COVID-19 Safety

Health & Safety Protocol

  • Section 1 – Education
  • Preventing person-to-person transmission via respiratory droplets is more important than cleaning and disinfection. Face masks, physical distancing, and indoor ventilation are most important in preventing the spread of COVID-19. 
  • COVID-19 spreads from person-to-person in the air through virus-containing respiratory droplets. These droplets enter the air when a person with COVID-19 breathes, especially when they talk, sing, cough, sneeze or exercise. In poorly ventilated indoor spaces, smaller droplets can float in the air and travel more than 6 feet. The virus that causes COVID-19 must enter a person’s eyes, nose or mouth to infect them.
  • COVID-19 can also spread if a person touches their eyes, nose or mouth after touching a contaminated surface (also known as a fomite), but this is less common. 
  • Exposure risk lies along a continuum. A rule of thumb is that a person must spend a total of 15 minutes in 24 hours within 6 feet of someone with COVID-19 to be at risk of infection.
    • Spending less time together is safer than more time; being further apart is better than being closer together.
    • Smaller groups are safer than larger ones, outdoor settings are safer than indoor ones. 
    • More people using face masks is safer than fewer people using face masks. 
    • Activities that produce fewer respiratory droplets are safer than those that produce many droplets (silence < quiet talking < loud talking < singing).
  • Section 2 – Prevent COVID-19 from Entering the Program
    Screen everyone entering the program for COVID-19 for symptoms and exposure. 
  • At drop off, families will be asked if their child has exhibited any of the following symptoms:
    • Fever (100.4°F/38°C or higher) 
    • Sore throat 
    • Cough (for children with chronic cough from allergies or asthma, a change in their cough from baseline) 
    • Difficulty breathing (for children with asthma, a change from their baseline breathing) 
    • Diarrhea or vomiting 
    • New loss of taste or smell 
    • New onset of severe headache
  • Children with symptoms or a fever will be sent home and encouraged to seek COVID-19 testing. 
  • Parent or caretakers of any child who is sent home will be instructed that the child and family must follow the criteria as well as any applicable requirements from the quarantine and isolation directives (available online at www.sfdph.org/dph/alerts/coronavirus-healthorders.asp) before returning to Summer Camp. If they are required to self-quarantine or self-isolate, they may only return to the camp after they have completed self-quarantine or self-isolation. If they test negative for the virus (no virus found), they may only return to camp after waiting for 24 hours after their symptoms have resolved. Children are not required to provide a medical clearance letter in order to return to camp as long as they have met these requirements.
  • Personnel conducting the screening will stand at least 6 feet away from the child and parent/caregiver.
  • Children who pass screening will wash their hands with soap and water or clean their hands with hand sanitizer before they enter the building or program.
  • Ask all other persons about COVID-19 symptoms and exposures when they arrive – including parents/caregivers, visitors, contractors, and government officials. Emergency personnel responding to a 911 call do not need to be screened. 
  • If people answer “yes” to any of the screening and exposure questions, do not let them enter. 
  • If children or youth arrive with symptoms, send them home. Keep children and youth who are waiting to be picked up in a designated isolation room. 
  • Staff, children and youth who are sick must stay home.
  • Remind families to keep children home when ill. A parent/guardian handout, “COVID-19 Health Checks/If Your Child has Symptoms” is available at sfcdcp.org/CovidSchoolsChildcare. 
  • Encourage family members of children and staff to get tested promptly if they have symptoms of COVID-19, to lower the risk of spreading infection to children and staff. 
  • Encourage staff and children to stay home for 10 days after traveling. 
  • SFDPH recommends that travelers quarantine at home after travel outside the Bay Area, if their activities put them at risk for COVID-19 infection. Higher-risk activities include: 
    • Spending time within 6 feet of people outside their household when not wearing face coverings, especially if indoors. 
    • Travel on planes, buses, trains, or other vehicles shared with people outside their household if face coverings were not worn at all times by all passengers. 
  • This recommendation does not apply to staff and children who commute to the program from outside of the Bay Area. For more information, see https://www.sfdph.org/dph/alerts/covid-guidance/COVID-Travel-Advisory.pdf 
  • CDPH also recommends that travelers quarantine after non-essential travel outside of California. For more information, see https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Travel-Advisory.aspx 
  • Restrict non-essential visitors. 
  • Allow only volunteers who are essential to the program operations. 
  • Discourage parents and other family members from entering the building. 
  • Therapists who are not OST program employees but work with children and youth on-site, such as ABA therapists, occupational therapists and physical therapists, are considered essential staff and should be allowed to provide services. 
  • Cancel or move to virtual platforms for special events that involve parents and families, such as festivals, holiday events, and performances.
  • Section 3 – Keep staff, children and youth in small, stable groups (“cohorts”).
    A cohort is a stable group that has the same staff, children and youth each day, stays together for all activities (e.g., snacks, recess, etc.), and avoids contact with people outside the group. Keeping staff, children and youth in the same small cohort each day lowers their exposure risk by limiting the number of people they interact with.
  • Limit cohort size 
  • The risk of COVID-19 spreading between people is greater indoors than outdoors. 
  • Limit indoor cohorts to no more than 14 children or youth and 2 supervising adults, or no more than 16 individuals total (children, youth and adults). 
  • Limit cohorts that are exclusively outdoors (e.g., sports teams, nature camps) to no more than 25 children and youth. Cohorts that are exclusively outdoors may have no more than 25 children and youth and 2 supervising adults. 
    • If a cohort spends time both indoors and outdoors, indoor size limits apply. 
  • San Francisco requires that each cohort be supervised by no more than 4 staff, including volunteers and interns. 
  • The maximum cohort size applies to all children and youth in the cohort, even if not all children attend the program at the same time. For examples for indoor cohorts, 
    • A cohort may not include 2 staff, 6 children who attend full-time, 6 children on Mon/Wed/Fri, and 6 children on Tu/Th (total of 20). 
    • A cohort may not include 2 staff, 8 children who attend for the entire day, 4 who attend mornings only, and 4 who attend afternoons only (total of 18). 
    • A cohort may not include 14 children, a teacher, one parent-volunteer on Mon/Wed/Fri, and a 2nd-parent volunteer on Tu/Th (total of 17). 
  • Newly enrolled children and youth may join a cohort at any time, but they must enroll for a period of at least 3 weeks. Do not allow children to attend for shorter periods.  
  • Children and youth must only participate in one OST program at a time, even if the programs occur on different days of the week. For example, a child may not attend both an afterschool program Mon-Fri and a Saturday youth sports program.
  • Staff who work with children over 5 years of age must be assigned to only one cohort and work only with that cohort. Staff may not work with more than one cohort of children or youth. For example, 
    • Staff working with children over 5 years of age may not work with one cohort on Mon/Wed/Fri and another cohort on Tu/Th. 
    • Staff working with children over 5 years of age may not work with one cohort in the mornings, and another in the afternoons. 
  • Staff who work only with children 0-5 years of age may be assigned to two cohorts. Programs where staff work with two cohorts must place staff in groups of up to 4 staff members. Everyone in a staff group must work with the same two cohorts. Staff must work only with other staff in their staff group, and can only be in 1 staff group. For example: 
    • Allowed: (3 staff members in a group working with 2 cohorts) Staff A and B work with one cohort of children on Mon/Wed/Fri. Staff B and C work with a different cohort of children on Tu/Th. 
    • NOT allowed (5 staff members working with 2 cohorts) : Staff A, B and C work with one cohort of children on Mon/Wed/Fri. Staff C, D and E work with another cohort of children on Tu/Th. 
    • NOT allowed: (4 staff members working with 3 cohorts) Staff A and B work with cohort 1 on Mon/Wed/Fri. Staff A and C work with cohort 2 on Tu/Th mornings. Staff B and D work with cohort 3 on Tu/Th afternoons. 
    • Substitute providers who are covering for short-term staff absences are allowed, but must only work with only one cohort of children per day. 
    • “Floaters,” who provide brief coverage for providers throughout the day, must work with only one cohort of children per day. 
  • When determining the number of staff in a cohort, do not count people who provide one-to-one services to individual children but do not interact with the entire cohort. This includes but is not limited to occupational therapists, physical therapists, speech and language therapists, and ABA providers. See the San Francisco Health Directive on Specialized Support Services for more information at https://www.sfdph.org/dph/alerts/files/Directive-2020-26-SpecializedSupport.pdf
    • Avoid moving staff from one cohort to another if possible
  • Keep cohorts from mixing. 
  • Each cohort must be in a separate room or space. 
  • Minimize interactions between cohorts, including interactions between staff in different cohorts. 
    • Stagger playground time and other activities so that no two cohorts are in the same place at the same time. 
    • Do not hold activities that bring different cohorts together, even if outdoors wearing face coverings. 
    • For specialist activities such as art and music, staff may cross between cohorts to meet children’s educational and enrichment needs. Limit staff movement between cohorts as much as possible. 
    • Staff must document visits that are not part of their cohort. Consider using a sign-in sheet/log to keep track of when staff have worked with different cohorts, to help determine which children, youth and staff were exposed to COVID-19 after a COVID-19 case occurs in the program. 
    • Assign children and youth who live together or carpool together to the same cohort, if possible and consistent with age and developmental needs.  
    • Avoid moving children and youth from one cohort to another, unless needed for a child’s or youth’s overall safety and wellness. 
  • Partition large indoor spaces to prevent direct air flow between cohorts. 
  • A room divider or partition may be used to allow more than one cohort to use a large indoor space if the following requirements are met: 
    • All cohorts are from the same program. 
    • Staff, children and youth can access bathrooms, kitchens, and other common areas or exits without entering another cohort’s space. If one cohort must pass through another cohort’s space to access common areas or exits, use partitions to separate the pass-through space from both cohorts. 
    • The room divider must prevent direct air flow between cohorts. 
      • Best Practice: Solid, non-permeable, cleanable partitions extending from the floor to as close to the ceiling as practical, to reduce direct and indirect air flow between cohorts. 
      • Minimum Requirement: Solid non-permeable, cleanable partitions extending from the floor and at least 8 feet high.
    • The room divider must not: 
      • Interfere with ventilation of each space (e.g. windows must be present on either side of the partition, or if mechanical ventilation is used, supply and return diffusers must be present on each side of the partition) 
      • Obstruct sprinkler systems, access to emergency exits and other fire and building codes. 
    • If smoke detectors are required and/or are in use in the building, separate smoke detectors may be required on each side of the room divider. Seek consultation as needed for each facility.
  • Limit sharing
  • Consider suspending or modifying use of drinking fountains. Encourage the use of reusable water bottles instead.
  • Limit sharing of art supplies, school supplies, manipulatives, and other high-touch materials as much as possible. If feasible, have a separate set of supplies for each child and youth.
  • Avoid sharing electronic devices, sports equipment, clothing, books, games and learning aids when feasible. Clean and disinfect shared supplies and equipment between uses.
  • Keep each child’s or youth’s supplies and belongings in separate, individually labeled boxes or cubbies.
  • Section 4 – Face Masks and Cloth Face Coverings
    Face masks and other face coverings keep people from spreading the infection to others, by trapping respiratory droplets before they can travel through the air. They also help protect the person wearing the face covering from infection.
    For this guidance, “face masks” includes cloth face coverings that cover the mouth and nose and do not have an exhalation valve. 
  • All adults and children 2 years of age and older must wear face masks over both their nose and mouth. This includes family members and caregivers dropping off or picking up children outside the building. 
  • People may not enter the building unless they are wearing a face mask or have documentation of a medical contraindication to face masks. 
  • Provide face masks to children who forget to bring their face mask to the program. Reusable cloth face masks are recommended over disposable masks, and can be sent home with families to be laundered. 
  • Keep a supply of face masks for other individuals who have forgotten to bring one. 
  • Some children will need additional support to consistently wear face masks. Programs should take into account equity and each child’s individual circumstances when deciding how to best support children in wearing face masks. 
  • Do not exclude children from in-person participation if they have an approved medical exemption to face masks. For children and youth with documented medical exemptions to face masks due to developmental delay, autism or other conditions that limit their ability to tolerate face masks, encourage and remind them to wear their face mask as much as possible. 
  • For children and youth who have difficulty keeping their face masks on at all times, prioritize consistent face mask use in the following situations: 
    • In hallways, bathrooms and other spaces where they may encounter staff and students from other classrooms. 
    • For younger children, during times where physical distancing is relaxed.  
    • When a child or youth is ill and waiting to be picked up (and is not asleep).  
    • When in public and within 6 feet of others, for example, while walking to a nearby park or outside the program at drop-off. CDPH requires face masks for children ages 2 and up in public. Wearing face masks at drop off also protects staff who are screening children and youth for COVID 19. 
  • Avoid excluding children from the program or disciplining them if they initially have difficulty wearing a face covering. Continue to encourage and remind them to wear their face covering. Exemptions to cloth face coverings; use of face shields 
  • Children 0-1 year old must not wear face coverings due to the risk of suffocation. 
  • People who are unconscious, asleep, or unable to remove a face mask independently.
  • Children and youth with documented medical or behavioral contraindications to face masks are exempt. This includes children and youth who are unable to tolerate face masks due to autism or sensory sensitivity, or children and youth unable to remove a face mask independently due to developmental delay or disability. Seat children and youth who are not wearing face masks at least 6 feet away from others, if possible to do so without stigmatizing the child or youth.
  • Adults with a medical contraindication documented by a medical provider to a face covering may be allowed to wear a face shield with a cloth drape on the bottom tucked into the top of their shirt. However, this is not thought to be as effective as a face mask in preventing spread of infection. 
  • Asthma, claustrophobia, and anxiety are not usually considered to be contraindications to face masks. 
  • Staff working alone in a private indoor space do not have to wear a face mask if
    • The space is completely enclosed (i.e. a private office, not a cubicle), and
    • Other people are not likely to enter the space at any time in the following few days. 
    • Staff working alone in a classroom that will be used later by others are not exempt, and must wear a mask. Similarly, administrators in a private office must wear a mask, even when alone, if they can reasonably expect others to enter their office to ask questions or to meet. 
  • Staff working with children and youth who are hard-of-hearing may use a clear mask (a disposable or cloth face mask with a clear window). If this is not feasible, a face shield with a cloth drape tucked into the shirt may also be used. Staff must wear a face mask at other times, for example, in staff-only areas. 
  • Do not use face shields in other situations. Face shields have not been shown to keep the wearer from infecting others. 
  • Consider using a face shield in addition to a face mask. Face shields provide additional protection for the wearer. When used with a face mask, a cloth drape is not needed. 
  • For more information, see https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID19/guidance-for-face-coverings.aspx
  • Section 5 – Physical Distancing
    Physical distancing decreases the risk of COVID-19 from respiratory droplets. 
  • Stay at least 6 feet from other adults, including staff in the same cohort, as much as possible. 
    • Set up offices and staff rooms so that staff do not work or sit within 6 feet of each other. 
    • Encourage virtual meetings using video conferencing apps for staff meetings and parent staff discussions, instead of meeting in-person. 
  • Stay 6 feet away from children and youth as much as possible while meeting their learning needs. 
    • If it is not possible to stay 6 feet apart, keep the interaction short, make sure to wear face coverings, and consider wearing a face shield in addition to a face covering. 
  • During individual activities, space children and youth at least 6 feet apart. 
  • Rearrange furniture and work/play spaces to prevent crowding and promote physical distancing between children who are not playing together. 
  • Arrange desks, workstations, or computers facing in the same direction, so that children do not sit facing each other. Have children sit in the same seats each day if possible. 
  • Offer more opportunities for individual activities, such as reading, painting or crafts. Choose group activities that do not involve close contact between children. 
  • During group activities, such as playtime, physical distancing may be relaxed for younger children who have difficulty staying 6 feet apart, especially if outside and wearing facemasks. 
  • Prioritize preventing interactions between cohorts over physical distancing within a cohort in shared spaces like outdoor areas, hallways and bathrooms. 
  • Limit occupancy of bathrooms, elevators, staff rooms and similar shared spaces to allow 6 feet of distancing. Adjacent bathroom stalls may be used. Post signs with occupancy limits. 
  • At places where people congregate or wait in line, mark spots on the floor or the walls 6 feet apart to indicate where to stand.
  • Section 6 – Staff Considerations
    Protect staff, especially those at high risk of severe COVID-19 illness. See sfcdcp.org/vulnerable for a list of groups at higher risk for severe COVID-19. 
  • Offer options that reduce exposure risk to staff who are in groups at higher risk for severe COVID-19 (e.g. telework, reassignment, or modified job duties that limit direct interaction with staff and children). 
  • Avoid assigning staff at higher risk for severe COVID-19 to screen people for symptoms or monitor/care for sick children waiting to be picked up. 
  • Consider using portable plexiglass barriers, a clear window, or other barrier for staff who must interact with large numbers of children or adults within 6 feet. 
  • Consider the use of face shields, to be used with face coverings, for staff whose duties make it difficult to maintain physical distancing. 
  • Consider covering your regular clothes with a smock or large shirt to keep tears, mucus, saliva from touching your clothing 
  • Keep staff in different stable cohorts from mixing. During the two weeks before the program opens, do not hold in-person staff development, meetings, or team-building activities that bring together staff who will be working with different stable cohorts. 
  • Implement sick leave policies that support staff in staying home when ill. 
  • Plan for staff absences of 10 14 days due to COVID 19 infection or exposure. Cross train staff and have a roster of back up staff experienced in working with children. Avoid combining cohorts when staff are absent, as this increases the risk of infection spreading in your program.
  • Staff break rooms, work rooms and offices 
    • Break rooms are a common source of COVID-19 exposure in all work settings. Staff often do not view themselves and colleagues as sources of infection, and may forget to take precautions with coworkers, especially during social interactions such as breaks or lunch time, in the copy room, when checking mailboxes, etc.
  • Strongly discourage staff from eating together, especially indoors. 
    • Programs must notify staff that they should not eat indoors when possible. 
    • Programs must provide an outdoor break area, if feasible, for staff to eat. 
  • Discourage staff from gathering in break rooms and other indoor staff spaces. 
  • Limit the number of people in indoor break rooms and other staff spaces to the lesser of a) 25% of the maximum occupancy or b) the number of people allowed by 6 foot distancing. 
  • Post the maximum occupancy for break rooms and other staff areas. 
  • Post required signs in break rooms, including signs reminding staff to stay 6 feet apart, keep their facemasks on unless eating, and wash their hands before and after eating. 
  • Open windows and doors to maximize ventilation, when feasible, especially if staff are eating or if the room is near maximum occupancy.
  • Section 7 – Ventilation and Outdoor Spaces
    Being outside is much lower risk than being inside. When indoors, increasing outdoor air circulation lowers the risk of infection by “diluting” any infectious respiratory virus in the air with fresh outdoor air.
  • Outdoor spaces 
  • Do as many activities outside as possible, especially snacks/meals and exercise. 
  • Stagger use of outdoor spaces to keep cohorts from mixing. If the outdoor space is large enough, consider designating separate spaces for each cohort. 
  • Outdoor spaces may be covered (e.g. with a canopy). by a tent, canopy, or other shelter), as long as the shelter complies with: (1) CDPH’s November 25, 2020 guidance regarding “Use of Temporary Structures for Outdoor Business Operations” (online at https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Use-of-Temporary-Structuresfor-Outdoor-Business-Operations.aspx); and (2) SFDPH’s guidance on “Safer Ways to Use New Outdoor Shared Spaces for Allowed Activities During COVID-19” (online at https://www.sfdph.org/dph/files/ig/Guidance-Shared-Outdoor-Spaces.pdf). 
  • If used, outdoor playgrounds/natural play areas only need routine maintenance. Make sure that children wash or sanitize their hands before and after using these spaces. When hand hygiene is emphasized, cleaning and disinfection of outdoor structures play is not required between cohorts. 
  • Limit use of other shared playground equipment in favor of activities that have less contact with shared surfaces 
  • Make sure that indoor spaces are well-ventilated. 
    • Ventilation systems can decrease the number of respiratory droplets and infectious particles in the air by replacing indoor air with fresh, uncontaminated air and/or filtering infectious droplets out of the air. 
  • Review SFDPH Ventilation Guidance. Make as many improvements as feasible. 
  • Note which improvements you made, and keep a copy of your notes. 
  • Your program can use ventilation guidance from the Centers for Disease Control (CDC), CDPH, or the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) instead of SFDPH’s guidance. 
  • Ventilation recommendations include:
    • Open windows to increase natural ventilation with outdoor air when health and safety allow. When possible, consider also leaving room doors slightly open to promote flow of outdoor air through the indoor space. 
    • Do not prop or wedge open fire doors. Continue to follow fire and building safety requirements. 
    • If open windows pose a risk of falls for children, use window locks to keep windows from opening more than 4 inches, or other safety devices to prevent falls. 
  • If your program has an HVAC system (sometimes called mechanical ventilation, forced air, or central air), follow the recommendations in SFDPH Ventilation Guidance. Prioritize maximizing the intake of outdoor air and minimizing recirculated air during the COVID-19 pandemic. Recommendations include: 
    • Make sure the HVAC system is checked by a professional and is working properly. 
    • Open outdoor air dampers and close recirculation dampers (“economizers”). This will maximize the amount of outdoor air that the HVAC system takes in, and minimize the amount of indoor air that is recirculated. 
    • If you can use higher-efficiency air filters without reducing airflow or damaging your HVAC system, use air filters rated MERV13 or better. 
    • Disable “demand-control ventilation controls” so fans keep running even when a room doesn’t need to be heated or cooled. 
    • Keep the HVAC system running even when the building is not being used, if you can. If your HVAC system has a timer, set it to run, at a minimum, from 1-2 hours before the building opens until 2-3 hours after everyone has left the building, including custodial staff. 
    • Consider installing portable air cleaners (“HEPA filters”). 
  • If your program uses fans, adjust the direction of fans so that air does not blow from one individual’s space to another’s space. For more information about ventilation, see www.sfcdcp.org/COVID-ventilation and https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/ventilation.html
  • Section 8 – Drop-Off and Pick-Up Procedures
    If children, youth and parents/caregivers from different households gather and interact with each other during arrival and dismissal, this creates an opportunity for COVID-19 to spread in the program.
  • Only CDS employees are permitted on campus.
    • Family members and caregivers are required to wear face coverings when dropping off or picking up children in the parking lot. 
  • Staff will remain 6 feet apart from parents and caregivers. 
  • Staff will greet children outside as they arrive. Sign-in stations will be outside with sanitary wipes to clean pens between uses.
  • There will be no parking or car drop-off in the CDS parking lot. Families will be required to walk their children to the designated drop off area where staff will be waiting. 
    • All adults picking up and dropping off must remain 6 feet away from people from other households at all times
  • The same family member or designated person is encouraged to drop off and pick up the child every day. 
  • Transportation
    • Since vehicles are small enclosed spaces that do not allow physical distancing, it is easier for COVID-19 to spread between people in a vehicle, especially if everyone inside does not wear a mask. Biking and walking are lower risk than shared vehicles. 
  • Public transportation: Wear face coverings, maintain at least 6 feet of physical distancing as much as possible, and practice hand hygiene upon arrival. Carpools and shared rides: Advise staff and families to carpool with the same stable group of people. Open windows and maximize outdoor air circulation when feasible. Everyone in the vehicle must wear a face covering.
  • Section 9 – Hygiene and Sanitation
  • Hand Washing
    • Frequent handwashing for at least 20 seconds and hand sanitizer use removes COVID-19 germs from people’s hands before they can infect themselves by touching their eyes, nose or mouth. 
  • Develop routines and schedules for staff, children and youth to wash or sanitize their hands at staggered intervals, especially immediately after arriving, before and after eating, upon entering/re-entering a space, and before and after touching shared equipment such as computer keyboards. 
  • Every space and common area (staff work rooms, eating areas) must have hand sanitizer or a place to wash hands upon entering. 
  • Establish procedures to ensure that sinks and handwashing stations do not run out of soap or paper towels, and that hand sanitizer does not run out. 
  • Post signs encouraging hand hygiene. A hand hygiene sign in multiple languages is available for download at http://eziz.org/assets/docs/IMM-825.pdf
  • Cleaning and Disinfection 
    • Routine cleaning should continue, but routine disinfection is no longer recommended. Contaminated surfaces are not thought to be a significant route of transmission, and frequent disinfection can pose a health risk to children due to the strong chemicals often used. 
  • Clean frequently touched surfaces daily and between stable cohorts. Routine cleaning focuses on frequently touched surfaces like door handles, shared desks and tables, light switches, sink handles, and keyboards. 
    • Desks and chairs that are only used by one person do not need to be cleaned daily. 
  • After a known case of COVID-19, clean and disinfect the areas where the person with COVID-19 spent a large proportion of their time (classroom, or an administrator’s office). Take the following steps: 
    • Open windows and use fans to increase outdoor air circulation in the areas to be cleaned. 
    • Wait 24 hours, or as long as practical, before cleaning and disinfection.  
    • Clean and disinfect all surfaces in the areas used by the ill person, including electronic equipment like tablets, touch screens, keyboards, and remote controls. Use a disinfectant effective against COVID-19. See EPA’s List N for EPA approved disinfectants effective against COVID 19.  
    • Vacuum the space if needed. 
  • For more information, see CDC guidelines on “Cleaning and Disinfecting Your Facility” at https://www.cdc.gov/coronavirus/2019 ncov/community/disinfecting building facility.html and CDPH COVID-19 and Reopening In-Person Instruction Framework & Public Health Guidance for K-12 Schools, section on Cleaning and Disinfection at https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/COVID19/Consolidated_Schools_Guidance.pdf
  • Section 10 – Specific Situations
  • Meals and snacks 
    • Eating together is especially high risk for COVID-19 transmission because people must remove their face masks to eat and drink. Children often eat with their hands, and people often touch their mouths with their hands while eating. In addition, meals are usually considered time for talking together, which further increases risk, especially if they must speak loudly to be heard. 
  • Do not eat with other staff. This is a common way that staff are exposed to COVID-19 at work. 
  • Eating outdoors is safer than eating indoors. 
  • Designate an eating area for each group, and mark places to sit at least 6 feet apart. Without marked spaces, children and youth may sit more closely. 
  • Outdoor eating areas may be covered (e.g. with an awning) 
  • Space children and youth as far apart as possible when eating. Try to seat them so they do not sit face-to-face. Physical distancing is especially important when eating, since face masks cannot be worn. 
  • Use individually plated or bagged meals or snacks instead of family-style meals. 
  • Make sure that children, youth and staff wash their hands or use hand sanitizer immediately before and after eating. Pay special attention to children who like to suck/lick food off their hands. 
  • Consider starting lunch with silent eating time, followed by conversation time, to discourage talking while masks are off. 
  • Stay at least 6 feet away from children and youth when their face masks are off, especially when indoors. Be sure to wear your own face mask while others are eating. 
  • Clean and disinfect tables and chairs between different cohorts. If eating outdoors, sidewalks and asphalt do not have to be disinfected. 
  • When holding or physically comforting a crying child, try to position the child so that they are not directly facing you (sitting sideways in a lap, for example, or standing slightly behind the child while rubbing their back). Try to keep your face away from child’s face while holding or comforting them. Consider taking the child outside to comfort them. 
  • Activities to avoid: Group singing, wind instruments, and field trips 
    • Avoid group singing and playing wind instruments (woodwinds and brass instruments). These activities produce large numbers of respiratory droplets, increasing the risk of COVID-19. Piano, percussion and string instruments are allowed. 
    • Field trips are not allowed at this time. 
  • Higher-risk activities: Group sports, dance and exercise 
    • Sports, dance, and exercise are higher risk for COVID-19 transmission, and have been linked to numerous outbreaks. In other parts of the US, sports have been a major source of COVID-19 spread among youth. Sports, dance and other exercise are higher-risk for COVID-19 because people breathe much more air when exercising, and have close contact in many sports. During exercise, a person with COVID-19 breathes many more infectious droplets into the air. The infectious droplets in their breath travel further because they are breathing harder. People are also more likely to be infected during exercise because they are breathing more air. This is especially true in poorly ventilated indoor spaces. 
  • San Francisco now allows certain sports, based on the tier-based guidance from CDPH. Even if San Francisco moves to a lower tier, the San Francisco Health Officer must first allow those sports before competition can begin. Outdoor physical training and conditioning with face masks, 6 foot distancing, and cohorting continues to be allowed in all tiers. 
  • All physical education, sports, dance and group exercise must comply with the San Francisco Health Directive on Youth and Adult Sports as well as CDPH sports guidance to prevent the spread of COVID-19. 
  • For more information, see San Francisco Health Directive on Youth and Adult Sports https://www.sfdph.org/dph/alerts/files/Directive-2021-01-Sports-Youth-and-Adult.pdf
  • CDPH Guidance on Recreational Sports https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/outdoor-indoor-recreationalsports.aspx
  • Children and youth receiving special services
  • Therapists and other support staff are considered essential staff and should be allowed onsite to provide services. 
  • Accommodations and related services for special education, learning disabilities and medical conditions should be met, even if it creates cross-over between cohorts. Provide supervision for children who need additional support maintaining physical distancing, wearing a face covering, or handwashing. 
  • Additional accommodations may be needed for children and youth to safely participate in the program. For example, a child who cannot tolerate a face covering due to a medical or developmental condition may need a desk with clear screens or privacy barriers.
  • Section 11 – What to do when someone has COVID-19 symptoms or confirmed COVID-19 
  • Refer to the Quick Guide for Suspected or Confirmed COVID-19 Cases. 
  • First, see the following summary charts in the Quick Guide at https://sfcdcp.org/CovidSchoolsChildcare:  
    • Steps to take when staff, children or youth have COVID-19 symptoms, confirmed COVID-19, or were exposed to COVID-19 (for example, a parent or sibling has tested positive)  
    • Returning to the program after COVID-19 symptoms, confirmed COVID-19, or exposure to COVID-19. 
  • When staff or students have symptoms of COVID-19 
  • Staff who develop symptoms at work must notify their supervisor and leave work as soon as they can. 
  • Send students with symptoms home. Keep ill students who are waiting to be picked up in a separate area, away from others. Make sure that they keep their face masks on. 
  • When a parent or guardian arrives to pick up a child, have the student walk outside to meet them if possible instead of allowing the parent or guardian into the building. Since children with COVID-19 may have been infected by a parent or other adult in their home, the parent may also have COVID-19. 
  • Open windows in areas used by the sick person to air out those spaces and bring in outdoor air. Close off those areas as soon as you can, until they can be cleaned and disinfected. 

When there is a confirmed COVID-19 case
All documents listed below are online at sfcdcp.org/COVIDSchoolsChildcare

  1. Use the Exposure and Investigation Tool to collect the important details about the case BEFORE contacting the SFDPH Schools and Childcare Hub. 
  2. If possible, obtain a copy of the lab report and attach it to the Exposure and Investigation tool. If your program does not have the test results yet, please note the test results are pending. Send the lab result to the School/Childcare team when you receive it. 
  3. Report the case within 1 hour to the SFDPH Schools and Childcare Hub by emailing (please put SECURE: in the subject line) OR calling (628) 217-7499. An on-call public health professional will get back to you as soon as possible. 
  4. The Schools and Childcare Hub may ask you to identify people who had close contact with the COVID-19 case and may have been infected. When interviewing people to determine if they had close contact, and informing them that they may have been exposed, do not disclose the identity of the person with COVID-19, as required by law. 
  5. Use the List of Close Contacts template to collect details of any close contacts. 
  6. Email the List of Close Contacts to within 24 hours. Please put SECURE: in the subject line of the email. 
  7. Communicate to staff, families and participants in your program within one business day as indicated in the Quick Guide. SFDPH has developed standard notification letters for programs for children and youth. Translations will be posted at sfcdcp.org/CovidSchoolsChildcare
  8. Close the areas used by the ill person. 
    1. Open windows in areas used by the sick person to maximize outdoor air circulation. Close off those areas as soon as feasible, until they can be cleaned and disinfected. 
    2. Clean and disinfect the classroom and other areas where the person spend significant time. This does not have to be done until students and staff have left for the day. 
    3. If needed, find alternative locations for cohorts whose regular rooms are being cleaned or disinfected. 
  • The decision to close a program should be based on COVID-19 cases in the program, not on community COVID-19 rates, which may not reflect the conditions at the program. Any decisions should be made in consultation with the SFDPH Schools and Childcare Hub. In general, programs with smaller, more contained cohorts are less likely to require closure. Situations where SFDPH may recommend closing a program may include the following: 
  • 25% or more of the cohorts in a program have had outbreaks1 in the last 14 days. 
  • At least three outbreaks have occurred in the last 14 days AND more than 5% of the staff and participants are infected. 
  • Investigation of an outbreak by SFDPH suggests ongoing COVID-19 transmission within the program.