COVID-19 Decision Tool for Child Care Attendees

Version 3.0. Updated on December 4, 2020, and adapted from COVID-19 Decision Tool for Schools (JK-Gr12)

Children should be excluded from attending child care, under the following conditions:


(A)     If the child has one or more symptoms, even if it is mild, the child should stay home, self-isolate, get tested or contact their health care provider.

(B)     If a child's sibling, or children in the same household has one or more of the above symptoms, they should also stay home, self-isolate and follow instructions from public health.


(C)     If the child has been in close contact with a person who has COVID-19, the child will need to self-isolate for 14 days, even if they don't have symptoms. If the child has or develops symptoms, their household members will need to stay home and self-isolate until COVID-19 is ruled out.

(D)    If the child has travelled outside of Canada, they must self-isolate for 14 days. Their household members do not need to self-isolate if they have not travelled, if they don't have symptoms of COVID-19, and if they are not a close contact of a positive case.

Children without symptoms
If a child does not have symptoms of COVID-19 he/she may attend the child care setting if they do not have a sibling with symptoms (B), if they are not a close contact (C) or have travelled outside of Canada (D).

Siblings or children in same household without symptoms

  • If the child attendee has symptoms and has an alternative diagnosis, siblings do not need to self-isolate.
  • If the child has symptoms and tests negative for COVID-19, the child and their siblings can return to child care.
  • If the child has symptoms, does not go for testing and is not a close contact of a positive case, the child andtheir siblings must self-isolate for 10 days.
  • If the child has symptoms, does not go for testing and is a close contact of a positive case, the child must self-isolate for 10 days from when symptoms started. Their siblings should self-isolate for 14 days as this is how long it can take for symptoms to appear.
  • If the child has symptoms and tests positive, the child must self-isolate for 10 days, and siblings must self-​isolate for 14 days.


​Children with symptoms

  • If a child attendee has any new or worsening symptoms, he/she must stay home, self-isolate, and get tested or contact their health care provider.
  • The child attendees' siblings will also need to stay home and self-isolate.
  • Adults in the home, including parents, will have to self-monitor for symptoms, but may go to work as long as the adult does not have symptoms and the child is not a close contact of someone with COVID-19 and the has not tested positive.


Child who test positive for COVID-19

  • Children must stay home and self-isolate for 10 days, starting from the day the symptoms first appear.
  • Children may return to child care after 10 days if they do not have a fever (without use of medication), and their symptoms have been improving for at least 24 hours.
  • Children without symptoms still have to stay home and self-isolate for 10 days, from the day of the test.
  • All their household members should stay home, self-isolate and follow public health advice.


Children who test negative for COVID-19

  • Children can return to child care if their symptoms have been improving for 24 hours, they are not a close contact of someone with COVID-19 or have travelled outside of Canada, they are well enough to participate in program activities.


Children with an alternative medical diagnosis who are not tested for COVID-19

  • Children with symptoms, but who have been given an alternative diagnosis by a health care provider (not related to COVID-19), may return to child care if their symptoms have been improving for 24 hours.
  • Family members without symptoms should self-monitor and may go to school or work.
  • A cold or respiratory infection is not considered an alternative diagnosis, and the individual should be tested for COVID-19.


Children not tested for COVID-19

  • If a child has symptoms of COVID-19 that are not related to an existing medical condition and they are not tested, the child and their siblings must stay home and self-isolate for 10 days from the date their symptom(s) first started.
  • Children may return to child care after 10 days if they do not have a fever (without taking medication), and their symptoms are improving for 24 hours.


Children in close contact with someone with COVID-19

  • Children in close contact with a person with COVID-19 must stay home and self-isolate for 14 days from their last date of exposure to that person.


Return to Child Care Confirmation Form

  • Toronto Public Health does not recommend or require medical notes for return to child care.
  • It is the decision of each child care operator to decide if they choose to accept a Return to Child Care Confirmation Form.

Updated COVID-19 screening for symptoms:
Parents/guardians must complete a self-screening questionnaire before attending child care. Child attendees with chronic health issues that is medically diagnosed and unrelated to COVID-19, should look for new, different or worsening symptoms.

What to do when your Child is sick