Licensed Child Care COVID-19 Health Screening Checklist for Children Attending Child Care Centre's - March 2022 Update.
An enhanced screening process must be completed daily in licensed child care settings, as per Ministry of Health direction. The responses you provide will be used to determine your child's eligibility to enter the program on the current day.  The health of children, families and the clients of essential workers who access this child care program depends on your honesty and accuracy in completing this screening tool.

Collection of personal information

Applies to personal information about the children in our care, their parents/legal guardians, their siblings, and other individuals who are involved in their care and upbringing (collectively, “the children in our care and their families”). Niagara Nursery School respects privacy and we have a longstanding commitment to protecting the personal information of the children in our care and their families.
For the purposes of this policy, “personal information” is defined as any identifiable information about the children in our care and their families, such as contact details, health information, living arrangements, background information, the child’s personal characteristics and behaviour styles.
Personal information is only collected, used and disclosed by Niagara Nursery School in accordance with this Privacy Policy and the legal obligations imposed by the Personal Information Protection and Electronic Documents Act (PIPEDA).
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Please select your relationship to Niagara Nursery School *
Employee/Visitor/Student name: *
Date *
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NOTE: When the option of [5,10] days is listed:  Use 5 days if you are fully vaccinated AND/OR 11 years old or younger.  Use 10 days if you are 12 years old or older and not fully vaccinated OR if you are immunocompromised, OR if you attend or work at a school or student lodging in a highest risk congregate care setting (e.g., Provincial Demonstration School, a hospital school, or an Education and Community Partnership Program).
1. In the last [5,10] days have you experienced any of these symptoms?  Anyone who is sick or has any new or worsening symptoms of illness, including those not listed below, should stay home until their symptoms are improving for 24 hours (or 48 hours for nausea, vomiting, and/or diarrhea) and should seek assessment from their health care provider if needed.  You may select "No" to all symptoms if ALL of these apply: - You have completed your isolation of [5/10] days OR you tested negative for COVID-19 on one PCR test or rapid molecular test, or two rapid antigen tests taken 24 to 48 hours apart AND - You do not have a fever AND - You symptoms have been improving for 24 hours (4 hours if you have nausea, vomiting, and/or diarrhea).  Choose any/all that are new, worsening, and not related to other known causes or conditions you already have. *
No. Continue
Yes. No entry. Isolate.
Fever and/or chills. A fever is a temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher and/or chills.
Cough or barking cough (croup) Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, or other known causes or conditions you already have)
Shortness of breath. Out of breath, unable to breathe deeply (not related to asthma or other known causes or conditions you already have)
Decrease or loss of smell or taste. NOt related to seasonal allergies, neurological disorders, or other known causes or conditions you already have.
2. In the last (5, 10) days have you or your child experienced any of the following symptoms? - If you only had ONE of these symptoms, you may select "No" if  your symptom has been improving for 24 hours (48 hours if you have nausea, vomiting, and/or diarrhea).  If you had TWO or MORE of these symptoms, you may select "No" if all of these apply: - You have completed your isolation of [5/10] days OR you tested negative for COVID-19 on one PCR test or rapid molecular test, or two  rapid antigen tests taken 24 to 48 hours apart AND - You do not have a fever AND - Your symptoms have been improving for 24 hours (48 hours if you have nausea, vomiting, and/or diarrhea).  Chose any/all that are new, worsening, and not related to other known causes or conditions you already have. *
No. Continue
Yes. No entry. Isolate.
Runny or stuffy/congested nose. Not related to allergies, being outside or other chronic conditions
Sore throat or difficulty swallowing. Not related to seasonal allergies, being outside or other known causes or conditions you already have).
Headache. Unusual, long-lasting. Not related to tension-type headaches, chronic migraines or other chronic conditions. If the child received a COVID-19 and/or flu vaccination in the last 48 hours and is experiencing a mild headache that only began after vaccination, select "No".
Extreme tiredness. Unusual, fatigue, lack of energy (not related to depression, insomnia, thyroid dysfunction, sudden injury, or other known causes or conditions you already have). If you have received a COVID-19 and/or flu vaccination in the last 48 hours and are experiencing a mild headache that only began after vaccination, select "No".
Muscle aches or joint pain. If you or your child received a COVID-19 and/or flu vaccination in the last 48 hours and is experiencing mild fatigue and/or mild muscle aches/joint pain that only began after vaccination, select "No".
Nausea, vomiting and/or diarrhea or loss of appetite. Not related to known causes such as irritable bowel syndrome, anxiety, menstrual cramps., or other known causes or conditions they already have
3. Has a doctor, health care provider or public health unit told you that the child should currently be isolating (staying at home)?  This can be because of an outbreak or contact tracing. *
4. Do any of the following apply? Select "No" if you: - are 18 years of age or older and have received your booster OR - are 17 years of age or younger and are fully vaccinated OR - completed your isolation after testing positive in the last 90 days (using a rapid antigen, rapid molecular, or PCR test).  Select "No" if your household member is isolating because of COVID-19 symptoms but has already tested negative on on PCR or rapid molecular test, or two rapid antigen tests. *
No. Entry.
Yes. No entry. Isolate.
You or your child lives with someone who is currently isolating because of a positive COVID-19 test
You or your child lives with someone who is currently isolating because of COVID-19 symptoms
You or your child lives with someone who is currently isolating while waiting for COVID-19 test results.
5. In the last 14 days, have you or your child:   *
No. Continue
Yes. No entry. Isolate.
Travelled outside of Canada and been advised to quarantine as per the federal quarantine requirements AND/OR
Travelled outside of Canada and been advised to not attend school/ child care.
6. In the last [5,10] days, have you tested positive for COVID-19 on a lab-based PCR test, rapid molecular test, rapid antigen test or home-based self-testing kit? *
No. Continue.
Yes. No entry.
Select "No" if you have already completed your isolation period of [5,10] days because your symptoms started before your positive test result AND:
your symptoms have been improving for 24 hours (48 for nausea, vomiting, and/or diarrhea) AND
You do not have a fever
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