COVID-19 Outbreak/Pandemic Policies and Procedures

Implemented: June 19, 2020 in response to the COVID-19 Pandemic

Updated: Dec 2, 2020

Point Edward Early Learning Centre Policy and Procedure Guidelines

COVID-19 Outbreak/Pandemic Policy

Intent:

The intent of this policy is to support our families during an infectious disease outbreak/pandemic that has been declared an emergency by Lambton Public Health. Point Edward Early Learning Centre will collaborate with Lambton County Public Health, the County of Lambton, and the Province of Ontario to offer childcare in the safest way possible for the duration of the pandemic or emergency situation.

References to ‘infectious disease’, or ‘infectious disease outbreak’ in these policies and procedures refer only to outbreaks that are deemed emergencies or pandemic situations. Normal outbreak procedures will be enforced in all other outbreak situations.

This policy shall remain in effect as long as it is considered an emergency. Certain procedures shall remain in effect after the emergency is declared over. These exceptions are noted in the policy. There will be flexibility with easing of restrictions beyond this policy as is required in each situation.

Policy:

It is the policy of Point Edward Early Learning Centre to treat everyone with dignity and respect during a pandemic. This is of utmost importance during this time as stress levels are high for all individuals and unique situations will arise. Providing clear instructions and communication is vital. Following the guidelines of established procedures is helpful but adapting these guidelines as situations arise and new information is shared is equally important.

Procedure:

Process for Calling Children Back:

Services are reserved first for our current families, selected in this order:

1) Children of families in which the single parent or both parents in a two-parent household must work. This includes employees of Point Edward Early Learning Centre who cannot return to work until care is available for their children.

2) Other existing families as space allows. Children with special needs will be given priority on a case by case basis.

3) New families

Employee:

Call-Back Process:

1) Employees will receive an official recall letter. The letter provides an estimated restart date and outlines the options employees have with respect to returning to work. It should include a list of any activities that are required before the restart date. An example would be training or signing off on policies and procedures.

2) Communication is key and providing an opportunity for employees to ask questions, consider options and make clear decisions should be provided.

3) Employees who are able to return to work will be part of the startup team. Remaining employees will be given the opportunity to return as needed based on:

a. Seniority

b. Interest

c. Job responsibility

4) As each employee is scheduled to return, they will be invited, by appointment, to come to the Centre and re-familiarize themselves with their workplace. They will complete and sign a checklist that has been developed by the Executive Director using criteria unique to the pandemic, but which will include a declaration of good health. The checklist will also list any new or updated policies and procedures that need to be reviewed and all prescribed training. Also, they will be educated on the symptoms of COVID-19 and the conditions that would require isolating the child or other employees.

Additional Employee Training:

· All employees working at the Centre will review and be familiar with these policies and procedures before commencing work.

· Additional training and support outlined by Lambton County Public Health include

· Familiarity with current respiratory and gastrointestinal outbreak measures in childcare centres.

· Knowledge on routine infection control practices including when/how to properly wash hands, good adherence to enhanced cleaning schedules, respiratory etiquette, staying home if sick, etc.

· It is important employees continue to stay informed of most current information on any infectious disease outbreaks. Refer to www.lambtonpublichealth.ca.

Employee Health and Safety Considerations:

*Employees will be screened every weekday until the Lambton County Public Health advises otherwise. Each employee must answer yes to a set of questions. They must have their temperature taken and it must be below 37.8°C when they arrive at Point Edward Early Learning Centre.

Employee Declaration:

DO YOU OR ANYONE FROM YOUR HOUSEHOLD HAVE ANY OF THE FOLLOWING SYMPTOMS/SITUATIONS? IF SO, DO NOT ENTER

· Feeling feverish

· Any respiratory congestion, cough, or difficult breathing

· Any flu like symptoms

· Feeling unwell with any symptoms regardless of being infectious disease related.

· If you or anyone in your party has travelled anywhere deemed unsafe by the Province of Ontario Government (i.e. in an early Stage of recovery)

· If you or anyone in your party, has travelled anywhere outside Canada

· Close contact with a confirmed or probable case of COVID-19

· Close contact with a person with acute respiratory symptoms any time during the 14 days before their symptom onset

Washing hands is recommended over an alcohol-based hand rub for children and employees.

Once employees are cleared to enter the building, they must wash their hands, put on a medical face mask and eye covering/face shield, and wash their hands again (follow proper PPE procedures). Refer to Appendix E.

Be aware that your usual room may be changed to accommodate ratio based on our numbers. When you are in your room, you cannot go into another room.

A disposable, Ministry of Education approved face masks and eye protection (goggles/face shield) must be worn in the halls and classrooms of the Centre and any time social distancing is not practical starting on September 1, 2020. You do not have to wear a mask in situations where you are able to be at least 6 feet way from the nearest person, for example, in the staff room if you are alone, or during nap time if you are able to ensure that you are never within 6 feet of either your coworkers or the children (i.e. you must wear a mask if you are doing sleep checks or if you have to tend to a child during nap time) You MUST wear a mask and eye protection in the following situations:

· In the screening area and when accompanying children into the program from the screening area

· When cleaning and disinfecting blood or bodily fluids spills

· When caring for a sick child or a child showing symptoms of illness

· Anytime you cannot maintain a 6 feet distance from another child/person

You may wear gloves when disinfecting, then discard when one set of cleaning is done. Use different gloves each time you disinfect. You may use bare hands if you prefer, provided you use proper hand hygiene.

It is recommended, but not required staff should wear their hair pulled back in a ponytail or headband. This is to deter unconscious face touching.

At breaks or lunchtime, make sure you are social distancing from other people. Lunches must be coordinated so that no more than two people are breaking in the Upper Staff Room and one person in Lower at a time (Main Site) or two people at Bridgeview Site. Each employee are encouraged to disinfect the items they are using in the staff room with the disinfectant provided. This way each employee knows it has been done properly.

It is recommended that each staff member wipe down the staff toilet seat before personal use to ensure the space is clean. Wash your hands after cleaning the toilet and before leaving the bathroom.

At the end of the day, consider changing work clothes to your street clothes, put work clothes in a plastic bag and wash hands before leaving the daycare. Work clothes should be brought home and washed that day.

As restrictions lift, these guidelines will be relaxed as required for individual situations.

Staff Entering Premises:

· You are required to be ready to work when your shift starts so please keep that in mind when arriving to work. The screening process may cause delays. Staff enter the building at the Southwest door and self-assess their health, taking and documenting their temperature and signing the declaration.

· Every employee will complete the health screening training and know how to conduct the screening process.

Establishing Cohorts:

A cohort is defined as a group of children and the teachers assigned to them, who stay together throughout the duration of the program for a minimum of 7 days. Each cohort must stay together throughout the day and are not permitted to mix with other cohorts. Reduced ratios are permitted as set out under the CCEYA if cohorts are not mixed with other cohorts.Comment by Mary Shafer: Information with respect to how staff shifts will be scheduled to minimize the risks with respect to the coronavirus (COVID-19).

Point Edward Early Learning Centre will offer three (3) to four (4) cohorts at Main Site and two (2) or three (3) at Bridgeview Site. Each cohort will consist of the licensed capacity for the room plus at least the minimum staff required to maintain ratio.

Special Needs Resource Staff are not counted as part of the cohort.

Cleaning staff that enter the room while empty, who wear a mask while in the room are not counted as part of the cohort.Comment by Mary Shafer: A description of physical distancing measures that will be implemented.

· Where possible, we will practice social distancing within said space.Comment by Mary Shafer: A description of physical distancing measures that will be implemented.

· We will always refrain from mixing with other groups within our Centre (except in emergency situations).Comment by Mary Shafer: Information with respect to how staff shifts will be scheduled to minimize the risks with respect to the coronavirus (COVID-19). Comment by Mary Shafer: A description of physical distancing measures that will be implemented.

· The staff in the lower level preschool rooms A and B, will be considered one cohort to be able to relieve one another for breaks. The children will remain in their own programs as much as possible except during outside play.

· We will encourage more physical space between children by: Comment by Mary Shafer: A description of physical distancing measures that will be implemented.

· Spreading children out into different rooms/areas

· Staggering, or alternating, lunchtime and outdoor playtime

· Increase our outdoor playtime from two hours per day to as much as possible given the weather and space available

· Incorporating more individual activities or activities that encourage more space between children

· Increase the distance between cots or mats during sleep time, positioning them toe to toe or head to toe where a proper distance is not possible

· When holding children, use blankets or cloths over childcare providers’ clothing; change the blankets/cloths between children and wash hands between children

· Reduced ratios are permitted as set out under the CCEYA provided that cohorts are not mixed with other cohorts.

· Staff shall be assigned to one site for the duration of the 7-day period that is defined in a cohort. Administration staff shall avoid entering any space designated for the individual cohorts, unless absolutely necessary.Comment by Mary Shafer: Information with respect to how staff shifts will be scheduled to minimize the risks with respect to the coronavirus (COVID-19).

Drop off/Pick-Up ProcedureComment by Mary Shafer: A description of the procedures that will be followed when a child is dropped off at and picked up from the centre or premises.

In order to facilitate a smooth drop off and pick up, please abide by the following rules.

Your patience is appreciated.

The front entrances are the only point of access for both sites.

The parking lot at 213 Michigan Ave will be off limits to parents until further notice.

· Drop off is between 7:00am and 9:30am Monday through Friday, except when the Centre is closed. Please allow enough time to follow the drop off procedure. There may be delays.

· If you are unable to drop off during this time, you will need to call the Centre to arrange a drop off time so that an employee is available to perform the Health Screening Procedure.

· For drop offs, each family shall pull up in front of the Centre and wait until there are no more than three families in line. Once the line is short enough, each family may get their child(ren) out of the vehicle and one parent/guardian shall proceed with the child(ren) to the front entrance. Please maintain social distancing. Comment by Mary Shafer: A description of physical distancing measures that will be implemented.

· Please bring a water bottle with you. If you must wait in your car, you and your child(ren) might become hot, which could affect your temperature. If your temperature is above the recommended limit, and you believe it is a result of being hot, you will be permitted to stand in the shade and retry in a few minutes. In the winter, if a child’s temperature is hot, removing hats, coats and mittens will be practiced. After a few minutes, a retesting of the child’s temperature will occur.

· Once you have arrived for pick up, pull up out front. Wait in the vehicle, with the ignition turned off and call the Centre: Main Site: 519-337-4468 or Bridgeview 226-886-1661. An employee will gather your child(ren) and their belongings and bring them out to you. Please be patient as this may take a few minutes and please be respectful to any other parents waiting for their child(ren).

Health Screening Procedure (Personal Protective Equipment etc.):

The Centre will employ additional protocols to maintain a safe and healthy environment for all employees, children, and families and respond to provincial and municipal pandemic response plans.

· Precautions may include daily screening of employees, children and any other person engaging in the business prior to entering the building, increased cleaning, and reduced group sizes. These restrictions may lift as we move through the pandemic.

· Children will be encouraged, but not required, to wear cloth face coverings while in doors at the Centre, parents will be asked to provide them, to be left here and washed daily, if the child is to wear a cloth face covering. Children under 2 years will not be asked to wear a face covering. Children in grade 4 and above will be required to wear a cloth face covering provided by the parents, to be brought home and washed daily.

· Use of Personal Protective Equipment (PPE) and social distancing will be consistent with recommendations by Lambton Public Health.

· PPE is required for day to day interactions with children as of September 1, 2020.

· Ministry approved, medical face masks and face shields will be provided for each employee.

· If the employee wishes to use goggles instead of a face shield, it is acceptable but must be purchased by the employee at their cost.

· Gowns and gloves are not required. If desired by an employee, they will be provided during the period where an emergency is declared and during the subsequent phases of recovery.

· When meals or snacks are provided, ensure children have their own individual meal or snack and that they sit in an arrangement that encourages physical distance. Food must not be shared. Comment by Mary Shafer: A description of physical distancing measures that will be implemented.

· In consultation with Lambton Public Health, employees will adhere to the following new procedures developed for Emergency Child Care operations:

· Appendix A: Environmental Cleaning and Disinfecting Health Screening Procedure Policy and Procedures

· Appendix B: Exclusion of Children or Employees Who are Ill Policy and Procedures

· Appendix C: Hand Hygiene Policy and Procedures

· Appendix D: Health Screening Procedure

· Appendix E: Recommendations for use of PPE in Childcare Centres

· Appendix F: Covid-19 Outbreak Response

Screening:

Please refer to Appendix D: Health Screening Procedure

· Every employee, child and any persons engaging in business inside the Centre will be screened daily prior to being admitted into the Centre.

· Screening should be completed just outside the front door of Main Site, or in the hall, next to the gym and not inside the double fire doors at Bridgeview Site.

· Entry will be denied to any person including the child of a parent/guardian (or any person residing in the child’s home) who meets the following criteria:

· Signs or symptoms of respiratory infection, such as cough, shortness of breath, sore throat, runny nose, headache, muscle aches, fatigue and/or fever (over 37.8 degrees Celsius). See Ministry of Health reference for full list of symptoms.

· Any other symptoms of illness or feeling unwell

· Anyone who has travelled outside of Canada in the last 14 days.

· Screening will include exterior signage at the Centre and on exterior doors, followed by active screening questions to the child and parents/caregivers outlined by Lambton Public Health. This will be completed at a distance of 2 meters where possible. A table will be used to encourage a safe distance. Comment by Mary Shafer: A description of physical distancing measures that will be implemented.

· Temperatures will be checked of all children, employees, and persons engaging in business inside the Centre, provided that they pass the screening test; thermometers must not be used between children/employees without single-use protective covers and disinfecting between uses.

· Visitors to the Centre will not be permitted during the emergency. Resuming allowing visitors shall depend on the directives of the County of Lambton, The Ministry of Health or the province.

· Parents/guardians will not be permitted beyond the entry point of the Centre; they will instead be offered virtual meetings, tours and pictures.

· Deliveries should be left at the door. Once the emergency is declared over, the delivery person shall be admitted into the Centre provided they pass the screening test. This shall continue until all other restrictions are lifted.

· In the case where deliveries are too heavy for an employee to bring them into the Centre, delivery persons are permitted to enter the premises, only through the back door and they are to proceed directly to the kitchen or staff room (water delivery only) provided they pass the screen test including temperature.

· Essential services such as repair persons, inspectors, support facilitators etc. shall be allowed into the Centre provided they pass the screening and record the date and time of their presence, their temperature, and their contact information.

Cleaning: Comment by Mary Shafer: Actions that will be implemented to sanitize the centre or premises and the indoor and outdoor equipment, materials and furnishings therein.

Refer to Appendix A

· In accordance with the Environmental Cleaning and Disinfecting Policy and Procedures, the Centre will be thoroughly cleaned prior to opening and throughout the day.

· Ensure all current infection prevention and control practices are adhered to, this includes but is not limited to:

· Ensuring all toys used at the Centre are made of material that can be cleaned and disinfected (e.g. avoid plush toys).

· It is recommended that books, puzzles, cardboard/boxboard, etc. that are absorbent and cannot be easily cleaned and disinfected are limited or removed.

· Increasing the frequency of cleaning and disinfecting indoor objects, toys and frequently touched surfaces.

· Refrain from using water or sensory tables. Sensory materials may be used if designated for each child and not shared with others, for example play dough bagged with child’s name.

· Linens must be laundered per usual guidelines.

· Children must not share soother, bottles, sippy cups, toothbrushes, facecloths, etc. Label these items with the child’s name to discourage accidental sharing.

· Frequently touched surfaces that are most likely to become contaminated, including doorknobs, light switches, toilet handles, and tabletops must be disinfected at least twice a day.

· Performing proper hand hygiene (including assisting children with hand hygiene) .

· Incorporating additional hand hygiene opportunities into the daily schedule.

Specific Information for Point Edward Early Learning Centre:

· If a child needs some extra time with their parent or guardian, the metal bench at the front of Main Site or two plastic chairs at Bridgeview shall be provided for this use. The seats shall be disinfected in the morning during set up, and in between each use.

· Each child shall have his or her own cubby. There shall be at least one vacant cubbie between those assigned to attending children. As restrictions ease and we are allowed more children, occupied cubbies may be side by side, however, cubbies shall not be shared until all other restrictions have been lifted.

· Comfort toys/blankets shall be discouraged. However, if a child brings one comfort toy/blanket, that will be acceptable. It will need to be laundered right away. The comfort toy/blanket shall only be used at rest time and shall remain at the Centre until the child no longer attends.

· No other toys are permitted until the emergency is declared over and all restrictions have been lifted.

· Soothers are allowed but must be hung up immediately upon arrival, and when the child is finished with it. They must be hung far apart from other soothers. All soothers need to be labeled.

· Bottles from home must be wiped with a disinfected wipe and put in the fridge. Make sure each bottle is labeled as usual.

· Children should bring extra clothes from home to be kept at the Centre until they are used. Soiled clothes will be sent home with the child. New clothes should be provided on the next day the child attends.

· Every child must wash their hands upon entering the room; the child shall be guided by a designated teacher to avoid accidental contamination of surfaces or toys. The child shall wash their hands every hour after. This will be monitored by a teacher or other staff.

· The Toddler/Preschool shared bathroom shall be divided in half in some way that stands out (i.e. red duct tape). Each room will have access to two toilets and two sinks.

· Wash children’s toys between transitions. Wash indoor toys after use and in the evening or morning per the cleaning schedule.

· Use of the yards, strollers, and wagons - After the children are done playing outside, they will wash their hands immediately upon reentering the building. All outdoor play equipment, strollers and wagons shall be sprayed down with bleach sanitizing spray every evening. The emphasis should be on proper hand hygiene rather than keeping these items spotless. Once the temperature reaches freezing (below 0℃), the children can play on the equipment while wearing mittens.Comment by Mary Shafer: Actions that will be implemented to sanitize the centre or premises and the indoor and outdoor equipment, materials and furnishings therein.

· It is recommended that books, puzzles, cardboard/boxboard, etc. that are absorbent and cannot be easily cleaned and disinfected are limited or removed. Hard covered books that can be wiped down can be used, five at the most. Wood puzzles (social distancing) can be used only during certain times (develop special time usage schedules for certain toys). After use, disinfect and put away for the next day.Comment by Mary Shafer: Actions that will be implemented to sanitize the centre or premises and the indoor and outdoor equipment, materials and furnishings therein.

· No sensory bins or loose parts should be offered at this time. Sensory materials may be used if designated for each child and not shared with others, for example play dough bagged with the child’s name. Great supervision on this will be needed. Only big toys and nothing that can be put in their mouth, no plush toys at this time. Hard dolls only.

· Staggering lunch and snack times when the allowed cohort size has increased to 20.

· During meals or snacks, ensure children have their own individual servings and that food is not shared. The children should sit in an arrangement that encourages physical distance. Food must not be shared. All food should be cut up by nutritionists rather than teachers in the rooms in order to keep an extra eye on the children. Food should be handed out by teachers rather than served family style to avoid contamination. This occurs when children touch a food they do not choose to put on their plate. Scraping may be okay; supervision is needed to ensure children do not play with or eat the waste.

· Increase the distance between cots or mats during sleep time. If space is tight, place children head to toe or toe to toe. Wash all blankets and sheets and disinfect cots per usual routine (weekly and between children).

· Frequently touched surfaces are most likely to become contaminated, including doorknobs, light switches, toilet handles, and tabletops must be disinfected at least twice a day, at naptime and at the end of the day or first thing in the morning, before children arrive.

· Bathrooms should be cleaned twice a day: after lunch and either at close or before open the next day.

· During the period of emergency, any staff meeting should be held outside, in a space large enough for everyone to socially distance, or virtually.Comment by Mary Shafer: Information with respect to the rescheduling or cancellation of pre-planned group events and in-person meetings.

· Aside from staff, only service people and members of our Board of Directors shall be permitted past the front foyer and then, only when required. They must perform a health check and wear an approved face mask.Comment by Mary Shafer: Information with respect to the rescheduling or cancellation of pre-planned group events and in-person meetings.

· There shall be no in-person tours. Virtual tours have been made available on our website or pictures of the rooms shall be provided upon request. Comment by Mary Shafer: Information with respect to the rescheduling or cancellation of pre-planned group events and in-person meetings.

· Until the COVID-19 pandemic is over, no program shall take part in community activities or enter any community buildings. Any scheduled events will be cancelled until further notice.

Important Note About 205 Albert St, Bridgeview Site:

Bridgeview Site will not reopen simultaneously with Main Site. There will be a lag-time of no less than one week. The site will only be reopened when it is safe to do so.

The procedures contained in Specific Procedures for Point Edward Early Learning Centre are general guidelines and are open to revision to conform with regulations.

Bleach is not allowed in the Bridgeview Public School classrooms. Instead, a Lambton Kent District School Board approved disinfectant will be purchased by Point Edward Early Learning Centre and used in Bridgeview Public School classrooms.

The Nursery School program activities will incorporate outside play and walks as much as possible during the pandemic emergency, sharing the play yard with the preschool room. A schedule will be made for sharing the space and it will be cleaned and disinfected after every use. Comment by Mary Shafer: Actions that will be implemented to sanitize the centre or premises and the indoor and outdoor equipment, materials and furnishings therein.

The Nursery School program will share classroom space with the School Age Programs. They will use toys designated for their program. School Age will use toys designated for the School Age program. Comment by Mary Shafer: Actions that will be implemented to sanitize the centre or premises and the indoor and outdoor equipment, materials and furnishings therein.

The classroom will be cleaned and disinfected in between each cohort.

The classroom will also be used as a staff room/office. The desks used for lunch will be cleaned and disinfected after use and the Site Supervisor’s desktop, drawers, filing cabinet and printer will be disinfected once per day.

Screening shall take place before admittance to the program as per the Disease Outbreak/Pandemic Policy and Procedures.

School Age Procedures:

· All children in grade 4 and high are required to wear a cloth face covering. This shall be provided by the parents and washed daily at home. Children in Kindergarten through Grade 3 will be encouraged, but not required to wear a face covering.

· The Before and After School program will have two mandatory screening procedures every school day.

· The parents must bring their child to the screening table every morning to sign the screening declaration.

· All children in the After-School program must also be screened, even if they were screened in the morning. This will include recording temperatures.

· The children will keep their backpack, lunch pails, coats (if needed) and outdoor shoes in the hallway.

· There will be no toys or electronics from home.

· Per ‘Specific Information for Point Edward Early Learning Centre’, only toys that are easily disinfected shall be used, being sure to use the same cleaning regime.

· The number of Centre owned outside toys will be limited to those that can be easily disinfected allowing for variety in developmentally appropriate activities. There will be a bin in the hallway near the outside door to the back field with balls, skipping ropes and sand toys that can easily be disinfected. The teachers and site supervisor will help with this task each time they are used.

Other Health and Safety Details:

· In addition to these preventative measures, and as per direction from the Ministry of Education, we will have a protocol in place in the event that a child, parent or employee at the site is exposed to COVID-19.

· A child or employee who has been exposed to a confirmed case of COVID-19 or symptomatic person(s) shall be excluded from the Centre for 10 days.

· The Centre will contact Lambton Public Health to notify them of a potential or confirmed case and seek input regarding the information that should be shared with other parents of children in the Centre.

· Please refer to Appendix B: Exclusion of Children or Employees Who are Ill Policy and Procedures.

· Environmental cleaning of the isolated/exclusion space the child/employees were in will take place. Refer to Appendix A: Environmental Cleaning and Disinfecting Policy and Procedure.

Social Distancing ConsiderationsComment by Mary Shafer: A description of physical distancing measures that will be implemented

· Physical distancing between children can be difficult to maintain; however, it is an important strategy that shall be encouraged whenever possible.

· It is also important to maintain a welcoming and caring environment for children. We use the document “Building On How Does Learning Happen?” for support and ideas on how to provide an engaging environment while physically distancing.

· Each group of children must have their own assigned indoor space. The Toddler room and Upper Preschool room share a bathroom. That shall be divided in half by a barrier that meets ministry guidelines, with two sinks and two toilets on each side.

· When in the same common space (e.g., entrances, hallways), physical distancing of at least 2 metres must be maintained between different groups and shall be encouraged, as much as possible, between children within the same group by:

· spreading children out into different areas, particularly at meal and dressing time;

· incorporating more individual activities or activities that encourage more space between children; and,

· using visual cues to promote physical distancing.

· In shared outdoor space, a distance of at least 2 metres must be maintained between groups and any other individuals outside of the group at all times.

· Recognizing that physical distancing is difficult with small children, additional suggestions include:

· planning activities that do not involve shared objects or toys;

· when possible, moving activities outside to allow for more space; and,

· avoid singing while inside

· Do not use community playgrounds

Appendix A

Environmental Cleaning and Disinfecting Policy and Procedures Comment by Mary Shafer: Actions that will be implemented to sanitize the centre or premises and the indoor and outdoor equipment, materials and furnishings therein.

Intent:

To ensure that all employees are aware of and adhere to the directive established by Lambton County Public Health, the Ontario Ministry of Health, and Lambton County Children's Services and Point Edward Early Learning Centre regarding environmental cleaning and disinfecting. This policy applies to all employees, community members and any other persons engaged in business with Point Edward Early Learning Centre.

Policy:

Point Edward Early Learning Centre is committed to providing a safe and healthy environment for children, families, and employees. We will always take every reasonable precaution to prevent the risk of communicable diseases within our Centre but especially during a pandemic or emergency situation.

Definitions:

Cleaning: refers to the physical removal of foreign material (i.e. dust, soil) and organic material (i.e. blood, secretions, microorganisms). Cleaning removes, rather than kills microorganisms.

Warm water, detergent, and mechanical action (i.e. wiping) is required to clean surfaces. Follow the manufacturer's instructions when using commercial cleaning products.

Disinfecting: describes a process completed after cleaning in which a chemical solution (i.e. bleach) is used to kill most disease-causing microorganisms. In order to be effective, disinfectants must be left on a surface for a period of time (contact time). Contact times are generally prescribed by the product manufacturer. Any items children may come into contact with requires a final rinse after the required contact time is observed.

Procedures:

All products including cleaning agents and disinfectants must be out of reach of children, labeled, and must have Safety Data Sheets (SDS) up to date (within three years), which are stored on the Health and Safety wall located outside the classroom. Products must not be expired, and product must have a DIN number approved by Health Canada.

Cleaning:

· Use detergent and warm water to clean visibly soiled surfaces

· Rinse the surface with clean water (warm to tepid temperature preferred) to ensure detergent is removed

· Let the surface dry

Disinfecting:

Choosing an approved disinfectant:

· Most everyday disinfectants are capable of killing most viruses. As with any chemical solution, it must be used according to the manufacturer's directions to ensure its effectiveness in killing pathogens the product claims. All cleaning/disinfection products must be labelled with product name, WHMIS health and safety information, and employees must have access to the manufacturer's directions for use and have access to the manufacturers recommended personal protective equipment when using the product. Make sure health and safety training on the safe and proper use of the chemicals is provided to the childcare staff.

· Any product chosen must have an expiry date and a Health Canada approved DIN number. Products without a DIN may not be effective at killing pathogens, including the viruses. The only exception to this is bleach, which may be used but does not have a DIN number.

· Examples of adequate active ingredients for disinfectants are sodium hypochlorite, isopropyl alcohol, quaternary ammonium compounds and hydrogen peroxide. When choosing a disinfectant, take into consideration ease of use, concentration, and contact times. It is recommended by public health to choose a product with a lesser amount of contact time.

· A product with a one-minute to 5-minute contact time would be more appropriate with the frequency of cleaning and disinfection that is required during a pandemic. Public Health also recommends using a product that can be used for both cleaning and disinfection, and one that is ready to use, as opposed to mixing, for accuracy, and health and safety reasons. (examples of acceptable high-level disinfectants include bleach and water at 1000ppm (1 min contact time), or accelerated hydrogen peroxide products with a 1-minute contact time.

· If the product directions state that food contact surfaces must be rinsed with potable water prior to use, that means any surface that food touches, or the child eats from, or any mouthed toys such as teethers/pacifiers must be rinsed with water and left to air dry, prior to use. Please note* It is important that only food grade disinfectants are continued to be used in any inspected food preparation areas, such as the kitchen, in order to comply with the Food Premises Regulation 493.

Cleaning and Disinfection frequency requirements:

Clean and disinfect upon ENTRY to childcare (for employees):

· Any hard surfaces such as water bottles, travel mugs, cell phones, lunch containers.

Clean and disinfect frequencies for other surfaces and items:

· Cleaning and disinfecting routines must be increased as the risk of environmental contamination is higher.

· Tables and countertops: used for food preparation and food service must be cleaned and disinfected before and after each use.

· Spills must be cleaned and disinfected immediately.

· Hand wash sinks: staff and children washroom areas must be cleaned and disinfected at least two times per day and as often as necessary (e.g., when visibly dirty or contaminated with bodily fluids).

· Floors: cleaning and disinfecting must be performed as required, i.e., when spills occur, and throughout the day when rooms are available, i.e., during outdoor play.

· Outdoor play equipment: Must be sprayed with an approved disinfectant solution every evening until the weather drops below freezing. Cleaning should be performed as required (e.g., visibly dirty). Any outdoor play equipment that is used must be easy to clean and disinfect. Do not use community playgrounds. Small outdoor toys should be brought indoors to be cleaned and disinfected each day or in between cohorts.

· High-touch surfaces: any surfaces at your location that have frequent contact with hands (e.g., light switches, shelving, containers, handrails, doorknobs, sinks, toilets etc.,). These surfaces should be cleaned at least twice per day and as often as necessary (e.g. when visibly dirty or contaminated with body fluids) We are recommending toilets be disinfected prior to each use by staff using the toilet.

· Other shared items: (e.g., phones, IPADs, IPODs, attendance binders etc.) must be disinfected between users.

· Note: Most areas are best cleaned with a suitable low-level disinfectant. Follow the manufacturer's directions regarding drying time, etc.

· Please refer to Cleaning and Sanitizing in the Workplace at the end of the manual.

Clean and disinfect daily:

· Low-touch surfaces (any surfaces at your location that have minimal contact with hands), must be cleaned and disinfected daily (e.g. Window ledges, doors, sides of furnishings etc.).

· Carpets are to be vacuumed daily when the rooms are available (i.e. during outdoor play).

Clean and disinfect as required:

Blood/Bodily Fluid Spills:

Using the steps below, the surface must be cleaned first then disinfected:

1. Isolate the area around the spill so that no other objects/humans can be contaminated

2. Gather all supplies, perform hand hygiene, then put on single-use gloves and gown

3. Scoop up the fluid with disposable paper towels (check the surrounding area for splash/splatter) and dispose of in separate garbage bag

4. Clean the spill area with detergent, warm water, and single-use towels

5. Rinse to remove detergent residue with clean water and single-use towel

6. Discard used paper towels and gloves immediately in a tied plastic bag

7. Spray high level disinfectant in and around the spill area and allow the appropriate disinfecting contact time

8. A final rinse is required if children come into contact with the area

9. Remove gloves as directed and discard them immediately

10. Perform hand hygiene as directed

Notes:

· If the spill includes broken glass, ensure a brush and dustpan is used to pick it up and discard. Disinfect the brush and dustpan after use. NEVER use your hands to clean up glass

· If the spill occurs on a carpet, follow the above steps along with professional steam/wet cleaning the carpet.

· Please refer to Blood and Bodily Fluid Spills Fact Sheet at the end of manual

Cots/mats/cribs cleaning and disinfecting:

· Cots/mats/cribs must be labeled and assigned/designated to a single child per use

· Cots/mats/cribs must be cleaned and disinfected before being assigned to a child

· Cots/mats must be stored in a manner which there is no contact with the sleeping surface of another cot/mat

· Bedding must be laundered weekly, between children, and when soiled or wet

Additional Infection Prevention and Control Practices for Hygiene Items:

· Pacifiers must be individually labeled and stored separately (not touching each other), they must not be shared among children. The pacifier must be washed in soap and water upon arrival to the Centre.

· For creams and lotions during diapering, never put hands directly into lotion or cream bottles, use a tissue or single-use gloves. Use a spatula or other tool to dispense, and do not "double-dip" into the product. Upon arrival to the Centre, wipe the cream/lotion container with a disinfecting wipe.

Appendix B

Exclusion of Children and Employees Who Are Ill: Policy and Procedures

Intent:

To ensure that all employees are aware of and adhere to the directive established by Lambton County Public Health, the Ontario Ministry of Health, Lambton County and Point Edward Early Learning Centre regarding the exclusion of children and employees who are ill. This policy applies to all employees, community members and any other persons engaged in business with Point Edward Early Learning Centre.

Policy:

Point Edward Early Learning Centre is committed to providing a safe and healthy environment for children, families, and employees. We will take every reasonable precaution to prevent the risk of communicable diseases within our Centre.

Procedures:

As required by the Child Care and Early Years Act and Ministry of Health, we must separate children of ill health and contact parents/guardians to take the child home.

When children are ill and/or exhibit infectious disease related symptoms, employees will ensure the following:

· Ill children will be separated and monitored by an employee until parent/guardian pick up

· Symptoms of illness will be recorded on a surveillance form, in the child’s daily record and in a daily log as per the CCEYA

· The parent/guardian of the ill child will be notified to take them home

· If it appears that the child requires immediate medical attention, the child will be taken to the hospital by ambulance and examined by a legally qualified medical practitioner or nurse registered under the Health Disciplines Act. R.R.O. 1990, Reg. 262, s. 34(3)

If you suspect a child has symptoms of a reportable communicable disease, please report them immediately to Lambton Public Health at 519- 383-8331.

When to Exclude a Child from Program:

Employees should exclude a child from the program when the child has one or more symptoms of COVID-19: See the most current Ministry of Health reference document for list of symptoms.

*If the child has a runny nose but no other symptoms, it is not necessary to also isolate any siblings in attendance at the Centre. All other protocols shall be complied with.

How to Exclude children experiencing non-infectious disease related symptoms:

· Child should be isolated from other children until the parent can pick them up.

· Encourage the parents to have the child assessed by a healthcare provider (HCP.)

· Follow the directions of the HCP - if determined not to be infectious disease-related, the child may be allowed back into the Centre after 24 hours if symptoms have not worsened. This extends to 48 hours symptom-free during gastrointestinal outbreaks and 72 hours of improvement for a cough.

How to Exclude in a Child Care Centre Children experiencing Infectious Disease related symptoms:

1. Please refer to the current Ministry of Health reference document for symptoms.

2. Children should be immediately isolated in a separate, supervised room until parents can pick them up. If unable to reach parents, call the emergency person listed.

3. Only one employee should be in the designated room and they should attempt physical distancing of 2 metres. Comment by Mary Shafer: A description of physical distancing measures that will be implemented. Comment by Mary Shafer: A description of physical distancing measures that will be implemented.

4. If the employee supervising the symptomatic child cannot maintain a distance of 2 metres, they will wear the following personal protective equipment (PPE):

· Mask (procedural/surgical/medical - not homemade)

· Gloves

· Cloth or blanket if comforting / picking the child up is required

· Follow the proper steps for putting on and taking off PPE

· Employees should avoid touching their face, especially with gloved or unwashed hands

· The child should also wear a mask if tolerated.

*Note: children under age two should not have their face covered due to suffocation risk.

Instructions for donning (putting on) and doffing (removing) PPE:

Putting on Gloves: https://www.youtube.com/watch?v=UIBmi578NmE

Removing Gloves: https://www.youtube.com/watch?v=WDl0Zj573Js&feature=emb_rel_end Putting on Mask: https://www.youtube.com/watch?v=1YiLjpLXvg4

Removing Mask: https://www.youtube.com/watch?v=pFJaU9nxmTA Putting on full PPE: https://www.youtube.com/watch?v=s2z1uM1fXN8 Taking off full PPE: https://www.youtube.com/watch?v=crGlUX3_4DA

Recommended Steps for Putting on and Taking Off PPE https://www.publichealthontario.ca/-/ media/documents/ncov/ipac/ppe-recommended-steps.pdf?la=en

How to wash your hands and How to use hand sanitizer https://www.publichealthontario.ca/-/ media/documents/ncov/factsheet/factsheet-covid-19-hand-hygiene.pdf?la=en

5. Every effort will be made to keep the child comfortable until someone arrives to take him or her home.

6. Tissues should be provided to the child for proper respiratory etiquette, with proper disposal of the tissues and proper hand hygiene.

7. Increase ventilation in the designated exclusion room if possible (e.g. open windows/doors)

8. Once the child and their siblings have been picked up, immediately conduct environmental cleaning of the space the child was separated in including all toys the child may have used. Comment by Mary Shafer: Actions that will be implemented to sanitize the centre or premises and the indoor and outdoor equipment, materials and furnishings therein.

9. Contact Lambton Public Health 519-383-8331 to notify them of a potential or confirmed infectious disease case and see input regarding the information that should be shared with other parents of children in the Centre. Comment by Mary Shafer: An explanation of how confirmed cases of the coronavirus (COVID-19) will be reported.

10. Children with a new symptom must be excluded from childcare for 10 days or obtain a negative test result, AND the symptoms must be improving for at least 24 hours before returning (in the case of a child who has a cough but no other symptoms, the cough must have been improving for at least 72 hours, after which the child may return to the Centre). If you do not wish to have your child tested and/or isolate for 10 days, you may choose to take your child to a doctor to confirm that the symptoms are not COVID related, at which point the child may return to childcare (So long as a fever is not present and they have been symptom free for 24 hours or 72 hours for coughs as above).

If the symptom is due to an underlying condition (allergies, asthma, food intolerances, etc.) and is normal for the child, the child may return after 24 hours, as long as the symptom does not worsen or a secondary symptom does not occur. If the symptoms are gastrointestinal in nature (due to underlying condition), the child must be sent home as soon as possible after the onset of symptoms (first vomit or diarrhea) and kept away for 48 hours.  If the symptom/symptoms worsen or more infectious disease symptoms develop, see protocols for new symptoms above.

11. Children or employees who have been exposed to a confirmed case of COVID-19 should be excluded from the childcare setting for 10 days or produce a negative test result to return.

Criteria for coming out of isolation for symptomatic providers, employees or children with infectious disease symptoms:

· Where individuals can manage their symptoms at home and are not health care/essential service workers, it is required that they get tested or self-isolate for 10 days from symptom onset.

· If the worker or child’s guardian chooses to forgo testing, after 10 days, if they are without fever and their symptoms are improving, they may discontinue self-isolation.

· Absence of cough is not required for those known to have chronic cough or who are experiencing reactive airways post-infection. If symptoms or fever are persisting, individuals should follow-up with their primary care provider or Telehealth.

·

· Criteria for coming out of isolation for asymptomatic employees or children who were in close contact with staff or child with infectious disease symptoms:

Employees

· Must produce a negative test result or self-isolate for 10 days from last exposure to the symptomatic individual.

· Once a negative test result has been procured, the worker can come back provided they do not have both a cough and a runny nose and that symptoms must be improving.

Child

· See COVID-19 Screening Tool for Children in School and Childcare on the Ministry of Health website. COVID-19 Screening Tool for Children in School and Child Care (ontario.ca)

12. Encourage the parents to call their Health Care Provider to have the child assessed.

13. They can also complete an online assessment tool such as the one at: https://covid-19.ontario.ca/self- assessment

14. If they do not have a doctor, they can call Lambton County Public Health to be assessed at 519 383-8331.

2) Employees Illness:

1. Any employee who suspects they have an infectious disease should not attend the Centre if they are not well, particularly if their symptoms include any outlined in COVID-19 screening. Employees must pass the daily active screening process to work at all sites.

2 If an employee becomes ill with COVID-19 symptoms while at the Centre, they should let their supervisor know, put on a face mask, and remove themselves from the Centre as soon as possible.

3. The employee will begin self-isolation at home and will not be permitted back to work until 10 days of isolation are complete.

4. If an employee is suspected to have or is diagnosed with COVID-19, the childcare worker must remain off until symptoms are fully resolved, or negative laboratory tests have been confirmed.

5. The supervisor or designate will notify Lambton Public Health of the symptomatic employee or positive case and include the following details: Comment by Mary Shafer: An explanation of how confirmed cases of the coronavirus (COVID-19) will be reported.

a. Staff name

b. What Child Care Centre

c. What Room

d. Names of people (employees and other children) who have been in close contact (as defined) up to 48 hours prior to symptoms.

Following the instructions of Lambton Public Health, the Centre or cohort may need to close. All instructions for communicating the news of a positive case to parents of the Centre will be followed, including how and when parents are to be informed of the situation.

6. The supervisor or designate will contact children and/or staff who have been in close contact (up to 48 hours before symptoms) with a symptomatic person(s) (or confirmed infectious disease positive), with instructions to begin self-isolation for 10 days.Comment by Mary Shafer: An explanation of how confirmed cases of the coronavirus (COVID-19) will be reported.

7. The supervisor will notify Disability Management and Health and Safety for any illnesses that are believed to be the result of exposure to infectious disease through the course of work. Disability Management and Health and Safety will file notification with the appropriate bodies (MOL). Comment by Mary Shafer: An explanation of how confirmed cases of the coronavirus (COVID-19) will be reported.

8. Staff with a new symptom must be excluded from the Centre for 10 days or obtain a negative test result, AND the symptoms must be absent or improving for at least 24 hours before returning (in the case of staff who have a cough but no other symptoms, the cough must have been improving for at least 72 hours, after which they may return to the Centre). If you do not wish to be tested and/or isolate for 10 days, you may choose to see your doctor to confirm that the symptoms are not COVID related, at which point you may return to work (So long as a fever is not present and they have improving symptoms for 24 hour, 72 hours for coughs as above). You will be required to sign a declaration attesting to the doctor’s approval as we will not ask for a doctor’s note. If the symptom is due to an underlying condition (allergies, asthma, food intolerances, etc.) and is normal for staff, they may return after 24 hours, as long as the symptom does not worsen or a secondary symptom does not occur. If the symptoms are gastrointestinal in nature (due to underlying condition), the staff must be sent home as soon as possible after the onset of symptoms (first vomit or diarrhea) and kept away for 48 hours. If the symptom/symptoms worsen or more infectious disease symptoms develop, see protocols for new symptoms above.

9. The Site Supervisor or designate shall create a Serious Occurrence Report for every positive case of COVID-19. This report shall be submitted to the Ministry of Education and displayed in a prominent place within the Centre.Comment by Mary Shafer: An explanation of how confirmed cases of the coronavirus (COVID-19) will be reported.

Returning from exclusion due to illness:

Employees and /or children who are being managed by Lambton Public Health (e.g., confirmed cases of COVID-19, household contacts of cases) should follow instructions from Lambton Public Health to determine when to return to the facility.

Employees who are required to leave work due to suspected/confirmed illness or person in their household’s suspected/confirmed illness

Any employee currently working at Point Edward Early Learning Centre who is requested by an administrator to get tested for COVID-19, either because they failed the screening test or because a person in their household has failed the screening test, will be paid for 2 days off while they await the results of their test. An information sheet of locations and times for testing will be provided by the Centre.  If the testing process takes more than 2 days, the employee may use personal time. If an employee refuses to take a test, they must self-isolate for 10 days and this time will be unpaid.

It is at the discretion of the Executive Director to determine if an employee is overusing this policy.  If this situation occurs, the Executive Director has the right limit the scope of this policy and to tell the employee they must use sick days or have unpaid days off.

Appendix C

Hand Hygiene Policy and Procedures

Intent:

To ensure that all employees are aware of and adhere to the directive established by Lambton Public Health, the Ontario Ministry of Health, Lambton County, and Point Edward Early Learning Centre regarding hand hygiene. This policy applies to all employees, community members and any other persons engaged in business with Point Edward Early Learning Centre.

Policy:

Point Edward Early Learning Centre is committed to providing a safe and healthy environment for children, families, and employees. We will take every reasonable precaution to prevent the risk of communicable diseases within our Centre.

Definitions:

Hand Hygiene is a general term referring to any action of hand cleaning. Hand hygiene relates to the removal of visible soil and removal or killing of transient microorganisms from the hands. Hand hygiene may be accomplished using soap and running water or a hand sanitizer (70-90% alcohol based). Hand washing with soap and running water must be performed when hands are visibly soiled.

Procedures:

Hands carry and spread germs. Touching your eyes, nose, mouth or sneezing or coughing into your hands may provide an opportunity for germs to get into your body or spread to others. Keeping your hands clean through good hygiene practice is one of the most important steps to avoid getting sick and spreading germs.

Ensure that employees and children are always practicing good hand hygiene. Use soap and water when hands are visibly dirty and/or after:

· Sneezing, coughing, or blowing your nose

· Using the washroom

· Handling garbage

· Handling raw foods

· Outdoor play

· Toileting/diapering routine

· Handling soiled laundry or dishes

· Handling soiled toys or other items

· Coming into contact with bodily fluids

· Coming into contact with any soiled/mouthed items

· Gardening

· Hands should be cleaned using soap and water or alcohol-based sanitizer before and after:

· Preparing, handling, serving and eating food

· Handling animals

· Touching a cut or open sore

· Coming into contact with any bodily fluids

· Changing diapers or providing assistance with toileting

· Glove use

· Before and after giving medication

For washing hands with soap and water, follow these steps:

1. Remove rings, bracelets and watches

2. Wet hands

3. Apply soap

4. Lather for at least 15 seconds. Rub between fingers, back of hands, fingertips, under nails

5. Rinse well under running water

6. Dry hands well with paper towel or hot air blower

7. Turn taps off with paper towel, if available

Hand sanitizer information:

When hands are not visibly dirty, a 70-90% alcohol-based hand sanitizer can be used. Hand sanitizers must always be used under adult supervision. Adults must ensure that the product has completely evaporated from the child's hands before allowing the child to continue their activity.

For hand hygiene with hand sanitizer, follow these steps:

1. Apply alcohol-based hand sanitizer (70-90% alcohol content)

2. Rub hands together for at least 15 seconds

3. Work sanitizer between fingers, back of hands, fingertips and under nails

4. Rub hands until dry

Hand hygiene monitoring:

To ensure that employees are using proper hand hygiene methods, supervisors will review hand hygiene practices on a regular basis and provide feedback to employees as required.

Glove Use:

Gloves shall be worn when it is anticipated that hands will come into contact with mucous membranes, broken skin, tissue, blood, bodily fluids, secretions, excretions, contaminated equipment or environmental surfaces. Gloves should be single use only.

Gloves and Hand Hygiene

Gloves do not replace the need for proper hand hygiene. Hand hygiene shall be practiced before applying and after removing gloves. Gloves shall be removed and discarded after each use. Do not wear rings with gloves unless they have a smooth band.

To reduce hand irritation related to gloves:

· Wear gloves for as short a time as possible

· Ensure that hands are clean and dry before wearing gloves

· Ensure gloves are intact, clean and dry inside

· Gloves are single use only, and must be task specific such as for diaper changes

Covering Your Cough Procedure (Respiratory Etiquette)

Germs, such as influenza, COVID-19 and other infectious diseases, are spread by coughing and/or sneezing. When you cough or sneeze on your hands, your hands carry and spread these germs.

Attempt to keep your distance (more than 2 meters/6 feet) from people who are coughing or sneezing. Follow these steps to stop the spread of germs:

1. If you have a tissue, cover your mouth and nose when you cough, sneeze or blow your nose. If no tissue is available, cough or sneeze into your upper sleeve or elbow, not into your hands. Always cover and protect your coughs and sneezes.

2. Put used tissues in the garbage

3. Clean your hands with soap and water or hand sanitizer (70-90% alcohol based) regularly and after using a tissue on yourself or others

Appendix D

Health Screening Procedure

Intent:

In order to help reduce the risk of infectious disease spread during a pandemic or emergency, an active health screening procedure will be put in place.

This procedure applies to all employees, parents, guardians, children, and any other persons engaging in business within Point Edward Early Learning Centre.

Policy:

Everyone must be screened prior to entering premises of all Point Edward Early Learning Centre sites. Any person who fails to answer or answers yes to any of the screening criteria will be denied entry into the building. No visitors will be permitted into the Centre during a declared emergency. Deliveries shall be left in the designated location outside the entrance. If the item being delivered is too heavy for an employee to carry, the delivery person may enter the building, provide s/he has passed the screening process. The delivery person may proceed to the kitchen or staff room only.

Once the pandemic is declared over, visitors, including deliveries will be allowed in all sites provided they pass the Health Screening Procedure. The Health Screening Procedure will change depending on the level of concern for outbreaks of illness.

Procedure:

All individuals including employees, children, and parents/guardians must be screened each day, prior to being admitted into the Centre. Employees must follow the screening checklist for each person and record the child’s temperature on the individual Screening Sign-off sheet. Parents/guardians must sign the sheet before the child is admitted. Failure to answer questions or answering yes to one or more questions will result in non-admittance to the Centre. These Screening Sign-off sheets shall be kept in a binder, in alphabetical order. Records shall be maintained for a period of one year. Room attendance sheets are maintained daily by each program. They list the arrival and departure times and shall be used for contact tracing.

Set up the location screening:

· Place a table and canopy or umbrella at the front entrance visually blocking the entrance into the Centre. From October 1 to May 1, assessments will be completed inside the front foyer. Approved Public Health signage must be posted at the entry way identifying the screening process, hand hygiene, and respiratory etiquette.

· Only ONE entrance/exit is to be used to admit children, to ensure that each child is screened. Employees and any visitors will be screened in the back entrance.

· Maintain a minimum of 2 meters distance between employees conducting screening and the person being screened when possible.

· Screening employee shall wear a face mask, shield and gloves. Each employee shall wash/ use sanitizer on their gloved hands between each family. Discarded gloves and masks shall be disposed of in a garbage provided expressly for this purpose at the end of the intake/exiting period. Under no circumstances shall discarded masks or gloves be thrown on the ground or otherwise be disposed of improperly. Gowns shall be available if required.

· Place hand sanitizer at the screening table. Spray each employee and adult and child’s hands as they approach for screening. Only the screening personnel will touch the hand sanitizer spray.

· Place a cleaning/disinfecting spray within reach of the screening personnel. This is to be used to clean the table and pens between people and clean the bench should it be used.

· Ensure Lambton Public Health resources are available for anyone who does not pass the screening.

Questions for employees and families:

· Screening

· A COVID Questionnaire will be provided to families upon first reopening of the Centre, by supervisors, along with current best practices and recommendations by Lambton Public Health and the Ontario Ministry of Health. Families will be required to monitor themselves and their children prior to arrival at the Centre, to ensure they are not exhibiting symptoms.

· Greet everyone into our Centre with a friendly, calm manner. Request that only ONE parent/guardian lines up with the child, and request that they both use hand sanitizer.

· Ensure that each family knows the purpose of the screening and that we are following Lambton Public Health guidelines.

1. Question A-Do you/the child, or any member of your household have any of the following symptoms.

· Fever (37.8 degrees Celsius or higher)

· New olfactory (smell) or taste disorder(s)

· New or worsening cough

· Difficulty breathing

If yes, the child may not enter and must do one of these choices: receive a COVID test, see a doctor, or isolate for 10 days.

Question B- Does the child have any of the following symptoms:

· Sore throat

· Difficulty swallowing

· Runny nose

· Sneezing

· Nasal congestion

· Hoarse voice

· Nausea/vomiting Diarrhea

· Fatigue, lethargy, muscle aches or malaise

If yes to one, the child may not enter and must stay home for 24 hours and for gastrointestinal, 48 hours

With two or more of the symptoms in Question B, your child must receive a COVID test, see a doctor or isolate for 10 days.

2. Have you given your child any type of fever reducing medication in the last 5 hours? Yes/No

· If yes record reason for administering medication.

· It is at the screeners discretion whether to escalate to Lambton Public Health.

3. Have you/the child travelled outside of Ontario within the last 14 days? Yes/No

4. Have you/the child travelled to any area designated as phase 1(red) in the last 14 days? Yes/No

5. Employees will take child/children's temperature at screening booth.

a. They will use the temporal artery or tympanic thermometer provided.

b. The thermometer will be disinfected between each use.

c. No other type of thermometer will be permitted to be used.

*The child/employee temperature shall not exceed 37.8 °C.

6. Have you or anybody in your household tested positive for COVID-19?

All screening results are to be recorded and signed by parent/guardian.

How to respond:

If the individual answers NO to all questions, and their temperature is recorded as less than 37.8°C, they have passed the screening and can enter the building.

If the individual answers YES to any of the screening questions except question 2, their temperature is 37.8°C or higher, or they refuse to answer, then they have immediately failed the screening and cannot enter the building.

If the response is for an employee, advise that the Executive Director will be notified and will follow up later in the day.

Appendix E

Recommendations for the use of Personal Protective Equipment (PPE) in Child Care Centres

For non-healthcare settings the use of PPE should be considered based on a risk assessment of the task, the individual and environment.

Any Government guidance documents for your specific sector should be followed.

Key Recommendation:

· Droplet and Contact Precautions are recommended for the care of someone suspected or confirmed with COVID-19

· N95 respirators are not indicated for use in childcare settings.

Staff Role

Type of PPE Required

PPE Conservation Guidelines

Screener

Droplet and Contact Precautions, including:

• Surgical/Procedure Masks

• Re-useable face shields or goggles

• Gowns (optional)

• Gloves (optional)

Follow conservation guidelines for masks to extend use.

Recommendation:

2 masks/ day

1 gown/day

Staff member in cohorts

Providing care for a sick child (suspect case of infectious disease)

· Surgical/Procedure Masks

· Re-useable face shields or goggles

· Gowns

· Gloves (optional). If not wearing gloves, need to practice hand washing

Cleanup of bodily fluids with the risk of splashing/soiling of clothing:

· Surgical/Procedure Masks

· Re-useable face shields or goggles

· Gowns

· Gloves

Masks, gloves and gowns should not be re-used and be discarded.

Recommendation:

· 2 mask/cohort/week

· 2 gown/cohort/week

· 2 sets gloves/cohort/week

Environmental staff/ staff moving between classrooms

Staff that are involved in tasks that do not require close contact or direct care to children and are moving in between cohorts should wear:

• Surgical/Procedure Masks

Follow conservation guidelines for masks to extend use.

Recommendation:

· 2 masks/day

Appendix F

COVID-19 Outbreak Response PolicyComment by Mary Shafer: An explanation of how confirmed cases of the coronavirus (COVID-19) will be reported.

Intent:

It is the intent of Point Edward Early Learning Centre that our response to any outbreak should follow the guidance of Lambton Public Health, the Province of Ontario, and the County of Lambton.

Policy:

If one child or staff with new symptoms consistent with COVID-19, this will immediately trigger an outbreak assessment.

Procedure:

1. If a child or employee becomes sick while in the program, they should be isolated and family members contacted for pick-up. If the sick person is a child, an employee should remain with the child until a parent/guardian arrives. If tolerated and above the age of 2, the child should wear a surgical/procedure mask.

The Executive Director will specify where the isolation room will be and who will be responsible for monitoring the child. As soon as the child is isolated from others, the staff member caring for the child should perform hand hygiene and put on a surgical/procedure mask, face shield/goggles if there is risk of exposure to infectious droplets. Gowns and gloves are available if requested. The employee should also avoid contact with the child’s respiratory secretions.

Reasonable effort should be made to maintain social distancing. Staff member must perform hand hygiene after any contact with the ill child. Comment by Mary Shafer: A description of physical distancing measures that will be implemented.

If a separate room is not available, the ill child should be kept at a minimum of 2 metres from other children. This may be achieved by using physical barriers, floor markers, etc. The ill child should be provided with tissues and reminded of hand hygiene, respiratory etiquette, and proper disposal of tissues.

All items used by the ill person should be cleaned and disinfected by the cleaning staff designated for that cohort. Any items that cannot be cleaned (paper, books, cardboard puzzles) should be removed and stored in a sealed container for a minimum of 3 days. Comment by Mary Shafer: Actions that will be implemented to sanitize the centre or premises and the indoor and outdoor equipment, materials and furnishings therein.

2. Childcare centre licensees have a duty to report confirmed cases of COVID-19 under the Health Protection and Promotion Act. The Public health unit will provide specific advice on what control measures should be implemented to prevent the potential spread and how to monitor for other possible infected staff members and children. Symptomatic staff and/or parents/guardians of symptomatic children should contact Lambton Public Health.

3. Where there is a confirmed case of COVID-19 in a child, parent, or staff, the licensee must report this to the ministry as a Serious Occurrence. Where an infectious disease outbreak is declared and a room/centre is closed, the licensee must report this to the ministry as a Serious Occurrence. All Serious Occurrence Reports must be posted in a conspicuous area.

4. Enforce enhanced screening measures among children and staff such as screening upon arrival and more frequent monitoring of staff/children throughout the day.

Exclusion:

Individuals who are tested:

· Children/staff who test negative for COVID-19 must be excluded until 24 hours after symptom begin to improve.

· Children/staff who test positive for COVID-19 must be excluded from the Centre 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 10 days from onset of their symptoms.

Management of a Single Case in a Child/Staff: Comment by Mary Shafer: An explanation of how confirmed cases of the coronavirus (COVID-19) will be reported.

Two positive cases in a child/staff results in an outbreak. All members of the cohort are to be excluded for 10 days. In consultation with Public Health, cohort members may be referred for testing.

Required Steps in an Outbreak:

If an outbreak is declared at the Centre, the following measures must

be taken:

1. Consult with and follow directions from Public Health.

2. Within 24 hours of declared outbreak, a Serious Occurrence Report must be made.

3.Notify all family, staff, and essential visitors of the facility’s outbreak status. (i.e. letters and signage).

4. Enhance cleaning and disinfecting procedures.

5. Enhanced screening procedures (i.e. increased frequency of health checks).

6. More frequent hand hygiene with children and staff.

7. 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 Centre 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 infectious disease positive staff/child.

1.Apply hand sanitizer to your hands.

2.Rub using friction until hands are dry.

ACTIVE SCREENING IN EFFECT

DO YOU, YOUR CHILD OR ANY ONE FROM YOUR HOUSEHOLD HAVE ANY OF THE FOLLOWING SYMPTOMS/SITUATIONS?

IF SO, DO NOT ENTER

❒ Feeling feverish

OR

❒ Any respiratory congesting, cough or difficulty breathing

OR

❒ Any other symptoms or feelings of being unwell

OR

❒ If anyone in your party has travelled anywhere outside of Canada

OR

❒ Close contact with a confirmed or probable case of COVID-19

OR

❒ Close contact with a person with acute respiratory illness with recent travel to anywhere outside of Canada 14 days before their symptom onset.

IF ANY ANSWERS ARE YES TO ANY ABOVE

Family and children enrolled: Do Not Enter!

Please contact your physician or emergency room as needed and notify the Centre supervisor. People who have travelled anywhere outside of Canada need to be self-isolated for 10 days.

Staff: Do Not Enter! Contact your supervisor prior to returning to work for direction

STAFF MEMBER WILL BE ACTIVELY SCREENING ANYONE ENTERING THE BUILDING

FACT SHEET

Healthcare

Cleaning Up Body Fluid Spills (Urine, Feces, Vomit, Blood, Breast Milk)

Avoid direct contact with body fluids, as they may contain germs that can cause serious infections. Germs in feces and vomit spread easily if agitated, so it is very important to clean and disinfect contaminated areas quickly and carefully.

The following is a good procedure to use:

1. Gather the required materials (e.g. spill kit, disinfectant)

2. Put on gloves. If there is a risk of splashes to the face, wear facial protection (i.e. mask and goggles).

3. Using paper towels, contain and wipe up the spill, working from the least to most soiled areas. Be careful not to agitate spills of feces or vomit, so that infectious particles do not become airborne. Dispose of waste materials into a plastic bag and then into the regular waste receptacle, unless materials are saturated (dripping), in which case they must be disposed of into a biomedical waste bag.

4. Clean and disinfect the contaminated area. The procedure will depend on the type of disinfectant used.

Accelerated hydrogen peroxide (0.5%) wipes (for smaller spills):

Clean the area with a wipe. Follow the manufacturer’s instructions for contact time. Wipe dry. Dispose of wipe.

Disinfect the area with a wipe. Follow the manufacturer’s instructions for contact time (multiple wipes may be needed to ensure area stays wet for entire contact time). Wipe area dry or rinse.

Dispose of waste materials.

Bleach solution at 1000-5000 ppm concentration (for larger spills):

If the area is still visibly soiled, clean with warm water and soap or detergent, then rinse.

Disinfect the area using a bleach solution at a concentration of 1000- 5000 ppm. The solution must be made fresh daily to be most effective. Ensure area stays wet for a minimum of 10 minutes.

Dispose of waste materials.