Updated Child Care Guidance

As scientists continue to learn more about the new coronavirus, the Centers for Disease Control and Prevention (CDC) updates its guidance. The most recent update to the CDC’s guidance for child cares that remain open includes the following:

Cloth face coverings

The latest CDC guidance for child care sites that remain open states:

“When feasible, staff members and older children should wear face coverings within the facility. Cloth face coverings should NOT be put on babies and children under age two because of the danger of suffocation.”

Whether wearing cloth face coverings^* is feasible will be dependent on a variety of factors including the ages of children in care and how tolerant the individual child is to wearing the face covering. It will be important to have a discussion with the parents prior to implementing. If cloth face coverings are worn, it is important to keep hands away from the face and not fidget with it. Supervise children closely if they are wearing cloth face coverings to ensure they are not touching it, taking it off, sharing it with a friend, etc. Remember that all social distancing guidance developed for child care facilities must still be followed, whether cloth face coverings are worn or not. Cloth face coverings must be cleaned and stored properly after each use. Click here for more information on caring for cloth face coverings.

^*The cloth face coverings should not be surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.

Here are a few tips for getting children to wear face coverings:

For some children face coverings can be scary. Introduce face coverings slowly. Showing children that the person is the same with or without the mask by putting it on and off a few times can be helpful.
Tell children that people are wearing face coverings to help other people. You can try equating it to how superheroes help others.
Choose a colorful fabric for the cloth face covering, or let the child help choose the material. Older children could use a plain colored fabric and draw a design with fabric markers.
Start by wearing masks for just a short period of time.
The American Academy of Pediatrics has more information on Cloth Face Coverings for Children during COVID-19.

There are many simple ways to make cloth face coverings at home from readily available materials. Here are a few links:

CDC Video - How to Make Your Own Cloth Face Covering
CDC Website – Sew and No Sew Instructions
CDC Poster – Face Covering Do’s and Don’ts
There are also many different patterns and instructions available if you do a search online.
Food Banks in Snohomish County are accepting donations of cloth face coverings and may have some available to hand out.

Entry screening for children

Updated guidance also includes more information on how to protect child care providers as they conduct daily health screenings of children when they arrive each day. According to the CDC, the most protective measures incorporate social distancing of at least 6’ or use of a physical barrier between the screener and the child.

The child care provider conducting the screening should remain at least 6’ away from the child and their parent or conduct their assessment from behind a physical barrier such as a window, plexiglas panel, or glass door. Visually check the child for signs of infection, including flushed cheeks, fatigue, extreme fussiness, and other indicators of illness. Ask the parent or guardian whether the child has experienced any of the following since the last time they were in care:

A fever (100.4°F or higher), or a sense of having a fever?
A cough that you cannot attribute to another health condition?
Shortness of breath that you cannot attribute to another health condition?
A sore throat that you cannot attribute to another health condition?
Muscle aches (myalgias) that you cannot attribute to another health condition, or that may have been caused by a specific activity (such as physical exercise)?
Nausea, vomiting, or diarrhea?
Does anyone in your household currently have any of the above symptoms?
Has your child been in close contact with anyone with suspected or confirmed COVID-19 illness?
Has your child been given any fever-reducing medication before coming to care?

If the answer to any of the above questions is “yes” or if the child shows physical signs of illness, the child should not be admitted to the program. Children with symptoms consistent with COVID-19 should be remain home for at least 7 days and 72 hours after fever resolves and symptoms improve.

The child’s temperature should be checked if possible. The best method is to have the parent/guardian take the child’s temperature before coming to the facility or to bring a thermometer and check their child’s temperature upon arrival at the child care in view of the child care provider and then report the finding. The child care provider should stay at least 6’ away from the parent or child while temperature screening is occurring. The child care should have a clean, disinfected thermometer available in case a parent does not have one or forgets to bring one. The use of 70% alcohol is the preferred method for disinfecting a thermometer. If a child care provider will be conducting the temperature screening, they should either conduct the screening by reaching around a clear physical barrier, such as glass or plastic. Child care providers conducting screenings must use proper hand hygiene and wear gloves. For further guidance on alternative methods of conducting temperature screenings, please see the CDC guidance.

Infant and toddler care
Infants and young children need to be held throughout the day, when they need comforting or while feeding. The CDC recommends that when holding infants and young children close, child care providers should wear long hair in a ponytail and put a protective covering over their clothing, such as a large button-down, long-sleeved shirt that can be removed and washed if it becomes contaminated with secretions from the child (such as saliva, nasal discharge, spit-up). Alternately, a lightweight blanket can be used as a cover between the provider and the child. Place any contaminated outer clothing or blankets in a plastic bag until it can be washed. Providers caring for young children should have extra changes of clothing available to change into should their clothing become contaminated. Providers should wash hands thoroughly after feeding babies and young children. They should also wash any areas of bare skin on their body that the feeding child may have touched, such as their face, neck, or arms.

Playground Structures

The CDC’s latest updated child care guidance includes playground structures on the list of surfaces that need to be cleaned and disinfected more frequently. Playground structures, such as slides and climbers, are not easily cleaned and disinfected. Moreover, the CDC’s guidance on visiting parks and recreation areas clearly states “Do not use playgrounds…it can be challenging to keep surfaces clean and disinfected… the virus can spread when young children touch contaminated equipment and then touch their hands to their eyes, nose, or mouth.” Therefore, it is best to restrict children from using outdoor playground structures, including slides and climbers.

Another Reminder

Remember the importance of keeping groups small and consistent. This includes having consistent staff. Make sure that there are enough staff at your child care to prevent having staff persons who care for different groups of children during the day. Avoid having a float staff who provides breaks for every classroom. If additional staff must go into a classroom to provide breaks, consider, for example, the director providing breaks one classroom and the program supervisor breaks a different classroom, etc.

More Updates for Child and School Age Care

Guidance documents for child care and school-age programs have been updated on our website to reflect these changes:

More information for schools and child care programs can be found on our website at: https://www.snohd.org/491/COVID-19-Info-for-Schools-Child-Cares

Please contact the Snohomish Health District Child Care Health Outreach program if you have questions about these guidelines or other child care health and safety issues. You can reach us by leaving a message at 425-252-5415 or sending us an email at childcarehealth@snohd.org.

If you have questions related to your own health or symptoms related to COVID-19, please contact your own health care provider.