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COVID-19 and Child Care Centres

As the Government of Ontario continues to implement its Framework for Reopening the Province, childcare centres and home care providers in Leeds, Grenville and Lanark are now permitted to re-open provided they have specific rules, enhanced health and safety, as well as strict operational requirements in place. When developing health and safety protocols, childcare providers are responsible for adhering to the advice set out in the Ministry of Education’s Operational Guidance document as well as that provided by Leeds, Grenville and Lanark District Health Unit (LGLDHU) in this Guidance Document. The Ministry of Education has indicated that childcare providers do not require local public health units to sign-off on health and safety protocols. As such, LGLDHU is providing operators with this Guidance Document, to be used in concert with the Ministry of Education’s guidance, to ensure they have the information they need to protect themselves, their households, and children.

We have created some guidance materials for you which include:

The Health Unit is prepared to support your plan provided it contains the measures in the guidance documents outlined above. Once your plans are complete, confirm that they contain the required measures by completing the Child Care COVID-19 Checklist and forward the checklist to protection@healthunit.org. You will receive a response that the plan has been received and that we are aware of your re-opening.

It is the responsibility of each child care centre to ensure the appropriate safety measures are in place based on guidance from the Ministry of Education and the Leeds Grenville and Lanark District Health Unit.

Your plan will not require Health Unit approval to re-open your child care setting.

Child care centres do not require an inspection prior to re-opening if they are operating under an existing license; however, an onsite inspection will follow at a later date to ensure childcare centres are meeting their requirements to keep children, their families, and child care workers protected.

Thank you for your ongoing dedication to keeping our children safe. Please feel free to contact your Public Health Inspector should you have questions that are not covered in the resources provided.

Child Care Re-opening Questions and Answers

Note: Several new questions have been added since the first edition was sent on June 17, 2020. The responses regarding the plan approval process have been updated to reflect Health Unit changes. A notice, information package, and checklist have been developed to assist you in your re-opening and has been sent out via your Children Services contact at your County.

If a staff member is experiencing a COVID-19 symptom that is unusual for them, testing for COVID-19 is recommended.

It is up to the employer to set their own policy regarding sick leave/sick time paid and how they will support staff away from work for 14 days who have chosen not to be tested. We cannot make recommendations on this.

If staff do not pass the screening they cannot enter the child care centre. If staff become ill while at work, they must leave immediately. Ill staff are recommended to go directly to an assessment centre for testing. They must then self-isolate until the results are received. If the results are negative they can return to work once their symptoms have resolved, following routine exclusion policies at their workplace. If their symptoms persist or worsen, re-testing should be considered.

If they choose not to go to an assessment centre, the staff member must remain off work until 14 days after onset of symptoms. They may return to work after 14 days.

Staff that test positive will be followed up by Public Health.

* All ill staff and children should be reported to the Health Unit, at 1-800-660-5853 extension 2222

Yes. If screeners follow the appropriate precautions when screening and escorting children to the program, as per the Ministry of Education “Operational Guidance During COVID-19 Outbreak: Child Care Re-Opening” document, they can work with children within a cohort.

Appropriate Precautions include:

  • maintaining a distance of at least 2 meters/6 feet from those being screened or being separated by a barrier
  • wearing personal protective equipment (surgical/procedure mask and eye protection); this includes proper procedures for putting on and taking off PPE, and changing it at appropriate times (i.e., when wet or soiled).

Ministry of Education guidance requires that child care setting staff wear medical masks and eye protection while inside the child care premises. Wearing masks and eye protection protects the wearer from infection when in close contact (within 2 metres) of others.

Acceptable alternative to a face shield include safety glasses or goggles. Ensure the eye protection wraps around the side of the eye area. Regular eye glasses are not considered eye protection. Ensure the product you choose is used according to the manufacturer’s instructions for use – i.e. if they are labelled as single use, disposable they must be discarded at the end of each day; if they are labelled for re-use/multi-use, ensure that they are cleaned and disinfected at the end of each day and when visibly soiled.

Frequently touched surfaces include toilets, faucets, sinks and counter tops which are required to be cleaned at least twice a day. All surfaces must receive additional cleaning when soiled or potentially contaminated.

Note: Bathrooms should be dedicated to a single cohort. One cannot schedule specific times in the day for when different cohorts can use the bathroom and are therefore represent a common, high-touch area between cohorts. Any centre that wishes to share a bathroom between one or more cohorts must include a detailed plan to the Health Unit as to how this will be done safely in a feasible and effective way. More info found in questions below.

Fountains should be disabled or made inaccessible. Fill cups or bottles rather than having them drink directly from the mouthpiece of water fountains.

There is not a prescribed frequency for cleaning toys. The virus is able to survive on smooth surfaces for several days. Handling contaminated toys can contaminate hands with the virus, which then can lead to infection if hands are brought to the eyes, nose or mouth. Regular disinfection will kill the virus. Frequent hand hygiene will reduce contamination of toys and prevent infection of children and staff.

Toys must remain designated to a cohort and cleaned and disinfected as often as possible.

Mouthed toys must be cleaned and disinfected after each use. All toys that are shared between cohorts must be cleaned and disinfected between cohorts. Sensory toys should be single use and not shared between children.

Anything that can be handled by children should be easily cleanable – smooth, non-absorbent. Consider putting them higher where the children can see but not touch.

The cook would be counted as part of the cohort only if they are not able to maintain physical distancing (2 metre/6 feet) from cohort. Ensure other staff and children are not able to enter the kitchen by using physical barriers. Ensure that the delivery/pick up method to provide food does not bring the cook into close contact with cohorts or vice versa.

An inspection is not required prior to reopening.

Children and staff must be screened each day before entering the child care setting. If the child/staff does not pass screening, they cannot enter the child care centre. They should be referred to an assessment centre immediately. You are not required to notify the Health Unit each time a child/staff does not pass screening. The Health Unit must be notified only if the child/staff is present in the program when symptoms begin. This should be done by calling 1-800-660-5853 and dial extension 2222. Leave a message if necessary. Do not call or leave telephone messages for individual staff members.

Testing and return to childcare:

  • Those who test negative for COVID-19 must be excluded from the program until 24 hours after symptom resolution
  • Those who test positive for COVID-19 must be excluded from the program for 14 days after the onset of symptoms and/or clearance has been received from the local public health unit

Exclusion if the parent chooses not to have child assessed/tested:

  • Exclude from the program for 14 days after onset of symptoms

Note: There may be situations where a health care provider does not advise COVID-19 testing after assessment is completed. In these situations, the child can return to childcare according to routine exclusion policy.

As of September 1, 2020, child care and early years programs were able to return to maximum group sizes as set out under the Child Care and Early Years Act.

Staff and children should be assigned to a specific group where possible. If groups are changed, we recommend be preceded by a 2 day absence from the centre. Since cases are considered to be contagious 2 days before onset of symptoms, anyone developing symptoms on the day the group changed they would not have exposed the previous week’s cohort. For example, if the group was changed on Monday after the centre was closed on the weekend, and one of the attendees becomes ill, they would have exposed only those in their current group and would not have exposed anyone in the previous week’s group.

Those whose symptoms are caused by allergies do pass screening. Refer to the most recent version of The COVID-19 Reference Document for Symptoms for a list of typical and atypical symptoms of COVID-19. The Child Care Centre should develop an internal policy for documenting allergies and other underlying conditions which includes usual COVID-19 symptoms such as GI issues or headache/migraines for all attendees.

The lunch bag and contents of it would be considered a personal item brought from home. It should be well labelled and kept with that child’s personal items. If it requires refrigeration, place inside another bag from the centre first so it does not contact other food items. Preferably, bagged lunches should contain only non-hazardous and non-perishable foods.

Groups must maintain physical distancing (2 metres) from other groups at all times. Your plan must include how you will be able to ensure this is maintained at your centre. If staff and children must pass through an area used by another cohort, consider strategies that will prevent close contact such as setting up a schedule or a way to communicate with the other groups, performing hand hygiene before entering the space, use of barriers or visual cues to direct children and staff etc. Any surfaces that may be touched or contaminated must be cleaned and disinfected between groups, including hand rails, sinks, toilets etc.

Ideally, each cohort should have its own bathroom. If this is not possible because of the layout of your centre, it is your responsibility to ensure your plan covers how you will maintain physical distancing between cohorts, and clean and disinfect surfaces between cohorts when spaces are shared, including bathrooms.

Children may need to use the washroom outside of their scheduled time – ensure your plan includes how to manage this situation safely. Consider having an “occupied” sign on the door, or having a potty in the child care room for emergencies.

Anyone outside the cohort must maintain physical distancing from the children and staff in the cohort, including custodial staff. If custodial staff need to enter child care centre spaces they should arrange to do so when the children and staff are not in the room, if possible. If they must come into the room when the cohort is present, they must maintain physical distancing from the cohort. Consider the use of barriers or visual cues to maintain separation. PPE is not required if physical distancing can be maintained, with the exception of PPE that is used for other reasons such as gloves or safety glasses for contact with cleaning chemicals.

General Guidance for disinfectants:

  • Use only disinfectants that have a Drug Identification Number (DIN). A DIN is an 8-digit number given by Health Canada that confirms it is approved for use in Canada.
  • Follow the manufacturer’s instructions on any products being used:
    • Properly prepare solutions;
    • Allow adequate contact time for disinfectants to kill germs (see product label);
    • Wear gloves when handling cleaning products if indicated on the product label, including wipes;
    • Wear any other personal protective equipment recommended by the manufacturer.
    • Check expiry dates of all products.

Disinfecting wipes can be used in a child care centre provided the manufacturer’s instructions are followed. Long contact times can be difficult to maintain with a wipe and may require several wipes to achieve. Also, if they are to be used to wipe toys that may be mouthed by children, follow the manufacturer’s instructions for whether a potable water rinse is required following the contact time. To determine whether your disinfectant is effective against COVID-19, visit the Health Canada website and enter the product name or DIN.

For more information on cleaning and disinfection refer to our Child Care Infection Control Manual.

No – however use caution when using a “touchless” infrared (“laser”) type thermometer as they tend to be less accurate and affected by outside temperatures. Always have a back-up method such as a tympanic (ear) thermometer. These can be used with disposable covers or be disinfected between uses. We recommend that parents do the temperature checks in the morning at home and record the temperature upon screening; however, you must have a thermometer in case they forget or in case a child becomes ill during the day.

Sensory materials, including sand should be provided for single use (i.e., available to the child for the day) and labelled with the child’s name. Avoid the use of sandboxes. Some outdoor play areas are covered in sand. Ensure children clean their hands and discourage sand play as much as possible.

Screening is required only for anyone entering the childcare centre. Screening includes asking whether the child has been in contact with a confirmed case of COVID-19. If they answer yes, they do not pass screening.

Supply/replacement staff should be assigned to a specific group so as to limit staff interaction with multiple group s of children.