Guidance for child care administrators: What to do when you have a suspected/confirmed case of COVID-19 in your facility

Make sure that children or staff with suspected or confirmed¹ COVID-19 stay home:

• Students and staff with COVID-19 symptoms should stay home and away from others. Learn more about COVID-19 symptoms.
• Examples of COVID-19 symptoms: cough, shortness of breath or difficulty breathing, fever (100.4° F or higher), chills, muscle pain, sore throat, new loss of taste or smell, or other signs of new illness that are not related to a preexisting condition (such as seasonal allergies).
  
  
• People who are sick should stay home and away from others until:
  • at least 10 days have passed since their symptoms first appeared
    AND
  • they have had no fever for at least 72 hours (three full days without the use of medicine that reduces fever)
    AND
  • other symptoms have improved (for example, symptoms of cough or shortness of breath have improved)

¹ * A "suspected case" = a person who shows symptoms of COVID-19 but has not yet been tested or is waiting for test results. A "confirmed case" = a person (with or without symptoms) who received a positive result from a COVID-19 laboratory test.

• Inform all staff and families in your child care community who had close contact with the individual while that person was sick. Provide a copy of the COVID-19 Fact Sheet for Families.
  
  Close contact includes being within 6 feet of a suspected or confirmed case for about 10 minutes. Close contact also happens if someone with COVID-19 coughs on you, kisses you, shares utensils with you, or you have contact with their body fluids.

• Ask staff and children to stay home and watch for symptoms for 14 days if they had close contact with the person while they were showing symptoms, or in the 48 hours before symptoms began.

• Families working in essential services (such as health care workers and first responders) who are able to keep their child at home and out of child care during this 14-day period without affecting these vital services should do so. However:
  • Public Health – Seattle & King County encourages child cares to consider staying open to families that work in essential services (e.g. healthcare) who do not have this option, as long as the child remains well.
  • Child care providers may continue to work during the 14-day period if they:
    • do not have symptoms AND
    • wear a cloth face covering at all times while working in the child care facility
  • Advise families to not send their children to other child care facilities while recovering from illness or watching for symptoms
    
  • Advise staff to not work at other child care facilities while recovering from illness or watching for symptoms (see flowchart below).

Download the decision-tree flowchart for next steps for when a child care facility remains open.

YES! Please notify Public Health even if you have a single, mild case and, especially if:

• You see a group of children or staff (i.e. a cluster) with suspected or confirmed COVID-19 infection in your childcare, OR
• Staff, children, or volunteers become severely sick with suspected or confirmed COVID-19 infections or undiagnosed respiratory illness (requiring hospitalization or causing death).

To notify Public Health, call the King County Novel Coronavirus Call Center: 206-477-3977. Interpretation is available. Please identify yourself as a childcare provider.

• Notify families and staff in your child care community who had close contact with the case while the case was sick. See COVID-19 Fact Sheet for Families.
  • Advise people who had close contact and have symptoms to stay at home and away from others and to tell their doctor.
  • Advise people who had close contact with the sick individual and do not have symptoms to stay at home for 14 days from their last contact with that person and to look for possible symptoms.
    
    
• Discourage gatherings.
• Cancel extracurricular group activities.
  
  
• Clean and disinfect your facility
• Refer to the CDC's Environmental Cleaning and Disinfection Recommendations for U.S. Community Facilities with Suspected/Confirmed Coronavirus Disease 2019.
  
  
• Maintain communication with staff and families.
• Make sure staff and families understand that sick people should remain home until well (see section above: "Make sure that children or staff with suspected or confirmed COVID-19 stay home")
• Include messages to address potential stigma and discrimination.
• Maintain confidentiality of children, students and staff members as required by the Americans with Disabilities Act (ADA) and the Family Education Rights and Privacy Act (FERPA).
  
  
• Continue to provide meal programs, when possible.
• Consider ways to distribute food to students.
• Do not distribute meals where people might gather in a group or crowd. Consider options such as “grab-and-go” bagged lunches or meal delivery. Find additional meal resources in King County.
  
  
• Consider alternatives for providing essential medical and social services for students.

• Continuously communicate. Advise all parents, children, staff, and volunteers about steps everyone can take to protect themselves and prevent further spread. These include: staying home and away from the facility while sick, reducing non-essential activities in the community, frequent handwashing for 20 seconds, and avoiding sick people.
  
  
• Refer to the Checklists for Child Care Administrators: Steps to Prevent COVID-19
• See section, "Education and Preparation"
  
  • Review CDC guidelines, "Screen children upon arrival." Decide which type of arrival health screening your child care program will implement.
    
  • Plan to maintain the same group of children and staff from day to day. Use a separate classroom or group for the children of health care workers, first responders, and other essential workers, if possible.
    
  • Print Illness Logs to help monitor absences or children who develop symptoms while in care.
    
    
• When feasible, ask staff members and older children to wear cloth face coverings within the facility. Cloth face coverings should NOT be put on babies and children under age two. See section, "Prevention"
  • A child or staff member should isolate at home if they have: cough, shortness of breath or difficulty breathing, fever (100.4F or higher), chills, muscle pain, sore throat, new loss of taste or smell or other signs of new illness unrelated to a preexisting condition. Learn more about COVID-19 symptoms.
  • All staff and children should follow the Keep Me Home If WAC illness guidelines.
  • Ask parents/guardians to take their child’s temperature before coming to child care. 
    
    
• Throughout the day:
  • Visually inspect children for signs of illness. These could include flushed cheeks, rapid breathing or difficulty breathing (without recent physical activity), fatigue, or extreme fussiness.
  • Perform routine environmental cleaning. Frequently clean, rinse, and sanitize or disinfect commonly touched surfaces (for example, doorknobs, light switches, countertops, and toys). Use the 3-step method.