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Licensed Child Care Centres Region of Peel Public Health & Early Years and Child Care Services Last updated: June 2020 Module 3 General Sanitary Precautions & Physical Distancing Measures COVID-19 Enhanced Health and Safety Protocols All information contained in this presentation is explained in further detail in the COVID-19 Enhanced Health and Safety Protocols – Guideline for Licensed Child Care Centres. Any links found in the notes portion of this presentation can be cut and pasted into your browser – clicking the link will not take you directly to the site. 1

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Page 1: D } µ o ï ' v o ^ v ] Ç W µ ] } v W Z Ç ] o ] v ] v P D µ...> ] v Z ] o v Z P ] } v } ( W o W µ o ] , o Z o Ç z v Z ] o ^ À ] > µ W : µ v î ì î ì D } µ o ï ' v o ^

Licensed Child Care CentresRegion of Peel Public Health & Early Years and Child Care Services

Last updated: June 2020

Module 3General Sanitary Precautions & Physical Distancing MeasuresCOVID-19 Enhanced Health and Safety Protocols

All information contained in this presentation is explained in further detail in the COVID-19 Enhanced Health and Safety Protocols – Guideline for Licensed Child Care Centres.

Any links found in the notes portion of this presentation can be cut and pasted into your browser – clicking the link will not take you directly to the site.

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What will be covered?

• Overview• Policy• Procedures• Physical Distancing Measures• Additional Resources

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All information contained in this presentation and accompanying Guideline document and Forms, are in accordance with Peel Public Health and the Ministry of Education’s Operational Guidance During COVID-10 Outbreak – Child Care Re-Opening found at http://www.edu.gov.on.ca/childcare/child-care-re-opening-operational-guidance.pdf

This Ministry’s Guidance document has been designed for use in conjunction with the Licensing Manual, the CCEYA and its regulations.

In the event of a conflict between the Ministry’s Guidance document and Licensing Manual, the Guidance document will prevail.

Advice of the local public health unit must be followed, even in the event that it contradicts the Guidance document.

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Overview

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• Every child care operator must ensure that there are written policies and procedures outlining their health and safety protocols.

• Operators must train staff and share with parents the policies and procedures regarding health and safety protocols to COVID-19.

• Operators may want to consider providing links to helpful information, as well as detailed instructions regarding screening and outbreak management protocols.

Additional information for child care setting is also available through the “Keep on Track’ manual, which includes the “Preventing and Managing Illnesses in Child Care Centres” guidelines. https://www.cdrcp.com/keep-on-track

Pg. 9 of the Ministry’s Guidance Document lists that policies and procedures must be included as part of the attestation submitted to the Ministry:• direction set out by the local public health, and • how the child care setting will operate during and throughout the recovery phase

following the pandemic including: sanitization of the space, toys and equipment; • how to report illness; • how physical distancing will be encouraged; • how shifts will be scheduled, where applicable; • rescheduling of group events and/or in-person meetings; and, • parent drop off and pick up procedures.

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Policy

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• All child care centres must be thoroughly cleaned prior to re-opening their operations.

• Operators must maintain routine infection prevention and control practices and adhere to additional sanitary precautions and physical distancing measures in all aspects of care to prevent the spread of COVID-19.

• Operators must communicate the requirements under this policy to any third-party vendors contracted for cleaning services at the centre.

From Region’s Guideline document.

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ProceduresThe COVID-19 Enhanced Health and Safety Protocols for Licensed Child Care Centres and the Ministry’s Guidance document describe procedures for the following: Hand Washing Gloves, Masks and Eye Protection Cleaning and Disinfecting Toys and Equipment Equipment Used for Nap/Sleep Time Meal Times Interactions with Infants/Toddlers Additional Infection Control Practices

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Printable posters to support these practices are available through Peel Public Health

The Ministry Guidance document describes many of the procedures as having children placed into COHORTS. Cohort is defined as a group of children and the staff members assigned to them, who stay together throughout the duration of the program for a minimum of 7 days.

The maximum cohort size for each room in a child care centre (including each family age group) will consist of no more than 10 individuals (“a cohort”), space permitting. This includes both staff and children. If a classroom is currently licensed for a maximum group size of less than 10 children due to square footage requirements, the centre can only have the number of children listed on the license and must ensure the cohort does not exceed 10 (including staff).

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Hand Washing • Perform and promote frequent, proper hand hygiene.

• Staff should supervise hand washing and assist children.

• Hand washing using soap and water is recommended over alcohol-based hand rub for children.

• Staff must ensure hand washing supplies are well stocked at sinks and in washrooms.

• Hand sanitizer (containing at least 60% alcohol) must be supplied when hand washing is not possible:

Hand sanitizer should only be used on children over the age of two and under staff supervision.

Staff must ensure that the product has completely evaporated from the child’s hands.

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The Region’s Protocol document outlines specific situation where Staff and Children MUST wash their hands.

Staff should wash their hands with soap and warm water frequently, and must wash their hands in the following situations:

• When they arrive at the centre and before they go home • Before and after breaks• Before handling food, preparing bottles, feeding children• Before and after eating and drinking• Before and after touching their own or someone else’s face• After sneezing or coughing into hands• Before and after giving or applying medication or ointment to a child or self• Before and after diaper check or changing diapers, assisting a child to use the

toilet, and using the toilet• Before and after contact with bodily fluids (i.e. runny noses, spit, vomit, blood)• After cleaning and handling garbage

Children should wash their hands with soap and warm water frequently, and must wash their hands in the following situations:

• When they arrive at the centre and before they go home• Before and after eating and drinking• After a diaper change and using the toilet

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• After playing outside• After handling shared toys/items• After sneezing or coughing into hands

Staff should follow and role model the following steps for proper hand washing:

• Wet hands• Apply soap• Lather for at least 15 seconds (or as long as the “Happy Birthday” song). Rub

between fingers, back of hands, fingertips, under nails• Rinse well under running water• Dry hands well with paper towel or hot air blower• Turn taps off with paper towel, if available

• A poster is available through Peel Public Health to support the proper hand washing and hand sanitizing procedures.

• Ensure hand sanitizer or alcohol-based hand rub (containing at least 60% alcohol) is available at the designated entrance for the centre and throughout the centre.

• Hand sanitizer must be kept out of reach of young children to prevent accidental poisoning.

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Types of MasksMedical Masks• N95 Respirator

o wearer must be fit tested, used in healthcare settingo not required in child care

• Surgical/Procedure Maskso often blue coloured masko commonly seen in doctor and dentist clinicso required in child careo single-use

Non-medical Masks• Cloth Mask

o Homemade masks o Re-usable

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“My mask protects you, your mask protects me”

Additional information sheets are found offered by Public Health Ontario:

COVID-19: Non-medical Masks and Face Coverings:https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/2020/05/factsheet-covid-19-non-medical-masks.pdf?la=enMask Use for Non-Healthcare Workers: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/2020/05/factsheet-covid-19-masks-not-healthcare.pdf?la=en

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Medical Surgical/Procedure Mask

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“My mask protects you, your mask protects me”

Additional information sheets are found offered by Public Health Ontario:

COVID-19: Non-medical Masks and Face Coverings:https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/2020/05/factsheet-covid-19-non-medical-masks.pdf?la=enMask Use for Non-Healthcare Workers: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/2020/05/factsheet-covid-19-masks-not-healthcare.pdf?la=en

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Non-Medical Cloth Mask

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“My mask protects you, your mask protects me”

Additional information sheets are found offered by Public Health Ontario:

COVID-19: Non-medical Masks and Face Coverings:https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/2020/05/factsheet-covid-19-non-medical-masks.pdf?la=enMask Use for Non-Healthcare Workers: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/2020/05/factsheet-covid-19-masks-not-healthcare.pdf?la=en

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Masks, Eye Protection & Gloves

• Staff must wear surgical/procedural masks and eye protection (face shield, goggles or safety glasses) when:

1. Conducting active screening at screening station2. Cleaning and disinfecting blood or bodily fluids spills if risk

of splashing (gloves should also be worn)3. Caring for a sick child (gloves should also be worn)

• Masks should not be placed on children under age 2 or on anyone who has trouble breathing, is unconscious, or otherwise unable to remove the mask without assistance.

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“My mask protects you, your mask protects me”

If screening is conducted in an enclosed space and a physical distance of 2 meters cannot be maintained or plexiglass barrier not used, parents/guardians and staff must wear face coverings.

Cloth face coverings should not be placed on children under age 2 or on anyone who has trouble breathing, is unconscious, or otherwise unable to remove the mask without assistance. Face coverings may not be tolerated by everyone based on underlying health issues, behavioural issues or beliefs. If the mask interferes with the ability to breathe or speak clearly, maintain a two meter distance as much as possible.

Child care licensees should secure and sustain an amount of PPE and cleaning supplies that can support their current and ongoing operations. Early Years and Child Care Services is currently working with our procurement division to help child care operators access PPE.

Additional information sheets are found offered by Public Health Ontario:COVID-19: Non-medical Masks and Face Coverings:https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/2020/05/factsheet-covid-19-non-medical-masks.pdf?la=enMask Use for Non-Healthcare Workers: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet/2020/05/factsheet-covid-19-masks-not-healthcare.pdf?la=en

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Masks and Gloves• Staff must wear either a surgical mask or cloth mask when

physical distancing cannot be maintained including, but not limited to:

Staff who become ill until they leave centre Providing direct care (e.g. diapering, feeding,

handwashing) Holding or carrying a child Assisting a child with dressing

• Hand hygiene must be performed before putting on and after taking off a mask or gloves.

• Public Health Ontario resources are provided to demonstrate proper use of masks and gloves.

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See Peel Public Health’s website for further information on putting on/taking off masks and glove use or refer to Public Health Ontario’s website (see links below).

https://www.peelregion.ca/coronavirus/prevention/https://www.peelregion.ca/coronavirus/business/pdf/covid-19-wear-a-mask.pdfhttps://www.publichealthontario.ca/-/media/documents/covid-19/ipac/2020/04/ipac-ppe-recommended-steps.pdf

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Cleaning and Disinfecting• Frequently touched surfaces should be cleaned and disinfected at

least twice a day as they are most likely to become contaminated.

• Only use disinfecting solutions made with household bleach or disinfectants with a Drug Identification Number (DIN). Low-level hospital grade disinfectants may be used. Check expiry dates.

• Always follow the manufacturer’s instructions.

• It is recommended that centres set a schedule and develop a cleaning and disinfecting log to track and demonstrate cleaning.

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Clean frequently touched surfaces at least twice per day

Cleaning and disinfecting reduce the spread of germs. Some germs can live for hours, days or weeks on toys, counters, diapering table, door knobs, computer key boards and other surfaces.Cleaning with soap and water removes dirt and grease that can hide and protect germs from disinfectants. Cleaning will substantially reduce the number of germs that may be on surfaces.

Disinfecting after cleaning will kill most of the germs that were left behind. Cleaners and disinfectant products and methods already used by child care centres are effective against COVID-19. Only use disinfectants with Drug Identification Number (DIN) and labelled as a broad-spectrum viricide. Low-level hospital grade disinfectants may be used. Check expiry dates and always follow the manufacturer’s instructions. Particular attention should be paid to contact time, dilution, material compatibility, shelf-life, storage, first aid, and PPE.

Follow local public health advice regarding best practices for cleaning and disinfecting, including: • which products to use; • how to clean and disinfect blankets, sleeping mats and toys; • how to clean equipment; and, • other items to remember, including checking expiry dates of cleaning and

disinfectant products and following the manufacturer’s instructions.

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Additional Fact Sheets: • Cleaning and Disinfection for Public Settings - COVID-19 :

https://www.publichealthontario.ca/-/media/documents/ncov/factsheet-covid-19-environmental-cleaning.pdf?la=en

• Health Canada has developed the following list of hard surface disinfectants for use against COVID-19: https://www.canada.ca/en/health-canada/services/drugs-health-products/disinfectants/covid-19/list.html

Vinegar is not a disinfectant and should not be used for disinfecting in the centre. Vinegar does not kill germs!

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Adjust your cleaning schedule to follow

new guidelines

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Disinfection Solution Procedure

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This poster is found in the

Guideline document

The Ministry’s guidance document may also be used for additional information:Cleaning and Disinfection for Public Settings - COVID-19: https://www.publichealthontario.ca/-/media/documents/ncov/factsheet-covid-19-environmental-cleaning.pdf?la=en

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Toys and Equipment• Centres are encouraged to provide toys and equipment which

are made of materials that can be cleaned and disinfected (e.g., avoid plush toys).

• Mouthed toys should be cleaned and disinfected immediately after the child is finished using it.

• Where toys and equipment are shared, they should be cleaned and disinfected prior to sharing between cohorts.

• If sensory materials (e.g., playdough, water, sand, etc.) are offered, they should be provided for single use (i.e. available to the child for the day) and on an individual basis.

• Use of outdoor programming is encourage for physical distancing. All equipment must be cleaned and disinfected between cohorts.

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• Individual sensory materials must be discarded at the end of the day.

• Centres must ensure that all toys and equipment are in good repair, clean and sanitary. Staff must advise the Supervisor of any concerns regarding toys and equipment.

• Other items such as books, puzzles and cardboard that are absorbent and cannot be easily cleaned and disinfected should be removed.

• Tables and chairs being used are to be cleaned and disinfected before and after use and as often as needed, including after all meals.

• Staff are encouraged to have designated toys and equipment (e.g., balls, loose equipment) for each room or cohort. Where toys and equipment are shared, they should be cleaned and disinfected prior to being shared.

• If a child displays any symptoms of COVID-19, all toys and equipment accessed by the child must be cleaned and disinfected as soon as possible.

• Follow provincial and municipal guidance or laws with respect to use of community playgrounds.

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Equipment Used for Nap/Sleep Time

• Children must have an individual cot or crib assigned to them; sharing is not allowed.

• Increase the distance between cots and cribs or place children head to toe or toe to toe if the space is limited.

• Cots and cribs must be cleaned and disinfected daily.

• Sheets and blankets must be cleaned weekly or more frequently as needed, individually labelled and not shared.

• Families can bring their own blankets but they must be laundered prior to use, if possible at centre. Items must be laundered weekly or more frequently as needed.

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• This equipment can be a cot, crib, mat or any other approved equipment for resting purposes.

• Ensure equipment sheets and blankets belonging to different children are labelled with the child’s name and stored separately in bags or bins in clean dry areas to prevent mold growth and kept out of the way of everyday activities.

• Families will be permitted to bring their own blankets for children. If not laundered at the centre, ensure that parents/guardians who supply their own blankets for children launder all items prior to bringing them to the centre and store them separately in a clean bag.

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Meal Times• Centres should adapt meal practices to ensure there is no “family

style” self-serve or sharing of food at meal times:

Utensils should be used to serve food Meals should be served in individual portions to children by staff

• Reinforce messages with children not to share food, drinks, feeding utensils, bottles, sippy cups, etc.

• There should be no food provided by family (except where required).

• Children should neither prepare nor provide food that will be shared with others.

• Ensure proper hand hygiene is practiced when staff are preparing food and for all individuals before and after eating.

• Where possible, children should practice physical distancing while eating.

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There should be no food provided by the family/outside of the regular meal provision of the program (except where required and special precautions for handling and serving the food must be put in place).

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Interactions with Infants/Toddlers

• Staff should continue to supervise and hold bottles for infants not yet able to hold their own bottle to reduce the risk of choking.

• When holding infants and toddlers staff should place blankets or cloths over clothing and change the blankets or cloths between children.

• Avoid getting close to faces of all children, where possible.

• If using cribs, these should be placed using physical distancing to increase space between them.

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There are specific recommendations in the Guidance document related to Infants and Toddlers.

Recognizing that physical distancing is difficult with small children and infants, suggestions to support physical distancing include: • planning activities that do not involve shared objects or toys • when possible, moving activities outside to allow for more space

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Additional Infection Control Practices• Low-touch surfaces must be cleaned and disinfected daily (i.e.

window ledges, doors, sides of furnishings, etc.).• Keep garbage in waterproof containers lined with plastic bags and

dispose daily. Blood-soiled items must be discarded in sealed bags.• Ensure washrooms are frequently cleaned and disinfected.• Carpets are to be vacuumed daily.• Toothbrushes, bottles and pacifiers must be individually labelled

and stored separately.• For creams and lotions during diapering, staff must never put

hands directly into lotion or cream bottles.• Children should provide own sunscreen and should not be shared.

Staff may help to apply it, exercising proper hand hygiene.• Personal belongings (e.g., backpack, clothing, etc.) should be

minimized, but if brought should be labeled and kept in child’s cubby/designated area.

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Physical Distancing Measures

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Centres must put children and staff in cohorts/groups of 10 or less at any given time to manage physical distancing and limit number of people in close contact.

Each cohort must stay together throughout the day and are not permitted to mix with other cohorts.

Maintain physical distancing of at least 2 meters (6 feet) or more between staff, parents or children.

Ways to Support Physical Distancing:

Stagger arrival, departure and activity transition times Spread children out into different areas, particularly at

meal, nap and dressing times Incorporate more individual activities Use visual cues and barriers to promote physical distancing When possible, move activities outdoors

The ministry recognizes that physical distancing between children in a child care setting is difficult and encourages child care staff to maintain a welcoming and caring environment for children.

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Physical Distancing Measures

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Staffing Considerations:

Staff should work at only one child care location. Supervisors and/or designates should limit their movement

between rooms, doing so only when absolutely necessary. Supply staff should be assigned a specific cohort. Staff should separate work clothes for laundering as they

could potentially be a source of contamination. Centre should encourage virtual meetings where possible. Alter workplace layout by moving furniture or using visual

cues such as tape on floor to enhance physical distancing. Lunchrooms and break rooms must be arranged to follow

physical distancing practices. Consider staggered lunch and break times to reduce number

of staff gathering.

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Useful Signage

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These posters are either supplied in a link in this presentation or part of the document package you received by email.

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Additional ResourcesChild Development Resource Connection Peel (CDRCP)

• E-Learning Opportunities

• Public Health Ontario• Tip Sheets

Region of Peel• Masks and Face Coverings• Resource Posters• Translated Resources

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Questions?

Contact Information:Early Years and Child Care [email protected]

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