Table of Contents
Introduction
This guidance is aimed at providing support for safe, in-person learning and care in K-12 schools, child care, and related settings by mitigating the spread of communicable diseases. It 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. The principle guiding these strategies is that safe, in-person learning and care are essential for the well-being and development of children.
This guidance offers considerations for various settings where children spend their time, including licensed child care centers and family child care homes, licensed-exempt child care providers, early childhood education sites, K-12 schools (public and private), before/after-school programs, and summer school/intersession programs.
It is important to note that many of the strategies used to reduce transmission of infections can also protect against harmful environmental effects. School administrators and child care providers in California 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 the best available scientific and epidemiological knowledge and is subject to change.
General Considerations
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This guidance provides general recommendations and 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.
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The California Department of Public Health (CDPH) and the California Department of Social Services (CDSS) acknowledge 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.
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Local health departments or state agencies may implement additional requirements that go beyond this statewide guidance based on local circumstances. Providers should follow the strictest requirements if there are differing requirements between the most current CDPH, Community Care Licensing (CCL), Cal/OSHA, and local health department guidance or health orders.
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When applying this guidance, confer with local health officials and consider the following factors:
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Vaccination coverage in the community and among children, teachers, and staff
- Local disease outbreaks or transmission patterns
- Facility-specific indoor air quality
- Availability and accessibility of resources, including masks and tests
- Availability and capacity of school and child care
- Population served, with attention to individuals at high risk for severe disease and immunocompromised populations
- Community input, including from children, families, and staff
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Socioeconomic, cultural, and linguistic barriers that may disproportionately impact populations and increase the risk of infection, limit access to health care services, and reduce the adoption of recommendations
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It is recommended that school administrators and child care providers communicate their health and safety strategies to children, parents, and staff using multiple strategies, including parent communications and on-site reminders. Communication should be appropriate to the languages and literacy levels of community members.
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This document updates and replaces the following guidance documents:
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COVID-19 Guidance for Child Care Providers and Programs
- COVID-19 Public Health Guidance for K–12 Schools to Support Safe In-Person Learning, 2022-2023 School Year
- Preliminary Testing Framework for K–12 Schools for the 2022-2023 School Year, pursuant to California Education Code section 32096
Mitigation Strategies
Staying Up to Date on Vaccinations
Vaccinations, also known as immunizations, can help protect against certain diseases by working with the body’s natural defenses to safely build immunity. Vaccinations not only protect the person who receives the vaccination but also reduce the burden of disease in communities and protect individuals who are not vaccinated or may not develop a strong immune response from vaccination.
Recommended Actions:
- Encourage children, families, and staff to stay up-to-date on all vaccinations recommended by their health care provider. Review vaccination requirements for entry into K–12 schools and pre-K/child care settings.
- Visit the CDPH Shots for School site for resources related to school or child care immunization requirements.
- Note that COVID-19 and influenza vaccines are not currently included in the list of required immunizations for school or child care. However, both vaccines are strongly recommended for all eligible individuals in California.
- Work with local health departments and community partners to conduct school-located vaccine events whenever possible.
Optimizing Indoor Air Quality
Indoor settings with poor air quality pose a higher risk of getting and spreading respiratory infections. Effective ventilation and filtration can reduce the spread of these infections and protect students, children, and staff from exposure to wildfire smoke, airborne allergens, and other pollutants.
Recommended Actions:
- Follow CDPH recommendations to improve indoor air quality. Facility maintenance staff should review technical considerations.
- Optimize ventilation in transport vehicles, such as buses or vans, by opening windows to increase airflow from outside when feasible and safe to do so.
- Consult with local health department officials in circumstances where outdoor air quality is poor, such as from wildfire smoke. Consider using air filtration strategies that do not rely on outdoor air sources, utilizing alternative spaces with better air quality, keeping windows and doors closed, using higher-quality face masks, and finding alternative ways to commute to/from school.
- Whenever possible, facility HVAC upgrades can improve indoor air quality while supporting energy efficiency. Resources and guidance from the California Energy Commission, California Department of Education, and the California Air Resources Board can provide further information.
Using Face Masks
Face masks, especially high-quality and well-fitting masks, are effective tools to protect oneself and others. No person should be prevented from wearing a mask as a condition of participation or entry unless wearing a mask would pose a safety hazard.
Recommended Actions:
- Support access to face masks.
- Develop and implement local protocols to provide appropriately sized, high-quality masks to children who do not have one but desire to use one.
- Employers should provide face coverings and ensure they are worn by employees when required by CDPH regulations or orders.
- Unless otherwise directed by local health departments, follow CDPH guidance on masking, including wearing a mask around others if experiencing respiratory symptoms.
- Certain individuals should not wear face masks, including infants and children younger than 2 years old, persons eating or sleeping, persons with a medical condition or disability that precludes safe and effective mask-wearing, and persons for whom wearing a mask would create a safety hazard related to their work.
Maintaining Good Hygiene
Frequent hand washing and other good hygiene practices can help prevent the spread of communicable diseases and protect the health of students and staff at schools and child care facilities.
Recommended Actions:
- Ensure adequate supplies of soap and water, tissues, and no-touch trash cans. If used, hand sanitizers should contain at least 60 percent alcohol and should be stored up, away, and out of sight of younger children.
- Teach and reinforce proper handwashing to lower the risk of spreading communicable diseases. Handwashing with soap and water is preferred over the use of hand sanitizers.
- Teach and reinforce the practice of covering coughs and sneezes.
- Discourage sharing of personal items such as cups, food, utensils, water bottles, lip balm, cell phones, and makeup.
Managing Individuals with Symptoms
Staying home when sick can lower the risk of spreading communicable diseases.
Recommended Actions:
- Follow CDPH COVID-19 Isolation Guidance for suspected or confirmed COVID-19 infection.
- Avoid policies that incentivize coming to school or child care while sick.
- Support access to education resources and health-related information when appropriate.
Reporting Diseases and Responding to Outbreaks
Notifying local health departments and other authorities about communicable diseases and potential or confirmed outbreaks in schools and child care can facilitate the deployment of additional strategies and resources to contain transmission.
Recommended Actions:
- Review reporting regulations.
- Contact local health departments about outbreaks and potential exposures.
- Support local health department contact tracing efforts.
- Contact CDPH for consultation as needed.
- Refer to CDPH Workplace Outbreak Employer Guidance for more information.
Cleaning Facilities
Clean and well-maintained facilities reduce the spread of communicable diseases transmitted through contact with contaminated or high-touch surfaces.
Recommended Actions:
- Perform routine daily cleaning with water and mild detergent. Additional sanitization might be necessary during certain disease outbreaks.
- Consult with local health departments during outbreaks.
- Use asthma-safer products if disinfectants are used.
- Routine cleaning of drinking fountains is recommended.
- Train and monitor staff to follow infection control practices for cleaning and disinfection, housekeeping, sanitation principles, and universal health precautions.
- Ensure compliance with the Healthy Schools Act requirements for anyone using disinfectants at a school or child care center.
- Note: Training requirements do not apply to family child care homes.
Getting Tested
Testing can detect and reduce the transmission of communicable diseases. At-home antigen-based testing, currently widely available for COVID-19, provides individuals with convenient, rapid, and accurate test results.
Recommended Actions:
For COVID-19:
- Follow CDPH testing guidance for COVID-19.
For other communicable diseases:
- Testing should be considered by a healthcare provider based on related symptoms. At-home tests are not widely available for the vast majority of communicable diseases.
Additional Considerations
In addition to the mitigation strategies mentioned above, there may be other factors to consider when implementing health guidance in 2023. These factors include:
- Mental health and well-being support for students, children, and staff
- Policies and procedures for responding to outbreaks and communicable diseases
- Collaboration with local health departments and community partners
- Ongoing monitoring and evaluation of prevention strategies
- Continuity of education and access to resources during periods of remote learning or reduced in-person attendance
By considering these additional factors and implementing the recommended mitigation strategies, schools and child care providers can create safer environments for students, children, and staff while promoting their overall health and well-being.