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.





  • 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.



  • 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.




COVID-19 Resources For Parents