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Child Care

Child care safety guidance for parents, operators and staff.
Last updated: September 29, 2020 at 11 AM
Child care centres can be operated safely by following public health principles like staying home when sick, encouraging physical distancing and minimizing physical contact, practicing hand hygiene and respiratory etiquette and frequent cleaning and disinfecting. COVID-19 has a very low infection rate in children and most children are not at high risk.

Public health guidance and resources


Frequently Asked Questions (FAQ) for child care operators and staff

Here you will find answers to common questions about child care settings for operators and staff. 

About COVID-19


COVID-19 is a respiratory illness caused by a novel coronavirus.  To find the latest information about COVID-19 visit bccdc.ca/covid19.  
 

 
COVID-19 is a respiratory illness caused by a novel coronavirus. 

Though there is a wide range of possible symptoms, the key symptoms of concern, most specific to COVID-19 are:
  • Fever
  • Chills
  • Cough
  • Difficulty breathing (in small children, this can look like breathing fast or working hard to breathe)
  • Loss of sense of smell or taste
  • Nausea
  • Vomiting
  • Diarrhea
Children usually have very mild symptoms of COVID-19. These symptoms are often a low fever and a dry cough. Some children do not have any symptoms. For children, it’s important to think about what is usual or unusual about their specific symptoms. For example, a child may have a low fever, irritability and a runny nose because they are currently teething or a child may have a runny nose due to seasonal allergies. 

Check with your health care provider, or call 811 to speak with a nurse, if you have concerns.


 
 

COVID-19 spreads through respiratory droplets when a person with the virus coughs or sneezes, and sometimes when they talk or sing. Respiratory droplets are small liquid particles that may travel about 1-2 metres through the air before settling on a surface. 

The virus is spread when:
  • a droplet comes in contact with a person’s mouth, nose or eyes.
  • a person touches an object or surface with the virus on it, and then touches their mouth, nose, or eyes before washing their hands.


 
 

Children and staff should stay at home when new symptoms of illness develop.  The key symptoms to watch for are fever, chills, cough, difficulty breathing*, loss of sense of smell or taste, nausea, vomiting and diarrhea. 

  • If the staff or the child’s parent/guardian indicates that the symptoms are consistent with a previously diagnosed health condition and are not unusual for that individual, they may return to daycare. No assessment or note is required from a health care provider. 
  • If children and staff have only one of the key symptoms without fever or difficulty breathing, children and staff can monitor at home for 24 hours. If symptoms improve, they can return to the child care facility without further assessment
  • If symptoms include fever or difficulty breathing, two or more of the key symptoms, or if after 24 hours, symptoms remain the same or get worse, seek a health assessment. A health assessment can include calling 8-1-1, a primary care provider like a physician or nurse practitioner, or going to a COVID-19 testing centre.
*In small children, difficulty breathing can look like breathing fast or working hard to breathe.
Remember, if you think your child is ill, please keep them at home.

For more information, or to find a local collection centre in your area, visit the BCCDC Testing page.

Assessing risk 


 
 

‎COVID-19 is less commonly spread between children, and between children and adults. 


Younger children are at a lower risk of catching and spreading COVID-19. In BC, young children have had a much lower rate of COVID-19 infection than adults. Children who have developed COVID-19 have most likely acquired it from adults in the household setting.

COVID-19 is more likely to spread between adults than among children. 

Following public health prevention strategies (such as frequent and thorough hand washing, avoiding touching your face, staying home when sick, and avoiding direct physical contact / maintaining physical distancing) can reduce the risk of COVID-19 for everyone.



 
 

Children and staff without symptoms can still go to child care even if someone else in their household is sick. They cannot go to child care if public health has told them not to. This is the same as for other settings like workplaces and public spaces.  


Most people who are sick or have symptoms of illness in BC are not sick with COVID-19. 

If someone has been diagnosed with COVID-19, public health will identify close contacts and ask them to stay home and self-isolate. The person who is sick or has COVID-19 symptoms should use the self-assessment tool at bc.thrive.health, call 8-1-1, or consult a health care provider for assessment. 

 
Public health will provide the necessary information around a safe return to child care.

For more information on living with someone with COVID-19, visit the BCCDC Self-Isolation page.
 

 
Pregnant women are not at higher risk of getting COVID-19 or developing severe disease.

Pregnant staff should consult their health care provider to assess their risk and to determine if they should work.

Pregnant women however need to be careful with the hand sanitizer they use. Read the label before use as some products are not appropriate during pregnancy or when breastfeeding.

For more information, visit the  BCCDC Pregnancy page.
 

 
People with chronic health conditions such as diabetes, heart disease and lung disease may be at higher risk of developing more severe illness or complications from COVID-19.

Staff with underlying health conditions should consult their health care provider to assess their risk and to determine if they should work.

For more information, visit the BCCDC Priority Populations page.
 

 
Infants (under age 1 year), children and youth with immune suppression (e.g., they have a medical condition or are receiving treatment that affects their immune system) and medical complexity are considered more vulnerable (visit the BCCDC Priority Populations page for further details).

Parents are encouraged to consult with their health care provider to assess their risk and determine if they can send their child to care.

Child care centres should always have care plans for vulnerable children.
 

 
Each family is different. Some families may live with older people or Elders. Other families may visit or depend on them to help with childcare. Families need to think about their own unique situation to decide if and how to be with older people, like grandparents and Elders, in the safest way possible.

If you live with or spend a lot of time with older people or Elders, there are things you can do to lower the chances of getting and spreading the virus. This may include decreasing the number of contacts your family has outside of your household. For example, you can limit contacts to only family members outside of child care, work and other commitments. You can also visit outside when the weather is good and keep a 2 metre distance when visiting.

For more information, visit the BCCDC Priority Populations page.
 


 
 

There is no evidence that children of health care workers (HCWs) are at increased risk of COVID-19 infection than children of non-HCWs. This is likely due to precautions used in the healthcare environment as well as careful monitoring of HCWs for symptoms.‎

 

Sickness at child care settings or at home


 
 

‎

A “health check” helps us keep track of our health and monitor if we develop of any symptoms of COVID-19. 

Parents and caregivers need to check their children for COVID-19 symptoms every day before bringing their children to child care.

Staff should learn about common COVID-19 symptoms to:
  • teach older children about common symptoms so they can let staff or their parent/caregiver  know if they don't feel well
  • monitor themselves daily for symptoms
  • ask parents and caregivers to check their child(ren) daily for symptoms before bringing them to child care
Child care directors should let people who regularly attend a child care setting (i.e. staff, parents or caregivers of children, and other adults) know that they have a responsibility to do a “health check” before attending or dropping their child off at the setting. 

Appendix B in the Public Health Guidance for Child Care settings document has an example of a “health check”. 

There is no need for a child care facility to verify that a health check has occurred every day; similarly, parents do not need to submit a daily health check form to the facility. Child care providers are not expected to screen other staff or children for specific symptoms or to take temperatures – these health assessments should be reserved for health care professionals. 


 
 

Staying home when sick is one of the most important ways to decrease the spread of COVID-19. 


Staff and children should stay home when new symptoms of illness develop. Key symptoms to watch for are 
  • fever
  • chills
  • cough
  • difficulty breathing (in small children, this can look like breathing fast or working hard to breathe)
  • loss of sense of smell or taste
  • nausea or vomiting
  • diarrhea 
Here are a few helpful rules that can be followed:
  • If the staff or child is having symptoms that are common to what they usually experience with a previously diagnosed health condition (eg. allergies, asthma) they may return to the child care facility. No note is required from a health care provider. 
  • If children and staff have only one of the key symptoms without fever or difficulty breathing, children and staff can monitor at home for 24 hours. If symptoms improve, they can return to the child care facility without further assessment
  • If symptoms include fever or difficulty breathing, two or more of the key symptoms, or if after 24 hours, symptoms remain the same or get worse, seek a health assessment by calling 8-1-1- or a primary care provider. 
Remember, if you think your child is ill, please keep them at home.

If a COVID-19 test is recommended as a result of a health assessment, self-isolate while waiting for results. 


 

‎If someone has travelled outside of Canada, they must self-isolate for 14 days upon return. Returning travellers who develop symptoms of COVID-19 during this time period should go for testing.


If someone was told by public health or a health care provider that they are a close contact of a COVID-19 case, self-isolation is required for 14 days from the day of last contact.

Visit the BCCDC website for more information on self-isolation and testing.


 
 

A child will need to be separated from others and supervised, provided tissues to cover up their coughs or sneezes, and their parents or caregiver will be contacted as soon as possible and asked to pick them up. The child will continue to be cared for until their parent or caregiver can come and pick them up. 


If a staff member is sick, they will be separated and asked to go home as soon as possible. 

In both cases, the spaces they were in need to be cleaned and disinfected. 

Child care settings need to follow the guidance on what to do if a child or staff member develops symptoms found here in Appendix D. 


 
 

Children and staff with seasonal allergies or other COVID-19-like symptoms related to pre-existing conditions don’t need to stay home if their symptoms are what they normally experience (e.g. itchy eyes, runny nose). They may return or stay in the child care setting and no assessment or note is needed from a health care provider.

If they experience any new or unexplained symptoms, they should assess if they have any of the key symptoms of COVID-19 which include:
  • fever
  • chills
  • cough
  • difficulty breathing (in small children, this can look like breathing fast or working hard to breathe)
  • loss of sense of smell or taste
  • nausea and vomiting
  • diarrhea 
If children and staff have only one of the key symptoms without fever or difficulty breathing, children and staff can monitor at home for 24 hours. If symptoms improve, they can return to the child care facility without further assessment.

If symptoms include fever, difficulty breathing, or two or more of the key symptoms, or if after 24 hours, symptoms remain the same or get worse, seek a health assessment by calling 8-1-1- or a primary care provider, like a doctor or nurse practitioner. 

Remember, if you think your child is ill, please keep them at home.

Physical distancing

 
The physical space requirements for licensed child care settings, set out in the Child Care Licensing Regulation, mean that child care centres have sufficient space to support physical distancing. This means child care centres have enough space for at least 1-2 metres between staff. There is no need to reduce the number of children in care at any one time. 

Child care facilities should consider creating small and consistent groups of staff and children, and to minimize the mixing of staff and children from different groups. 

Staff should: 
  • Reduce prolonged face-to-face contact between other staff members and maintain physical distance where possible. 
  • Avoid physical contact between other staff. 
  • Reduce the number of different staff that interact with the same children throughout the day.
  • Minimize unnecessary physical contact with children.
  • Minimize the number of visiting adults that enter the centre, unless that person is providing care or supporting the inclusion of a child in care. 
  • Organize more activities that encourage individual play and more space between children and staff. 
  • Encourage everyone to spread out as much as possible within the space available.
  • Encourage children to minimize physical contact with each other. 
Staff caring for young children should not avoid appropriate physical contact, such as assisting children with washing their hands.

Child care settings should focus on how children and staff can move around safely. You do not need to follow every example given, but should consider broadly what your child care setting can do. Here are a few additional principles to consider:


 


 
 

Playgrounds are a safe environment for children to play together. Focus more on minimizing physical contact between each other rather than staying any particular distance apart. 


All children should practice hand hygiene before and after play. 

No extra cleaning or disinfection is required for playground structures. More information is available here.

 
Buses or vans used for transporting children should be cleaned and disinfected according the guidance provided in the BCCDC’s Cleaning and Disinfectants for Public Settings document. Additional guidance is available from Transport Canada. 

Bus drivers should: 
  • Clean their hands often, including before and after completing trips. 
  • Use alcohol-based hand sanitizer with at least 60% alcohol during trips.
  • Wear a non-medical mask or face covering when they cannot practice physical distancing or be behind a physical barrier during trips. 
Children should: 
  • Clean their hands:
    • before they leave home
    • when they leave the child care facility prior to taking the bus
    • And, when they get home. 
To reduce the number of close, in-person interactions, the following strategies are recommended: 
  • Use consistent and assigned seating arrangements; seating can be altered whenever necessary to support child health and safety. 
  • Prioritize children sharing a seat with a member of their household.
  • If space is available, each child should have their own seat, and sit beside the window.
  • Consider installing a physical barrier made of transparent materials between the driver and children.
  • Use of masks for those aged 5 and older if required by the transit provider.

 

Hand hygiene, respiratory etiquette and masks


Liquid or foam soap is preferred for hand washing. Antibacterial soap is not required.

If sinks are not available (e.g., children and staff are outside), supervise the use of a Health Canada approved alcohol-based hand sanitizer. If hands are visibly dirty, alcohol-based hand rub may not be effective. If soap and water aren’t available and hands are visibly dirty, use a hand wipe followed by hand sanitizer. Read labels carefully as certain products should not be used on infants, children or by pregnant or breastfeeding staff. 

All children under the age of six should be supervised when using hand sanitizer. Use enough to cover the front and back of a child’s hands and between their fingers. Ensure that the hand sanitizer has dried completely before children resume regular activities and prevent children from putting wet hands in eyes or mouth. 

If a child accidentally consumes any amount of hand sanitizer, call the BC Drug and Poison Information Centre: 604-682-5050 or 1-800-567-8911. 

 

 

No, you can use any temperature of water to wash your hands. Cold water and warm water are equally effective at cleaning hands as long as soap is used.

 

 

Yes, it's safe to wash your hands with soap and tap water if you are living in a community with a Boil Water Advisory (BWA) or a Do Not Consume (DNC) advisory. However, if you are living under a Do Not Use (DNU) advisory you should wash your hands with bottled water.

 


 
 

‎Encourage hand washing often. 


Promote proper and frequent handwashing through signs/pictures, role modelling and creating a routine for hand washing. All sinks should be supplied with liquid or foam soap.

If sinks are not available, use an alcohol-based hand sanitizer with at least 60% alcohol. If hands are visibly dirty, wipe your hands with a hand wipe before using hand sanitizer. Otherwise, avoid touching your face or eating any food or beverages until hands can be washed.



 
 

‎

The COVID-19 guidelines for child care outline recommendations for how to provide a safe setting for both staff and children. Therefore, masks are neither recommended nor necessary. However, some staff and older children may choose to wear non-medical masks. Wearing a non-medical mask in a child care setting is a personal choice. It is important to treat people wearing masks with respect.

Transit providers may require the use of masks for those aged 5 or older while on transit.

Children under two years of age should NOT wear masks because there are risks of breathing problems, choking or strangulation. For young children over the age of two, masks are generally not recommended as they can be irritating and may lead to increased touching of the face and eyes. If an older child wants to wear a mask: show them how to do so safely and properly. 

Remind children that other children and adults have reasons for wearing or not wearing masks, so it is important to be kind and respectful to others. 

Child care staff should monitor and address any discrimination or bullying associated with mask wearing, whether it is experienced by those who do or do not wear masks.

For more information on masks and mask use please see the BCCDC Mask page and How to Wear a Face Mask.


 
 

Child care settings are implementing environmental, administrative, and personal infection prevention and control measures to reduce the transmission of COVID-19. Therefore, the use of non-medical masks when just staff and children are present is not necessary. 


However, general recommendations would suggest that staff wear a mask when interacting in close proximity to parents, guardians, and any other adults doing drop-off or pick-up. This is also advisable if staff are interacting in close proximity with other non-staff adults in the course of running a childcare centre. Mask use is not a substitute for other measures such as distancing and handwashing. 

If a child becomes ill during the course of the day both the staff caring for the child and the child (if over 2 years) should wear a mask until the child is picked up.
 

Cleaning

 
 

Clean and disinfect high touch surfaces at least twice a day. This includes door knobs, light switches, toilet handles, water fountains, tables, chairs, electronic devices and toys.

 

General cleaning and disinfecting of the premises should happen at least once a day.

 

Clean toys in the child care facility daily with soap and water and then disinfect with a store-bought product or bleach solution. Find more information here.

 

Personal items (e.g., blankets, reusable food and drink containers) can be brought into the child care setting from home for individual use. Parents and caregivers should label these items and wash these items at the end of the day. 

 

Clean and disinfect cots and cribs after each use, and launder crib linens between children. If parents are providing their own linen, the linens should be laundered and placed in a sealed plastic or washable bag before bringing to the centre. Do not shake the linens.‎

 
 

Child care supplies and items

 

There is no evidence that the COVID-19 virus is transmitted via books, paper or other paper-based products. As such, there is no need to limit sharing of books or paper based resources to children because of COVID-19.‎

 

 
Offer toys and items that encourage individual play and that can be easily cleaned and reduce hand-to-hand-contact and cross contamination. 

Ask parents and caregivers to only bring personal comfort items (e.g., stuffed animals) if necessary and if they are clean and laundered regularly.

Toys and objects that children have placed in their mouths should be set aside, for example in a “to be washed” bin, until they are cleaned and disinfected. Toy, objects, and surfaces known to have been in contact with bodily fluids should be cleaned as soon as possible and between uses by different children.

Provide adequate amounts of high touch materials, such as art supplies, in order to minimize sharing between children.

Meals and food

 
Children and staff should not share food, drinks, soothers, bottles, sippy cups, toothbrushes, facecloths, and other personal items. 

Personal items should be labelled with the child’s name to discourage accidental sharing. 

If meals or snacks are provided, ensure each child has their own individual meal or snack. Reusable utensils must be cleaned and sanitized after each use. Any disposable utensils need to be thrown out. 

For food contact surfaces, ensure any sanitizers or disinfectants used are approved for use for food service application and is appropriate for use against COVID-19. See here for more information. 

If you are preparing snacks or meals, make sure you wash your hands well (20 seconds) with soap and water and avoid touching your face.

It is safe to gather traditional foods or use food from gardens. Be sure that you and the children wash hands before gathering the food and that all food is scrubbed under potable running water. It is not safe to wash fruit and vegetables in a bleach solution.

 

Child care settings are not allowing homemade food items to be shared or sold at this time (e.g., birthday treats).‎

 
There is no evidence that COVID-19 is spread through food, so masks are not required when food is being handled. Normal cooking temperatures for foods will also destroy the COVID-19 virus and other microbes in food. 

Masks are not effective when wet and should be properly laundered before use. See the following for more information:

 

Frequent and proper handwashing is always encouraged as it is the best way of preventing all respiratory virus infections and other foodborne illnesses.

 

If someone chooses to use gloves, they should wash their hands thoroughly before putting them on and change gloves regularly. Wearing gloves does not reduce the need for handwashing and may make staff and students feel as if they do not have to wash their hands as often.

 

Child care settings can continue to accept donated food items, including Traditional foods, in line with regular food safety precautions and regulations for accepting food donations. ‎

 

 

Yes, re-usable plates, utensils and containers can continue to be used if normal cleaning and disinfecting protocols for dishwashing are implemented. ‎

 

Activities

 

Exercise, play, and other activities should be done outdoors when possible. Group play activities should be organized in a thoughtful way, taking into consideration physical distancing. Hand hygiene is encouraged before and after play.‎

 

 

Sand and water can be used for play provided that children wash their hands before and after play.

 

COVID-19 does not survive well on surfaces, other than hard surfaces.

 

There is no evidence showing that the virus survives on sand, in water, or on playdough.

 

‎Speaking and singing can lead to the release of large respiratory droplets, which are the primary route of transmission for COVID-19. However, singing in groups can be a safe activity if people are able to stand 2 metres apart to reduce the spread of droplets. Consider singing outdoors or opening windows to increase ventilation. Other hand hygiene and respiratory etiquette principles should be practiced.

 

Mental health

 
COVID-19 affects more than our physical well-being. With so much happening, it’s normal to feel worried and overwhelmed. Mental wellness, particularly stress, also impacts our physical well-being and our behaviours, and can increase our risk of getting sick.

It’s important to focus on your own, as well as children and other staff members’, mental well-being. Child Health BC is a provincial organization supporting children’s health. Visit their website for a list of mental health resources for parents and caregivers, children and staff. Visit their website for a list of mental health resources for parents and caregivers, children and staff.
 
 

Shared environment

 

Yes, staff can share appliances and other objects. Treat items like microwaves as high touch surfaces. Disinfect them at least twice per day. Always wash your hands before and after handling shared objects.

 


 
 

‎Ventilation systems in good operating conditions bring fresh air indoors and help reduce and remove many different contaminants from indoor air. During COVID-19, all mechanical heating, ventilation and air conditioning (HVAC) systems in child care settings should be checked to ensure they are working properly. Where possible and if local conditions permit, windows can also be opened to help bring in more fresh air.


In homes, increase ventilation by keeping bathroom fans or ceiling fans running continuously. If an air cleaner or purifier is available, place it in the area where people spend the most time and direct the airflow so it does not blow directly from one person to another. Forced air systems should be run as much as possible with the “FAN ON” setting. 

For more information on , please see WorkSafe BC’s guidance on general ventilation and air circulation.

 
Child care providers can work in more than one location. The important consideration is ensuring an adequate number of child care providers to children, as per licensing regulations. 

 
Child care settings can operate at full capacity as permitted under licensing.

The Provincial Health Officer’s Order for Mass Gatherings prohibits gatherings and events of people in excess of 50, however this Order does not apply to child care settings. As such, there can be more than 50 children and staff in any given child care setting as per usual licensing limits.
 

 

Public health will determine the need to exclude any children or staff, or to temporarily close the child care, in the event a case of COVID-19 is identified in any child care setting.

 


 
 

If a staff member or child is a confirmed (positive) case of COVID-19, public health will identify who that person has been in recent close contact with (i.e., contact tracing) to figure out how they became infected and who else might be at risk of infection. 


If it is determined that a person with COVID-19 was in a child care setting when they may have potentially been infectious, public health will work with staff in the child care setting to understand who may have been exposed and will notify everyone considered a close contact*.

* Public health will determine who is a close contact. This is done by figuring out how long a person was exposed to the confirmed (positive) case and what type of interaction or contact they had.

Appendix C provides additional information of the public health actions if a staff, child, or other person who has been in the child care setting is a confirmed COVID-19 case. 

To support a person’s privacy, public health will only provide the information required to help with contact tracing. Staff should not notify others about potential or confirmed cases of COVID-19 in the child care setting unless specifically asked to by public health. If necessary, public health will provide notification to the broader community if it is determined that not all potential close contacts can be reached directly.

 
Child care operators in these settings should follow the guidance provided in this document and may wish to review the COVID-19 Public Health Guidance for K-12 School Settings for information specific to the school setting.

Child care operators in these settings should work closely with school administrators to coordinate accessing shared spaces or resources, and to support coordination and clear communication to parents.
SOURCE: Child Care ( )
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