solution. If other products are used to disinfect or disinfect, they should also be fragrance free and EPA registered. If the surface is dirty, it should be cleaned with detergent or soap and water before disinfection.

If reusable cloth diapers are used, they should not be rinsed or cleaned in the facility. The soiled cloth diaper and its contents (without emptying or rinsing) should be placed in a plastic bag or in a plastic-lined, hands-free, covered diaper pail for delivery to parents / guardians or the laundry service.

Washing, feeding, or holding a child

It is important to comfort babies and young children who are crying, sad, and / or anxious, and they often need to be held. Whenever possible, when washing, feeding, or holding very young children: Child carers can protect themselves by wearing an oversized shirt with long sleeves and long hair on the collar of a ponytail or other updo.

Child carers should wash their hands, neck, and anything touched by a child's secretions.
Child carers should change the child's clothing if there are secretions on the child's clothing. They should change the button-down shirt if there are secretions on them and wash their hands again.
Contaminated clothing should be placed in a plastic bag or washed in a washing machine.
Infants, toddlers and their caregivers should have multiple changes of clothes on hand in daycare or home childcare.
Child carers should wash their hands before and after handling home or facility-made baby bottles. Bottles, bottle caps, nipples, and other bottle feeding devices should be thoroughly cleaned after each use by washing them in the dishwasher or with a bottle brush, soap, and water.

Healthy hand hygiene behavior

All children, staff, and volunteers should deal with hand hygiene at the following times:
- Arrival at the facility and after breaks
- Before and after preparing food or drinks
- Before and after eating or handling food or feeding children
- Before and after the administration of any medication or medicinal ointment
- Before and after diapering
- After using the toilet or helping a child use the bathroom
- After contact with body fluid
- After handling animals or cleaning up animal waste
- After playing outdoors or in the sand
- After handling trash
Wash your hands with soap and water for at least 20 seconds. If hands are not visibly dirty, alcohol-based hand sanitizers containing at least 60% alcohol can be used if soap and water are not readily available.
Monitor children for using hand sanitizer to prevent ingestion.
Help children wash their hands, including infants who cannot wash their hands on their own.
- After helping the children wash their hands, staff should wash their hands as well.
Place posters with hand washing steps near sinks. Development-ready posters in several languages are available from CDC.

Meal preparation and service

If a cafeteria or dining room is typically used for groups, serve meals in classrooms instead. If meals are usually served in a family manner, cover each child's meals so that several children do not use the same serving utensils.
Food preparation should not be done by the same staff who have diapered babies.
Sinks for food preparation should not be used for any other purpose.
Caregivers should ensure that children wash their hands before and immediately after eating.
Caregivers should wash their hands before preparing food and helping children eat.

Facilities should follow all other applicable federal, state, and local codes and guidelinesexternal symbol

Vulnerable / high risk groups

Based on currently available information and clinical expertise, older adults and people of all ages with serious underlying illnesses may be at greater risk of developing serious illnesses due to COVID-19. To protect those at higher risk, it is important that everyone practices healthy, hygienic behavior.

If you have staff or teachers who are 65 years of age or older or have serious health problems, encourage them to speak with their health care provider to assess their risk and determine whether to stay home.
Information about COVID-19 in children is somewhat limited, but the information available suggests that many children have mild symptoms. However, it has been reported that a small percentage of children have a more severe illness. If you have children with underlying health conditions, speak to their parents about their risk. Follow child care plans for underlying health conditions such as an asthma action plan.
If you have children with disabilities, talk to their parents about how their children can continue to get the support they need.

Other resources

The CDC website contains a variety of resources for childcare programs and K-12 schools, including detailed guides, closings considerations, and FAQs for administrators, teachers, and parents. Together, these resources provide additional information on:

What to do if a child or an employee in your facility falls ill?
Closure of childcare programs.

The resources emphasize that any decision to temporarily close childcare programs or cancel related events should be made in coordination with your federal, state, and local education officials, as well as state and local health officials. Childcare programs are not expected to make decisions about closings for themselves. The resources also cover steps to ensure continuity of meal programs and other critical services if your facility is closed. Additional government resources on meals and snacks can be found here: https://www.fns.usda.gov/cacfpexternal symbol

Instructions on these topics are also available: