General Considerations

Local health jurisdictions may continue to implement additional requirements that go beyond this statewide guidance based on local circumstances. If there are differing requirements between the most current CDPH, Community Care Licensing (CCL), Cal/OSHA, and local health department guidance or health orders, providers should follow the strictest requirements. Implementation of this guidance should also be adapted for the setting in which care is provided and may require training and support for staff, communicating updated information to families, while considering child and family needs.

In workplaces, employers are subject to the Cal/OSHA COVID-19 Emergency Temporary Standards (ETS) or in some workplaces the Cal/OSHA Aerosol Transmissible Diseases (ATD) (PDF) Standard and should consult those regulations for additional applicable requirements.

Written Safety Plan

Child care providers should continue to minimize the spread of COVID-19. All providers should apply new and updated policies and requirements and should update their written safety plan to ensure implementation. 

It is recommended that providers develop a written communication plan with parents, guardians, and caregivers to share information and guidelines in their preferred language and format (for example, printed vs. email or website). 

Mitigation Strategies

2. Recommended Practices:  

• Teach and reinforce proper handwashing to lower the risk of spreading viruses, including the virus that causes COVID-19. In child care, handwashing with soap and water is preferred over the use of hand sanitizers.
• Ensure adequate supplies are available to support hand hygiene behaviors, including soap, tissues, no-touch trashcans, and hand sanitizers with at least 60 percent alcohol for staff and children who can safely use hand sanitizer. 
• Hand sanitizers should be stored up, away, and out of sight of younger children and should be used only with adult supervision for children ages 5 years and younger.  Hand sanitizer is NOT recommended for children under 24 months.
• Teach and reinforce covering coughs and sneezes to help keep individuals from getting and spreading infectious diseases, including COVID-19.

Cleaning Facilities and Disinfection

Routine cleaning is usually enough to sufficiently remove potential viruses such as COVID-19 that may be on surfaces. However, for general health and infection prevention, child care providers should follow recommended procedures and universal health precautions for cleaning, sanitizing, and disinfection for specific activities such as diapering, feeding, and exposure to bodily fluids. 

1.      Required Actions:  

• Follow the directions on the label of cleaning products to ensure safe and effective use of the products. If disinfectants are used, use asthma-safer products.
• Laundry, such as clothing and bedding, should be washed using the appropriate hot water setting. If handling dirty laundry from a person who is sick, staff should wear gloves and are strongly recommended to wear a mask.  See PIN 20-14-CCLD (PDF) for more information.

• Providers must take action to exclude or isolate any child, parent, caregiver, or staff showing symptoms of a contagious disease or illness as required pursuant to Title 22 CCR sections 101216(h), 101226.1(a)(1), 101226.2, 101426.2, 101526.1, 101626.1, 101626.2, and 102417(e).
• Isolated children must continue to receive adequate care and supervision and the health of the child must be continually observed while in the facility according to licensing requirements.
• California requires employers to provide COVID-19 supplemental paid sick leave for certain workers through December 31, 2022 as stated in AB 152. This includes circumstances in which workers are experiencing symptoms of COVID-19 and seeking a medical diagnosis, attending a vaccine appointment for themselves or for a family member, and/or if a worker's child is isolating due to COVID-19 infection.
  

• Develop standard criteria for managing people who develop symptoms of infectious diseases, including COVID-19. In most situations, any person who develops new, unexplained symptoms should not return until it is clear that symptoms are mild and improving or are due to a non-infectious cause (e.g., allergies). This includes waiting until 24 hours have passed since resolution of fever without the use of fever-reducing medications. 
• If a person's symptoms are concerning for COVID-19, it is strongly recommended that the person wear a mask and get tested immediately. Follow CDPH recommendations for retesting and/or isolating if results are positive.
  

• Child care centers are required to report epidemic outbreaks to CCL through their local Regional Office (PDF) pursuant to Title 22 CCR section 101212(d).
• Family child care homes are required to report a communicable disease outbreak, when determined by the local health authority, to CCL through their local Regional Office (PDF) pursuant to Title 22 CCR section 102416.2(c)(3).
• As workplaces, child care providers are subject to COVID-19 workplace outbreak reporting requirements as specified in AB 685 and Cal/OSHA Emergency Temporary Standards.
• Providers are required to report the death of any child from any cause to CCL by telephone or fax within the next working day and during its normal business hours pursuant to Title 22 CCR section 101212(d)(1)(A) or Health and Safety Code 1597.467. In addition, a written report containing specified information must be submitted to CCL within seven (7) days. The Unusual Incident Report (UIR) (LIC 624 (PDF) may be used for centers or LIC 624B (PDF) may be used for family child care homes).
  

• In covered workplaces, employees who are diagnosed with COVID-19 must follow Cal/OSHA requirements. See COVID-19 Emergency Temporary Standards Frequently Asked Questions for Isolation and Quarantine for more information.
  

• Providers or staff with COVID-19 should follow the recommendations listed in CDPH's Table 1 (Persons Who Test Positive for COVID-19). Employees diagnosed with COVID-19 who qualify to return to work before 10 days should wear a well-fitting mask around others for a total of 10 days.

• Refer to "Individual with Symptoms" above for symptomatic children and providers
• If providers, family members, or children have symptoms, they should isolate from others (not attend care) until symptoms improve and test(s) for COVID-19 are negative.
• If a family child care provider has symptoms or is infected with COVID-19, the provider should close the child care facility during their isolation period, unless they can isolate from child care attendees and other staff and follow CDPH isolation recommendations. Staff who test negative and have no symptoms can provide care for the children while the family child care provider is isolating. If an individual who resides in a family child care home has a diagnosis of COVID-19, the individual should isolate from child care attendees and other staff and  follow CDPH isolation recommendations. Broad disruptions, such as temporary closures for COVID-19, should remain a last resort and considered only under the guidance local health officials after other alternatives have been explored.

• Ensure the responsible parent or guardian of a child receiving services in a child care facility has the right to enter and inspect the facility without advance notice during the normal operating hours of the facility or at any time that the child is receiving services in the facility, as required by Section Health and Safety Code 1596.857.
• Federal and state disability laws require an individualized approach for working with children and youth with disabilities consistent with the child's Individualized Education Plan (IEP), Section 504 plan, or Individualized Family Service Plan (IFSP). Reasonable modifications, when necessary, must be provided to ensure equal access to in-person learning for students with disabilities. . Providers should ensure direct service providers (DSPs), such as paraprofessionals, therapists, early intervention specialists, and mental health and healthcare consultants are provided access to a child in care receiving services.
• Provide access to authorized persons to pick up children, and to essential visitors, including CDSS staff. (See Title 22, CCR sections 101200 and 102391).

2.      Recommended Practices:

• Review and update protocols for visitors and family engagement activities to reduce the risk of infection, including the strongly recommended use of face masks while indoors (unless required by the local public health department) and any other health and safety protocols that have been established. 
• Ensure direct service providers are following currently recommended prevention strategy guidance including vaccination, COVID-19 testing, and contact tracing in combination with isolation/quarantine.
  

Resilience Tips

Many people are facing challenges that can be stressful, overwhelming, and cause strong emotions in adults and children. Below are a few recommendations to help yourself, staff, children, and families manage stress, grief, and anxiety:

• California's playbook on Stress Relief during COVID-19 (PDF) 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.
• Learn more about resources available to support social and emotional learning and mental health resources for youth, including California's Healthy Minds, Thriving Kids Project.
• 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.
• Domestic Violence Prevention assistance contact number and links:
• If you are being abused, call the National Domestic Violence Hotline at 1-800-799-7233 or 1-800-787-3224. 
• If you have been raped or experienced sexual violence, call the National Sexual Assault Hotline at 1-800-656-4673.
• More resources are available from the National Coalition Against Domestic Violence  

Disclaimer

To the extent this guidance includes information about and links to certain relevant requirements outside of California Department of Public Health (CDPH) or California Department of Social Services (CDSS) authority, the information is provided solely for ease of reference and is not intended to impose CDPH or CDSS requirements. 

Originally published on June 29, 2021