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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


August 25, 2020


TO:
All Californians

SUBJECT:
COVID-19 Case and Contact Management Within Child Care Facilities


Overview

This document provides COVID-19 guidance for California child care facilities. It is meant to be complementary to California's guidance for Child Care Programs and Providers (PDF), other CDPH guidance, and the Centers for Disease Control and Prevention (CDC) Guidance for Child Care Programs that Remain Open. This guidance is focused on areas that are not fully addressed in the CDC guidance, including but not limited to:  case and contact management, and considerations for closure of the child care facility or classes/groups within the facility.

For the purposes of this document, child care facility refers to all group care facilities for children who are not yet in kindergarten in an elementary school. This includes child care centers, child development facilities, family child care homes, and preschools (including transitional Kindergartens, pre-Kindergartens and Kindergartens that are part of preschool programs or are independent of both preschool and elementary school programs). 

CDPH recommends that administrators and child care providers in all child care facilities become familiar with and implement the CDC Guidance for Child Care Programs that Remain Open. The main topics covered in the CDC guidance are: 1) general preparedness and planning; 2) social distancing strategies ; 3) parent drop-off and pick-up; 4) health screening for symptoms; 5) cleaning and disinfection; 6) caring for infants and toddlers; 7) healthy hand hygiene behavior; 8) food preparation and meal service; and 9) vulnerable/high risk groups.

New evidence about COVID-19 transmission, including variations by age, and the effectiveness of disease control and mitigation strategies in facilities for children continues to emerge. Guidance will be updated, if necessary, based upon the available science.


Identifying COVID-19 cases

CDPH recommends that children, parents, providers, and other staff with COVID-19 symptoms be excluded from the facility. To limit exposures to others, children who develop symptoms while in the child care facility should be immediately removed from the cohort and placed in an isolation area designated for sick children to wait for their parents to pick them up. Providers and other staff who develop symptoms while at work should immediately leave the child care facility.

Advise sick staff members and children not to return until they have met CDC criteria to discontinue home isolation, including at least 1 days with no fever, symptoms have improved and at least 10 days since symptoms first appeared.

Child care providers, other staff and parents of child attendees should be instructed to immediately report suspected or confirmed COVID-19 infections to the director of the program. The director should then contact the local Child Care Licensing Regional Office and the local health department to seek assistance in responding to the case, including but not limited to, contact tracing and exclusion of exposed individuals.

 

When a COVID-19 case is identified

Decisions on public health actions beyond exclusion of an ill child, provider or staff member from the facility should be made on a case by case basis with guidance from the local health department.

 

Identifying exposed persons

When a case is reported, all people who were potentially exposed* to the case while he/she was infectious should be identified as soon as possible. In child care facilities, it may be difficult to determine whether individual persons have met this criterion and if so, an entire cohort, classroom, or other group may need to be considered exposed, particularly if they have spent time together indoors.

Persons who have been identified as exposed to COVID-19 outside of the child care facility should be excluded from the facility for 14 days and quarantined at home per the local health department after their last exposure to the infectious case.  The time period for quarantine is not changed for persons who have a negative COVID-19 test. 

 

Testing recommendations

All persons with COVID-19 symptoms should be tested. Testing of exposed asymptomatic people can be considered if local lab capacity permits. Negative test results will not shorten 14-day exclusion/quarantine period for exposed people.

 

When closure of an entire child care facility should be considered

Closure of a facility should be considered in consultation with the local health department if cases have been identified in more than one cohort/class/group, or for family child care homes, when exclusion of the individual from the home is not possible.

 

If a facility is closed, when may it reopen?

* Exposure is defined as being <6 feet of an infectious† case for >15 minutes.
† Cases are considered infectious for 48 hours before symptom onset, or if asymptomatic, for 48 hours before date of positive test.

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