Child care providers should understand the aspects of reopening or continuing to operate during COVID-

Additional policies and procedures are strongly recommended to be put in place to protect the health and safety of children in care while maintaining a safe environment for child care employees and families. The CDC has developed a decision tool to assist in operating and reopening decisions during these unique circumstances. Child care providers should review and plan for the implementation of the CDC and DOH guidelines before reopening. It is suggested that child care providers develop and publicly post their implementation strategies to mitigate the further spread of COVID-19 and to inform parents of new procedures and expectations.

COVID-19 is mostly spread by respiratory droplets released when people talk, cough, or sneeze. It is thought that the virus may spread to hands from a contaminated surface and then to the nose or mouth, causing infection. Therefore, prevention practices and environmental cleaning and disinfection are important principles that are covered below.

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

All guidance below is strongly recommended in order to adhere to guidelines published by the CDC and DOH. 

Drop-off/Arrival Procedures 

Child care programs are strongly recommended to:

Post signage in drop-off/arrival area to remind staff and children to keep six feet of distance whenever feasible.

• Ideally, the same parent or designated person should drop off and pick up the child every If possible, individuals with serious underlying medical conditions should not pick up children because they are more at risk.
  • Set up hand hygiene stations at the entrance of the facility, so that children, staff, and parents 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.
  • Keep hand sanitizer out of children’s reach and supervise If possible, place sign-in stations outside, and provide sanitary wipes for cleaning pens between each use.
  • Consider staggering arrival and drop off times and plan to limit direct contact with parents as much as possible.
  • Consider greeting children outside as they
  • Designate a staff person to be the drop off/pick up volunteer to walk all children to their classroom, and at the end of the day, walk all children back to their cars.
  • Transport Infants in their car
• Set up hand hygiene stations at the entrance of the facility, so that children, staff, and parents 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.
• Keep hand sanitizer out of children’s reach and supervise If possible, place sign-in stations outside, and provide sanitary wipes for cleaning pens between each use.
• Consider staggering arrival and drop off times and plan to limit direct contact with parents as much as possible.
• Consider greeting children outside as they
• Designate a staff person to be the drop off/pick up volunteer to walk all children to their classroom, and at the end of the day, walk all children back to their cars.
• Transport Infants in their car seats.

Screening Procedures:

The best way to prevent the spread of COVID-19 is to prevent it from getting inside the facility. Child care providers should:

• Conduct a daily health screening of any person entering the building, including children, staff, family members, and other visitors to identify symptoms, diagnosis, or exposure to COVID-19.
• Not allow staff and children to enter the child care facility if:
  • They have tested positive for or are showing COVID-19 symptoms.
  • They have recently had potential exposure with a person with COVID-
    • A potential exposure means being in a household or having close contact within 6 feet of an individual with a confirmed or suspected COVID-19 case for at least 15 minutes during the case’s infectious period.
    • Persons with COVID-19 are considered infectious from 2 days before onset of symptom until the end of isolation (discussed below in “Discontinuing at home isolation”).
  • Continue to monitor staff and child health throughout the
  • Immediately isolate a child or staff member that develops fever, chills, shortness of breath, new cough, or new loss of taste or smell and send them and any family members home as soon as
  • While waiting for a sick child to be picked up, have a caregiver stay with the child in a place isolated from If the child has symptoms of COVID-19, the caregiver should remain as far away as safely possible from the child (preferably 6 feet) while maintaining supervision. The caregiver should wear a cloth face covering. If the child is over the age of 2 and can tolerate a face covering, the child should also wear a cloth face covering.

Persons who have a fever of 100.4 degrees Fahrenheit or above, or other signs of illness should 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.

Routine disinfecting/sanitization procedures:

Child care facilities should post signs in highly visible locations (e.g., facility doors, lobby, restrooms) that promote everyday protective measures and describe how to stop the spread of COVID-19 such as by properly washing hands and properly wearing a cloth face covering.

Resources for signage for handwashing can be found here. Signage for face coverings can be found here.

Caring for Our Children (CFOC) provides national standards 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 should develop a schedule for cleaning and An example can be found here.
• Routinely clean, sanitize, and disinfect surfaces and objects that are frequently touched, especially toys and This may also include cleaning objects/surfaces not ordinarily cleaned daily such as doorknobs, light switches, classroom sink handles, countertops, nap pads, toilet training potties, desks, chairs, cubbies, and playground structures. Use the cleaners typically used at your facility. Guidance is available for the selection of appropriate sanitizers or disinfectants for child care settings.
• Use all cleaning products according to the directions on the label. For disinfection, most common EPA-registered, fragrance-free household disinfectants should be A list of products that are EPA-registered for use against the virus that causes COVID-19 is available here. 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 per
• Cleaning products should not be used near children, and staff should ensure that there is adequate ventilation when using these products to prevent children from inhaling toxic

Clean and Sanitize Toys: 

• Toys that cannot be cleaned and sanitized should not be
• Toys that children have placed in their mouths or that are otherwise contaminated by body secretions or excretions should be set aside until they are cleaned by hand by a person wearing gloves. Clean with water and detergent, rinse thoroughly, sanitize with an EPA-registered disinfectant, rinse thoroughly again, and air-dry. You may also clean in a mechanical
• Machine washable cloth toys should be used by one individual at a time or should not be used at all. These toys should be laundered 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. Washing with soapy water is the ideal method for Try to have enough toys so that the toys can be rotated through cleanings.

Clean and Disinfect Bedding:

• Use bedding that can be 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 weekly or before use by another child.
• When possible, bedding should be laundered by the facility to reduce the back and forth transportation between the child’s home and the facility.

If possible, child care classes should include the same group each day, and the same child care providers should remain with the same group each day. If your child care program remains open, consider creating a separate classroom or group for the children of healthcare workers and other first responders. Cancel or postpone special events such as festivals, holiday events, and special performances.

• Consider whether to alter or halt daily group activities that may promote
  • Keep each group of children in a separate room.

• Limit the mixing 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.

Child care staff are required to wear cloth face coverings. Children 2 years old and older are required to wear a face covering as described in the Order of the Secretary of the Pennsylvania Department of Health Order for Universal Face Coverings, unless you fit one of the exceptions included in Section 3 of the Order.

If a child is outdoors and able to consistently maintain a social distance of at least 6 feet from individuals who are not a part of their household, they do not need to wear a mask.

If a parent, guardian, or responsible person has been unable to place a face covering safely on the child’s face, they should not do so.

If a child 2 years old or older is unable to remove a face covering without assistance, the child is not required to wear one.

The Department of Health recognizes that getting younger children to be comfortable wearing face coverings and to keep them on may create some difficulties. Under these circumstances, parents, guardians, licensed child care providers in community-based and school settings or responsible persons may consider prioritizing the wearing of face coverings to times when it is difficult for the child to maintain a social distance of at least 6 feet from others who are not a part of their household (e.g., during carpool drop off or pick up, or when standing in line at school). Ensuring proper face covering size and fit and providing children with frequent reminders and education on the importance and proper wearing of cloth face coverings may help address these issues.

The following pertains to all child care staff, household members residing in a group child care home or family child care home, and children at a child care facility.

For confirmed positive COVID 19-cases:

• If the child is in care when the test results are confirmed positive, the child should be isolated until the appropriate party arrives to pick them up.
• Follow the “Discontinuing at home isolation” guidance below for timelines on returning to the child care setting.
• The facility should close for a period of 48 hours following the confirmed positive COVID-19 case of child or staff member in attendance so that the facility can be cleaned and disinfected
• The operator shall inform parents of enrolled children when there is a suspected outbreak of a communicable disease or an outbreak of an unusual illness that represents a public health emergency in the opinion of the Department of Health as per 55 Pa. Code §3270.136(b),
• 3280.136(b), and §3290.136(b).

*An outbreak is defined as a single positive COVID-19 case.

• The facility must report positive COVID-19 cases to the Department of Health (DOH) as per 55 Pa. Code 3270.136(d), §3280.136(d), and §3290.136(d). The facility must also report positive COVID-19 cases to the Pennsylvania Department of Human Services (DHS).
• The facility should develop a process to inform child care staff of positive COVID-19

Exposure to a person who tests positive for COVID-19:

Exposure is defined as being within 6 feet of the individual who tests positive for COVID-19 for a period of 15 minutes or more. It also means coming into direct contact with droplets from a COVID-19 positive individual. Persons who test positive are considered infectious 48 hours before the onset of symptoms. Persons testing positive but do not have symptoms are considered infectious 2 days after exposure (if known) or starting 2 days before test date (if exposure is unknown).

If a staff person, household member, or a child is exposed to an individual who tests positive for COVID- 19:

• It is strongly recommended and highly encouraged that they self-quarantine for a period of 14 days based on the CDC guidance.
• If a child becomes ill at the facility, the operator shall notify the child’s parent as soon as
• The operator shall inform parents of enrolled children when there is a suspected outbreak of a communicable disease or an outbreak of an unusual illness that represents a public health emergency in the opinion of the Department of Health as per 55 Pa. Code §3270.136(b),
• 3280.136(b), and §3290.136(b).
• The facility must report when a staff person, child, or household member is exposed to a positive COVID-19 case to the DHS and DOH.
• The facility should develop a process to inform child care staff of possible exposure to a positive COVID-19 case.

Discontinuing at home isolation:

There are different strategies for discontinuing home isolation. Options include a symptom based (i.e., time-since-illness-onset and time-since-recovery strategy) or test based strategy. Child care providers should utilize the strategy that is best for their facility and that maintains the health and safety of children in care.

1).  Symptom-Based Strategy

Individuals with COVID-19 who have symptoms and were directed to care for themselves at home may discontinue isolation under the following conditions:

• At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
• At least 10 days have passed since symptoms first appeared.

2).  Test-Based Strategy

Individuals who have COVID-19 who have symptoms and were directed to care for themselves at home may discontinue isolation under the following conditions:

• Resolution of fever without the use of fever-reducing medications and
• Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
• Negative COVID-19 test results from at least two consecutive respiratory specimens collected 24 hours or more apart (total of two negative specimens).

For Persons Who Tested Positive but have NOT had COVID-19 Symptoms in Home Isolation:

• Time-Based Strategy

Persons with laboratory-confirmed COVID-19 who have not had any symptoms and were directed to care for themselves at home may discontinue isolation under the following conditions:

• At least 10 days have passed since the date of their first positive COVID-19 diagnostic test assuming they have not subsequently developed symptoms since their positive test.

If they develop symptoms, then the symptom-based or test-based strategy should be used.

• Test-Based Strategy

Persons with laboratory-confirmed COVID-19 who have not had any symptoms and were directed to care for themselves at home may discontinue isolation under the following conditions:

• Negative COVID-19 results from at least two consecutive respiratory specimens collected 24 hours or more apart (total of two negative specimens).

The symptom-based, time-based, and test-based strategies may result in different timeframes for discontinuation of isolation post-recovery. Any individual who becomes ill should contact their medical provider for advice or testing. For any individual who has been exposed to COVID-19 as described above, or who tests positive for COVID-19, follow the information outlined above.

In all instances when reporting to DHS, please provide:

• The name of the facility
• The address of the facility including the county
• The number of cases
• Identify if the positive case is a staff person, household member (of a GCCH or FCCH), child, or family member

This information must immediately be reported to your Certification Representative or the appropriate Regional Office which can be found here.

For questions regarding COVID-19, isolation, and quarantine, please contact DOH at 1-877-PA-HEALTH.

To report confirmed positive cases of COVID-19, please contact DOH at 1-877-PA-HEALTH or 1-877- 724-3258.

If a child care provider is aware of a retailer selling personal protective equipment for well above the manufactures suggested retail price The Office of Attorney General handles these issues. Visit their website to file a complaint.

DHS provider resources: https://www.dhs.pa.gov/providers/Providers/Pages/Coronavirus-Provider- Resources.aspx

Pennsylvania Key resources on COVID-19 (coronavirus) in Pennsylvania for ECE programs and professionals: https://www.pakeys.org/ece-coronavirus-resources/

Department of Economic and Community Development – Pennsylvania COVID-19 PPE & Supplies Business-2-Business (B2B) Interchange Directory- to connect with Pennsylvania business selling supplies: https://dced.pa.gov/pa-covid-19-medical-supply-portals/pennsylvania-covid-19-ppe-supplies- business-2-business-b2b-interchange-directory/