Francis St.

COVID-19 Screening

This tool provides basic information only and contains recommendations for children to support decision making by parents about whether their child should attend school/childcare and/or needs to be tested for COVID-19. This can be used to assess symptoms of any child who attends child care or school (junor, intermediate, high school). It is not to be used as a clinical assessment tool or intended to take the place of medical advice, diagnosis or treatment. Screening must occur daily and at home before a child enters school or child care.

When assessing for the symptoms below, you should focus on evaluating if they are new, worsening, or different from your child’s baseline health status or usual state (check off “Yes”). Symptoms associated with known chronic health conditions or related to other known causes/conditions should not be considered unless new, different or worsening (check off “No”). (see examples below).

After developing symptoms, in general, children should no longer have a fever and their symptoms improving to be able to return to school/child care. Mild symptoms known to persist in young children (e.g. runny nose or mild cough that may persist following infections) may be ongoing at time of return to school/child care if other symptoms have resolved.

Child's First & Last Name:*

1. Does your child have any of the following NEW OR WORSENING symptoms? Please check all that apply. (Note: Symptoms should not be chronic or related to other known causes or conditions)*

Fever and/or chills (temperature of 37.8C/100F or greater)

Cough (more than usual if chronic cough) including croup (barking cough/making a whistling noise when breathing) and not related to other known causes or conditions such as asthma and reactive airway

Shortness of breath (dyspnea/out of breath/unable to breathe deeply/wheeze/that is worse than usual if chronically short of breath) and not related to other known causes or conditions

Decrease or loss of smell or taste (new olfactory or taste disorder) that is not related to other known causes or conditions such as nasal polyps/allergies/neurological disorder

NONE

2. Does your child have any of the following NEW OR WORSENING symptoms? Please check all that apply. (Note: Symptoms should not be chronic or related to other known causes or conditions)*

Sore throat (painful swallowing or difficulty swallowing) and not related to other known causes or conditions like post nasal drip/gastroesophageal reflux

Stuffy nose and/or runny nose (nasal congestion and/or rhinorrhea) and not related to other known causes and conditions like seasonal allergies/returning inside from the cold/chronic sinusitis

Headache that is new and persistent/unusual/unexplained/long-lasting and not related to other known conditions like tension headaches or chronic migraines

Nausea/vomiting and/or diarrhea that is not related to other known causes or conditions such as transient vomiting due to anxiety/chronic vestibular dysfunction/irritable bowel syndrome/inflammatory bowel disease/side effect of medication

Fatigue/lethargy/muscle aches or malaise (general feeling of being unwell/lack of energy/extreme tiredness/poor feeding in infants) that is unusual or unexplained and not related to other known causes or conditions such as depression/insomnia/thyroid dysfunction/anemia

NONE

3. Has your child travelled outside of Canada in the past 14 days?*

Yes

No

4. Has your child been identified as a close contact of someone who is confirmed as having COVID-19 by your local public health unit (or from the COVID Alert app if they have their own phone)?*

Yes

No

5. Has your child been directed by a health care provider including public health official to isolate?*

Yes

No

6. Is someone available during the day for pickup should your child develop symptoms while in care that require them to be sent home?*

Yes

No

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