As mandated by the Massachusetts Department of Early Education and Care in their MASSACHUSETTS CHILD AND YOUTH SERVING PROGRAMS REOPEN APPROACH, Minimum Requirements for Health and Safety, June 1, 2020

All staff, parents, children, and any individuals seeking entry into the program space must be directed to self-screen at home, prior to coming to the program for the day.

  • Self-screening shall include checking temperature (temperature of 100.0°F or above is considered a fever), and checking for symptoms included fever, cough, shortness of breath, gastrointestinal symptoms, abdominal pain, unexplained rash, new loss of taste/smell, muscle aches, or any other symptoms that feel like a cold. Anyone with a fever of 100.0°F or above or any other signs of illness must not be permitted to enter the program.
  • Parents and staff must sign written attestations daily regarding any household contacts with COVID-19, symptoms (e.g., fever, sore throat, cough, shortness of breath, loss of smell or taste, or diarrhea), or if they have given children medicine to lower a fever. (c) Individuals who decline to complete the screening questionnaire or have temperature checked will not be permitted to enter the program space.

Verbally screen children and parents asking the following questions. If any of the below are yes, the child must not be allowed to enter the building. The child must return home with their parent or caregiver.

Today or in the past 24 hours, have you or any household members had any of the following symptoms?

  • Fever (temperature of 100.0°F or above), felt feverish, or had chills?
  • Cough?
  • Sore throat?
  • Difficulty breathing?
  • Gastrointestinal symptoms (diarrhea, nausea, vomiting)?
  • Fatigue?
  • Headache?
  • New loss of smell/taste?
  • New muscle aches?
  • Any other signs of illness?

Has any household member had one or more of the symptoms listed?

Yes, we have had symptoms in the house.No one has had any of those symptoms.

In the past 14 days, have you or anyone in you household had close contact with a person known to be infected with the novel coronavirus (COVID-19)? (Close contact is defined as being within 6 feet of an individual who has tested positive for COVID-19 for more than 10 minutes while that person was symptomatic, starting 48 hours before their symptoms began until their isolation period ends.)

Yes, there has been close contact.No close contact.

I have read the above and have screened as directed.

By writing my name here and clicking "Submit" I am signing this Checklist electronically. I agree and understand that my typed electronic signature is the legal equivalent of my manual signature on the Checklist and I am attesting to the truth of the statements above.

I am a parent of a studentI am a staff member
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