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Coronavirus Disease 2019 (COVID-19)

Childcare and early childhood education centers guidance

The following is intended as a plain-language summary of rules during the COVID-19 emergency and does not replace the need to follow all applicable federal, state, and local laws and regulations.


This content was last updated on March 3, 2021.

Childcare providers play a vital role in Philadelphia–they provide children with a safe place to learn and play and their parents with a service that is critical to allowing them to work and carry out other daily activities. Keeping children and staff safe during COVID-19 is of the utmost priority.

The following guidelines will help childcare and early childhood education centers decrease the risk of COVID-19 for children and staff. The guidance provided are a set of baseline or minimum recommendations based on guidelines from the Philadelphia Department of Public Health, the CDC, and the Pennsylvania Office of Child Development and Early Learning.

The detailed guidance is categorized by the following key practices:

  1. Promote social distancing through physical distancing, modification of activities, and cohorting of students.
  2. Keep the center clean through intensified cleaning and disinfecting practices.
  3. Promote healthy habits including robust hand hygiene and facial covering universal face mask use by students, teachers, and staff.
  4. Screen students, teachers, and staff for symptoms daily.
  5. Plan for when someone becomes sick or potentially exposed to COVID-19.
  6. Optimizing ventilation when possible.

As the COVID-19 pandemic in Philadelphia evolves, there may be additional changes to the guidance, so please connect to the COVID-19 texts (text COVIDPHL to 888-777) to have the most up-to-date information.

Face masks help to prevent the transmission of COVID-19. Learn more about why, when, and how to wear a mask (PDF).

Promote social distancing

Create cohorts of children and staff

  • It will not be possible to prevent young children and infants from coming in close contact with one another and their teachers. Instead, the goal is to limit the number of people in close contact in order to lower the risk of transmission.
  • Ensure that classes include the same group of children each day, and that the same childcare providers remain with the same group each day.
  • There should be no more than 22 people in a classroom (teachers plus students) at any one time. Consider having fewer children per classroom if staffing and space permits.
  • Increase the space between cribs and rest mats to maximize the space between children. The cribs and rest mats should be 6 feet apart if space permits. Consider having children nap in head-to-feet positioning to maximize space between children’s faces.
  • Restrict nonessential visitors and volunteers. Limited visitor policies should still allow for therapeutic services for children, such as early intervention, to access the center. Maintain electronic records of all visitors’ contact information to help facilitate contact tracing. Consider having staff meet parents outside for drop off and pick up, so that parents do not need to enter the building.
  • Avoid activities where children from different cohorts interact. For example, stagger use of playgrounds/indoor play spaces, do not combine cohorts for enrichment activities.
  • For staff:
    • As much as possible, keep the same teachers with the same children (create stable cohorts of children and teachers).
    • Stagger break and lunch hours for staff in order to minimize interactions.
    • Move chairs in break rooms so that employees do not sit opposite or next to each other while eating. Staff should be at least 6 ft apart when eating because this is a high-risk moment for COVID transmission.
    • Post signs alerting employees to maintain distance and avoid eating near or across from each other.

Minimize contact and crowding at pick up and drop off

  • Have parents sign children in with their own pen. If using a pen from the center, wipe down the pen with alcohol each time it is used.
  • All parents should wear face masks at pick up and drop off.
  • Limit direct contact with parents as much as possible. Instead, prioritize giving parents updates on their children electronically or by phone.
  • Consider the following options to avoid over-crowding during pick up and drop off times:
    • Assign staggered arrival and drop off times for families.
    • If staffing allows, have a designated staff-member greet children outside as they arrive and escort them to their classroom and escort children to exit the building during drop-off.
    • Require families to wait 6 feet apart (can use space marker) while waiting to drop off their children and complete daily health screen.
    • Consider use of an online or app-based daily health screen survey that can be completed by parents each day before children arrive to avoid bottlenecks at drop-off.
  • For staff and children who must use carpools, encourage all riders other than children <2 yrs. to wear face masks if car will include individuals who do not live together.. Recommend using hand sanitizer with at least 60% alcohol before and after entering the vehicle. Recommend limiting the number of passengers in the vehicle to only those necessary. If possible, passengers should Ssit as far as possible from the driver, such as in the rear seat diagonally across from the driver. Recommend improving ventilation by opening the windows or setting the air ventilation/air conditioning on non-recirculation mode.
  • Store all children’s personal car seats or strollers out of children’s reach since these surfaces may be contaminated. Strollers used by the school for walks should be wiped down with disinfectant between use.
  • Encourage families to have the same parent or designated person drop off and pick up the child every day.

Implement additional food safety procedures

  • If a cafeteria or group dining room is typically used, serve meals in classrooms instead. If meals are typically served family-style, plate each child’s meal to serve it so that multiple children are not using the same serving utensils.
  • Children may bring food from home without additional restrictions.
  • Sinks used for food preparation should not be used for any other purposes.
  • Staff should ensure children wash hands prior to and immediately after eating.
  • Staff should wash their hands before preparing food and after helping children to eat.
  • Staff should wear gloves while preparing food/bottles and feeding children or giving them bottles
  • Mealtimes are one of the most common times we have seen staff-to-staff transmission of COVID-19. Remind staff that they should limit the amount of time that they are not wearing a face mask and that they should continue to wear their face masks while in the break room when not actively eating. Staff should maintain at least 6 feet of distance from one another during staff mealtimes.

Keep the center clean

  • Clean and disinfect frequently touched surfaces at least daily. This includes tables, chairs, doorknobs, light switches, remote controls, countertops, handles, desks, phones, keyboards, toilets, faucets, strollers and sinks.
  • Wipe off any equipment between usage by different classrooms of children.
  • All toys should be washed at least daily and before and after each use if possible.
  • Set aside all toys that need to be cleaned in a container marked “soiled toys”. Wash toys that have not been mouthed with soapy water and air dry before the next use.
  • Toys that have been mouthed should be set aside until cleaned by someone wearing gloves using EPA-approved disinfectant.  The CDC has steps for cleaning and disinfecting.
  • Remove all plush toys or toys that require laundering from the classroom.
  • Use bedding (sheets, pillows, blankets, sleeping bags) that can be washed. Keep each child’s bedding separate, and consider storing in individually labeled bins, cubbies, or bags. Cots and mats should be labeled for each child. Bedding that touches a child’s skin should be cleaned at least weekly or before use by another child.
  • Facilities should use cleaning products that are EPA-approved for use against COVID-19. Store all cleaning products securely and out of the reach of children.
  • Keep each child’s belongings separated and in individually labeled storage containers, cubbies, or areas and taken home each day and cleaned, if possible.

Promote healthy habits

Instruct staff and children how to practice appropriate hand hygiene

  • Hand hygiene should be practiced at the following times:
    • Entry to the facility at handwashing stations or using hand sanitizer and after breaks.
    • Before and after eating or assisting children with meals and bottles.
    • Before and after preparing food, bottles, and drinks.
    • Before and after medication administration.
    • Before and after diapering.
    • After using the toilet or helping a child use the bathroom.
    • After coughing, sneezing, or blowing their nose.
    • After playing outdoors.
    • After coming in contact with bodily fluids.
    • After handling garbage.
  • Perform hand hygiene by washing hands with soap and water for at least 20 seconds.
  • If soap and water are not available and hands are not visibly dirty, an alcohol-based hand sanitizer that contains at least 60% alcohol can be used.
  • Children should be supervised by an adult when using hand sanitizer to avoid accidental ingestion or contact of hand sanitizer with their eyes. For younger children, staff should apply the sanitizer and rub the children’s hands until they are dry.
  • Hand sanitizer should be stored out of reach of children. If a child accidentally ingests hand sanitizer, call poison control immediately, 1-800-222-1222

Use Personal Protective Equipment

  • All staff should wear face masks whenever in facility except during meals or outdoor break time. If using a disposable face mask, should use a new mask each day. If a cloth face mask, should launder every day. Asthma is not a contraindication to wearing a face mask.
  • Children 2 years and older should be encouraged to wear a face mask. Face masks are most important when indoors, especially when physical distancing is difficult. Wearing a face mask  may be more challenging for younger children and enforcement of this policy should be developmentally appropriate.
  • Face masks should not be placed on:
    • Babies and children younger than 2 years old.
    • Anyone who has trouble breathing or is unconscious.
    • Anyone who is incapacitated or otherwise unable to remove the cloth face mask  without assistance.
    • During naptime.
  • Parents should wear face masks at pick up and drop off.
  • Staff should wear gloves when diapering and preparing food or bottles.
  • For staff who work with multiple children who cannot wear face masks, additional barriers such as plexiglass, face shield, or goggles may be considered.

Screen children and staff for symptoms

  • All facilities should create a daily screening checklist for children and staff which includes screening for fever, symptoms, exposure and a visual inspection. The Health Department has developed a sample screening tool.
  • Schools have the following screening protocol options:
    • 1) Self-screening: Parents  and staff should be given instructions to self-screen on behalf of their child or for themselves if a staff-member at home every day. If they answer yes to any of the screening questions, they should not report to the facility. Note: if community transmission of COVID-19 in Philadelphia increases, the Health Department may direct facilities to switch to one of the two active symptom monitoring options below.
    • 2) Self-screening with reporting: Parents and staff should complete a daily screen (paper, app-based, or web-based). A designated staff-person at the center should be responsible for reviewing completed screens every day and ensuring that those with a positive screen do not enter the facility.
    • 3) On-site screening: A designated staff person should administer the screen for all children and staff daily upon arrival to the facility. Those with a positive screen should not enter the facility.
  • Components of Screener
    • Fever: If either a child or staff member has a temperature of 100.4 or higher, they should remain home. The following options can be considered for temperature monitoring:
      • 1) Self-screening: staff take their own and parents take their child’s temperature at home and stay home if they have a fever.
      • 2) Self-screening with reporting: staff take their own and parents take their child’s temperature at home and report the value on the screening platform (paper, web or app) or on-site during the daily screening. They will not be allowed in the facility if they have a fever.
      • 3) On-site screening:
        • Staff take their own and parents take their child’s temperature upon arrival to facility using facility-provided disposable thermometers (e.g. Tempa dot) OR
        • A designated staff-member wearing a face mask and gloves can use a no-contact (temporal) thermometer to take temperatures on all staff and children. The no-contact thermometers should be cleaned with an alcohol wipe (or isopropyl alcohol on a cotton swab) between each client. The same wipe can be reused as long as it remains wet. The staff-member can wear the same set of gloves as long as they did not have physical contact with the individual whose temperature they are taking. Temperature measurements may be affected by the environmental temperature. Please consult the device manufacturer’s instructions for optimal use.
      • Note: Oral thermometers should not be used for on-site temperature screening.
    • Symptoms: If a children or staff member has symptoms of COVID-like illness, the child or staff-member should return or remain home.

COVID-like illness is defined as:

At least ONE of these
major symptoms

OR

At least TWO of these
minor symptoms

new or persistent cough

shortness of breath

new loss of sense of smell

new loss of sense of taste

fever

chills

muscle pain

headache

sore throat

nausea/vomiting

diarrhea

fatigue

congestion/runny nose

    • Visual Inspection: If a child has signs of illness, which could include flushed cheeks, rapid breathing or difficulty breathing (without recent physical activity), fatigue, or extreme fussiness, cough, or shortness of breath, the child should stay home.
    • Exposure: If a staff member or child has been exposed to anyone with a confirmed case of COVID-19 in the past 10 days, they should return or remain home.  The Health Department has developed a sample letter to be given to caregivers explaining why the child is being dismissed and criteria for returning to the facility.

Plan for when someone becomes sick or potentially exposed to COVID-19

Encourage staff and parents to talk to their own and their children’s physicians about their individual risk factors for COVID-19 and the risks of working at or attending school. We strongly recommend  flexibility and accommodations for staff who are at higher risk for severe illness from COVID-19, such as those 65 years and older and those with weakened immune systems.

Ensure facility has updated contact information (including date of birth, phone number, home address, grade level, and cohort) for all staff and families to facilitate contact tracing and rapid communication.

  • The Health Department has created a sample parent/guardian agreement that describes their commitment to keeping their children home when sick and seeking appropriate medical care.
  • Facilities should designate an isolation room or area for anyone who experiences COVID-like symptoms. If using the nurse’s office, this area should be at least six feet apart from where other children or staff use the nurse’s office.  If possible, use screens or room314 curtains to create a barrier between individuals who are ill and in nurse’s office.
  • Staff who develop symptoms of COVID-like illness should immediately be sent home. If they need to be picked up, they should wait in the designated isolation room or area while waiting.
  • If children develop symptoms, they should be brought to a designated isolation room while waiting to be picked up. The staff member waiting with the child should wear a surgical mask.
  • If a child or staff member has COVID-like illness:
    • They can return to school if:
      • Initial COVID-19 testing is negative, and individual meets the facility’s normal criteria for return after an illness OR
      • A clinician has evaluated the child/staff member and documented an alternative diagnosis and that the student/staff member may return to school OR
      • COVID-19 testing was not done, and all of the following are true: 1) at least 10 days since the onset of symptoms AND 2) fever free without fever-reducing medications for 24 hours AND 3) symptoms are improving.
  • If a student or staff member has a diagnosis of COVID-19:
    • During normal business hours, please contact the Philadelphia Department of Public Health call center at (215) 685-5488, which is operational on weekdays (8:30 am-5 pm) and weekends (9 am-5 pm). Inquiries and reports may also be emailed to covid.schools@phila.gov.
    • In order to continue to make public safety recommendations, the Health Department’s COVID Containment team has been tracking patterns of transmission in schools, daycares, and other settings.
    • Learn about calcuating isolation and quarantine period.
    • Individuals with a confirmed or probable case of COVID-19 should isolate:
      • A confirmed case of COVID-19 is someone who tests positive for COVID-19.
      • A probable case is someone who has had close contact with someone with COVID-19 within the last 14 days and develops a COVID-like illness.
      • Isolation means staying in a separate room from others, using a separate bathroom, avoiding contact with other household members and pets, and not sharing personal items, including utensils, cups, and towels.
      • In accordance with Health Department guidance, the individuals with a confirmed or probable case should self-isolate until all of the following are true: 1) at least 10 days since the onset of symptoms AND 2) fever free without fever-reducing medications for 24 hours AND 3) symptoms are improving.
      • Isolation may need to be extended for certain individuals who continue to have symptoms, have severe COVID, or have a severely weakened immune system. Refer to CDC guidelines on duration of isolation for more details.
    • The Health Department will assist in identifying individuals who may have been in close contact with the case at the facility during the case’s infectious period.
      • The infectious period begins 2 days before the individual with COVID-19 became symptomatic (or, for asymptomatic individuals, 2 days prior to specimen collection for testing). The infectious period goes through the case’s duration of isolation.
      • Per CDC guidelines, the Health Department currently defines students and staff as close contacts when they fall into tier 1 (highest risk of transmission) and tier 2 (next highest risk). Regardless of face mask use, these individuals generally include:
        • Anyone who was within 6 feet for 15 minutes or more over a 24-hour period.
        • Anyone in the same cohort.
        • Anyone in a shared office space.
        • Anyone carpooling (to and from the facility).
        • Anyone eating lunch together (i.e. adults eating in a shared space).
      • If the individual with COVID-19 was present at the facility during their infectious period, in-person activities for these exposed groups must be paused for 14 days following last exposure. The duration of isolation or quarantine for an individual may differ from this. Hence, some individuals may end isolation and quarantine earlier and resume other activities in the community, but in-person activities should be paused for 14 days. Children and staff may not return earlier, even if they receive a negative COVID-19 test result. This is because the incubation period (the time between exposure and infection) for COVID-19 can last up to 14 days.
      • Close contacts should self-quarantine. Quarantine means to stay home for 10 days after last contact with someone who has COVID-19, watch for symptoms like fever, cough, shortness of breath, or new loss of taste or smell, and stay away from others as much as possible. See Calcuating isolation and quarantine period.
        • Quarantine may be shortened to 7 days if the student/staff member tests negative for COVID-19. The test should be done no more than 48 hours before they plan to leave quarantine.
        • If an individual develops a COVID-like illness during quarantine, they are considered a probable case – see above for recommendations.
      • Quarantine is also recommended for those individuals who were potentially exposed to COVID-19 in the broader community. A close contact is someone who was within 6 feet of someone with COVID-19 for 15 minutes or more over a 24-hour period.
    • The COVID-19 positive individual does NOT need a repeat COVID test or a doctor’s note in order to return to the facility.
    • Persons who have been fully vaccinated do not need to quarantine when exposed to someone with COVID-19 if they meet all of the following criteria:
      • They are fully vaccinated, and it’s been at least 2 weeks after the last dose in the vaccine series;
      • They are within 3 months following receipt of the last dose in the series; AND,
      • They have remained asymptomatic since the current COVID-19 exposure.
    • Vaccination is not 100% effective.
      • Anyone who develops COVID-19 symptoms should get tested.
      • Anyone who is positive for COVID-19 must isolate according to CDC guidelines.
      • After vaccination you must still wear a mask, keep your distance, and avoid crowds.
  • Threshold for daycare facility closures:
      • Facilities must follow Health Department recommendations for closure and pausing in-person activities.

Situation

Response

Single case of COVID-19 in facility

Pause in-person activities for entire cohort for 14 days.

Two or more cases in two or more classes of the same grade

Pause in-person activities for entire grade level for 14 days.

Multiple cases in faculty/staff:

        3 within 14 days where exposed at facility

        6 or more within 14 days (regardless of source of exposure).

 

Pause in-person activities for entire facility for 14 days.

Multiple clusters of cases in multiple grades

Pause in-person activities for entire facility for 14 days

 

    • Cleaning/Disinfecting after a COVID case or COVID-like illness:
      • Close off areas used by the person who is sick.
      • Open outside doors and windows to increase air circulation in the areas.
      • Clean and disinfect all areas used by the person who is sick, such as classroom, offices, bathrooms, and common areas.
      • Clean and disinfect surfaces in your isolation room or area and in the classroom where the sick child or staff member was after the sick child or staff member has gone home.

Optimize ventilation when possible

Note: Increasing ventilation is an additional safety step and not a replacement for people wearing face masks, keeping a safe distance from each other, reducing crowd sizes, installing droplet barriers, handwashing, and other safety precautions.

  • If possible, increase ventilation in the building by either:
    • Opening windows and/or doors on opposite sides of the building and consider using fans to blow outside air through the building; OR
    • Optimizing ventilation provided by the heating, ventilation, and air conditioning (HVAC) system by:
      • Having the HVAC system checked to assure that it is working properly.  If it can be adjusted, the system should be set to provide at least 6 air exchanges per hour if possible or the maximum possible setting.
      • Maximizing the amount of outside air circulated by the system.
      • Installing filters with minimum efficiency reporting values (MERV) of 13, or the highest compatible with the filter rack.
      • Checking that the external air inlet duct is not blocked and that it is at least 15 feet from persons.

Additional resources

If you believe there was a COVID-19 case at your facility (child or staff), call the Philadelphia Department of Public Health at (215) 685-5488 or send email to covid.schools@phila.gov for further instructions. The Health Department will consult with you on management issues for your facility.


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