Guidance for Childcare/Daycare Centers

Interim Recommended Guidance for Preventing Spread of COVID-19 in Childcare/Daycare Centers

SARS-CoV-2 is a novel coronavirus that causes mild to severe respiratory illness (abbreviated as COVID-19). Public health experts continue to learn about SARS-CoV-2 however, based on current data, the primary mode of spread appears to be from an infected person to close contacts (those within about six feet) via respiratory droplets. Transmission of SAR-CoV-2 to persons from surfaces contaminated with the virus has not been documented, but evidence suggests that SARS-CoV-2 may remain viable for hours to days on surfaces.

Appropriate steps to prevent spread of COVID-19 in childcare/daycare centers will vary based on the level of COVID-19 community transmission and presence of COVID-19 cases within the facility. Guidance provided in this document are best practices for preventing spread of all viral respiratory illnesses. However, when there are high levels of COVID-19 community transmission in your community, these practices may not be sufficient to prevent transmission in the childcare/daycare center environment and closure by local or state officials may be recommended.

This guidance provides recommendations for childcare/day care centers while remaining operational.

Symptoms

Clinical features are fever or signs/symptoms of lower respiratory illnesses. Symptoms may include:

  • Fever
  • Cough
  • Shortness of breath
  • Human coronaviruses can sometimes cause lower-respiratory tract illnesses, such as pneumonia or bronchitis.

Transmission

Human coronaviruses most commonly spread from an infected person to others through:

  • Respiratory droplets formed when the infected person coughs or sneezes;
  • Close personal contact, such as touching or shaking hands;
  • Touching an object or surface with the virus on it, then touching your mouth, nose, or eyes before washing your hands; and
  • Rarely, fecal contamination.

Prevention

The following can help prevent the spread of coronaviruses and protect yourself, staff and the children from becoming infected:

  • Wash hands often with soap and water for at least 20 seconds or at least 60% alcohol-based hand sanitizer solution, upon entering or leaving facility and before and after eating;
  • Avoid touching eyes, nose, or mouth with unwashed hands; and
  • Avoid close contact with people who are sick.

There are currently no vaccines to protect against human coronavirus infection.

Preventative Actions for the introduction of respiratory germs INTO your facility

  • Post signs outside the entrance restricting entry to anyone with symptoms of illness/respiratory infection.
  • Daycare staff should be checked for fever before entering the facility at the beginning of their reported work period and maintain records of monitoring.
  • Ensure sick leave policies allow employees to stay home if they have symptoms of respiratory infection.
  • Monitor children daily for signs/symptoms of COVID-19.
  • Exclude any staff or child with symptoms of COVID-19 from the daycare setting.
  • Depending on the facility plan, stagger drop-off and pick-up times to avoid overcrowding of children and parents/guardians in confined spaces.
  • Limit parents/guardians to one per child during drop-off and pick-up.
  • No outside visitors should be allowed in the daycare for activities, regardless of their security clearance. However, this does not apply to maintenance/repair workers. For these persons, a log shall be maintained including date/time, name, phone number/cell number and email.
  • Develop a communication plan with parents and staff in the event a COVID-19 case occurs in a staff or child.
  • Coordinate with your local health department; inform them of COVID-19 cases reported in your childcare or daycare center and stay informed of local developments.

Preventative Actions for the spread of respiratory germs WITHIN your facility

  • Promptly isolate any staff or child with symptoms of COVID-19, including use of a procedure mask (as tolerated by children).
    • If the child cannot tolerate a face mask, the staff assigned to that child should wear the facemask.
    • Limit the staff to 1:1 care for children who have been isolated.
    • Follow childcare/daycare facility procedures on notifying parent/guardian.
    • Educate parent/guardian on contacting their family physician.
  • Clean/disinfect area after the child leaves.
  • Cohort children and daycare staff. Children should be kept in the same group with same staff every day including meal, snack, rest and play periods. Limit groups/classes to 10 or less.
  • Post signs throughout the facility describing ways to prevent the spread of germs.
    • More information can be found here.
  • Monitor and enforce hand hygiene among staff and children.
  • Avoid shaking hands as a social greeting.
  • Ensure employees clean their hands according to CDC guidelines, including before and after contact with members, and after contact with contaminated surfaces or equipment.
  • Put alcohol-based hand rub in every room (ideally both inside and outside of the room).
  • Teach and reinforce healthy hygiene as is age appropriate (covering coughs/sneezes, disposing of tissues, handwashing, keep fingers away from eyes, nose and mouth).
  • Make sure tissues are available and any sink is well-stocked with soap and paper towels for hand washing.
  • Position trash cans for easier discarding of tissues and paper towels for staff and children.
  • Intensify cleaning and disinfecting of frequently touched items, including doorknobs, toys, phones, keyboards, mice and other items identified as frequently handled.
    • More information can be found here.
  • Cancel or postpone all non-critical gatherings and events.
  • Increase ventilation by opening windows or adjusting air conditioning

Preventative Actions for Vulnerable Populations

Social distancing actions are taken to restrict when and where people can gather to stop or slow the spread of coronavirus disease (COVID‐19) or other infectious diseases in communities. Social distancing actions include limiting large groups of people coming together, closing buildings or canceling events. Staff and parents/guardians over the age of 60 years, especially if they have serious medical conditions, and any children with serious underlying medical conditions, may wish to avoid a congregate setting such as a childcare or daycare center.

Contingency Planning

Consider reducing open hours or maximum capacity. Check the IDPH and CDC websites daily for updated guidance to reduce spread of COVID-19.

Closure of Childcare Facilities

A childcare facility might need to implement short-term closure procedures if an infected person has been in a childcare facility. If this happens, IDPH recommends the following procedures regardless of the level of transmission in the community.

  • Upon learning of a COVID-19 case in someone who has been in the childcare facility, immediately notify the local health department. The local health department will help the childcare facility administrators determine a course of action for the childcare program.
  • Dismiss students and most staff for a minimum of 2-5 days.
  • This initial short-term dismissal allows time for the local health department to assess the current COVID-19 situation and to work with facility administrators to determine appropriate next steps, including whether an extended dismissal duration is needed to stop or slow further spread of COVID-19.
  • This also allows for a thorough cleaning and disinfection of the facility.
    • Close off areas used by the individual(s) with COVID-19 and wait as long as practical before beginning cleaning and disinfection to minimize potential for exposure to respiratory droplets. If possible, wait up to 24 hours before beginning cleaning and disinfection. Open outside doors and windows to increase air circulation in the area.
    • Use a cleaning and disinfection product that is effective against SARS-Co-V-2, the virus that causes COVID-19, and use according to the product label instructions. More information is available here.
  • The local health department should assist the childcare facility in development of messaging to communicate with parents/guardians and staff about the temporary closure of the facility and potential COVID-19 exposures.
  • Childcare facilities who offer essential medical or social service programs should consider alternative methods for providing these services. Coordination with other agencies and providers may be indicated to determine how best to accommodate the needs of high-risk children and families.

Local health department recommendations for the duration of childcare facility dismissals will be made on a case-by-case basis using the most up-to-date information about COVID-19 and the specific cases in the community.

Resources

CDC What to do if you are sick
CDC When and How to Wash Your Hands
CDC People At-risk for Serious Illness from COVID-19
CDC Print Resources
CDC K-12 Schools and Childcare Programs FAQs
CDC Workplace and School Guidance

Frequently Asked Questions about Isolation and Quarantine

Note: Isolation and quarantine are different. These two terms are not interchangeable. Isolation refers to the separation of sick people with a contagious disease from people who are not sick. Quarantine refers to the separation of asymptomatic people who were exposed to a contagious disease in case they become sick.

Q. What if a parent/guardian or other household member of a child or staff member is placed in isolation?

A. In the event a parent/guardian or other household member of a child in your program is diagnosed with COVID-19 and has been told to isolate, the individual in isolation cannot enter the childcare program for any reason. They must utilize an emergency contact authorized by the parent to come pick up the child. If the child has been in close contact with the individual with COVID-19 in the 14 days prior to the household member’s symptom onset, the child is considered a contact and cannot return to the childcare program for the duration of the child’s quarantine period (14 days after the last exposure to the individual with COVID-19).

Staff members who are contacts to COVID-19 cases are to be quarantined. See the question below regarding staff members in quarantine.

Q. What if a parent/guardian or other household member of a child or staff member is quarantined?

A. If the parent/guardian or other household contact has been exposed to someone with COVID-19 and doesn’t have any symptoms of respiratory disease but is being quarantined as a precautionary measure, childcare staff should walk out or deliver the child to the parent/guardian outside the childcare building. The child can return to the childcare program if the quarantined individual remains asymptomatic. If the quarantined individual develops any COVID-19 symptoms, the child should be excluded from childcare for 14 days after the last day the household member had a fever.

Q. What if a child is quarantined?

A. Children who have been quarantined through exposure to the virus must not attend programs for the duration of the quarantine period.

Q. What if a staff person at a childcare program is quarantined?

A. If a staff member has been exposed to the virus and has self-quarantined but has not tested positive, the individual must not report to work during the quarantine period (usually 14 days after exposure). The center may continue to operate unless notified otherwise by the local health department or IDPH.

Q. What if a child or staff member is diagnosed with COVID-19 infection?

A. If a child or staff member has been diagnosed with COVID-19 or is suspected of having a COVID-19-like illness, the ill person cannot attend childcare or work for the duration of their isolation period. Promptly notify your local health department. Notification should be sent to parents/guardians of attendees and all staff. The need for closure of the facility will be determined on a case-by-case basis in coordination with local health officials. At a minimum, the facility may need to close temporarily for thorough cleaning and disinfection of the facility. You will receive guidance from your local health department with specific directions.

Q. What if a household member of a home-based provider is quarantined or isolated due to COVID-19?

A. The program must not operate for the duration of the quarantine or isolation period, whichever applies.

Q. If our childcare facility is required to close temporarily because of a COVID-19 case in a staff member or an attendee, how long will it be closed?

A. Each situation must be assessed on a case-by-case basis, but initially, if a student or staff member attended school before being confirmed as having COVID-19, the childcare center may need to close for 2-5 days. This initial short-term dismissal allows time for the local public health officials assess the COVID-19 situation impacting the childcare center and for custodial staff to clean and disinfect the affected facilities. The local department and facility administrators will work together to determine appropriate next steps, including whether a longer period of closure is needed to stop or slow further spread of COVID-19.