COVID Disclosure

COVID-19 PUBLIC HEALTH EMERGENCY
SPECIAL PROGRAM ATTENDANCE
ACKNOWLEDGMENT AND DISCLOSURE

FAMILY/CHILD VERSION: This should be initialed and signed by ALL custodial parents/guardians.

Please read and initial each statement below and sign at the bottom.

1. I understand that during this COVID-19 Public Health Emergency I will NOT be permitted to enter the facility beyond the designated drop-off and pick-up area. I understand that this procedure change is for the safety of all persons present in the facility and to limit to the extent possible everyone’s risk of exposure. I understand that it is my responsibility to inform any Emergency Contact persons of the information contained herein.

2. I understand that IF there is an emergency or special circumstances requiring me to enter the facility beyond the designated drop-off and pick-up area, I MUST wash my hands before entering, remove my shoes and wear a mask. While in the facility I must practice social distancing and remain 6ft from all other people, except for my own child.

3. I understand that to enter upon the facility premises my child must be free from COVID-19 symptoms. If, during the day, any of the following symptoms appear my child will be separated from the rest of the people in the center. I will be contacted, and my child MUST be picked up from the facility within 30 minutes of being notified.
Symptoms include:

fever of 100.4 degrees Fahrenheit or higher
dry cough
shortness of breath
chills
loss of taste or smell
sore throat
muscle aches

While we understand that many of these symptoms can also be related to non-COVID-19 related issues we must proceed with an abundance of caution during this Public Health Emergency. These symptoms typically appear 2-7 days after being infected so please take them seriously. Your child will need to be symptom free without any medications for 72 hours before returning to the facility.

4. I understand that Beary Cherry Tree is taking every precaution to keep my child healthy, utilizing the Office of Public Health guidelines. These include:

Requiring staff to take everyday precautions to prevent the spread of respiratory illness such as COVID-19 such as washing hands often, cleaning and disinfecting frequently touched surfaces, avoiding close contact, covering coughs and sneezes and covering mouth and nose with face masks.
Requiring sick children and staff to stay home.
Isolating children who become sick (before they are picked up) followed by cleaning and disinfecting processes.
Implementing social distancing strategies.
Changing parent drop-off and pick-up processes.
Screening children and staff upon arrival.
Intensifying cleaning and disinfecting efforts.
Ensuring proper diapering techniques are followed.
Ensuring proper washing, feeding, and holding of children.
Ensuring healthy hand hygiene of children and staff including using CDC-recommended handwashing procedures throughout the day using warm running water and rubbing with soap for at least 20 seconds.
Ensuring healthy food preparation and meal service.
Addressing vulnerable/high risk groups.

5. I understand that outside of care, in order to control my child’s exposure in the community, I will comply with any and all state, county or local stay-at-home orders, and CDC recommendations.

6. I will immediately notify Beary Cherry Tree management if I become aware of any person with whom my child or I have had contact exhibits any of the symptoms listed in Number 1 above, is advised to self-isolate, quarantine, or has tested positive, or is presumed positive for COVID-19. Further, I will immediately notify Beary Cherry Tree management if anyone from my place of employment is presumed positive or tests positive for COVID-19 whether or not I have had direct contact with that person.

7. I understand that while present in the facility each day my child will be in contact with children, families and other employees who are also at risk of community exposure. I understand that no list of restrictions, guidelines or practices will remove 100% of the risk of exposure to COVID-19 as the virus can be transmitted by persons who are asymptomatic and before some people show signs of infection. I understand that I play a crucial role in keeping everyone in the facility safe and reducing the risk of exposure by following the practices outlined herein.

I certify that I have read, understand, and agree to comply with the provisions listed herein.

Please Use Your Mouse To Sign The Form Below:

COVID Disclosure

COVID-19 Resources For Parents