YMCAChildCare

COVID-19

OperationalProcedure

Created:June26,2020

Updated:June29,2020

**PleasenotethisisalivingdocumentthatwillbeupdatedasdirectedbylocalPublicHealth,MinistryofEducation,MinistryofLabourandLocalMunicipalities.

*Updatesfrompreviouswillbehighlightedinyellowforeasyreviewandsignoff.

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TableofContents

OVERVIEW.........................................................................................................................................3Introduction.................................................................................................................................................3GuidingProceduresandPrinciples:..............................................................................................................4OpeningChecklist(BeforeChildrenArrive)...................................................................................................4RoleofSupervisororDesignate....................................................................................................................6RoleofStaff.................................................................................................................................................6SchedulingStaffandRequirements..............................................................................................................7COVID-19ParentInformation*ProvidedtoEachParentand/orGuardian....................................................7

PersonalProtectiveEquipment(PPE)…………………………………………………………………………………………………………..8

DAILYOPERATIONS............................................................................................................................9

StaffPersonalBelongings&Routines.........................................................................................................10Cleaning&Disinfecting..............................................................................................................................10Cleaning&DisinfectingBodilyFluids..........................................................................................................11StepstoCleanandDisinfectBodyFluids.....................................................................................................12UseofThermometers.................................................................................................................................12DeliveriesorVisitors..................................................................................................................................12SpecialNeedsResourcingStaff...................................................................................................................13SchoolBoardStaff......................................................................................................................................13HandHygieneandWashing........................................................................................................................13HandSanitizer............................................................................................................................................14CoughandSneezeEtiquette(RespiratoryEtiquette)..................................................................................14DiaperingandToileting..............................................................................................................................15Rest/Sleep..................................................................................................................................................15Medication.................................................................................................................................................15Anaphylaxis................................................................................................................................................15FoodHandling............................................................................................................................................16

MONITORINGHEALTHOFSTAFF,CHILDREN&PARENTS/GUARDIANS.............................................17TrackingSymptomsofIllHealth.................................................................................................................17IsolatinganIllChildand/orStaff................................................................................................................17ManagingaSituationwhenaChildorAdultPresentswithCOVID-19SymptomsORIsPresumedorConfirmedtoHaveCOVID-19.....................................................................................................................18TestingforCOVID-19..................................................................................................................................19GuidelinesforAftertheTesting..................................................................................................................20

RESOURCES/SIGNAGE.....................................................................................................................21ImportantResources..................................................................................................................................21ImportantSignstoBePostedinCentre......................................................................................................21

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OVERVIEW

IntroductionOnJune9th2020,theGovernmentofOntarioannouncedchildcarecentresacrossOntariowouldbeabletoreopeneffectiveFridayJune12th,2020.Thisdecisioncomesafterthereopeningofmanybusinessandestablishments,leavingmanyparentsinneedofchildcare.TheYMCAhasamorethan165-yearhistoryofadaptingourservicestomeettheneedsofourcommunity.Therearemanyexamplesoverourhistory.DuringWorldWarI,forexample,theYMCAopeneditsdoorstoprovidethousandsofsoldierswithbathingfacilities.And,followingHurricaneHazelin1954,manyYMCAlocationswereusedasaheadquartersformilitarypersonneldealingwiththeafter-effectsofthehurricane,asaclothingdistributioncentre,andforthepreparationoffoodanddrinkforrefugeesandreliefworkers.And,withCOVID-19,wehadopenedourYMCAfacilitytosupportthehomelesscommunity(duetogrowingdemandforspaces,theemergencyshelterhadtoberelocated),provided‘emergencychildcare’forourcommunity’sessentialserviceworkersandnowduringPhase2ofReopeningOntario,wearecontinuingtoprovidechildcare.

AboutourEarlyChildhoodEducationTeamOurteamishighlytrainedandexperiencedindeliveringahigh-qualityplay-basedprogramonadailybasis.AllstaffwillbetrainedonourchildcareproceduresforworkingduringtheoutbreakofCOVID-19,whichhasbeenapprovedbylocalPublicHealthandtheMinistryofEducation.

HelpingFamiliesandChildrenTransitionintoanEmergencyChildCareEnvironmentEverydaytheYMCAteamsupportsnewchildrenandtheirfamiliestotransitionintoYMCAprograms.Weunderstandtheindividualneedsofchildrenexperiencingnewenvironmentsandcaregivers.Ourteamisstandingby,readytosooth,calm,reassureandwelcomeallchildrenandfamiliestotheYMCA.Weunderstandthisisatimeofuncertaintyandarepreparedtobeflexibleandaccommodating.

Parentsand/orguardianswillreceiveanorientationandintroductiontotheYMCApriortotheirstartdate.Theorientationwillcoversafetyproceduresaroundscreening,cleaningandsanitarypracticesandtheimportantreportingrequirementsaroundsignsorsymptomsofillness(includingourdutytoreportandconsultwithlocalPublicHealth).Wefeeltheseextrastepswillassistfamiliesandchildrenwiththetransitionofattendingachildcarecentreatthistime.

CurriculumandProgrammingOurfocuswillbedevelopingrelationshipswithchildren(socialenvironment)andensuringtheirhealthandsafety.Wewillcontinuetoprovidehigh-qualitycarethroughthedeliveryofourYMCAcurriculumsbasedontheagegroupandinterestsofthechildren.

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GuidingProceduresandPrinciples:• Firstandforemost,ensureallhealthandsafetyproceduresareinplaceatalltimes,safetyexceedsthe

programming.• EducateourstaffonCOVID-19symptomsaswellaspreventativemeasures.• Regulatemealstoincludegrab-and-goserve.School-agewillcontinuetobringbaggedlunches,if

approvedbylocalHealthUnit• Mandatethatthosewhoarenotfeelingwelltostayhometopreventthespreadofgerms.• Developaroutineandscheduleasithelpschildrenfeelsafeandcomfortable.• Planactivitiesandexperiencesthatsupporttheinterestsandneedsofthechildrenwithaprogramplan.• Roomcapacitieshavebeenlowered;therefore,youmaybeflexiblewiththenumberofactivities

providedatonetime.Forexample:o Sometoyscanbetakenoutofrotationanddisinfected,aslongasthereisenoughvarietyand

toysforthechildren.o Suspensionofallsensoryactivities(water,sand,etc...)whereindividualbinsarenotpossible.o Set-upenoughtableactivitiesforthechildren,notnecessarilyalltableswillberequired.o Someplayareasmaybeclosedattimes(morningorafternoon)fordisinfecting.o Ensureyouaresupportingplaybybeingacaring,sensitiveandfunco-learnero Toysthatarehardertocleanwillberemovedfromtheplayenvironment.

• Childrennaturallyplayinclosephysicalproximity.Thereisnorequirementtoseparatechildrenduringplay,ratherweareimplementingadditionalprecautionslikescreeningandenhanceddisinfectiontoreducethespreadofillness.However,activitieswillbesetuptoallotforadditionalspacebetweenallchildrenwhereverpossible.

• Whenchoosingsmallgroups,focusonkeepingthesamechildrenandstafftogetherasmuchaspossibletoreducethespreadofillness.

• Youngerchildrenwillbeinfencedareasorinstrollerswherephysicaldistancingwillapply.• Beyourself,havefun,knowthatyouaredoingsomethingimportantandthatyouarehelpingour

community.

OpeningChecklist(BeforeChildrenArrive)• Allstaffarescreened.• Regulartasksassociatedwithopeningtherooms(e.g.Flushforlead,checkforfireextinguishers,etc.).• Cleanwithdetergent/soapandthendisinfectusingrequireddilutionforoutbreak(seelabelor

ManufacturerSafetyDataSheet(MPDS)formoreinformationoncorrectdilution):o Allhightouchareas(e.g.doorknobs/pushbars,lightswitches,railings,sinks,toilets,soap/hand

sanitizerdispensers,phones,computers,garbagecans,changetables,diapergenies,countertops,tabletops,chairs,mirrors)atleasttwiceaday.

o Allshelves,equipment,andtoys.• Putawayallsoft/plushtoys,dress-upclothes,rugs,pillows,blankets,andfurnishingsthatcannotbe

cleanedandsanitizedeasily.• Putawayallgroupsensoryactivities(I.e.nogroupwaterorsandplay).Onlyuseindividualsensory

activitiesthatarediscardedaftereachchild’suse.

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• Putaplaninplacetoclosetheoutdoorsandbox,ifchildrencannotphysicallydistancethemselvesfromothers(e.g.Sandboxissmall)orotheroutdoorsensoryactivities(e.g.tarp,conesortape).

• Makesuretoonlyhavefreerunningwaterwhenoutsideplaying–sonobucketsorwatertankstoplayin–removeifwaterisstillout.

• Takeoutofcubbiesallregularchildren’spersonalbelongingsfromcubbiesandstoreinplasticbags,labelledwiththechild’snameuntilourregularchildrenreturntochildcare.Cleananddisinfectallcubbies.Markeverysecondcubby(e.g.maskingtape)sothatthereisacubbyleftemptybetweeneachchild’spersonalbelongings.

• Discardanyexpiredoropened/unlabelledfood.• Takeoutofbinsallregularchildren’spersonalbelongingsfromthediaperingareaandstoreinplastic

bags,labelledwiththechild’snameuntilchildreturnstothecentre.Cleananddisinfectstoragebasketssotheyareavailableforthechildren.

• Takeinventoryofpersonalprotectiveequipmentincludingdisposablecoversforearprobethermometers,vinylgloves,masks(onlyproceduralorsurgicalgradeandmustbeminimumClass1orASTMLevel1)andgogglesandgowns(frombloodspillkit).InformyourSupervisor/Managerwellinadvanceifyourequiremoresupplies(beforeyoursuppliesaredepleted).

• Takeinventoryofcleaninganddisinfectingsuppliesincludingdetergent/soap,disinfectant,cleaningsupplieslikecloths,disposabledisinfectingwipes,liquidhandsoapandhandsanitizer.Inventoryofallrequiredsuppliesperclassroom,kitchenandfullcentrewilloccur.InformyourSupervisor/Managerwellinadvanceifyourequiremoresupplies(beforeyoursuppliesaredepleted).

• Takeinventoryofpaperproductsincludingnapkins,dishes,cutlery,disposableservingutensils,tissue,andpapertowels.InformyourSupervisor/Managerwellinadvanceifyourequiremoresupplies(beforeyoursuppliesaredepleted).

• Purchaseback-updiapers,diaperwipes,andsnacks/lunchesforeveryoneincasefamiliesarenotpreparedforemergencysituations.

• Roomsthatdonothavewallsthatgoallthewaytotheceilingbetweenroomsshouldhavewalls8feethigh.

• Therewillbeoneroomdesignatedastheisolationroomforanyonethatbecomesillduringoperationalhours.Theroomwillhaveadoorthatcanclose.AllPPEmustbeinaplacethatisknownbyallstaffintheeventthisprocessisenacted(masks,gloves,cot,linedbucket,etc.).

• Familiesorguardianswillbeinformedontheprocedurefordrop-offandpick-up.Thiswillallotforphysicaldistancing.Note:Therewillonlybeonefamilymemberallowedinthescreeningareaatonegiventime.

• Thescreeningareaasabestpracticewillbeoutdoors(frontentrance),weatherpermitting• Postrelevantinformationonthefrontdoorincluding:

o Allsignsandinstructions.o Hoursofoperationandcontactinformation.o COVID-19screening/information.o Listofitemspermittedinchildcare(e.g.nutproducts,toys,etc).o Addressofshort-termshelter/evacuationsite.

• Updateemergencycontactlistandensureallstaffknowhowtocontacteachotherandallfamilies.• Short-termandlong-termevacuationsitemustbecontactedandaccessiblepriortoreopening.

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• CommunicationMethods:Intercoms,personalcellphones,Walkie-Talkies(ensurewhatneedstobechargedischarged).Thescreenerwillneedsomeformofcommunicationtocontactstaffinside.

• Tourand/ortrainingforallnewpersonsapprovedtodrop-offandpick-upwilloccurpriortotheirfirstday.Limitof1adultatdrop-offandpick-upandconsistentmembersandonlythosethatareapprovedwiththeregistration.

RoleofSupervisororDesignate• ProvideallstaffwithacopyoftheseCOVID-19proceduresandreview/trainstaffsothatthey

understandtheirresponsibilities.Postacopyonthestaffinformationboard.• Asabestpracticethesupervisorswillnotbecaringforillchildreninisolation.• EnsurethatstaffknowhowtousePPEcorrectly,asperPublicHealthguidelines.• Reassurestaffthatmasks/glovesarenotrecommendedduringregularactivities–onlywhencleaning

anddisinfectingbodyfluidsorcaringforanillchild.• Beonsiteduringallhoursofoperation(oradesignate).• Screeningandregistration.Recordallergies/foodrestrictions,medication,andindividualizedplans(I.e.

anaphylaxis,medical,specialneeds).Ensurethereareemergencycontactsinadditiontoimmediatefamily.

• Dispenseallmedication,withtheexceptionofemergencymedications.• Monitorsymptomsofhealthofstaff/childrenthroughouttheday.• Monitorthroughouttheday,thatstaffareimplementingCOVID-19procedures.• ImmediatelyreporttothePublicHealthoutbreakphoneline,ifachild,parent,orstaffis

suspected/confirmedpositiveforCOVID-19.FollowalldirectionsofPublicHealth.ThesupervisorwillalsocontacttheYMCAChildCareManagementTeam,

• Orientstaffwhoarenewtothecentre.Takethemonatour,reviewthefire/emergencyplanandallchildren’semergencyhealthinformation.

• AllmediainquirieswillgototheVP.TheCEOortheirdesignateistheonlypersonthatwillspeakwiththemediaoranyotherpersonwithinquires,includingthepublic/neighbours,etc.

• EnsureallYMCAPoliciesandtheCCEYAarebeingfollowed.• ReviewPPEprocedureswithstaffpriortoworkingandasrequiredthereafter.

RoleofStaff• Welcomechildrenandhelpthemchooseacubbytostoretheirpersonalbelongingsandassistthemto

washtheirhandsbeforeenteringtheclassroom.• Signinandoutthechildrencomingintocare.• Formanychildren,itwillbelikestartingontheirfirstdayofchildcarealloveragain.Bepatientwith

children.Allowthemtimetore-familiarizethemselveswiththeirenvironments,educatorsandpeers.• Provideplay-basedactivitiesorexperiencesbasedonchildren’sagesandinterestsandupdateparents.• Provideasmanyopportunitiesofprogrammingasyouareableto,keepinginmindcurrentlimitationsor

restrictionsto:o groupsensoryactivitieso soft/plushtoys,dress-upclothes,rugs,pillows,blankets,andfurnishingso singing–inclosedspaces,areasthatarenoteasytoclean(singingcanbedirectedtoan

outdooractivity)o neighborhoodwalks–physicaldistancingmustberespected

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o sendingartworkhomeonlyafterminimum7daysofquarantine• Assistwithcleaninganddisinfecting.• Duringlunchbreaks,observephysicaldistancingfromallstaff,andwashhandsbeforestartingwork

again.• Sendallchildren’spersonalbelongingshomeatendofdaytobecleanedanddisinfected.• Childrenmustnotsharesoothers,bottles,sippycups,facecloths,etc.Labeltheseitemswiththechild’s

nametodiscourageaccidentalsharing.• Reportanyhealthorsafetyconcernstoyoursupervisorimmediately.• Practiceandrespectconfidentialityatalltimes.

SchedulingStaffandRequirements• Supervisorsortheirdesignatearerequiredtobeonsiteduringallhoursofoperation.• Maximumgroupsizeisacohortof10(includeschildrenandadults).• Ifpossible,siblingsremaininthesamegroupforFamilyGroupingorMixedAgeGrouping• RatiosmustbemaintainedinaccordancewiththeCCEYA.• Whenpossible,trytohaveadditionalstafftoensureproperongoingcleaninganddisinfection.Where

possible,thesestaffwillnotbeincludedinratio.• ThecookwillhavetheirFoodHandlerCertificate.• Therewillbeasupply/back-upstaffavailableintheeventthatastaffisunabletoreporttowork.• Staffincludedinratiosandallhomechildcareprovidersarerequiredtohavevalidcertificationinfirst

aidtrainingincludinginfantandchildCPR,unlessexemptundertheCCEYAo Specialnote–theWSIBhasindicatedthatallcertificationsthatexpireafterMarch1,2020are

automaticallytemporarilyextendeduntilSeptember30,2020.• AllstaffandotherswhoareinteractingwithchildrenatthepremisesarerequiredtoobtainaPRCVS.

COVID-19ParentInformation*ProvidedtoEachParentand/orGuardian• Youandyourchild(ren)willbescreenedeachdayforCOVID-19.• Weencouragethesameparent/guardiantodrop-off/pick-upchild.Werequestthisbelimitedto1

personatatimeandconsistentifpossible(18yearsofageorolder).• Bringallrequireddiapers,wipes,creams,medications/Epi-Pen,approvedfood(ifrequiredforhealth

reasons),changeofclothesandclothestoplayoutdoorseveryday.Diapersandwipescanbeleftovernight.

• Labelallitemswithchild’sname.• IfsomeoneinthehouseholddevelopssignsofCOVID-19(cough,fever,difficultybreathing),stayhome

andcontacthealthcareproviderandthecentreimmediately.• Donotbringanyfood,especiallyanypeanutornutproductsintothecentre.Specialapprovalbythe

supervisormustbeprovidedtobringfoodfromhomeintothecentre.AsperlocalPublicHealth,School-ageisstillpermittedbaggedlunchesasperCCEYAPolicy.

• Parentswillnotbepermittedtoenterthechildcarefacility(limitedtothescreeningareaonly).• Explainimportanceoftheemergencypick-upperson.• Providerswillensurefreshlylaunderedblankets/sleeptoysaredoneeachdayatthechildcarecentre.

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PersonalProtectiveEquipment(PPE)ThebelowproceduresoutlinetherequiredPPEforallstaffasperPublicHealth.TheYMCAwillprovidestaffwithallrequiredPPEandtrainingwillbeprovidedonthebelowinstructions.

• Thescreener,allstaffthatarewithanillchild(isolationroom)andstaffworkingwithacohorttheyarenotassignedtomustwearaproceduralmask.

• Whenphysicaldistancingcannotbemaintainedstaffwithintheircohort,mustwearanon-medicalmask,including,butnotlimitedto:

o Providingdirectcare(forexample,feeding,assistingachildwithhandhygiene,diapering).o Consolinganupsetchild.o Assistingachildwithdressingorchangingclothes.o Thisrequirementapplieswithincohortsaswell.

• PPEshouldbestoredinawaythatitisprotectedfromcontamination(sealedbagorcontainer).• Reusablemasksshouldbetakenoffcarefullyandstoredinapaperbaglabelledwiththestaffname• Glovesshouldbedisposedofimmediately.• Gogglesandfaceshieldscanbedisinfectedandstoredawayfromcontamination.• Gownscanbehunginaplacewheretheyarenottouchedoradditionallycontaminated.

https://www.publichealthontario.ca/-/media/documents/poster-ipac-pss-putting-on-ppe.pdf?la=en

https://www.publichealthontario.ca/-/media/documents/poster-ipac-pss-removing-ppe.pdf?la=enThesupervisorwillreviewhowandwhentousePPEwithallstaffpriortoworkingandonaregularbasistoensurestaffunderstandhowtoputonandtakeofftheirPPE.

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DAILYOPERATIONS

ScreeningProcess(ReplacesDailyHealthChecks)Familieswillbetrainedontherequiredprocessfordrop-offandscreeningtoensurephysicaldistancing.Thescreenerwillhaveonapprovedpersonalprotectiveequipment(PPE)asrecommendedbylocalPublicHealth(facemask,shield,gloves,gown-ifcarryingachildin).

Staff,childrenandparents/guardianswillberequiredtotaketheirtemperaturebeforearrivingatthechildcarecentre.Ifunwell,theyarenottoarriveatthechildcarecentreandcallthesupervisorimmediately.Ifaparent/guardianissick,thechildcannotattendandtheHealthUnitshallbenotifiedimmediately.

Screeningquestionscanbedoneinperson,overthephoneorusinganonlinedocumenttocompletepriortoarrival.Belowarethestepstocompleteforscreening:

• Firstwelcomeandgreetallfamiliesandchildren.Wewanttomakesuretheprocessisasnaturalaspossibleforthechildren(ournewnorm).

• Letthemknowyouaregoingtoaskthemsomescreeningquestions,andthentaketheirtemperatureandrecordalltheinformation.

• Taketemperatureofchildandparent/guardianandrecordallinformation.Temperaturemustbelowerthan37.8.

• Iftheparticipantanswers“NO”toallquestions,theyhavepassedthescreeningprocessandcanenterintoprogram.

• Iftheparticipantanswers,“YES”toanyofthequestionsorrefusestocompletetheform,theycannotenterprogram.*Somediscretioncanbeusedduringallergyseason(runnynose,wateryeyeswithnopresentingsymptomsofillnessorbeingunwell).ConsultwithPublicHealthifunsure.

• Explain“Unfortunately,becauseyouanswered‘yes’tooneormoreoftheMinistryofHealthscreeningquestions,weareunabletoletyouenterourprogramtoday.Ifyouhavenotalreadydoneso,pleasereachouttolocalPublicHealth.

TheScreeningStaffordesignateisresponsibleforallscreeningofstaff,families,andchildreneveryday.

• Screeningwillbeconductedoutdoors(weatherpermitting)orinthevestibuleareawithopendoors.• Staggerarrival/departuretimesofparents.Parentswillberequiredtopracticephysicaldistancinguntil

thenextparenthasleftthescreeningarea.(i.e.stayincar,waituntilnextinline)• Parentswillnotbepermittedtoenterintothechildcarecentre(onlyscreeningarea)• Visitorswillnotbepermittedinthecentreexceptessentialworkers(e.g.Maintenance)butproperPPE

needstobeworn,andtheywillbescreened.• AnychildorstaffwiththesymptomsbelowwillbeexcludedandboththeYMCAandtheparentareto

calllocalPublicHealthandfollowalltheirdirections(supervisorstofollowSeriousOccurrenceProcedure):

o Severedifficultybreathing(strugglingforeachbreath,canonlyspeakinsinglewords)o Severechestpain(constanttightnessorcrushingsensation)o Feelingconfused(forexample,unsureofwhereyouare)

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o Losingconsciousnesso Fever(feelinghottothetouch,atemperatureof37.8degreesCelsiusorhigher)o Chillso Coughthat'sneworworsening(continuous,morethanusual)o Barkingcough,makingasqueakyorwhistlingnoisewhenbreathing(croup)o Shortnessofbreath(outofbreath,unabletobreathedeeply)o Sorethroato Difficultyswallowingo Hoarsevoice(moreroughorharshthannormal)o Runnynoses(stuffyorcongestednose)o Lostsenseoftasteorsmello Headacheo Digestiveissues(nausea/vomiting,diarrhea,stomachpain)o Fatigue(lackofenergy,extremetiredness)o Fallingdownmorethanusualo Foryoungchildrenandinfants:conjunctivitis,sluggishnessorlackofappetiteo PinkEye

• InconsultationwithPublicHealth,thescreeningstaffisabletousetheirdiscretion(onbothstaffand

children)wheretheindividualpresentswithknownsymptoms(i.e.allergies,migraines,etc.)orareeasilytiedtounrelatedevents(tiredinmorningfromlatenight,allergies,pronetomigraines,etc.).Theindividualwillbecarefullyassessedthroughoutthatday.ConsultwithPublicHealthifunsure.

• Afterscreeningiscompleted,theparent/guardianwillleavetheirchildwithaprogramstaffmemberandmustensurethatanyforms,information,ormedicationiscompleteandgiventothem.Atnotimecantheparententerthechildcarecentre(onlyinscreeningarea).

StaffPersonalBelongings&Routines• Bringonlywhatisnecessaryintocentre.• Eachstaffisdesignatedaspacetostorepersonalitemsthatisseparatefromotherstaff.Eachstaff

memberisresponsibleforcleaninganddisinfectingtheirareaattheendofeachshift.• Staffroom/washroom–eachstaffmemberisresponsibleforcleaninganddisinfectingaftereachuse.• Office–eachstaffmemberisresponsibleforcleaninganddisinfectingaftereachuseincluding-desk,

phone,computer,chairarms,doorhandles,andlightswitches.• Staffaretopracticephysicaldistancingwheneverandwhereverpossiblewithone-anotherorweara

mask.• Asabestpractice,werecommendedstafftowashtheirhandsandtheirclotheswhentheyarrivehome.

Cleaning&Disinfecting• Cleaning–removingallvisibledirtfromthesurfaceofanobject.Usedetergent/soapandwateranddo

notforgettorinseoffdetergent/soapresidue.

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• Disinfecting–reducesgermsonasurfaceandisdoneaftercleaning.Ensureyouunderstandthecorrectconcentrationofdisinfectanttouseduringoutbreaks,thatdisinfectantisnotexpired(discardmixeveryday),andthatyouareleavingdisinfectanttoremainonsurfacesforthecorrectcontacttime(I.e.don’twipedisinfectantoffimmediately).IfusingVirox,followthestrictguidelinesforuse(sprayontowelorcloth,letsitfortherequiredtimeandrinse).Childrenshouldbeawayfromtablesorothersurfaceswhentheyarebeingdisinfected.Youareabletouseothercleanersasapprovedbyyourlocalhealthinspector.

• Viroxcanbeusedbutitispreferredthatitisnotsprayedonanytoys.Toyscanbewashedinthedishwasher.

• UseofPersonalProtectiveEquipment(PPE)-gloves,goggles,masks,gowns–readthelabeloftheapproveddisinfectantorlookupthemanufacturer'sinstructionsontheinternettodeterminewhichPPEisrequired.Typically,PPEisonlyrequiredifcleaningupbodyfluids(saliva,urine,stool,vomit,mucus,blood).Alwayswashyourhandsafterremovinggloves.

• Whenpossible,docleaninganddisinfectingwhenchildrenarenotpresent.• Beforere-openingthechildcarecentreforemergencychildcare.• Beforeeating,cleananddisinfecttables.• Afterchildrenleavearoom,cleananddisinfectallhightouchareasandsharedtoys/equipment.• Afterallchildrenhaveleftfortheday,beforeyouclose,cleananddisinfectallcubbies.• Afterachildputsatoyintheirmouth,sneezesorcoughsontoys,takethetoyoutofrotationandclean

anddisinfect.• Washrooms,includingsinkfaucets,toiletflusher,andsoapdispensersshouldbecleanedanddisinfected

frequentlythroughouttheday,andalsoaftereverywashroomroutine.• Enhancecleaningeverynightinallareas,onalltouchedsurfaces.• Increasetheuseofanti-bacterialhandsanitizersanddisposablegloves.• Increasecleaninganddisinfectingforallelectronicdevices,suchassitephonesandiPadsaftereachuse,

aswellasstaffcellphonesandpersonalitems(waterbottle,thermos,etc.)• Instructemployeestowash/scrubtheirhands,andchildren’shands,aminimumofhourly,whichhas

beenprovenbytheCentreforDiseaseControltobethemostpreventativemeasures.

Cleaning&DisinfectingBodilyFluids• Treatallbodyfluids(e.g.,saliva,urine,stool,vomit,mucus,blood),aspotentiallyinfectious.• Takephoto(s)and/orbeabletodescribeindetailanybodyfluidsthatcouldbepotentialsymptomsof

COVID-19forHealthUnit.• Wearsingleusenon-latexgloveswhentheremaybecontactwithanotherperson’sbodyfluidssuchas

whencleaningcutsorscrapes,cleaningupblood,vomitand/orstoolfromsurfacesorcontaminatedlinens,andchangingdiapers.

• Inadditiontoeyeprotectionandgloves,staffshouldwearamaskwhencleaningupvomitorbodilyfluidsfromacontaminatedsurface.

• Anapron,gownorseparatesetofclothesmaybeusedifdirectcontactwithbodyfluidsislikelytooccur.

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StepstoCleanandDisinfectBodyFluids• Putonglovesandmask.• Cleanupbodyfluidsusingadisposableabsorbentcloth(e.g.,papertowel).• Cleantheareawithdetergent/soapandwater,thenrinseoffdetergent/soap.• Disinfecttheareausingthemanufacturerrecommendedconcentrationandcontacttime.• Discardcontaminatedpapertowels,gloves,etc.inaplasticbag.Tieclosedandplacewithregulartrash.• Contaminatedclothingcanbewrappedtiedclosedinaplasticbagandsenthomeforcleaning.Normal

detergentandlaundrycyclesareeffective.• Washhandsafterremovinggloves.

UseofThermometers• Bestpracticeistheuseofdigitalinfraredforeheadthermometers.However,ifthisisnotpossiblethe

useofadigitalwithdisposablecoversoradisinfectingprocessforeachusewillbeused.PublicHealthhasapprovedthisprocess.

• Ifusingthedigitalthermometer(whereitistouchingtheperson),thethermometermustbedisinfectantaftereachuse.

ApprovedPhysicalDistancingforChildCareProgramsOncethepersonhasbeenscreenedandpassedtheprocess;physicaldistancingof2metresintheactualchildcarecentre/classroomswillnotberequired.However,activitieswillbesetuptoallotforadditionalspacebetweenallchildrenwhereverpossible.

• Staffwillpracticephysicaldistancinginsidethecentre(i.e.lunchrooms,breaks,hallways,offices).• Staffwillpreventgroups(cohorts)tointeractatanytimeorduringtransitions.• Avoidgatheringingroupsinonearea(cubbies,outside).• Avoidholdinghands,exceptinsafetysituations;ensuringproperhandhygieneispracticed.• Avoidsharingoftoysandmaterialsbetweenchildren,wherepossible,withoutdisruptingplay.• Familieswillremainoutsideofthechildcarecentre.Theywillnotbepermittedtoenterthechildcare

centre.• Reducedchildcarecentreoperatingcapacity.• Childrenwillremainintheirassignedclassroom;theywillnottransfertoanothergrouporclassroom.• Set-upactivitiestoprovidelargerdistancebetweeneachchild.• Singingisnotpermittedindoors• Placecots2metersapartwherepossible(minimum1meter–head-to-toe)when2metersisnot

possible.

DeliveriesorVisitorsNooneotherthantheapproved(registered)staffandchildrenwillbepermittedtoenterthechildcarecentre,withtheexceptionofapprovedsupportworkers,seebelow.

• Alldeliverieswillbeleftatthedoor,sign-offswillbewaived.

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• Ifyouarepurchasingitems,pleaseensurethecompanyisawareofourprocessandno-onewillbeallottedtoenterthechildcarefacility.

• Inanemergencysituation,atminimum,thescreeningprocessoccursbeforeanyonecanenterthecentre(PublicHealth,otherYMCAadministrators,etc.).

SpecialNeedsResourcingStaff• SNRStaffandenhancedstaffwhoareonsiteandnotcountedaspartofratiosarenotincludedinthe

maximumcapacityrules(e.g.Notpartofthemaximumcohortsizeof10-includingchildrenandstaff)• SNRStaffandEnhancedstaffsupportingmorethanoncohortwillberequiredtowearappropriatePPE

whichincludesfacialmaskandeyeprotectionandpracticephysicaldistancingasmuchaspossible.• Handwashingmustoccuruponentering/leavingeachclassroom.

SchoolBoardStaff• Janitors/teachers/contractworkersdonotneedtobescreenedbythechildcarewhentheyareentering

schoolsaslongastheyuseaseparateentranceastheyhaveproceduresinplacefromtheirschoolboard,andtheydonothavedirectcontactwithchildrenorchildcarestaff.

• Ifoneofthesecriteriaisnotpossible,peoplewillhavetobescreenedatthechildcareentrancebyachildcareworker.

HandHygieneandWashing• Handwashingisthebestwaytopreventthespreadofillnessforstaffandchildren.Ensureanadequate

supplyofliquidsoapandpapertowelsorahotairhanddryerisineverywashroom.• Washhandsusingliquidsoapandrunningwaterfor30seconds.Canuseatimertohelpwiththis.• Staffareresponsibleforsupervisingchildrentoensuretheyarehandwashingcorrectly.• Ifsoapandwaterarenotavailable,handscanbecleanedwithanalcohol-basedhandsanitizerthat

containsatleast70%alcoholensuringallsurfacesofthehandsarecoveredandrubbedtogetheruntiltheyfeeldry.Ifthereisnoaccesstowaterandsoapandthechildrenareusingthehandsanitizer,theymustbesuperviseduntilthehandsanitizerhasfullydried.

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Whenstaffmusthandwash Whenchildrenmustwashhands• Afterarrivingtowork&beforeleaving.• Afterremovinggloves.• Before&afterhandlingfood,includingeating.• Aftercoughing,sneezing,orblowingyournose

orhelpingachild.• Afterusingthetoiletorhelpingeachchildto

usethetoilet.• Aftereachchild’sdiaperchange.• Beforeandafteradministeringmedication.• Beforeandaftercleaning/bandagingcuts,

scrapes,wounds.• Aftercleaning&disinfecting.• Whenhandsaredirty.• Afterplayingoutside.• Afterhandlinganimalsortheirwaste.

• Afterarrivingatthecentre&beforeleaving.• Before&aftereating.• Aftercoughing,sneezing,orblowingnose.• Afterusingtoilet.• Afterdiaperchange.• Afterplayingoutside.• Whenhandsaredirty.• Afterhandlinganimals**

**Noanimalsareallowedduringanoutbreak.Pleaseplaceanimalssomewheresafeawayfromchildrenandfoodpreparation.

HandSanitizer• Limittheuseofhandsanitizertoadultsonly(soapandwateristhebestmethod).• Usingsoapandwateristhebestmethodofcleaninghands.Usehandsanitizerwhensoapandwaterare

notavailable.• Ifhandsaredirty,theymustbewashedwithsoapandwaterbeforeusinghandsanitizer.• Minimumconcentrationofalcoholinhandsanitizeris70%,themaximumis90%.• Useenoughhandsanitizertowethandsfor15-20seconds.• Ifyoupermitchildrentousehandsanitizer,ensuretheyaresupervised,andthattheydonottouchtheir

eyes,noseormouthuntilitdries.• Infantsshouldnotusehandsanitizerasitisnotgoodforchildren(oranyone)toingest.Bestpracticeis

forthestaffmembertoputonthehandsanitizerandholdthechild’shandsbythewristsuntilitdries.

CoughandSneezeEtiquette(RespiratoryEtiquette)• Covermouthandnosewhenyoucoughorsneezewithatissue(useenoughtissuesothatfingersdonot

touchmucus).• Immediatelydisposeoftissueinabinlinedwithagarbagebagandwithlid.• Washhandswithsoapandwater.• Keephandsawayfromface.

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DiaperingandToileting• Amaskisworn• Provideabinforeachchildtostoretheirdiapers,creams,etc.• Cleananddisinfectbins.• Purchaseback-updiapersincaseafamilyisnotprepared.• Discardglovesandwashhandsafterdiaperingeachchild.• Assistchildtowashhandsaftertoiletingandeachdiaperchange.• Cleananddisinfectdiaperchangetableaftereachchild.• Increasefrequencyofcleaninganddisinfectingtoilets,sinks,andaftereachtoiletingroutine.• Provideabinwithalid,linedwithagarbagebagandtakethegarbageoutsideoftheclassroomwhen

full.

Rest/Sleep• Innewsituationsitmaybedifficultforchildrentofallasleep.Preparetogivereassuranceandoffer

alternateactivitiesifachilddoesnotwanttoliedown.• Placecots2metersapartwherepossible(minimum1meter–head-to-toe)when2metersisnot

possible.• Washsheets/blanketseverydaywithregulardetergentontheregularlaundrycycle.• Disinfectcotspriortostacking.• Donotstacksheets/blanketswithcots.• Ensurechildrenonlytakeoutplushtoys/blanketsatsleeptimeanddonotsharewithanyone(labelled

Ziplocbagisabestpracticeifpossibleandrefrainfrombringingthestuffedtoybackandforthfromhome).

Medication• SupervisorsorRECEdesignatewillberesponsibleforadministeringmedicationwiththeexceptionof

emergencymedication(I.e.Epi-Pen’s,puffers).• Followtheregularprocedureformedication.• Ensureallmedicationsaresenthomeattheendofeachday.

Anaphylaxis• Ensurefamiliesandstaffareawareofourpolicyregardingpeanuts/nuts.• Followtheregularprocedureforanaphylaxis.• Ensureallmedicationsaresenthomeattheendoftheday,ifnotaduplication.• Familieswillbeaskedtonotbringlunch/snacksintothechildcarecentreasperregularprocedure.If

therearespecialcircumstanceswherefoodmustbebroughtintothecentre(specialdietorallergies,etc.),thesupervisormustapprovethisplanandourregularpolicywilltakeeffect(labelandproperstorage).

• Ifanutproductoraknownallergenthatisextreme(I.e.childreactstoairborne/smellsallergen),eitherprovidethechildwithanalternativefoodfromthepantryormovethechildtoanotherroomtoeat.

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FoodHandling• DesignateonestaffwithacurrentFoodHandlerCertificatetoberesponsibleforhandlingsnacks/lunch

anddoinglunchchecks.Thispersonmustnotbethesamepersonwhoisassignedtodocleaninganddisinfecting,orthepersonassignedtolookafterillchildren.

• Thebestpracticeistohavethecookpre-plateandcover/wrapallmealsjustbeforeserving.Ifstaffareservingfood,theymusttakeextraprecautionsinplatingawayfromthechildrenandnochildcanself-serve.Unusedfoodmustbediscardedinthatclassroomafteruse.Therewillbenofamilystyleservingwherechildrenself-serve.Iftherearespecialmeals,theplatemustbelabelledwiththechild’sname.

• Supervisethechildrenatalltimessotheyarenotsharingfood.• Foodmustbecoveredorwrappedwhennotserving.• Provideabinwithalidthatislinedwithagarbagebagtodiscardfood.Takeoutsideeachday(outdoor

garbagebins).• Childrenmustnotprepareorhandlefood,thereforenocookingactivities.• Baglunchesfromhomeareallowed

o Cleanhandsbeforeandaftero Ensurechild’snameisonlunchbago Sanitizetableswherelunchbagswereono Sanitizecubbiewherelunchwasstoredo Whererequired,baglunchesshouldincludefreezerpackstoensurethatfoodismaintainedata

safetemperatureandnutritionalvalueismaintained.

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MONITORINGHEALTHOFSTAFF,CHILDREN&PARENTS/GUARDIANS

TrackingSymptomsofIllHealth• Thesupervisorisresponsibleformonitoringallstaffs’symptomsofillhealthduringtheday.• Staffareresponsibleformonitoringchildrenthroughoutthedayforsymptomsofillhealth.• Ifstaffobservechildrenwithsymptomsofillhealth,theymustreporttheirobservationtothe

supervisorimmediatelyanditwillbenotedinthelogbook.• UsethetrackingsystemapprovedbyPublicHealth.• Staffshouldbetrackingallsymptomsnoticed,includingnonCOVID-19symptoms.

IsolatinganIllChildand/orStaff• IfachildisobservedtohavesymptomsrelatedtoCOVID-19oranyothercommunicableillness,thechild

mustbeisolatedfromthegroup,underthesupervisionof1staffmember.• Siblingsarenottobeputintoisolationatthistime,unlessbothareshowingsymptoms.• Atminimumthechildshouldwearamask(iftolerated,exceptifunder2,donotuse).Thestaffinthe

roomwillwearamaskandgogglesorfaceshield.• Thesupervisorwillcalltheparentorguardianforimmediatepickup(within30minsifpossible

dependingoncircumstances)andPublicHealthforfurtherdirections.• TheSupervisorwillalsoadvisetheparenttocontacttheirhealthcareproviderorTelehealthandthe

supervisorwillalsocalllocalPublicHealth.• IfastaffmemberisobservedtohavesymptomsrelatedtoCOVID-19oranyothercommunicableillness,

thestaffistogohome,self-isolateandcontactlocalPublicHealthforinstructions.ThesupervisorwillalsoplacethecalltolocalPublicHealth.

• Staffshould(ifpossible)keepasmuchdistanceaspossible(2metersifpossible)fromtheillchildwhilemaintainingappropriatesupervision.

• Afterthechildispicked-up,adeepcleaninganddisinfectingmustoccur(bedding,cot,equipmentandfullisolationroom).

• Theremainingchildrenfromtheillchild’sclassroomwillberedirectedtoanotherspaceuntiltheclassroomisdeepcleaned.Thefirstlocationistogooutside,asecondarylocationiftheoutdoorsisnotanoptionistobeidentifiedbythesupervisorandcommunicatedtoallstaff.

• Allotherclassroomswillbedirectedtostayintheirclassrooms.• Theareaswherethechildwasplaying/toysmustbecleanedanddisinfected.• ThesupervisorwillcontactlocalPublicHealthregardinganyrequirednextsteps.• Tissuesshouldbeprovidedtothechildforproperrespiratoryetiquette,withproperdisposalofthe

tissuesandproperhandhygiene.

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ManagingaSituationwhenaChildorAdultPresentswithCOVID-19SymptomsORIsPresumedorConfirmedtoHaveCOVID-19TheinformationbelowhasbeensourcedfromtheCDCandPublicHealthOntariorecommendations.AllofthesesituationsrequireyoutonotifylocalPublicHealthandtaketheirdirectiononhowbesttoproceed,astheseinstructionscouldchangeday-by-daydependingonPublicHealthdirection.However,thefollowingprocedureswereapprovedatthetimethisprocedurewasreleased.TheYMCAwillupdateanyproceduresasrequestedbylocalPublicHealth.AllpresumedorconfirmedcasesmustbereportedtoPublicHealthandisareportableSeriousOccurrencewiththeMinistryofEducationandthemunicipality.TheschoolboardandYMCAManagementTeamwillalsobenotified.

• Ifachildstaff,orfamilymemberdevelopCOVID-19orsymptomsduringthescreeningprocess(seescreeningsymptoms),theywillbeexcludedfromenteringthechildcarecentreandimmediatelybeaskedtocontactPublicHealthforfurtherinstructions.TheYMCAwillalsoinformlocalPublicHealthandfollowtheirinstructions.

• Ifastaffmemberisinformedthatachildoranyofthatchild’shouseholdmembers/contactsareknowntohavesymptomsorapresumedorconfirmedcaseofCOVID-19,theywillbeexcludedfromenteringthechildcarecentreandimmediatelybeaskedtocontactPublicHealthforfurtherinstructions.TheYMCAwillalsoinformlocalPublicHealthandfollowtheirinstructions.

• IfachilddevelopssymptomsofCOVID-19whileatthechildcarecentre,staffwillimmediatelyseparatethechildtotheisolationroomandtheparent/guardianwillbecalledtopickupthechild.Ifpossible,thestaffwaitingwiththechildshouldstay2metersawayandwearappropriatePPE(mask,gloves,andfaceshield).TheYMCAwillcallandinformPublicHealthandfollowtheirdirections.

• IfastaffmemberdevelopssymptomsofCOVID-19whileworkingatthechildcarecentre,thestaffwillberelievedsotheycanleaveimmediatelyandwillbeaskedtocontactPublicHealth.TheYMCAwillinformPublicHealthandfollowtheirdirections.

• Atrackingsystemmustbeinplacewhereallregisteredfamiliesandstaffinformationisreadilyavailable

tosharewithPublicHealth.Otherpeople(visitors)thatcouldhavebeenwithinthechildcarecentre‘bubble’duringthisperiodwillalsobeincludedinthetracking,thereforepleaseensuretrackingsheetiscompleteddailyandup-to-dateatalltimes.

• WhenreportingtothePublicHealthanyillnessesinvolvingachid/familywhowereinvolvedinEmergencyChildCareatadifferentAgencyhighlighttoHealthUnitforcontacttracing.

• ChildrenorstaffwhohavebeenexposedtoaconfirmedcaseofCOVID-19shouldbeexcludedfromthechildcarecentreuntilclearedtoreturnbylocalPublicHealth.

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SpecialNotes:• Intheeventofaconfirmedcase,thatspecificcohortwillberequiredtobepickedupimmediatelyand

isolate(e.g.for14days,orpossiblylongerifadvisedbylocalhealthofficials.)TheYMCAwillfollowthedirectionprovidedbylocalPublicHealth.

• IfitisdeemedastafftestspositiveforCOVID-19duetoawork-relatedexposure,theYMCAManagement/Administrationwillbenotifiedimmediately.TheYMCAwillfollowallguidelinesasoutlinedintheOccupationalHealth&SafetyAct.

• Staff,childrenortheirparents/guardiansshouldnotattendorworkatanotherchildcareoremergencycarefacilitywheretheycouldpotentiallyexposeothers.Itisalsoabestpracticetonotrotatestafffromcentretocentre.

• Intheeventofaprogramclosure,thedurationoftheclosurewillbedependentonstaffinglevels,

outbreaklevelsinthecommunityandseverityofillnessininfectedindividual.AlldirectionswillbetakenbylocalPublicHealth.

TheSupervisor/ManagerwillContacttheFollowingPersonsifthereisaPresumedORConfirmedCaseofCOVID-19

• Thefollowingindividualswillalsobecontacted:o TheVPofChild,YouthandFamilyDevelopmento DNSSABo SchoolBoardo FollowtheregularSeriousOccurrence(SO)reportingrequirements(includingsubmittingaSO

reportinCCLSandpostingtheSOnotificationform)o Thestaffmustalsocompleteanincidentreport(withparentsignature),updatecommunication

bookandillhealthformintherespectiveclassroomo Parentsofchildrenenrolledatthechildcarecentrewillonlybenotifiedasdirectedbylocal

PublicHealth

TestingforCOVID-19• Newemployeesreturningtoworkdonotneedtobetested.• Childrenandstaffchangingsitesdonotneedtobetested.• Symptomaticstaffandchildrenshouldbereferredfortesting.• TestingofasymptomaticpersonsshouldonlybeperformedasdirectedbylocalPublicHealthorMinistry

ofEducationaspartofoutbreakmanagement.• ThosewhotestnegativeforCOVID-19mustbeexcludeduntil24hoursaftersymptomsresolution.• ThosewhotestpositiveforCOVID-19mustbeexcludedfromthechildcarecentrefor14daysafterthe

onsetofsymptomsanduntilclearancehasbeenreceivedfromlocalPublicHealth.§ ChildrenorstaffwhohavebeenincontactwithasuspectedCOVID-19caseshouldbetestedand

monitoredforsymptomsandcohorted(i.e.groupedtogether)untillaboratorytests,ifany,havebeencompletedoruntildirectedbyPublicHealth.

§ Staffmembersawaitingtestresults,forrandomtestingwhoareasymptomatic,maycontinuetowork.

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AllchildrenorstaffthatarebeingtestedisareportableSeriousOccurrencewiththeMinistryofEducation.Notificationinwriting(email)mustbegiventothelocalPublicHealth,theMunicipalityandtheMinistryofEducation’sDistrictManagerandLicensingAdvisor.

Intheeventofapositiveresult,thestafforchildcannotreturntothechildcarecentre.YMCAManagement,localPublicHealthandtheMinistryLicensingManager.NotificationswillalsobeprovidedtotheSchoolBoard,MinistryofLabourandMunicipality.Ifastafftestspositive,notifyYMCAManagementimmediatelyandtheprogramwillfollowtherequirementsaspertheoccupationalHealth&SafetyAct.

GuidelinesforAftertheTesting• Individuals(children/staff)mayreturntothechildcarecentreoncereceivinganoticefromtheHealth

Unitthattheirtestresultsarenegative.TheYMCAmustbeprovidedwithdocumentationfromtheHealthUnittovalidate.Thetwooptionsare:

o TheindividualcancontacttheHealthUnitandpickuptestresultsinperson;oro Theindividualcanlogintotheonlineportal(covid19results.ehealthontario.ca)andprint/emaila

screenshottothesupervisor.• Duetothedelayinthisprocess,individualscanprovideinwriting,theyhavereceivednegativetest

resultsandwillprovidedocumentationwithin3days.• Ifvalidationisnotprovidedwithintheoutlinedtimeframe,children/staffwillnotbeabletoattendthe

childcarecentre.

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RESOURCES/SIGNAGE

ImportantResources

Ontario.ca/COVID-19

ContactingyourPublicHealthUnit

Whatweknowsofar-PHO

GovernmentofCanadaCOVID-19Outbreakupdate

ImportantSignstoBePostedinCentre• ProperHandWashing/HandHygiene• CoveryourCough• COVID-19Tips• ProperPPE• IsolationRoominUse

Important:ThisdocumentisalivingdocumentandwillbeupdatedasrequiredbylocalPublicHealth.