Quality Tips Corner Installment 8

Q-T Corner (quality tips corner) 

The assessment team in PA is often asked if they have any tips to make meeting quality standards easier. Since they have experiences visiting many programs in their professional careers, they have seen many programs employ strategies to make things easier, more efficient, and more effective. Implementing quality can be stressful or time consuming, but always worth it. So, this Q-T Corner moment aims at helping you along the way.  

 Installment #8 COVID-19  

Times are pretty scary and uncertain right now with the COVID-19 pandemic. Many providers are scrambling to meet CDC guidelines so that they can keep children safe and healthy. This installment of Q-T corner, hopefully, is very timely in giving tips to help programs navigate this time as easily as possible.  

Tips to prevent the spread of Coronavirus: (If you adequately prepare and put measures in place to stop or slow the spread, you are helping children stay healthy.) 

1. Limit the number of people in the building. This will slow the spread as well as be helpful for contact tracing. 

• Encourage parents to drop off the children at the door while wearing a mask. Do a health check before admitting them. Drop off and screening methods are described in OCDEL Announcement C-20-12. 
• Encourage Early Intervention or other service providers to do virtual visits when they are able, and it is appropriate. 

• Cancel special visitors and field trips. 

2. Use cohorts as the standard for social distancing. Young children need to interact with you and with one another to develop fully. Their social and emotional needs do not go away with the pandemic nor should these needs be ignored. 

• Keep groups of children the same with the same teacher(s) throughout the day. That means we should avoid mixing groups for ratio reasons if possible. Therefore, close contact with one another is limited and the same each day.  
• Cohorts may prevent the need to close an entire facility if there is a positive case of COVID-19. If a teacher or child gets COVID-19 and they have only been in 1 room of the facility, then those who were exposed (and needing to quarantine for 14 days) is limited to the classroom. Please consult your health department and your DHS representative if you get a case so they can help you determine if one classroom or the whole facility needs to close for 24 hours. 
• Limit the number of children who can do an activity or play in a particular area of the classroom. For example, if you used to allow 4 children in the block area, try allowing 2 at a time. That way they still can interact socially, but with less crowding. 

• Separate the children by 6 feet when they do not have masks on for eating and sleeping and during less social activities such as yoga or listening to a story (circle time). 

3. Disinfect surfaces. While sanitizing removes many germs, disinfecting kills them. 

• Check the label on the disinfectant to be sure that there are disinfecting instructions. Follow them. 
• Disinfect toys and surfaces frequently. Pay attention to what children play with the most and disinfect those things often. For toys that get sneezed on or mouthed, remove them immediately for disinfecting. 
• Some items are hard to disinfect or cannot be disinfected. Wood blocks, books, art materials such as paper, and soft toys. Consider individual supplies when it comes to art. Consider removing soft toys from the classroom altogether. Consider quarantining books and other shared materials at the end of the day, for 3 days. Coronavirus droplets can live 72 hours on a surface.  

4. Wear masks. Current research says that masks are the #1 way to slow the spread since transmission is largely through respiratory droplets that travel person to person. Less cases have been found through touching surfaces. 

• Staff must wear masks at all times, even when outdoors. This is a DHS Certification mandate. 
• Children over 2 must wear masks except when napping and eating. This is a mandate from the Order of the Secretary of PA Department of Health.  
• There are a few exceptions for the mask mandates. Please visit the two links above for more information.  

 There is also some confusion about timelines for isolation/quarantine and closure to the classroom/facility. Here are some guidelines to consider. 

• Quarantine is 14 days from date of exposure to someone with COVID-19. The 14 days is because the start of symptoms may not happen until day 14.  
• Discontinuation of home Isolation is 10 days AFTER symptoms first appeared and being 24 hours fever free without fever reducing medicine and improvement in symptoms. 
• Isolation is different than quarantine. Quarantine is what you do if exposed to a person who tests positive. Isolation is what to do if you have symptoms or a positive COVID-19 test (with or without symptoms). 
• An example of the above: If a child is exposed to someone on day 1 and their symptoms show up day 14, they will need to wait another 10 days plus be fever free for 24 hours before returning without fever reducing medication and no additional symptoms.  

• 24 hours is the time a classroom or program must close after a positive case of COVID-19 (those areas used by the individual who tested positive must be closed for 24 hours). The Department of Health and DHS will guide you in knowing whether you need to close a classroom or the facility. Most stringent guidance must be followed.  If the Department of Health is less stringent, then OCDEL guidance must be followed.  

Finally, there is confusion between symptoms of COVID-19 and symptoms of other illnesses such as the common cold, ear infections, etc. 

OCDEL, in their newest announcement C-20-12, has released a symptoms chart to help programs identify a COVID-like illness. This will help programs know whether to exclude children for 10 days AND be fever free for 24 hours, or just the time length they would exclude them for other illnesses as they’ve done in the past.  

Be on the lookout and exclude children for a COVID-19 like illness if they have 1 of the following: new or persistent cough, shortness of breath, new loss of sense of smell, new loss of sense of taste. 

Be on the lookout and exclude children for a COVID-19 like illness if they have 2 or more of the following: fever ≥ 100.4°F, chills, muscle pain, headache, sore throat, nausea/vomiting, diarrhea, fatigue, congestion/runny nose.