Child Care Programs Guidelines
These guidelines are updated effective June 29, 2020 in St. Louis County. In accordance with the St. Louis County Department of Public Health’s (“DPH”) Second Amended Order for Business and Individual Guidelines for Social Distancing and Re-Opening, dated June 26, 2020 and effective June 29, 2020 (the “Order”), these guidelines may be replaced or modified by DPH based on new scientific information and local information including the trajectory of influenza-like illnesses, cases of COVID-19, and any other information deemed relevant to protect public health in St. Louis County.
***Please refer to www.cdc.gov for most up-to-date recommendations regarding COVID-19.***
Childcare programs that operate during the COVID-19 pandemic shall address these additional considerations:
Screen Children Upon Arrival
- Persons who have a fever of 100.4-F (38.00C) or above or other signs of illness shall not be admitted to the facility. Encourage parents to be on the alert for signs of illness in their children and to keep them home when they are sick. Screen children upon arrival.
- There are several methods that facilities can use to protect their workers while conducting temperature screenings. The most protective methods incorporate social distancing (maintaining a distance of 6 feet from others) or physical barriers to eliminate or minimize exposures due to close contact to a child who has symptoms during screening.
- Examples of Screening Methods relying on Social Distancing, Barrier/Partition Controls, and Personal Protective Equipment may be found on CDC.gov.
Social Distancing Strategies
If possible, childcare classes should include the same group each day, and the same childcare providers should remain with the same group each day.
- Consider creating a separate classroom or group for the children of healthcare workers and other first responders. If your program is unable to create a separate classroom, consider serving only the children of health care workers and first responders.
- Cancel or postpone all special events such as festivals, holiday events, and special performances. Halt daily group activities that may promote transmission.
- Keep each group of children in a separate room or a defined space.
- Limit the mixing of groups of children, such as staggering playground times and keeping groups separate for special activities such as art, music, and exercising.
- If possible, at nap time, ensure that children’s naptime mats (or cribs) are spaced out as much as possible, ideally 6 feet apart. Consider placing children head to toe in order to further reduce the potential for viral spread.
- Limit the number of individuals in a room at one time so that there is still enough space to socially distance.
- Stagger arrival and drop off times and/or have childcare providers come outside the facility to pick up the children as they arrive. Your plan for curb side drop off and pick up should limit direct contact between parents and staff members and adhere to social distancing recommendations.
- If possible, arrange for administrative staff to telework from their homes.
Clean and Disinfect
Caring for Our Children (CFOC) - https://nrckids.org/CFOC/Database/3.3 - sets national policy for cleaning, sanitizing and disinfection of educational facilities for children. Toys that can be put in the mouth should be cleaned and sanitized (see below). Other hard surfaces, including diaper changing stations, doorknobs, and floors can be disinfected.
Intensify cleaning and disinfection efforts:
- Facilities shall develop a schedule for cleaning and disinfecting.
- Routinely clean, sanitize, and disinfect - https://www.cdc.gov/coronavirus/2019-ncov/prepare/ disinfecting-building-facility.html - surfaces and objects that are frequently touched, especially toys and games, nap pads, toilet training potties, desks, chairs, cubbies, and playground structures.
- Use all cleaning products according to the directions on the label. For disinfection, most common EPA- registered, fragrance-free household disinfectants should be effective. A list of products that are EPA- approved for use against the virus that causes COVID-19 is available on the CDC’s website. If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection
- All cleaning materials must be kept secure and out of reach of children.
- Cleaning products may not be used near children, and staff should ensure that there is adequate ventilation when using these products to prevent children from inhaling toxic fumes.
Clean and Sanitize Toys
- Toys that cannot be cleaned and sanitized shall not be used.
- Toys that children have placed in their mouths or that are otherwise contaminated by body secretion or excretion must be set aside until they are cleaned by hand by a person wearing gloves. Clean
- with water and detergent, rinse, sanitize with an EPA-registered disinfectant, and air-dry or clean in a mechanical dishwasher. Be mindful of items more likely to be placed in a child’s mouth, like play food, dishes, and utensils.
- Machine washable cloth toys may only be used by one individual at a time or should not be used at all. These toys must be laundered - https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/ children.html - before being used by another child.
- Do not share toys with other groups of infants or toddlers, unless they are washed and sanitized before being moved from one group to the other.
- Set aside toys that need to be cleaned. Place in a dish pan with soapy water or put in a separate container marked for “soiled toys.” Keep dish pan and water out of reach from children to prevent risk of drowning. Washing with soapy water is the ideal method for cleaning. Try to have enough toys so that the toys can be rotated through cleanings.
- Children’s books, like other paper-based materials such as mail or envelopes, are not considered as a high risk for transmission and do not need additional cleaning or disinfection procedures.
Clean and Disinfect Bedding
Use bedding (sheets, pillows, blankets, sleeping bags) that can be washed. Keep each child’s bedding separate, and store in individually labeled bins, cubbies, or bags. Cots and mats must be labeled for each child. Bedding that touches a child’s skin must be cleaned weekly or before use by another child.
Parent Drop-Off and Pick-Up
Hand hygiene stations shall be set up at the entrance of the facility, so that children can clean their hands before they enter.
- If a sink with soap and water is not available, provide hand sanitizer with at least 60% alcohol next to parent sign-in sheets. If possible, place sign-in stations outside. Keep hand sanitizer out of children’s reach and supervise use.
Staggering arrival and drop off times and/or plan to limit direct contact with parents as much as possible.
- Have childcare providers greet children outside as they arrive.
- Infants can be transported in their car seats. Store car seat out of children’s reach.
Persons who have a fever or other signs of illness must not be admitted to the facility. Encourage parents to be on the alert for signs of illness in their children and to keep them home when they are sick. Screen children upon arrival:
- Conduct temperature screening, using the protocol provided below.
- Make a visual inspection of the child for signs of infection, which could include flushed cheeks, fatigue, extreme fussiness, etc.
- Record any symptoms in children’s logs or daily health logs
Caring for Infants and Toddlers
Diapering - https://nrckids.org/CFOC/Database/3.3
- When diapering - https://nrckids.org/CFOC/Database/188.8.131.52 - a child, wash your hands - https://www. cdc.gov/handwashing/index.html - and wash the child’s hands before you begin, and wear gloves, if possible. Follow safe diaper changing procedures. Procedures should be posted in all diaper changing areas. Steps include:
- Prepare (includes putting on gloves)
- Clean child and remove gloves
- Remove trash (including gloves)
- Replace diaper
- Wash child’s hands
- Clean up diapering station
- Wash hands
- After diapering, wash your hands (even if you were wearing gloves) and disinfect the diapering area with a fragrance-free bleach that is EPA-registered as a sanitizing or disinfecting solution.
- 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 into a plastic- lined, hands-free covered diaper pail to give to parents/guardians or laundry service.
- Posters with diaper changing procedures are available on the CDC’s website.
It is important to comfort crying, sad, and/or anxious infants and toddlers, and they often need to be held. When washing, feeding, or holding very young children:
- Childcare providers can protect themselves by wearing an over-large button-down, long sleeved shirt and by wearing long hair up off the collar in a ponytail or other updo.
- Childcare providers shall wash their hands, neck, and anywhere touched by a child’s secretions.
- Childcare providers shall change the child’s clothes if secretions are on the child’s clothes. They should change the button-down shirt, if there are secretions on it, and wash their hands again.
- Contaminated clothes must be placed in a plastic bag or washed in a washing machine. Infants, toddlers, and their providers should have multiple changes of clothes on hand in the childcare center or home-based child care.
Healthy Hand Hygiene Behavior
All children, staff, and volunteers must engage in hand hygiene at the following times:
- Arrival to 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 administering medication or medical ointment
- After diapering
- After using the toilet or helping a child use the bathroom
- After coming in contact with bodily fluid
- After handling animals or cleaning up animal waste
- After playing outdoors or in sand
- After handling garbage
Wash hands with soap and water for at least 20 seconds. If hands are not visibly dirty, alcohol-based hand sanitizers with at least 60% alcohol can be used if soap and water are not readily available.
- Supervise children when they use hand sanitizer to prevent ingestion.
- Assist children with handwashing, including infants who cannot wash hands alone.
- After assisting children with handwashing, staff shall also wash their hands.
- Place posters describing handwashing steps near sinks. Developmentally appropriate posters in multiple languages are available from CDC.
Food Preparation and Meal Service
- 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.
- Food preparation shall not be done by the same staff who diaper children.
- Sinks used for food preparation shall not be used for any other purposes.
- Caregivers shall ensure children wash hands prior to eating.
- Caregivers must wash their hands before preparing food and after helping children to eat.
- Facilities shall follow all other DPH’s Food Establishment and Bar Operation Guidelines for all food service.
Vulnerable/High Risk Groups
Children and adults with serious underlying medical conditions, as well as older adults, are believed to be at higher risk for more serious complications from COVID-19. To protect those at higher risk - https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/people-at-higher-risk.html, it’s important
that everyone practices healthy hygiene behaviors - https://www.cdc.gov/coronavirus/2019-ncov/about/ prevention.html.
- If you have staff members or teachers age 60 or older, or with underlying medical conditions, encourage them to talk to their medical provider to assess their risk and to determine if they should stay home.
- Information about COVID-19 in children - https://www.cdc.gov/coronavirus/2019-ncov/specific- groups/children-faq.html - is somewhat limited, but the information that is available suggests that children have mild symptoms. However, a small percentage of children have been reported to have more severe illness. If you have children with underling health conditions, talk to their parents about their risk.
- If you have children with disabilities, talk to their parents about how their children can continue to receive the support they need.
Wearing a Face Mask
- Staff must wear face masks at all times when interacting with other employees and children.
- Avoid touching the mask while using it. If you do need to touch the mask, first wash your hands with soap and water or alcohol-based hand rub.
CDC’s website contains a variety of resources for childcare programs and K-12 schools - https://www. cdc.gov/coronavirus/2019-ncov/community/schools-childcare/index.html, including detailed guidance, considerations for closures, and frequently asked questions for administrators, teachers, and parents.
Together, these resources provide additional information on:
- What to do if a child or staff member at your facility becomes sick.
- Closures of childcare programs.
To ensure continuity of meal programs and other essential services if your facility is closed, additional government resources related to meals and snacks can be found at https://www.fns.usda.gov/cacfp
Adapted from the CDC’s Guidance for Childcare Programs that Remain Open
Guidance is also available on the CDC’s website on these topics:
Children and COVID-19 - https://www.cdc.gov/coronavirus/2019-ncov/prepare/children.html
Talking with children about Coronavirus Disease 2019
Information about COVID-19 and Pregnancy and breastfeeding: https://www.cdc.gov/coronavirus/2019-ncov/prepare/pregnancy-breastfeeding.html
Stress and coping: https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html