Safeguards for daycares and adult care centers have been provided, along with some unique ways providers are adapting to ensure the safety of all involved. As time has passed, many of the original CDC recommendations are now considered standard. Many states have taken it a step further providing more specific guidance, especially with child day cares. These were shared if they were different from the standard guidelines.
Daycares- CDC Guidelines
- CDC Guidance has stayed relatively constant during the pandemic regarding daycares. They recommend the standard social distancing, cohorts, designating an employee to oversee monitoring, face coverings with exceptions, teaching children proper hygiene, posting signage, cleaning, and isolating the sick. Nothing new or innovative was mentioned as a safeguard.
- In school guidance, which was referenced in the daycare section, the CDC does not recommend using face shields, as a substitute for masks, as there is a lack of evidence of their effectiveness.
- The latest guidance, which addresses the above, was issued on 7/22/20 and may be read here.
- Educational videos, posters, and checklists for staff and parents may be viewed here.
- Additional guidance was issued on 7/23/20 that provided additional recommendations for screening like using barriers and PPE along with social distancing. Additional guidance was provided on the following:
- If there is a confirmed case, wait up to 24 hours, or as long as possible before cleaning to allow respiratory droplets to settle. If more than 7 days have passed since the person who is sick visited or used the facility, additional cleaning and disinfection is not necessary.
- When dropping off children, there should be a hand hygiene station at the entrance, or at a minimum, hand sanitizer. The facility should consider staggered drop off and pick up times.
- With small children, that need to be held, the worker should wear a large, button-down, long-sleeve shirt and keeping long hair in a pony tail. When finished, was hands, neck, and anywhere touched by a child’s secretions. If clothes are contaminated by secretions, place in a bag for disinfection. Both workers and children should have multiple changes of clothes on hand.
State Guidance for Daycares
- Childcare.gov provides a complete listing by states that includes what guidance they have provided and the status of centers in each state.
- The Hunt Institute also provides a state by state listing that details closures, how CARES funding was spent, issuances, resources, and group size limitations.
- In the guidance provided, they recommend daily health checks.
- Depending on age, there is a maximum group size that ranges from 8 infants to 15 school-age children.
- Cohorting, keeping families together, and grouping by employer are recommended.
- Face coverings are required for those that are 3rd grade and older.
3. New Jersey
- Groups shall not exceed ten children. Interactions and movement of groups must be limited. Staff will be assigned to a group and remain with that group.
- Ten feet of separation must be established between groups, including sleeping and play.
- A COVID-19 Response Plan is required of all providers that addresses how symptoms will be monitored, how social distancing will be practiced, hygiene practices, use of safety equipment, communication protocols, and isolation protocols.
- In order to use hand sanitizer on children, they must have an Authorization for Administering Medication/ Medical Procedures form (DHR-CDC-1949). This form must be signed by the parent or guardian. Hand sanitizer must be kept under lock and key, or a combination lock.
Individual Daycare Safeguarding Examples
- Daycares have implemented some unique ways to keep kids healthy like placing footprints on the floor, using tape to section off tables, and providing personalized shelves that have toys specific to each child.
- Bright Path Daycare uses hula hoops and pool noodles to show safe spacing during play times.
- The YMCA in New York has had tremendous success with slowing the spread of COVID-19. They have grouped pods of kids with the same adult and expanded into the gym, offices, anywhere they could fit. Interestingly, while they were in their pods they did not social distance or use masks.
- To reinforce hand washing, they wash their hands before each activity. They place a stamp on the child’s hand that they have to wash off before moving to the next activity. In the process, they learned how to scrub their hands and had fun.
- Where daycares used to have buckets to hold toys that needed to be sanitized at then end of each day, this now happens every couple hours.
Adult Care Centers
Providers are heavily focused on not only protecting seniors from the virus, but protecting their mental health during the pandemic. Almost all the examples incorporate ways to safely fight loneliness and depression, while increasing engagement. There was little research of media concerning adult care centers that did not focus on seniors. Even when research was entitled “adult”, in most cases it referred to seniors. Therefore, the majority of this information is pertaining to seniors. Considering that the guidelines are almost identical for both groups, the guidance could be applied equally to both.
Adult Care Centers- CDC Guidelines
- In the list of communities that the CDC provides guidance for, they do not specifically address adult care centers.
- They offer a toolkit with posters and general information for older adults and people at higher risk. They also offer guidance for those in retirement communities and independent living. This guidance is what the majority of states that were researched referred to. This section shared the standard protocols along with altering and staggering schedules, and installing partitions.
National Adult Day Services Association (NADSA)
- NADSA provides guidance along with a Facebook Support Group. In a 57-page document, they lay out plans for reopening and resources, along with surveys for clients and providers to assess needs.
- They recommend assessing an individual’s support needs to be based on her/his current aptitude and tolerance to practice universal precautions and required social distancing.
- Social bubble principles should be used along with a phased in approach that starts with the least risk.
- Assist support coordinators with guidelines on how to meet with individuals and their families regarding the risks, benefits and support needs in returning to day programs and employment services; ensure the guidelines are informed by individuals and families and are supplemented by highly individualized assessment and conversation tools.
National Council for Aging Guidance
- The National Council for Aging provides guidance as seniors go back to on-site centers.
- There is a slideshow available that shares guidance shared in a virtual meeting for all providers. In the slideshow, several survey questions are asked referencing internet accessibility, lack of volunteers, how services are offered, funding needs, and online platforms used.
- The most popular platforms used to reach seniors was BurnAlong, FreeConferenceCall.com. Google Hangouts, GoToMeeting, GroupMe, Facebook, Microsoft Teams, OneClick.chat, Skype, WhatsApp, YouTubeLIve, and Zoom.
- They share calendars from centers that shows activities that are planned for each day.
- They recommend establishing a flexible refund policy for those that are not well and must leave.
- They also recommend that the centers are only open 2-3 days per week.
State Guidance for Adult Care Centers
In an effort to not be redundant, it is understood that the states all provide the same general guidance in regard to the safety protocols that are considered standard. Interesting procedures that were noted during research are being shared. The links shared are the actual state guidance in its entirety.
- The state recommends that adult day centers provide alternate or remote services as much as possible in order to deliver support and services without introducing unnecessary risks. The rest of the guidance is standard and no other special precautions were noted.
- They go on to recommend one on one care as the preferred option. When possible, those that are at a higher risk should be prioritized.
- If transportation is provided, single person transportation is encouraged.
2. North Carolina
- North Carolina also provided general guidance. Of note, they state that participants are not ““forced” to wear a mask or face covering when in attendance at the program. When participants agree to wear a mask or face covering, assign one mask or covering to each participant.”
3. New York
- The Department of Health recommended that each center should develop a series of remote activities that can address the need for interaction, engagement, and activity. Methods for delivering remote activities include using Skype, Google Meet, Zoom, FaceTime, smartphones, or other modalities, to engage participants with stretching activities, games, educational activities, arts and crafts, and other group activities.
- An individual care plan must be developed for each client. The plan will be developed by all stakeholders and will address client needs, goals, methods to reach goals, time frame, progress, and a review date. While clients are at the centers they will receive daily health checks.
- All social service visits will be virtual.
- Cohorting is recommended.
- Limit the use of fans.
- Establish appointments and sign up times for activities ahead of time.
- Outdoor activities are encouraged as much as possible, including dining.
Individual Senior/Adult Care Center Safeguarding Examples
- Some centers are turning to technology to keep seniors safe. Aegis Living has created a YouTube channel that produces news videos three times per week. The videos cover pandemic related news and events that are relevant to the community.
- At New Generations Adult Day Centers in South Carolina, they shared all they were doing to combat the spread of COVID-19. Overall, there was nothing unique. The page seemed to be shared as a way to reassure those coming back to the center that social distancing, hand washing, screening, and masks would keep them safe.
- One center is using a program from Megadata where they take the pulse ox level of each client daily, then it is entered into a program. The thought is that the oxygen levels reflect what is going on in the lungs, giving them a hopeful head start on symptoms and prevention of spread.
- At Forest Hills in Queens, residents can come by and grab a packed meal in place of eating there. They also provide several virtual classes to keep them engaged.
- In Carl Junction, Missouri, to boost morale, they have daily car parades where the seniors can drive by and see staff.
- Some center have added grocery shopping and medication delivery, along with curbside delivery of meals to their list of services in order to keep seniors safer.
- The Ozark Senior Center hosts parking lot bingo. Participants may site in their vehicles or bring chairs and sit by their cars and play bingo to encourage engagement and overall mental health wellness during the pandemic.