Heritage Green Child Care Inc is a multi-site organization. The sites include Childcare, school age, and an EarlyON. The health and safety protocols may not apply to each site. These protocols will be updated as needed to reflect the directives of the provincial government, the Ministry of Education, and Public Health.
Heritage Green Child Care Inc
Pandemic Policy: Infectious disease
Responsibilities
Supervisor/Manager (or their designate):
- Review and communicate the current program to staff
- Develop and implement standards and procedures
- Implement a review of this policy as often as necessary to ensure policy is protecting all staff and children.
- Respond to recommendations from Public Health
- Provide ongoing training to Supervisors and Staff
- Communicate risk assessment results to the Board of Directors and the Health and Safety Representative
Supervisors:
- Understand their responsibilities under OHSA to take every precaution reasonable for the protection of persons within our workplace.
- Enforce the policies and procedures defined within this policy
- Train and educate persons with in our facility about the risk of infection and the controls to minimize possible infection of disease.
Staff:
- Understand your rights under OHSA
- Participate in training as directed by Public Health
- Wear the Personal Protective Equipment as directed by your supervisor and this policy/ procedure.
- Report any known violation of this policy or procedure
- Report to your supervisor if you feel or suspect that you may be infected or not feeling well
Health and Safety Representative:
- Be consulted in the development of programs and assessments, and review them for improvements
- Make recommendations where required
- Engage Staff in identifying hazards
Definitions/ Acronyms:
- COVID -19 – Is a disease caused by the 2019 Novel Coronavirus
- MOH -Medical Officer of Health
- PPE -Personal Protective Equipment
- Persons – includes workers, children & their families, support staff, contractors
- JHA -Job Hazard Analysis
Safe Work Procedure for working during COVID 19
The following safe work procedures will define how Heritage Green Child Care Inc. will manage the hazards of contacting COVID 19.
COVID 19
Coronaviruses are spread mainly from person to person through close contact, for example, in a household, workplace or daycare centre. There is no vaccine available to protect against the novel coronavirus
The 2019 novel coronavirus is spread through respiratory droplets:
-
- from person to person through coughing, sneezing, close contact; and
- touching contaminated surfaces.
Symptoms
Symptoms range from mild – like the common cold and other common respiratory infections – to severe, and can include: fever, cough, and difficulty breathing, muscle aches, fatigue, headache, sore throat, and runny nose. Also, difficulty swallowing, new olfactory or taste disorder.
Complications from the novel coronavirus can include serious conditions, like pneumonia or kidney failure, and in some cases, death.
Symptoms for children could include;
o Sore throat, hoarse voice
o Diarrhea
o Look to see if exhibiting a runny nose
Atypical Symptoms/ signs of COVID-19 should be considered, particularly in children, older persons, and people living with a developmental disability.
Atypical symptoms can include:
o Unexplained fatigue/ malaise
o Delirium (acutely altered mental status and inattention)
o Unexplained or increased number of falls
o Acute functional decline
o Exacerbation of chronic conditions
o Chills, Headache
o Croup, Conjunctivitis
o Atypical signs can include:
o Unexplained tachycardia, including age specific tachycardia for children
o Decreased in blood pressure
o Unexplained hypoxia (even if mild i.e. O2 sat>90%)
o Lethargy, difficulty feeding in infants (if no other diagnosis)
Parent Drop Off and Pick Up Procedures
Entry into the child care centre/classrooms, past the screening area, must be limited only to staff, children, and essential visitors.
- All individuals, including children, and staff must be actively screened and must answer all screening questions.
- Temperature checks must be conducted as part of the screening process.
Child Care
A greeting area will be set up in between the main entry doors of the child care site.
Parents/caregivers are to park along the side of the child care site, and bring their child up to the door, one family at a time. All other families waiting in line must remain in their cars and wait for their turn to drop off their child. The parent/caregiver is to wear a mask when bringing their child to the door. The screener will take the child’s temperature upon arrival and before entry into the child care building, and ask the screening questions.
School Age Programs
In the before and after school programs, families will text the program upon arrival to notify staff that their child has arrived at the program. The parent/caregiver will then walk their child to the door and wait for a staff member to greet the child. The parent/caregiver is to wear a mask when bringing their child to the door. A staff member will greet the child at the designated door and supervise to ensure that the child goes to their classroom. All children will be actively screened and temperatures will be taken. Individuals who have been screened for symptoms prior to the before school program would not need to be re-screened for the core day program. Similarly, an individual that has been screened prior to the after-school program would not need to be re-screened for the after-school program. The school age programs will work closely with the schools to maintain effective communication in regards to children who fail screening or are sent home during the school day.
Signage at each site will be used to inform parents/caregivers of where to drop off and pick up the children.
Alcohol based hand rub containing at least 70% alcohol content will be provided at the entrance to the facility. Any adult entering beyond the door must perform hand hygiene upon entering. Cohort staff (public health and the government direction: a cohort is defined as a group of children and staff) will assist child with hand hygiene upon entering the classrooms.
Pick Up Procedures
Child Care
Parents/caregivers at the child care site will pull up to the doors of the program and text the staff that they have arrived. The parent will wait outside at their vehicle and a staff will bring their child outside to them. Parents/caregivers will wear a mask when the staff brings the child out to them.
School Age Programs
Parents/caregivers at the school age program will park at the parking lot of the school. They will text the program that they have arrived and wait for their child at the doors of the school. The parent will remain outside of the school at all times and maintain social distancing from any other person waiting to pick up. A staff will bring the child to the doors. Parents/caregivers will wear a mask when waiting for their child.
Health Screening Procedure for Essential Visitors
Upon arrival of an essential visitor to the child care or school age program, a staff member will actively screen the visitor. Once the essential visitor has passed the screening, a staff member will gather information including the visitor’s name, email, phone number and arrival/departure time. Phone numbers and contact information for the essential visitor will be kept on file at each site for one year. No volunteers will be allowed at this time. Ministry and Public Health officials must be screened prior to entry and must wear PPE, and follow all protocols.
An individual who fails the screening process will be advised to contact their health care provider and book a COVID-19 test by visiting www.hamiltoncovidtest.ca. If unable to access the online booking site, individuals can call Public Health’s COVID-19 line at (905) 974-9848 option 2 to book a testing appointment.
Attendance Records and Contact Tracing
Should contact tracing be required, weekly/monthly attendance sheets, daily staff screening chart which includes staff’s shifts for each day, as well as the visitor log, will be kept in a log book at each site for a period of one year. The supervisor of the child care site, and at each of the school age sites, will be responsible for overseeing the log book. Records must include name, contact information, and time of arrival/departure for each child, staff and visitor who enters the program. These records will be kept up to date and available to facilitate contact tracing in the event of a confirmed COVID-19 case or outbreak.
Health Screening Procedure
This tool provides basic information only and contains recommendations for children to support decision making by parents about whether their child should attend school/childcare and/or needs to be tested for COVID-19. This can be used to assess symptoms of any child who attends child care or school. It is not to be used as a clinical assessment tool or intended to take the place of medical advice, diagnosis or treatment. Pre-screening by parents/staff must take place daily prior to arrival at the child care centre or the before and after school program using the online provincial tool found at https://covid-19.ontario.ca/school-screening/. However, each child will be actively screened upon arrival to the program.
When assessing for the symptoms below, you should focus on evaluating if they are new, worsening, or different from your child’s baseline health status or usual state (check off “Yes”). Symptoms associated with known chronic health conditions or related to other known causes/conditions should not be considered unless new, different or worsening.
After developing symptoms, in general, children should no longer have a fever and their symptoms improving to be able to return to school/child care. Mild symptoms known to persist in young children (e.g. runny nose or mild cough that may persist following infections) may be ongoing at time of return to school/child care if other symptoms have resolved.
Screening Questions for Children
1. Does your child have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.
Fever and/or chills
(Temperature of 37.8°C/100.0°F or greater)
Yes
No
Cough (more than usual if chronic cough) including croup (barking cough, making a whistling noise when breathing)
Not related to other known causes or conditions (e.g., asthma, reactive airway)
Yes
No
Shortness of breath (dyspnea, out of breath, unable to breathe deeply, wheeze, that is worse than usual if chronically short of breath) Not related to other known causes or conditions (e.g., asthma)
Yes
No
Decrease or loss of smell or taste (new olfactory or taste disorder)
Not related to other known causes or conditions (e.g., nasal polyps, allergies, neurological disorders)
Yes
No
2. Does your child have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.
Sore throat (painful swallowing or difficulty swallowing)
Not related to other known causes or conditions (e.g., post nasal drip, gastroesophageal reflux)
Yes
No
Stuffy nose and/or runny nose (nasal congestion and/or rhinorrhea)
Not related to other known causes or conditions (e.g., seasonal allergies, returning inside from the cold, chronic sinusitis unchanged from baseline, reactive airways)
Yes
No
Headache that is new and persistent, unusual, unexplained, or long-lasting
Not related to other known causes or conditions (e.g., tension-type headaches, chronic migraines)
Yes
No
Nausea, vomiting and/or diarrhea
Not related to other known causes or conditions (e.g. transient vomiting due to anxiety in children, chronic vestibular dysfunction, irritable bowel syndrome, inflammatory bowel disease, side effect of medication)
Yes
No
Fatigue, lethargy, muscle aches or malaise (general feeling of being unwell, lack of energy, extreme tiredness, poor feeding in infants) that is unusual or unexplained
Not related to other known causes or conditions (e.g., depression, insomnia, thyroid dysfunction, anemia)
No
Yes
No
3. Has your child travelled outside of Canada in the past 14 days?
Yes
No
4. Has your child been identified as a close contact of someone who is confirmed as having COVID-19 by your local public health unit?
Yes
No
5. Has your child been directed by a health care provider including public health official to isolate?
Yes
No
Results of Screening Questions:
If you answered “YES” to any of the symptoms included under question 1:
•Your child should stay home to isolate immediately.
•Contact your child’s health care provider for further advice or assessment, including if your child needs a COVID-19 test or other treatment.
If you answered “YES” to only one of the symptoms included under question 2:
•Your child should stay home for 24 hours from when the symptom started.
•If the symptom is improving, your child may return to school/child care when they feel well enough to do so. A negative COVID-19 test is not required to return.
•If the symptom persists or worsens, contact your child’s health care provider for further advice or assessment, including if your child needs a COVID-19 test or other treatment.
If you answered “YES” to two or more of the symptoms included under question 2:
•Your child should stay home to isolate immediately.
•Contact your child’s health care provider for further advice or assessment, including if your child needs a COVID-19 test or other treatment.
If the individual answers “YES” to question 3, 4 or 5
•Your child should stay home to isolate immediately and follow the advice of public health.
•If your child develops symptoms, you should contact your local public health unit or the health care provider for further advice.
Public Health at 905-974-9848, option 2 for testing.
Screening Questions for Staff
Are you currently experiencing any of these symptoms?
Choose any/all that are new, worsening, and not related to other known causes or medical conditions.
Fever and/or chills. (Temperature of 37.8oC or 100oF or higher)
Cough or Barking Cough (croup). Continuous, more than usual, making a whistling noise when breathing, not related to other known causes or conditions (asthma, post-infectious reactive airways)
Shortness of breath. Out of breath, unable to breathe deeply, not related to other known causes or conditions (asthma)
Sore throat. Not related to other known causes or conditions (seasonal allergies, acid reflux)
Difficulty swallowing. Painful swallowing, not related to other known causes or conditions.
Runny or stuffy/congested nose. Not related to other known causes or conditions (reoccurring styes)
Headache that’s unusual or long lasting. Not related to other known causes or conditions (tension-type headaches, chronic migraines)
Digestive issues like nausea/vomiting, diarrhea, stomach pain. Not related to other known causes or conditions (irritable bowel syndrome, anxiety in children, menstrual cramps)
Muscle aches that are unusual or long lasting. Not related to other known causes or conditions (sudden injury, fibromyalgia)
Extreme tiredness that is unusual. Fatigue, lack of energy, not related to other known causes or conditions (depression, insomnia, thyroid dysfunction)
Falling down often. For older people
None of the above
Have you travelled outside of Canada in the last 14 days?
In the last 14 days, has a public health until identified you as a “close contact” of someone who currently has COVID-19?
Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying home)?
In the last 14 days, have you received a COVID Alert exposure notification on your cell phone? If you already went for a test and got a negative result, select “No”.
If you answered no to all of the above questions, you can go to work. If you answered yes, please follow next steps listed below.
Next steps:
- Contact the school/child care to let them know about this result.
- You should isolate (stay home) and not leave except to get tested or for a medical emergency.
- Talk with a doctor/health care provider to get advice or an assessment, including if you need a COVID-19 test.
If you think you have a cold or the flue, you should still talk with a doctor or get tested. Symptoms are similar to COVID-19.
Siblings or other people you live with who do not have symptoms do not need to isolate. However, check with your local public health unit’s website or call or see if those without symptoms should go to school/child care.
COVID-19 Outbreak Response
Triggering an outbreak assessment
Once at least one child or staff has presented with new symptoms compatible with COVID-19, the child care centre/school age site should immediately trigger an outbreak assessment and take the following steps:
Exclusion
Individuals who are tested:
- Children/staff who test negative for COVID-19 must be excluded until 24 hours after symptom resolution
- Children/staff who test positive for COVID-19 must be excluded from child care centre/school age site for 10 days after the onset of symptoms and clearance has been received from the local public health unit.
Individuals who are not tested:
- Ill children/staff, if not tested, must be excluded for 14 days from onset of their symptoms
Outbreak Management
An outbreak may be declared by the local public health until when:
- Within a 14-day period, there are two or more laboratory-confirmed COVID-19 cases in children, staff/providers or other visitors with an epidemiological link (e.g., cases in the same room, cases that are part of the same before/after school care cohort) where at least one case could have reasonable acquired their infection in the child care setting.
If the local public health unit declares an outbreak, they will determine what happens next. This could include closing particular child care rooms or cohorts or an entire child care setting. The public health unit will help determine which groups of children and/staff need to be sent home or if a partial or full closure of the child care setting is required.
Communication Plan and Required Steps in an Outbreak
If a positive COVID-19 case, or an outbreak is declared at the child care centre/school age site, the following measures must be taken:
- Consult with and follow directions from Public Health.
- Notify all family, staff, essential visitors, school boards of the facility’s outbreak status by an email and/or phone call to each family.
- Enhance cleaning and disinfecting procedures
- Enhanced screening procedures (i.e. increased frequency of health checks)
- More frequent hand hygiene with children and staff.
- Review staff training on proper PPE use.
Management of cases in multiple cohorts
If there are additional positive cases in other cohorts, the facility will close. In consultation with Public Health, all staff and children in the child care centre/school age site may be referred for testing.
Declaring an Outbreak Over
In consultation with Public Health, the outbreak can be declared over if no new cases have occurred in 14 days from the last day of attendance of the most recent COVID-19 positive staff/child.
Physical Distancing
Every effort will be taken to encourage physical distancing between children by spreading children out into different areas, staggering lunch and snack times and play times outside.
We will avoid taking the children to community play grounds. Outdoor play at our own play area outside is encouraged in small groups. All equipment will be disinfected as needed.
We will stagger meal and snack times to allow for safe physical distancing.
When setting cots up for nap time, they will be set up in such a way to keep the children 2m apart or set up so that they are head to toe. Cots should be disinfected after each use. (Childcare only)
If we need to have conversations with parents, we will try and have these using live streaming programs like Zoom to have that discussion rather than a face to face meeting. Preplanned in-person meetings and preplanned group events will be cancelled or rescheduled to a later time.
Our center will provide tissues and dispose of used tissues in plastic-lined receptacles.
Staff will be required to regularly wash their hands for at least 20 seconds with soap and warm water at:
- At the start of their shifts
- Before preparing or serving food, cleaning up after meals and snack times
- After touching shared items and after using the washroom,
- Before and after changing an child’s diaper,
- Helping others with toileting and after handling garbage,
- Before leaving your workspace.
Personal Protective Equipment
Deciding to use PPE is based on your risk assessment of the situation.
PPE should not be worn when it is not needed but ensure everyone knows how to use and maintain the PPE that you are required to wear.
Social distancing at 2 metres and proper hand hygiene will be the most important way to protect yourself from the COVID-19 virus
Improper use of PPE can create a false sense of confidence, increase chances of infection and waste supply
Proper use of PPE is an effective part of infection prevention and control, however it is not a stand-alone method
Proper hand hygiene must be exercised before donning and after doffing PPE including gloves, face masks and eye protection.
The following PPE is available at all ECC sites and may be used is there is an identified risk of exposure to the COVID-19 virus:
Gloves, Masks and Eye Protection
Gloves may be worn when hands come into contact with a child exhibiting respiratory symptoms or objects that may be contaminated. Gloves are disposable and single use, and must be disposed of after the task is completed. Gloves protect you against contact with infectious materials. However, once contaminated, gloves can become a means for spreading infectious materials to yourself, other patients or environmental surfaces. Therefore, the way YOU use gloves can influence the risk of disease transmission. These are the most important do’s and don’ts of glove use.
Work from clean to dirty. This is a basic principle of infection control. In this instance it refers to touching clean body sites or surfaces before you touch dirty or heavily contaminated areas.
Limit opportunities for “touch contamination” – protect yourself, others and environmental surfaces. How many times have you seen someone adjust their glasses, rub their nose or touch their face with gloves that have been in contact with another person or surface? This is one example of “touch contamination” that can potentially expose oneself to infectious agents. Think about environmental surfaces too and avoid unnecessarily touching them with contaminated gloves. Surfaces such as light switches, door and cabinet knobs can become contaminated if touched by soiled gloves
Change gloves as needed. If gloves become torn or heavily soiled and additional tasks must be performed, then change the gloves before starting the next task. Always change gloves after use, and discard them in the nearest appropriate receptacle. Gloves should never be washed and used again. Washing gloves does not necessarily make them safe for reuse; it may not be possible to eliminate all microorganisms and washing can make the gloves weak.
A face mask must be worn by an individual with respiratory symptoms. If the individual is unable or unwilling to wear a face mask, the person providing care must wear a face mask if a physical distance of 2 metres cannot be maintained.
A combination of PPE types is available to protect all or parts of the face from contact with potentially infectious material. The selection of facial PPE is determined by the isolation precautions required or the nature of contact.
Masks should fully cover the nose and mouth and prevent fluid penetration.
Masks should fit snuggly over the nose and mouth. For this reason, masks that have a flexible nose piece and can be secured to the head with string ties or elastic are preferable.
Goggles/Face Shields provide barrier protection for the eyes; personal prescription lenses do not provide optimal eye protection and should not be used as a substitute for goggles. Goggles should fit snuggly over and around the eyes or personal prescription lenses. Goggles with antifog features will help maintain clarity of vision.
Eye protection and Face shields are reusable and must be washed and disinfected between each use.
There are four key points to remember about PPE use.
First, don it before you have any contact with another person, generally before entering the room. Once you have PPE on, use it carefully to prevent spreading contamination. When you have completed your tasks, remove the PPE carefully and discard it in the receptacles provided. Then immediately perform hand hygiene.
The gown should be donned first (if wearing one) The mask should be put on next and properly adjusted to fit. The goggles or face shield should be donned next and the gloves are donned last. Keep in mind, the combination of PPE used, and therefore the sequence for donning, will be determined by the precautions that need to be taken.
To don a gown, first select the appropriate type for the task and the right size for you. The opening of the gown should be in the back; secure the gown at the neck and waist. If the gown is too small to fully cover your torso, use two gowns. Put on the first gown with the opening in front and the second gown over the first with the opening in the back.
Some masks are fastened with ties, others with elastic. If the mask has ties, place the mask over your mouth, nose and chin. Fit the flexible nose piece to the form of your nose bridge; tie the upper set at the back of your head and the lower set at the base of your neck. If a mask has elastic head bands, separate the two bands, hold the mask in one hand and the bands in the other. Place and hold the mask over your nose, mouth, and chin, then stretch the bands over your head and secure them comfortably as shown; one band on the upper back of your head, the other below the ears at the base of the neck. Adjust the mask to fit. Remember, you don’t want to be touching it during use so take the few seconds needed to make sure it is secure on your head and fits snuggly around your face so there are no gaps.
If eye protection is needed, either goggles or a face shield should be worn. Position either device over the face and/or eyes and secure to head using the attached ear pieces or head band. Adjust to fit comfortably. Goggles should feel snug but not tight.
The last item of PPE to be donned is a pair of gloves. Be sure to select the type of glove needed for the task in the size that best fits you. Insert each hand into the appropriate glove and adjust as needed for comfort and dexterity. If you are wearing a gown, tuck the gown cuffs securely under each glove. This provides a continuous barrier protection for your skin.
In addition to wearing PPE, you should also use safe work practices. Avoid contaminating yourself by keeping your hands away from your face and not touching or adjusting PPE. Also, remove your gloves if they become torn and perform hand hygiene before putting on a new pair of gloves. You should also avoid spreading contamination by limiting surfaces and items touched with contaminated gloves.
To remove PPE safely, you must first be able to identify what sites are considered “clean” and what are “contaminated.” In general, the outside front and sleeves of the isolation gown and outside front of the goggles, mask, and face shield are considered “contaminated,” regardless of whether there is visible soil. Also, the outside of the gloves are contaminated. The areas that are considered “clean” are the parts that will be touched when removing PPE. These include inside the gloves; inside and back of the gown, including the ties; and the ties, elastic, or ear pieces of the mask, goggles and face shield.
The sequence for removing PPE is intended to limit opportunities for self contamination. The gloves are considered the most contaminated pieces of PPE and are therefore removed first. The face shield or goggles are next because they are more cumbersome and would interfere with removal of other PPE. The gown is third in the sequence, followed by the mask.
Removing gloves: Using one gloved hand, grasp the outside of the opposite glove near the wrist. Pull and peel the glove away from the hand. The glove should now be turned inside-out, with the contaminated side now on the inside. Hold the removed glove in the opposite gloved hand.
Slide one or two fingers of the ungloved hand under the wrist of the remaining glove. Peel glove off from the inside, creating a bag for both gloves. Discard in waste container
Removing face shield: Using ungloved hands, grasp the “clean” ear or head pieces and lift away from face. If goggle or face shield are reusable, place them in a designated receptacle for subsequent reprocessing. Otherwise, discard them in the waste receptacle.
The front of the mask is considered contaminated and should not be touched. Remove by handling only the ties or elastic bands starting with the bottom then top tie or band. Lift the mask away from the face and discard it into the designated waste receptacle.
Removing gown: Unfasten the gown ties with the ungloved hands. Slip hands underneath the gown at the neck and shoulder, peel away from the shoulders. Slip the fingers of one hand under the cuff of the opposite arm. Pull the hand into the sleeve, grasping the gown from inside. Reach across and push the sleeve off the opposite arm. Fold the gown towards the inside and fold or roll into a bundle. (Only the “clean” part of the gown should be visible.) Discard into waste or linen container, as appropriate.
After removing PPE: Hand hygiene is the cornerstone of preventing infection transmission. You should perform hand hygiene immediately after removing PPE. If your hands become visibly contaminated during PPE removal, wash hands before continuing to remove PPE. Wash your hands thoroughly with soap and warm water or, if hands are not visibly contaminated, use an alcohol-based hand rub.
Modifications to this Policy
Version 6 – last updated January 20th, 2021