Guidance Related to Childcare During COVID-19

A: You should take the temperature of all children and staff at check-in, using any method: axillary (armpit), oral or other. A fever is ≥ 100.5°F. For additional information, see the CDC Guidance for Childcare Programs that Remain Open.

The CDC offers suggestions for conducting these daily temperature checks including an option for parents conducting daily temperature checks and reporting fever. It is worth noting this option relies on parent knowledge and skill to appropriately use a thermometer. It may be worthwhile to share resources or instructions for families on the proper way to take a temperature.

Fever and Your Child tipsheet
Fever and Your Child tipsheet in Spanish

Relevant Caring for Our Children Standards: Standard 3.1.1 Daily Health Check

A: It is recommended to follow guidance from your state and local public health department as well as your state licensing entity. However, it is suggested to keep staff to child ratios as small as possible and to keep children from different classrooms in separate physical spaces.

Relevant Caring for Our Children Standards:
Standard 3.6.2 Caring for Children who Are Ill
Standard 1.1.1.2 Ratios for Large Family Child Care Homes and Centers
Standard 1.1.1.1 Ratios for Small Family Child Care Homes

A: First clean the surface (remove dirt and impurities from the surface) before disinfecting to kill the germs. If the surface is not cleaned first, the disinfectant is less likely to be effective.

Most common EPA-registered household disinfectants should be effective for disinfecting program spaces. The EPA offers a list here. However, the CDC also suggests that diluted household bleach solutions can be used if appropriate for the surface. Follow manufacturer’s instructions for application and proper ventilation. It is important to note that different bleach products have different concentrations. Check to ensure the product is not past its expiration date as the concentration will degrade over time. Never mix household bleach with ammonia or any other cleanser. 

It is important to note the contact time needed to disinfect a surface for COVID-19. Read more here.

Relevant Caring for Our Children Standards: Standard 9.2.3.10 Sanitation Policies and Procedures, 3.3 Cleaning, Sanitizing, and Disinfecting

A: CFOC recommendations from research studies range between forty-two to fifty-four square feet per child. Droplets from the virus that causes COVID-19 and other respiratory viruses can spread about 3 feet before they start to fall to the ground. However, some tiny particles may stay suspended for a longer distance. Therefore, when possible, keep children 6 feet apart during nap time (can have cots oriented head to foot), when eating and doing other activities. This may be difficult to achieve in the toddler and young child age groups. Avoid close group learning activities like reading circles.

Relevant Caring for Our Children Standards: Standard 3.6.2.2 Space Requirements for Care of Children Who Are Ill

A: The CDC recommends personal protective equipment (PPE) during daily temperature checks when social distancing or barrier/partition controls cannot be implemented. Head Start, child care center, and family child care home staff serving children of essential health care workers, are encouraged to consider utilizing PPE while changing diapers, feeding children, and sanitizing toys. Because PPE may be challenging to find at times, staff can prioritize facemasks and face shields if available. Safety or sports goggles can be used in the absence of face shields. Wearing gloves during cleaning, diapering and preparing food is recommended. Hand washing or use of an alcohol-based hand sanitizer after these procedures is always required, whether or not gloves are used.

The CDC is continually updating their guidance on personal protective equipment (PPE). Check their webpage for the newest guidance.

A: Families should contact their child’s doctor’s office. The AAP released guidance on receipt of well-child visits; it is recommended for children to have well-child visits through the first 24 months, because of the importance of early childhood immunizations and developmental screening. Individual primary care providers may have developed different processes and may be using telehealth.

A: Families should contact their child’s doctor’s office. Pediatric providers are rapidly learning new telehealth technologies, and government regulations and insurance payments have rapidly changed to make this a great strategy for families to stay connected with their doctor. 

A: The smaller the group, the better, as staffing allows. Infection control and prevention measures are your best defense (hand hygiene, respiratory etiquette, cleaning and disinfecting surfaces). Do these as often as you can.  

It is important to continue to be within ratios for age and avoiding mixing groups of children from different ages or rooms. It is also important that classrooms are separated by physical barriers. Your state licensing or public health department may offer further guidance.   

Relevant Caring for Our Children Standards:
Standard 3.6.2 Caring for Children who Are Ill
Standard 1.1.1.2 Ratios for Large Family Child Care Homes and Centers
Standard 1.1.1.1 Ratios for Small Family Child Care Homes

A: A professional trained childcare workforce is vital for supporting healthy child development and learning. During the COVID-19 pandemic, it might be the reality for some families to access childcare from providers with less training. It is encouraged for childcare providers to seek training and technical assistance through the National Center on Early Childhood Health and Wellness.

Additional Information:

For questions and technical assistance: email health@ecetta.info

• COVID-19 resources for ECE

• Managing Infectious Disease in Head Start webinar

• Tips for Keeping Children Safe: A Developmental Guide

• Responsive Feeding: Developing Health Eating Habits from Birth

• National Center on Early Childhood Development, Teaching and Learning

  • 15-minute in-service suites

American Academy of Pediatrics offers PediaLink courses for early care and education providers:

• Medication Administration
• Keeping Children Safe in Early Care and Education
• Safe Infant Sleep in Child Care
• Bug Busting in Early Care and Education

Also check Child Care Aware of America and your local Child Care Resource and Referral agencies for additional training and technical assistance opportunities.

A: The USDA is offering guidance on how to offer food during program closures. There are several models of childcare, Head Start programs, and schools offering takeout meals to families and being reimbursed through CACFP. Please contact the state agency that administers your CACFP program.

A: The goal is to increase hand hygiene as much as possible during this pandemic. The CFOC recommendation below is to use soap and water when possible and when there is visible soiling, but hand sanitizer is permissible if soap and water is not available. Given the COVID-19 pandemic, it is recommended to increase significantly the frequency of hand hygiene. If alcohol-based hand sanitizer is available and will increase the frequency that children and staff do hand hygiene, then use it if necessary. Remember that alcohol-based hand sanitizer is toxic if ingested and must be kept out of reach of small children.

Relevant Caring for Our Children Standards: Standard 3.2.2 Hand Sanitizers

A: Very few childcare centers have any sort of pandemic plan as outlined in this article. “Infectious Disease Outbreaks, Epidemics, Pandemics, and Bioterrorism” in the 2020 edition of Managing Infectious Diseases in Child Care and Schools (the 5th edition, chapter 7, pages 187-190.) discusses what to do to prepare for a pandemic, which includes having a plan for alternative child care arrangements for critical workers. Also included is the symptom record form (page 226) and the Enrollment/Attendance/Symptom form (page 227). Both forms are mentioned in Chapter 7 of Managing Infectious Diseases in Child Care and Schools. 

Once a pandemic has started, it is necessary to follow local health department guidance, which generally follows CDC guidance.

For Child Care and Development Fund Lead Agencies, they are asked to follow public health guidelines from their local health departments and the Centers for Disease Controls and Prevention (CDC) to prepare for a pandemic outbreak. Consider using resources such as:

• Child Care and Preschool Pandemic Influenza Planning Checklist
• Preparing Child Care Programs for Pandemic Influenza

Relevant Caring for Our Children Standards: Caring for Our Children – recommended standard: Standard 9.2.4.3: Disaster Planning, Training, and Communication and 9.2.4.4: Written Plan for Seasonal and Pandemic Influenza