Prepare

Preparing for how your program will respond and recover from health pandemics helps protect your program's children, families, staff members, and your community.

Programs should:

Organize and Maintain a Planning Committee

This planning committee should consist of staff members, program directors, families, and local health experts. It is recommended this committee meet at least annually to review and update pandemic plans, infectious disease procedures, and communications for staff and families. This committee can be used to maintain a list of key community contacts such as local health departments, licensing entities, health consultants, and other key community supports. The planning committee can also be used during a pandemic to revise services for children and support families and staff.

Promote and Support Immunizations for Caregivers and Teachers

  • Encourage caregivers and teachers to be current with all immunizations required by licensing authorities and/or recommended for adults by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) as shown in the "Recommended Adult Immunization Schedule" in the following categories:
    • Vaccines recommended for all adults who meet the age requirements and who lack evidence of immunity (i.e., lack documentation of vaccination or have no evidence of prior infection)
    • Recommended if a specific risk factor is present
  • Work with members of your community to support caregivers and teachers who may need help finding resources for vaccinations in your community.
  • Develop a system to document immunization compliance.

For staff members not fully immunized for legally allowable medical, religious, or philosophical reasons, the program should require written documentation of the reason. Develop and share a written procedure in case an unimmunized caregiver/teacher is exposed to a vaccine-preventable disease. A health department will be able to provide guidelines for exclusion requirements.

Develop a Written Plan

Each program should have a written plan. It may be helpful to first reference your statewide disaster plan or disaster plan for a tribe's service areas. Written plans should align with state, tribe, or territorial child care plans. Written plans should include:

  • Ways to identify who is involved, resources you use, and development and revision of your action plans
  • How a health emergency and pandemic is declared and communicated by local or regional health officials
  • How communication takes place with staff members, families, and others, including how families and staff will be contacted in the event of a closure.
  • Identification of local authority to close early care and education programs if there is a public emergency or pandemic
  • Your infection control policy and procedures including cleaning, sanitizing, and disinfecting surfaces, furniture, and toys that may require increased attention.
  • Methods for child learning and program operations during response and recovery
  • How to encourage families to consider their options for backup child care plans if a closure occurs
  • Maintaining sufficient supplies including liquid soap, disposable towels, hand sanitizer, tissues, diapers, toilet paper, and cleaning and disinfecting products
  • Plan for staff absences
  • How to administer expanded daily health checks prior to parent or guardian signing their child in
  • Caring for children with symptoms
  • How other natural and man-made disaster preparedness and recovery plans may be altered during health pandemic

See Caring for Our Children (CFOC) 9.2.4.4 Written Plan for Seasonal and Pandemic Influenza for more information.
Resource: California Childcare Health Program (CCHP) Pandemic Sample Policy and COVID-19 Sample Policy

Provide Training and Information to Staff Members

Throughout the year, schedule training and share information on health pandemic prevention and slowing viruses' spread. Educate and refresh staff member's understanding of the importance of the following:

  • The value of vaccinations, including the seasonal influenza vaccine
  • Hand-washing
  • Respiratory hygiene
  • Cough and sneeze etiquette
  • Wearing of face masks, shields, and other personal protection equipment
  • Cleaning and disinfecting of surfaces and rooms
  • Social distancing strategies
  • Symptom checking and exclusion criteria
  • Importance of staying home when ill
  • Infection control, including routes of transmission and risk reduction strategies

In the event of a pandemic, re-training staff on topics specific to the current health emergency will be critical.

Infection Control Procedures

Existing infection control procedures will be the consistent and reliable foundation of your pandemic plan. You should already have many existing protective measures against spread and exposure of illnesses.

Hand Hygiene

Washing hands regularly is often the strongest protection against illness and infection. Hand hygiene should be maintained or increased as much as possible during a pandemic. CFOC recommends the use of soap and water when possible and when there is visible soiling. Hand sanitizer with at least 60% ethyl alcohol is permissible when soap and water are not available. The use of antibacterial soap does not provide additional benefits at preventing infection and represent exposure to chemicals that may be harmful to human health. Hand sanitizers using an alcohol-based active ingredient must contain 60% to 95% ethanol (ethyl alcohol) to be effective in killing most germs. Alcohol-based hand sanitizer is toxic if ingested and must be kept out of reach of small children. Your written pandemic plan should adapt to local licensing requirements. Staff should follow normal infectious disease risk protocols, such as diapering and washing hands often.

Relevant CFOC Standards: Standard 3.2.2 Hand Sanitizers.

Cleaning and Sanitizing

Early childhood programs should use existing cleaning and sanitizing procedures as recommended in CFOC guidelines. The CDC should also be referenced regularly.

Special cleaning services or products are not recommended. Many viruses, including the coronavirus, are killed easily with Environmental Protection Agency (EPA) disinfectants and normal cleaning routines aligned to the CFOC standards.

Relevant CFOC Standards: Standard 9.2.3.10 Sanitation Policies and Procedures, 3.3 Cleaning, Sanitizing, and Disinfecting Appendix J, Routine Schedule for Cleaning, Sanitizing, and Disinfecting Appendix K.

Masks, Face Shields, and Other Protective Equipment

Programs should ensure staff have access to protective equipment, including multiple smocks, face coverings, gloves, face shields (as appropriate), and other resources during a pandemic. It will be important to consider access, storage, and cleaning in your written pandemic plan.

Masks can be safely worn by all children 2 years of age and older, including the vast majority of children with underlying health conditions, with rare exception. If children have a physical, mental, or sensory diagnosis that may make it difficult to wear a mask, adaptations and alternatives should be considered whenever possible to increase the likelihood of wearing a mask. Children should be encouraged to wear their mask but should not be reprimanded or punished. Early care providers, in partnership with parents, can be a helpful resource to teach children how to wear their mask and follow other guidelines, such as hand-washing and social distancing.

Ventilation

Depending on the infection route, efficient ventilation – taking indoor air outside and bringing fresh air in – may reduce the risk of infection when accompanied with other strategies, such as wearing masks, practicing hand hygiene, physical distancing, screening, and cleaning and disinfecting. Programs may contact licensed heating, ventilation, and air conditioning (HVAC) experts to inspect and assess their current systems and advise on how to ensure that ventilation systems operate most effectively.

Extend the indoor environment to outdoors by bringing the class (or part of a class) outside, weather and air quality permitting. If weather allows, open windows and screen doors. Do not open windows and doors if this creates a safety, supervision, or health risk (for example, poor air quality).

While access to fresh air is best, there are many other practices recommended for efficient and effective ventilation in the CFOC Online Standards Database.

Resources:
EPA, Where Can Professionals Who Manage School, Office, and Commercial Building Get Information on Ventilation and Filtration to Respond to COVID-19?
The American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE), COVID-19 Preparedness Resources

Social Distancing Strategies

Social or physical distancing may be recommended to slow or reduce a virus's spread during a health pandemic. Local, regional, or federal public health agencies will provide recommendations for social distancing.

Many people live in situations that present challenges with practicing social distancing, such as those living in shared housing, people with disabilities, and people experiencing homelessness.

Strategies for social distancing and for helping vulnerable populations are available on the CDC's Social Distancing: Keep a Safe Distance to Slow the Spread page.

Provide Education and Engagement Opportunities for Families

Throughout the year, schedule family education and engagement opportunities to share information on health pandemic prevention and slowing the spread of viruses. Educate and provide families with engagement opportunities to learn more about the following:

  • The value of vaccinations, including the seasonal influenza vaccine
  • Hand-washing
  • Cough and sneeze etiquette
  • Wearing of face masks, shields, and other personal protection equipment
  • Cleaning, sanitizing, and disinfecting of surfaces and rooms
  • Symptom checking and exclusion criteria
  • Importance of keeping their child home when sick

Resource: Sesame Street in Communities Health Emergencies

Education and Training Resources for Early Childhood Program Staff Members

Coronavirus-19 Resources for Schools and Child Care Programs
Office of Head Start COVID-19 Update Webinars

Create a Culture Full of Everyday Preventive Actions

Incorporate practices related to hand hygiene, cleaning, sanitizing, and disinfecting toys and surfaces into day-to-day activities. Share this information with staff members and families to create a culture where everyone plays a role in preventing the spread of germs.

See the CDC's Prevent Getting Sick resource. 

Stay Up-to-Date on How Your Program Operates During Each Phase of a Health Pandemic

Establish who in your program communicates with and stays up-to-date on guidance and standards from national, state, and local officials regarding program operation processes before, during, and after a pandemic. It may be helpful to discuss communication plans and procedures with families periodically as well.

Prepare in Advance for Flu Season

August and September are good times to start to prepare for the influenza season. See the following resources:

CDC
Planning and Preparedness Resources

Children and Influenza (Flu)
Influenza (Flu)
Protect Against the Flu: Caregivers of Infants and Young Children

Head Start Early Childhood Learning & Knowledge Center (ECLKC)
Why It's Important to Get the Influenza Vaccine Every Year

Communicate with Families Throughout the Year

Communicate with families about what they can do to prevent and control the spread of infectious diseases and the importance of vaccinations. These communications should take place throughout the year.

Family Communication Resources

American Academy of Pediatrics
Healthychildren.org

CDC
Multimedia Products for Parents
Flu Information for Parents with Young Children
Keeping Children Healthy During COVID-19

Head Start ECLKC
COVID-19: Health Considerations
Health Tips for Families Series
Protect your Child with Vaccines

Make Health Education a Part of Your Program's Education Curriculum

Work with your program's teachers and education staff members to make sure teaching children about healthy behaviors, such as hand-washing and cough/sneeze etiquette, are part of your program's classroom curriculum.

Support Vulnerable Populations

Systemic health and social inequities put many people at higher risk of getting sick, accessing care and testing, and being affected more during health pandemics.

Some of these inequities stem from:

  • Discrimination
  • Poor access to healthcare
  • Occupations that increase risk of exposure to viruses
  • Education, income, and wealth gaps
  • Housing that makes virus prevention strategies challenging

Head Start program standards and early childhood program best practices support vulnerable children and families when strategies are intentionally applied to protect children and families at risk for health inequities and disparities.

These strategies include:

  • Supporting families by ensuring enrolled children have an ongoing source of continuous, coordinated, accessible health care from a primary care provider so that emergency or urgent care is not the primary source for health services.
  • Working with community agencies to help families obtain health insurance coverage and access to high-quality health, oral health, mental health, and nutrition services.
  • Offering family support services for health, nutrition, mental health, and education during health pandemics when programs are closed or only open remotely.

For more information:

CDC
Coronavirus Diseases 2019 (COVID-19) Health Equity Considerations and Racial and Ethnic Minority Groups

Head Start ECLKC
Equity, Inclusiveness, and Cultural and Linguistic Responsiveness

Checklist to Help You Prepare

  • Develop and/or revise your program's written health pandemic plan. Use your Health Services Advisory Committee or pandemic planning committee for guidance
  • Schedule health pandemic preparedness, response, and recovery education for staff members and families
  • Display educational materials that encourage proper hygiene
  • Communicate with families about your program's health pandemic plans and available health pandemic resources your program and community can offer to families
  • Update family contact information and child health records
  • Encourage all staff members, children, and families to get the seasonal flu vaccine
  • Develop plans for children, families and staff members at highest risk for complications during health pandemics
  • Encourage families to talk to their doctor about vaccines for seasonal flu and other viruses and available antiviral medicines if they develop symptoms
  • Keep supplies of things you need to prevent the spread of infection, including any personal protection supplies such as masks or shields
  • Keep informed about who has authority to close and reopen your program due to a health pandemic or virus/disease outbreak
  • Identify all the ways that your program can support families and staff members during a health pandemic (access to remote services, community services, and other ways to continue essential functions during a program closure)
  • Find out if your community has options for free or low-cost broadband internet access for families and staff members in need
  • Visit website resources for the latest information and checklists for how to prepare: