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Department of Public Health (CDPH), with consultation from California
Department of Social Services (CDSS) and California Department of Education
This guidance is intended to support safe, in-person learning and care in K-12 schools, child care, and related settings by mitigating the spread of communicable diseases.
The guidance builds upon a multi-layer strategy used to manage COVID-19 and serves as a general prevention framework to reduce the spread of multiple types of infections, including COVID-19, influenza, respiratory syncytial virus (RSV), and norovirus. Strategies are guided by the principle that safe, in-person learning, and care are critical to the well-being and development of children.
This guidance provides considerations for various settings where children spend time, including but not limited to the following:
For ease of reference, these settings are collectively referred to as “schools and child care" throughout this document.
Additionally, many of the strategies used to reduce transmission of infections can also protect against harmful enviromental effects. California school administrators and child care providers should consider the approaches described below as potential methods to protect children and staff from allergens, pollutants, wildfire smoke, and other external causes of illness and disease.
The guidance is based on best available scientific and epidemiological knowledge. It is subject to change.
1. This guidance provides general recommendations, and the provided references are not intended to be comprehensive. It does not replace or revise existing laws or requirements that apply to schools and child care. Information about certain relevant requirements may be found throughout this guidance and other relevant requirements may also exist.
2. CDPH and CDSS (California Department of Social Services) affirm the authority of local health departments, local educational agencies, and child care providers to maintain or establish additional guidance, including required actions, for facilities in their respective jurisdictions.
3. In workplaces, employers are subject to the Cal/OSHA COVID-19 Prevention Non-Emergency Regulations, and in some workplaces the Cal/OSHA Aerosol Transmissible Diseases Standard (PDF).
4. Local health departments or state agencies may implement additional requirements that go beyond this statewide guidance based on local circumstances. If there are differing requirements between the most current CDPH, Community Care Licensing (CCL), Cal/OSHA, and local health department guidance or health orders, providers should follow the strictest requirements.
5. When applying this guidance, confer with local health officials and consider the factors listed below. An assessment of the complete situation, rather than any one single factor, is recommended.
6. It is recommended that school administrators and child care providers communicate their health and safety strategies to children, parents, and staff, utilizing multiple strategies including parent communications and on-site reminders. Communication should be appropriate to the languages and literacy levels of community members.
7. This document updates and replaces the following guidance documents:
Vaccinations (also referred to as “immunizations") can help protect against certain diseases by working with the body's natural defenses to safely build immunity to disease. Vaccinations protect the person who receives the vaccination. In addition, if many people are vaccinated, this may reduce the burden of disease in communities and protect individuals who are not vaccinated and individuals who may not develop a strong immune response from vaccination.
The risk of getting and spreading respiratory infections is greater in indoor settings with poor air quality. Effective ventilation and filtration can reduce the spread of these infections and may also protect students, children, and staff from exposure to wildfire smoke, airborne allergens, and other pollutants.
1. Follow CDPH recommendations to improve indoor air quality. Facility maintenance staff may also review technical considerations (PDF). Note that although the air quality guidance was developed to manage COVID-19, many of the recommendations also reduce the spread of other airborne pollutants and other respiratory infections.
2. Optimize ventilation in transport vehicles, such as buses or vans. Open windows to increase airflow from outside when feasible and safe to do so.
3. In circumstances where outdoor air quality is poor (such as from wildfire smoke), consult with local health department officials to determine the best approach forward and also consult CDC guidance on Ventilation in Schools and Childcare Programs. Considerations include using:
4. Whenever possible, and in compliance with relevant laws, facility HVAC upgrades can improve indoor air quality while supporting energy efficiency.
For more information, see resources and guidance from the California Energy Commission, California Department of Education and the California Air Resources Board.
Face masks, particularly high-quality and well-fitting masks, are effective, inexpensive, and easy to implement tools to protect oneself and others.
No person can be prevented from wearing a mask as a condition of participation in an activity or entry into a venue or business including schools or childcare, unless wearing a mask would pose a safety hazard.
1. Support access to face masks.
2. Unless otherwise directed by local health departments, follow CDPH Guidance to Get the Most Out of Masking, including the following:
3. The following individuals should not wear face masks:
Keeping hands clean with frequent hand washing can help prevent the spread of communicable diseases. Other good hygiene practices can also protect the health of students and staff at school and child care facilities.
Staying home when sick can lower the risk of spreading communicable diseases.
Notifying local health departments and other authorities about communicable diseases and potential or confirmed outbreaks in schools and child care can facilitate deployment of additional strategies and resources to contain transmission.
1. Review reporting regulations.
2. Typically, local health departments will lead response to disease outbreaks and provide recommendations on next steps, including assessing possible exposures.
Clean and well-maintained facilities reduce the spread of communicable diseases that are transmitted by contact with contaminated or high touch surfaces.
Testing can detect and reduce transmission of communicable diseases. At-home antigen-based testing, currently widely available for COVID-19, provides individuals with convenient, rapid, and accurate test results.
At this time, there are no widely available at-home tests for the vast majority of communicable diseases. When testing is available (e.g., influenza and RSV), it should be considered by a healthcare provider based on related symptoms. Testing is generally not recommended to receive clearance to return to school or child care.
Considerations for children with disabilities or other health care needs: When implementing this guidance, schools should carefully consider how to address legal requirements related to the provision of free appropriate public education. School administrators and certain child care providers must also ensure compliance with the Americans with Disabilities Act (ADA) and afford reasonable accommodation to children with disabilities. For additional recommendations for children with disabilities or special health care needs, refer to guidance provided by the American Academy of Pediatrics (AAP). Note that although the AAP guidance was developed to manage COVID-19, many considerations are broadly applicable in schools and child care.
Considerations for higher risk activities: Certain activities that involve close physical contact and/or increased and forceful exhalation can pose increased risk for getting and spreading communicable diseases, particularly if conducted indoors, in poorly ventilated settings, and/or without the use of masks. Accordingly, school administrators and child care providers may consider implementing additional measures to mitigate transmission in these settings, particularly during disease outbreaks or increased rates of community transmission of certain diseases. Consultation with local health departments is recommended.
Considerations for in-person learning: Broad disruptions to in-person learning, such as temporary closures of schools, classrooms, or child care settings due to a communicable disease outbreak should remain a last resort and be considered only after all available resources have been exhausted and after conferring with local health department officials.
Considerations for direct service providers at K-12 schools or child care settings: It is important to allow access for these providers (including persons providing vision, hearing, or dental screening) when developing disease mitigation procedures.
Considerations for boarding schools and programs that may operate residential components: Persons residing in congregate settings are at increased risk of contracting and spreading communicable diseases. Accordingly, such settings should have infection control plans that use multiple strategies described in this guidance to create a “layered" approach to preventing the spread of disease.