Planning To Reopen - Phase 2 Child Programs Minimum Requirements, Part 12

6/30/2020 (Permalink)

Child care and youth-serving programs remain a critical component in Governor Charlie Baker's overall plan to reopen the state of Massachusetts and get the residents of the Commonwealth back to work. This blog highlights the minimum requirements for food preparation as well as caring for children with special needs, vulnerable children, and infants and toddlers as outlined in Governor Charlie Baker's administration's guidelines for reopening child and youth programs.

As always, work with your local health officials to determine a set of strategies appropriate for your community’s situation.

(See our "Planning to Reopen series of blogs for more information regarding CDC, EPA, FDA, and OSHA safety requirements). To review the administration's reopening guidance from the state click here. To view Governor Baker's full report click here).

These requirements apply to all child and youth-serving programs, including recreational summer programs, recreational summer camps for children, municipal or recreational youth programs not traditionally licensed as camps, family child care, and center-based child care. As more is learned about the virus guidelines are updated accordingly. Those charged with planning to reopen child and youth programs should check the both the Massachusetts department of Early Education and Care (EEC) and the CDC website regularly to make sure that they are following the latest guidance. 

Programs that are unable to must make the following changes to their operations or remain closed and reopen at a later date.

Ensuring Food Safety

Program managers and their staff must follow these food safety guidelines.

1. Whenever possible, snacks must be pre-packaged or ready to serve in individual portions to minimize handling and preparation. Meals shall not be served family style.
2. To minimize potential spread of infection and to promote physical distancing, cafeterias and group dining rooms must be avoided. If there are no alternatives, programs must adequately physical distance during meals and add extra meal shifts.
3. Multiple children shall not use the same serving or eating utensils. Each child must have an individual cup to use.
4. Sinks used for food preparation must not be used for any other purposes.
5. Staff must ensure children wash hands prior to and immediately after eating.
6. Staff must wash their hands before preparing food and after helping children to eat.
7. Tables, chairs, high chairs, and high chair trays used for meals need to be cleaned and sanitized before and after use.
8. All food contact surfaces, equipment, and utensils used for the preparation, packaging, or handling of food products must be washed, rinsed, and sanitized before each use.
9. Programs must frequently clean non-food contact surfaces, such as doorknobs, tabletops, and chairs using sanitizers approved by the EPA for use against COVID-19 and for food-contact surfaces. 
10. Following the product label use directions for enveloped viruses, as indicated by the approved emerging viral pathogen claim on the master label.
11. If the directions for use for viruses/viricidal activity list multiple contact times or dilutions, use the longest contact time or most concentrated solution.
12. Be sure to follow the label directions for FOOD CONTACT SURFACES when using the chemical near or on utensils and food contact surfaces.

Identify and Understand Children's Healthcare Needs

To ensure that programs are adequately prepared to provide safe and appropriate services to children with special needs and vulnerable children, program managers and staff must take following steps.

1. Review medical information submitted by parents and determine whether and how many high-risk children are in attendance.
2. Reach out to parents of high-risk children and encourage them to discuss with their healthcare provider about whether the program is a safe option for the child and if additional protections are necessary.
3. Discuss with the parent any concerns they have with the new protocols and how you can best help their child understand and adhere as close as possible to the health and safety requirements.

Supporting Children with Special Needs

Children with special needs will require unique supports in programs that may make it less possible to practice physical distancing and will require ample staff support to carry out the necessary hygiene practices. Program managers and staff must ensure that the program is adequately staffed and that staff are prepared and properly trained to accommodate children’s needs.

1. Staff must be prepared to provide hands-on assistance to children with special needs for activities of daily living such as feeding, toileting, and changing of clothes.
2. staff who care for children requiring hands-on assistance for routine care activities, including toileting, diapering, feeding, washing, or dressing, and other direct contact activities must wear a long-sleeved, button down, oversized shirt over their clothing and wear long hair up or tied back during all activities requiring direct contact with a child.
3. Staff must change outer clothing if body fluids from the child get on it. Staff must change the child’s clothing if body fluids get on it. Soiled clothing must be placed in a plastic bag until it can be sent home with the child to be washed.
4. Staff must be adequately trained and prepared to support children with health care needs with the necessary provisions of health care such as administration of medication needed throughout the day, tube feedings, blood sugar checks, and allergies to certain foods.
5. For more invasive procedures, staff must protect themselves by wearing a gown or other body covering (e.g., an oversized button-down, long sleeved shirt, etc.), eye protection, and mask.
6. Children with special needs may be unable to comply with face covering because of intellectual, behavioral, or sensory issues. To minimize the risk of infection for children who are unable to wear a face covering, physical distancing must be maintained whenever possible and staff must wear a face covering at all times, including when working with a child who is unable to wear a face covering.
7. Programs serving children who are deaf or hard of hearing are encouraged to consider the use of transparent face coverings to facilitate the reading of lips and facial expressions.
8. Staff-to-child ratios must be higher for programs serving children with special needs, given their need for more individualized attention.
9. Groupings for children with special needs must be assigned based on the developmental level of the child and the impact of the disability on the child with regard to their ability to adhere to PPE requirements and physical distancing rather than their chronological age.
10. Smaller groups must be formed where the child requires more hands on assistance and a higher number of staff required to care for the children. Some children with special needs will require 1:1 assistance. Programs must refer to individual treatment plans or IEPs when assessing required ratios.

Caring for Infants and Toddlers

Infants and toddlers will need to be held. Staff must practice stringent hygiene and infection control practices to keep themselves and the young children they care for healthy and safe while in care.

1. Staff who care for infants and toddlers should wear protective covering, like a long-sleeved, button down, oversized shirt over their clothing and wear long hair up or tied back during all activities requiring that a toddler is held.
2. Staff must change outer clothing if body fluids from the child get on it.
3. Staff must change the child’s clothing if body fluids get on it.
4. Soiled clothing must be placed in a plastic bag until it can be sent home with the child to be washed.
5. All staff must follow safe and sanitary diaper changing procedures. Procedures must be posted in all diaper changing areas, and must include:
   1. Prepare (includes gathering all supplies, washing hands, and putting on gloves).
   2. Clean the child.
   3. Remove trash (soiled diaper, wipes, and gloves).
   4. Wash hands. Put on clean gloves, if wearing.
   5. Replace clean diaper.
   6. Wash child’s hands.
   7. Clean up diapering station.
   8. Remove and dispose of gloves.
   9. Wash hands.
6. During washing and feeding activities, staff must protect themselves by wearing a gown or other body covering (e.g., an oversized button-down, long sleeved shirt, etc.) and eye protection where available. Staff with long hair must tie their hair back so it is off the collar and away from the reach of the child.
   1. Child care providers must wash their hands, neck, and anywhere touched by a child’s secretions.
   2. Child care providers must change the child’s clothes if secretions are on the child’s clothes. They must change the button-down shirt, if there are secretions on it, and wash their hands again.
   3. Contaminated clothes must be placed in a plastic bag or washed in a washing machine.
   4. Infants and toddlers and their providers must have multiple changes of clothes on hand.
7. As infants and toddlers are not able to verbalize when they don’t feel well, staff must be attentive to any changes in a very young child’s behavior. If the child starts to look lethargic, and is not eating as well, staff must notify the parent to determine whether the child’s pediatrician must be contacted. If a toddler is showing signs of respiratory distress and having difficulty breathing, staff must call 911 and notify the parents immediately.

While the administration continues to work with communities to implement best practices and protocols we will continue to share with you guidance from the CDC, FDA, OSHA and the Governor's office to follow as we prepare for reopening. Also, we at SERVPRO of Norwood/West Roxbury know that not every business has access to the resources necessary to meet these strict guidelines. For those businesses, we are here to help!

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The Disaster Remediation Teams at SERVPRO of Norwood/West Roxbury are specialists in cleaning services and we adhere to the highest cleaning and sanitation standards. We are prepared to clean and disinfect your home or business, according to protocols set forth by the Centers for Disease Control and Prevention. We have years of experience in dealing with biological contaminants, and we will go beyond the scope of work of "normal daily cleaning". Call SERVPRO of Norwood/West Roxbury today for a free consultation - (781) 796-9125.

All of us here at SERVPRO of Norwood / West Roxbury want you and your loved ones to stay safe and know that we will make it through this together! Rest assured, we will continue to do our best to keep you up-to-date and informed!