COVID-19 Policy for Childcare Centers, Preschools and School Age Programs

Updated 8/6/2020
Download: Guidance for Childcare Centers - PDF

Johnson County Department of Health and Environment’s (JCDHE) childcare requirements reflect the current understanding of COVID-19 transmission in children. As new evidence emerges, guidance may change.

There are some changes from previous guidance due to new evidence-based information. As with your current disease policy, you can make your policy more restrictive, however, you must implement the policy equally with all children.

Screening

Screen children and staff daily before admittance for signs and symptoms of illness. Screening includes asking questions, observing for signs of illness, and checking for fever. Many facilities are doing after nap temperatures as well.

• Has there been travel within the last 14 days in a state or country identified as a hot spot for COVID-19? coronavirus.kdheks.gov/175/Travel-Exposure-Related-Isolation-Quaran
• Has there been an exposure to someone diagnosed with COVID-19, either household or non-household contact?
• Is anyone in the home showing signs of illness or who have the following:
  • fever greater than 100.4 degrees (F) (need to be aware of person’s “normal” temperature as some people run lower “normal” and therefore a fever for them could be below 100.4 degrees).
  • cough
  • shortness of breath/difficulty breathing
  • sudden loss of smell or taste
  • other signs of illness (headache, sore throat, general aches/pains, fatigue/weakness/extreme exhaustion) 
• Check the child’s/staff’s temperature

Mask usage

Daycare Center and SAP Staff JCDHE requires that childcare center staff always wear masks, including in classrooms and on playgrounds (unless 6 feet away from children and other staff while outside). In order to ensure that staff are wearing masks properly (covering nose and mouth), JCDHE recommends that accountability measures be put in place including having program directors checking on mask wearing compliance periodically throughout the day and empowering employees to respectfully remind each other when masks are not being worn appropriately.

In times when masks cannot be worn, staff members should be physically distanced (6 feet or more) from other individuals. During the COVID-19 outbreak it is not recommended that staff eat lunch with their students due to the added risk of exposure. Staff should be 6 feet away from children when eating. Snug fitting masks with the see-through face area are acceptable. Currently, JCDHE is not approving face shields alone.

If staff are outside with the children and are 6 feet or greater from anyone else, they may remove their mask for a break. As soon as any child or other staff person approaches, they must replace the mask. Supervision must be maintained at all times. Staff may remove masks when they are 6 feet or more from other individuals, including in the break room, bathroom, or outside on break. Individuals in private offices/rooms may remove their mask but must replace it as soon as anyone enters.

Children

Existing evidence points to young children being less likely to transmit COVID-19 to other individuals as well as being less likely to develop severe symptoms from this disease. For this reason, JCDHE does not require non-school aged children to wear masks in childcare classrooms, but children over the age of two should be encouraged to wear masks in common spaces, such as entering the building, walking in the hallways, and using the restroom. Children in kindergarten and higher must wear a mask while in attendance.

The masks need to be removed for nap time and, of course, meals. The facility must also plan for what to do with the masks at mealtime to keep them from becoming soiled or contaminated, as well as a plan for changing out wet or otherwise contaminated children’s masks.

Symptomatic Individuals in a Childcare Setting

Staff

JCDHE recommends all licensed childcare facilities follow the below guidance for exclusion criteria and management of COVID positive staff. In summary, staff should be excluded for 10 days after their symptoms began and 24 hours after their fever (if present) has been reduced without the aid of medication and their initial symptoms have improved if they have at least one of the primary symptoms or two of the secondary symptoms. Staff who meet these criteria should be encouraged to seek testing for COVID-19. If the staff member tests negative for COVID-19, they may return to work 24 hours after their symptoms resolve.

Primary symptoms (at least one)

• Cough
• Fever (measured or subjective)
• Shortness of breath
• Difficulty breathing
• Loss of taste and/or smell

Secondary symptoms (at least two)

• Chills
• Muscle or body aches
• Headache
• Sore throat
• Diarrhea/nausea/vomiting
• Congestion/ runny nose
• Extreme fatigue

Children

Due to children having fevers for a variety of reasons (e.g., teething), fever has been moved to the secondary symptoms. COVID-19 testing for young children in Johnson County is limited, and generally reserved for those with severe illness. For this reason, a child who develops at least one primary symptom, or two or more secondary symptoms, is presumed to have COVID-19 and should be excluded from childcare for 10 days after their symptoms began and 24 hours after their fever (if present) has resolved without the aid of medication and their initial symptoms have improved. If the child is tested for COVID-19, and tests negative, they can return to childcare 24 hours after their symptoms resolve. If a physician indicates the symptoms are due to a different diagnosis (e.g., allergies, asthma), a child can be re-admitted to childcare prior to their symptoms resolving. If a child has only one secondary symptom, JCDHE recommends they be excluded until at least 24 hours after the resolution of symptoms.

Primary symptoms (at least one)

• Cough
• Shortness of breath
• Difficulty breathing
• Loss of taste and/or smell

Secondary symptoms (at least two)

• Fever
• Chills
• Muscle or body aches
• Headache
• Sore throat
• Diarrhea/nausea/vomiting
• Congestion/runny nose
• Extreme fatigue

Management of a COVID-19 Positive Individual

Exclusion of Positive cases All individuals who test positive must be excluded from childcare settings until they are no longer infectious. An individual is considered infectious (capable of spreading the virus) three days before their symptoms began until 10 days after their symptom onset and 24 hours after their fever (if present) has resolved without the aid of medication and their initial symptoms have improved. If a child is sent home with symptoms but the test comes back positive a few days later, the 10 days is still based off the start of symptoms. If the individual is asymptomatic (not showing any symptoms), then the infectious period is three days before the date their lab test was collected until 10 days after their lab test. Please notify JCDHE’s Childcare Licensing Division – Eldonna Chesnut ([email protected]) at 913-477-8366 if you received notification of a positive case in your childcare facility.

Exclusion of contacts

Contacts of a COVID-19 Positive Staff If staff have been wearing masks appropriately in the facility, JCDHE is not recommending any exclusions of staff or students. If the COVID-19 positive staff member was in close contact with other staff without masks and physical distancing of 6 feet or more (e.g., lunch, socializing outside of work), it is recommended that they (contacts of the positive person) be excluded for 14 days.

Contacts of a COVID-19 Positive Child Based on current evidence, young children do not appear to efficiently spread COVID-19 to others. For this reason, JCDHE is not recommending any exclusions of contacts of a COVID-19 positive child, regardless of mask usage, as long as listed additional precautions are taken. The choices are to:

1. Cohort the classroom (contacts of the positive child)
2. Close the room

Cohorting of the Classroom If one individual (staff or student) tests positive for COVID-19, JCDHE requires the classroom where the positive occurred to be cohorted or excluded. If the classroom is cohorted, they are not to interact with any other children or staff, or visit any indoor common spaces (e.g., gyms, music room, etc.) until 14 days from the last exposure to an infectious case. Exposed children age two and up are required to wear masks in all non-classroom common spaces (e.g., lobby, hallway if other individuals are present, bathroom, etc.) of the childcare setting for 14 days, or be excluded. Exposed staff who remain working are required to wear a mask at all times.

Exclusion of a Classroom Facilities can decide to close the room if they are more comfortable with this option if only one positive case in the classroom. If there are two or more positives in a classroom, JCDHE should be consulted to determine if there is evidence of COVID-19 transmission (two positives within 14 days of one another, without another known exposure). If transmission is identified, the entire classroom may need to be excluded for 14 days from the last exposure to the infectious case.

Notification Following a COVID-19 Positive While JCDHE is not recommending exclusion of children when there is a positive in the classroom, it is recommended that families be notified of the positive and encouraged to monitor their children for signs and symptoms of COVID-19.

Letters are included to assist you in this notification:

• Child in same class tested positive
• Positive in facility - not in same class
• Staff tested positive - child was in classroom