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Updated Guidance for Child Care Programs and Providers

UPDATED CORONAVIRUS 2019 (COVID-19) INDUSTRY GUIDANCE FOR CHILD CARE SETTINGS

https://cdss.ca.gov/Portals/9/CCLD/PINs/2021/CCP/PIN-21-18-CCP.pdfGuidance for Child Care Providers and Programs

https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Child-Care-Guidance.aspx

June 29, 2021

Related Materials:

Overview

The State of California remains committed to taking actions that protect the health, safety, and welfare of the people in California. As businesses and activities reopen, guidance has been updated for Coronavirus Disease 2019 (COVID-19) infection control practices. Every child care program is expected to continue to minimize the spread of COVID-19 and to ensure the safety of children, providers, and families. All providers should apply new and updated policies and requirements that address the need for continued infection control and should update their emergency preparedness plan.

This guidance informs child care providers and the families they serve about infection control practices that prevent and mitigate the spread of COVID-19 infection in facilities. It is important for providers to maintain frequent communication with families and staff about implemented policies and practices to keep everyone safe.

This guidance supersedes prior COVID-19 guidance in the COVID-19 Update Guidance: Child Care Program and Providers dated July 17, 2020.

Licensees and other child care providers should continue to follow COVID-19 requirements and guidance in all applicable California Department of Social Services (CDSS) and Community Care Licensing (CCL) Provider Information Notices (PIN), in addition to guidance or requirements from California Department of Public Health (CDPH)California Department of Industrial Relations Division of Occupational Safety & Health (Cal/OSHA), and local public health departments, as applicable to the particular facility.

If there are differing requirements between the most current CDPH, CCL, Cal/OSHA, and local health department guidance or health orders, licensees and providers should follow the strictest requirements. Implementation of this guidance should be adapted for the setting in which you provide care and may require training and support for staff and adequate consideration of children and family needs.

Workplace safety and health regulations in California require employers to take steps to protect workers exposed to infectious diseases. Licensees and providers who fall under the scope of the Cal/OSHA COVID-19 Prevention Emergency Temporary Standards (ETS) must remain in compliance with these Standards.

Planning

  • Licensees and providers must continue to mitigate the spread of COVID-19. Review Cal/OSHA COVID-19 Guidance and Resources to implement steps to protect staff and minimize exposure to the COVID-19 virus.
  • The Cal/OSHA COVID-19 Prevention Program (CPP) is a written plan required under the Cal/OSHA COVID-19 Emergency Temporary Standards. For more details and to access a template, refer to the California Department of Industrial Relation's COVID-19 Prevention Emergency Temporary Standards.
  • Facilities should have a written plan for when a child or staff member has been exposed to someone with COVID-19, has symptoms of COVID-19 or tests positive for COVID-19.
  • Developing a written communication plan with parents, guardians, and caregivers to share information and guidelines in their preferred language is recommended.

COVID-19 Vaccines

  • The CDC has strongly encouraged vaccination as one of the most important tools to end the COVID-19 pandemic. Licensees and providers are eligible to receive vaccinations at no expense. There are several ways to obtain vaccination. Please see PIN 21-06-CCP for more information on vaccine safety, benefits, and how to get the vaccine.
  • Please share information about vaccines with staff and families, and reference the California COVID-19 Vaccine Website Homepage.
  • If a licensee or provider requests confirmation that a staff or child has received the COVID-19 vaccine, it is recommended the confirmation should be documented in the same way immunizations are documented and maintained in the facility file. Those confirming may review and accept a hard copy or digital record of vaccine receipt.

Testing

Face Coverings

  • Child care providers must ensure compliance with the current CDPH Guidance for the Use of Masks. As of June 15, 2021, the use of face coverings is required by the California Department of Public Health (CDPH) and the Division of Occupational Safety and Health (Cal/OSHA) in child care indoor settings regardless of vaccination status.
  • Never place face coverings on babies or children under 2 years of age because it poses a danger and risk for suffocation.
  • Children should not wear face coverings while sleeping.
  • Child care providers and licensees must ensure the use of face coverings does not cause children to overheat in hot weather.

Essential Protective Equipment and Supplies

Use the chart below for a quick reference to protective equipment and supplies to use in child care environments. Further information about face coverings, hand hygiene and disinfecting and cleaning is provided within this document.

Items

Child Care Workforce

Children

Face Coverings: 

Child care providers must ensure compliance with the current CDPH Guidance for the Use of Masks.Children aged 2 and older should be taught and reminded to wear face coverings.

Yes

 

Yes

 

Gloves:

for tasks such as serving food, diapering, handling trash, or using cleaning and disinfectant products

Yes,

 

No

Hand Sanitizer

Should contain at least 60% ethyl alcohol (preferred) or at least 70% isopropyl alcohol (a neurotoxin and eye irritant). WARNING Do not use any products that contain methanol. May be used under adult supervision only and must be kept out of children's reach. Call Poison Control if consumed: 800-222-1222 

Note that frequent handwashing is more effective than use of hand sanitizers. Sanitizer must be rubbed into children's hands until completely dry. Hand sanitizer is not recommended for children under 24 months.

Yes

 

Optional

Disinfectant Cleaning Products

Provide training and required protective equipment per manufacturer's recommendations. Must be kept out of children's reach.

Yes

 

No

Note: Child care providers and licensees may contact their local Child Care Resource and Referral Agencies or local First 5 offices for information about obtaining Personal Protective Equipment (PPE) and supplies.

Physical Distancing and Stable Groups

  • Physical distancing is an infection control best practice that may be implemented as an additional safety layer between groups of children and staff to reduce the spread of COVID-19.
  • Child care settings typically have a stable group model with the same groups of staff and children each day, and licensees and providers should consider continuing to implement stable groups as a best practice.
  • Staff should follow Cal/OSHA ETS for physical distancing requirements.

Ventilation

Ventilation is one component of maintaining healthy environments, and is an important COVID-19 prevention strategy for child care programs. Good ventilation is another step that can reduce the number of virus particles in the air. Along with other preventive actions, ventilation can reduce the likelihood of spreading disease and assists in ensuring a safe and healthy environment for children in care. (See for example, ventilation Title 22 requirements, California Code of Regulations (CCR) sections 101216(e)(2)101223(a)(2)101238(a)102416(c)102417(b), and 102423.)

  • All businesses permitted to operate indoors should follow the recommended CDPH interim guidance for ventilation, filtration, and air quality. This guidance includes practical steps to promote better ventilation, filtration, and air quality indoors to reduce the spread of COVID-19 and ensure the buildings and grounds are safe.
  • Consider how to safely bring fresh air into the child care facility.
  • Consider using child safe fans to increase the effectiveness of open windows. Point fans to blow air outwards. May also consider other approaches for reducing the amount of virus particles in the air, such as using an air filtration and exhaust fans.
  • Ventilation considerations are also important to have inside your transport vehicles, such as buses or vans. It is recommended to open windows to increase airflow from outside when safe to do so.
  • Additional information for child care facilities can be found on the CDC Ventilation in Schools and Child Care Programs page.

Cleaning and Disinfection

Cleaning and disinfecting surfaces can reduce the risk of infection. Train and monitor staff to follow infection control practices below related to requirements for cleaning and disinfection, housekeeping and sanitation principles, and universal health precautions. (See cleaning and disinfection requirements pursuant to CCR sections 101216(e)(2), 102416(c)101238(a) and 102417(b).) These practices also help ensure buildings and grounds are clean, safe and sanitary, and the personal right to safe and healthful accommodations. (See for example, of cleaning and healthful accommodations requirements pursuant to Title 22 CCR sections 101216(e)(2)101223(a)(2)101238(a)102417(b), and 102423.)

  • It is important to know the difference between cleaning, sanitizing, and disinfecting and when to do each in order to maintain a healthy child care environment and the well-being of children in care. See CDC guidance on Cleaning and Disinfecting Your Facility for detailed information on infection control practices related to cleaning and disinfection.
  • Laundry, such as clothing and bedding, should be washed using the appropriate hot water setting and allow items to dry completely. If handling dirty laundry from a person who is sick, wear gloves and a mask. See PIN 20-11-CCLD for more information.
  • When choosing cleaning products, consider using those approved for use against COVID-19 on the Environmental Protection Agency (EPA)-approved list "N" and follow product instructions.
  • Always follow the directions on the label to ensure safe and effective use of the product.
  • The Healthy Schools Act requires that anyone using disinfectants at child care centers complete annual California Department of Pesticide Regulation-approved training. Online training can be found by going to the California School & Child Care Integrated Pest Management website. Note: This does not apply to family child care homes.

Hand Washing and Hygiene

Using the personal hygiene practices below can reduce the risk of infection. Train and monitor staff to follow these strongly recommended universal health precautions and preventative health practices. (See handwashing and hygiene requirements in, Title 22 CCR sections 101216(e)(2) and 102416(c).)

Isolation for Illness

Child care programs must exclude or isolate any child, parent, caregiver, or staff showing symptoms of a contagious disease or illness as required pursuant to Title 22 in CCR sections 101216(h), 101226.1(a)(1) and 102417(e).

  • Take action to isolate children who begin to have COVID-19 symptoms while in care, from other children and staff.
  • Ensure that isolated children continue to receive adequate care supervision and that the health of the child is continually observed throughout the day according to licensing requirements.
  • If an individual who resides in a family child care home is exhibiting symptoms of COVID-19, the facility should follow public health guidelines for quarantine or isolation.
  • Notify local health officials, staff, and families immediately of any confirmed case of COVID-19.

Food Service and Meal Times

Changes may be made during meal times to help mitigate the spread of COVID-19.

  • Moving tables to spread children out or the use of name cards to provide adequate spacing of children is recommended.
  • Licensees and providers should follow proper handwashing, cleaning, and disinfection practices before and after eating. Follow CDC and CACFP COVID-19 food handling guidelines.
  • Implement outdoor meal times if space and weather allow.

How to Respond to Exposure or Outbreaks

Licensees and providers should have a plan in place for responding to COVID-19 exposures or outbreaks.

  • Actively encourage staff and families to notify the facility if they test positive for COVID-19 or have been exposed to someone with COVID-19 symptoms or a confirmed or suspected case.
  • Employers are required to report positive COVID-19 cases in a workplace to the local health department. Follow Cal/OSHA emergency temporary standards on COVID-19 for reporting.
  • Child care centers are required to report epidemic outbreaks to the CDSS Community Care Licensing Division (CCLD) through their local Regional Office as required pursuant to Title 22, CCR section 101212(d). Family child care homes must report a communicable disease outbreak, when determined by the local health authority, to CCLD through their local Regional Office pursuant to Title 22, CCR section 102416.2(c)(3).

Resilience Tips During the Pandemic

The COVID-19 pandemic has had a major effect on our lives. Many are facing challenges that can be stressful, overwhelming, and cause strong emotions in adults and children. It is natural to feel stress, anxiety, grief, and worry during the COVID-19 pandemic. Below are a few recommendations to help yourself, staff, children, and families manage stress:

  • California's playbook on Stress Relief during COVID-19 provides guidance on how to notice stress in kids and outlines tools and strategies on how to reduce stress for children and adults.
  • Promote healthy nutrition, sleep, and physical activity habits and self-care.
  • Discuss and share stress reduction strategies.
  • Encourage staff and children to talk with people they trust about their concerns and feelings.
  • Communicate openly and often with staff, children, and families about mental health support services available in the community, including if mental health consultation is available to the program.
  • Consider posting signage for CalHOPE and the national distress hotline: 1-800-985-5990, or text TalkWithUs to 66746.
  • Encourage staff to call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255), 1-888-628-9454 for Spanish, or Lifeline Crisis Chat if they are feeling overwhelmed with emotions such as sadness, depression, or anxiety; or call 911 if they feel like they want to harm themselves or others.

 

January 2021 CDE Updated resources links:

The CDE, ELCD has developed a COVID-19 State of Emergency guidance and resource web page that includes answers to frequently asked questions, all MBs issued to implement pertinent legislation, webinars, and other relevant resources at https://www.cde.ca.gov/sp/cd/re/elcdcovid19.asp.

To be informed of updated information, please sign up for ELCD’s email distribution list at https://www.cde.ca.gov/sp/cd/ci/progspeclist.asp.

For more information about CDSS Community Care Licensing Division Provider Information Notices which provides guidance on social and physical distance, ratio and group sizes, and healthy practices during the COVID-19 State of Emergency, please visit their website at https://www.cdss.ca.gov/inforesources/community-care-licensing.

For essential factual information and resources about the extent of early childhood homelessness, in addition to concrete research-based strategies teachers can implement that benefit all of the children in their care, and are essential for young children and their families impacted by homelessness, visit the ELCD Resources webpage for a copy of the Responsive Early Education for Young Children and Families Experiencing Homelessness at https://www.cde.ca.gov/sp/cd/re/cddpublications.asp#other.

For more information about federal and state guidance and response to COVID-19 State of Emergency, please refer to the Centers for Disease Control and Prevention (CDC) website at https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/index.html, the California Department of Public Health’s website at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/ncov2019.aspx and the California COVID-19 Response website at https://COVID19.ca.gov/.

For more information about COVID-19 State of Emergency guidance from the Office of Head Start, including the Collaborating Actively in Meaningful Planning (CAMP) series, please visit their website at https://eclkc.ohs.acf.hhs.gov/about-us/coronavirus/ohs-covid-19-updates.

For more information about COVID-19 and the Indian Health Services, who are working closely with tribal partners, state, local and public health partners to provide resources and supports during this public health threat, please visit their web page at https://www.ihs.gov/coronavirus/.

___________________________________________________________________________________________

On June 5, 2020, the California Department of Public Health issued Updated Guidance for Child Care Programs and Providers at https://covid19.ca.gov/pdf/guidance-childcare.pdf that aims to support child care providers and programs as they begin to reopen and other programs transition from emergency childcare for essential workers to enhanced regular operations. To help all providers apply the new and updated policies and requirements and make updates to their emergency preparedness plan, there are also resources and tools available at the California Health and Human Services Agency (CHHS) Early Learning and Care Playbook website at https://www.chhs.ca.gov/home/master-plan-for-early-learning-and-care/ which provides information and links to tips, training, and other resources that will help providers and parents as they navigate the new guidance and requirements. On June 8, 2020, the CDE released a guidance document that includes a section on school-based early learning and care programs, “Stronger Together: A Guidebook for the Safe Reopening of California’s Public Schools.” The guidance document can now be found on the CDE Stronger Together website at https://www.cde.ca.gov/ls/he/hn/strongertogether.asp. Please check out the new Guidance, Early Learning and Care Playbook, and CDE public school reopening guidance to support the wellness and safety of children, teachers, providers, staff, and families. 

Reopening info for providers LINKS

https://californiaall.org/providers

https://www.chhs.ca.gov/home/master-plan-for-early-learning-and-care/

https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2-covid-19

CA cleaning and disinfecting - Eng: https://www.cdc.gov/coronavirus/2019-ncov/community/reopen-guidance.html

Spanish: https://espanol.cdc.gov/coronavirus/2019-ncov/community/reopen-guidance.html

Bleach use for disinfecting VIDEO: https://www.youtube.com/watch?v=1Oc2Q-Sr944&feature=youtu.be

List N: Disinfectants for Use Against SARS-CoV-2 (COVID-19)
All products on this list meet EPA’s criteria for use against SARS-CoV-2, the virus that causes COVID-19.
Finding a Product: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2-covid-19#filter_col1
To find a product, enter the first two sets of its EPA registration number into the search bar below. You can find this number by looking for the EPA Reg. No. on the product label.
For example, if EPA Reg. No. 12345-12 is on List N, you can buy EPA Reg. No. 12345-12-2567 and know you’re getting an equivalent product. 
Search by EPA registration number: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2-covid-19#filter_col1
Using Other Products
If you can’t find a product on this list to use against SARS-CoV-2, look at a different product's label to confirm it has an EPA registration number and that human coronavirus is listed as a target pathogen.
Follow the Label
When using an EPA-registered disinfectant, follow the label directions for safe, effective use. Make sure to follow the contact time, which is the amount of time the surface should be visibly wet, listed in the table below. Read our infographic on how to use these products: https://www.epa.gov/pesticide-registration/six-steps-safe-effective-disinfectant-use
These products are for use on surfaces, NOT humans.
Additional Resources
Still have questions? See our FAQs about this list.
Read our Guidance for Cleaning and Disinfecting Public Spaces.
Use EPA’s COVID-19 hub to find other resources.


Note: Inclusion on this list does not constitute an endorsement by EPA. Additional disinfectants may meet the criteria for use against SARS-CoV-2. EPA will update this list with additional products as needed.

Disinfect Child Care Surfaces with a Bleach and Water Solution: Preventing the spread of germs is a challenge in child care programs. A solution of household bleach and water is an inexpensive and easy way to disinfect surfaces and sanitize objects in child care programs. But child care providers need to be careful to use bleach correctly to ensure that children are safe and surfaces are properly disinfected or sanitized. 

New Bleach Concentrations Mean New Use Recommendations
In early 2013, manufacturers of household bleach changed the concentration of bleach sold in stores. The bleach solutions now sold have a higher concentration of sodium hypochlorite (8.25%). The lower-concentration bleaches are no longer being manufactured and soon will not be available in stores. Because the new bleaches are more concentrated, the recommendations for diluting a bleach solution for disinfecting now depend on the specific bleach that is used. Here are the latest recommendations for bleach use in child care: 
Use bleach products that have been registered with the EPA whenever possible. Check the product label for an EPA registration number. If the product has a number, it is EPA-registered.
If the bleach product is EPA-registered, go to the EPA’s Pesticide Product Label System website (http://iaspub.epa.gov/apex/pesticides/f?p=PPLS:1) and enter the EPA registration number into the “EPA Registration Number” field of the online form. You should get a list of dates the EPA approved the product.
Click on the link next to the most recent EPA approval date. This link will open a PDF file of the manufacturer’s instructions. Scroll down to find a chart with instructions for using the product to sanitize or disinfect.
Follow the instructions on the chart when preparing bleach solution for use in child care. You may want to post these instructions near sinks and cleaning areas or tape the instructions to the bottle.
If you buy a new brand of bleach, remember to check the new brand using these instructions. The specific recommendations for diluting bleach may be different. Be sure to update any instructions or labels that are posted.
Do NOT mix household bleach with other household chemicals such as toilet cleaners, rust removers, acids, or products containing ammonia. Mixing these chemicals with bleach may produce toxic hazardous gases.


Using Bleaches without EPA Numbers
Child care programs that are using bleaches without an EPA number on the label should contact the state or local health department for information on how to safely use that particular bleach for disinfecting in a child care program.


Sanitizing versus Disinfecting
Bleach manufacturers include two kinds of instructions for bleach use: sanitizing and disinfecting. Although these terms are sometimes used interchangeably, they mean different things. Before you mix up a bleach solution, be sure you are using the correct instructions. Sanitizing solutions use less bleach than disinfecting solutions. The manufacturer’s instructions will tell you the appropriate amount to use.
Sanitizing reduces germs to levels considered safe, but does not eliminate them. Sanitizing is safe for food contact surfaces (such as silverware and high chair trays) and for toys and pacifiers that children may place in their mouths.
Disinfecting eliminates or inactivates germs. Disinfecting requires a stronger concentration of bleach to kill the germs. Surfaces that should be disinfected include diaper changing tables, potty chairs, toilets, countertops, sinks, floors, drinking fountains, cabinet handles, and doorknobs.

 
Using Bleach-Water Safely in Child Care
Bleach-water solution is poisonous and can be dangerous to children. Keep children safe from accidental poisoning with these simple tips:


1.Clean objects and surfaces when children are not around, or place them out of children’s reach while they dry.
2. Do not allow children to handle bleach-water solution.
3. Keep children away from disinfected surfaces until the bleach-water solution dries.
4. Store bleach and other toxic chemicals in their original containers in a locked cabinet or closet.
5. Store bleach-water solution in a locked cabinet out of children’s reach.

Be sure to label spray bottles so adults will know what’s in them.

For More Information


Health and Safety in Child Care
Cleaning, Sanitizing, and Disinfecting in Child Care

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