Health Promotion and Protection

Conduct of Daily Health Check

After reading the CFOC standard, see COVID-19 modification below (Also consult applicable state licensure and public health requirements).

Every day, a trained staff member should conduct a health check of each child. This health check should be conducted as soon as possible after the child enters the child care facility and whenever a change in the child’s behavior or appearance is noted while that child is in care. The health check should address:

  1. Reported or observed illness or injury affecting the child or family members since the last date of attendance;
  2. Reported or observed changes in behavior of the child (such as lethargy or irritability) or in the appearance (e.g., sad) of the child from the previous day at home or the previous day’s attendance at child care;
  3. Skin rashes, impetigo, itching or scratching of the skin, itching or scratching of the scalp, or the presence of one or more live crawling lice;
  4. A temperature check if the child appears ill (a daily screening temperature check is not recommended);
  5. Other signs or symptoms of illness and injury (such as drainage from eyes, vomiting, diarrhea, cuts/lacerations, pain, or feeling ill).

The caregiver/teacher should gain information necessary to complete the daily health check by direct observation of the child, by querying the parent/guardian, and, where applicable, by conversation with the child.

COVID-19 modification as of January 10, 2022: 

Early childhood programs should implement daily health screening procedures for children and include temperature checks. Programs may need to alter their drop off procedure and daily health screening to ensure they have adequate staff and time to screen children upon arrival and maintain physical distancing. Screening criteria may change as we learn about the different symptoms of new variants.

Children who are experiencing any of the symptoms/exposures/testing listed below should not enter the program.

  • COVID-19 symptoms most likely seen in children:
    • Congestion, runny nose or other allergy like symptoms
    • Sore throat
    • Headache
    • Fever (100.4F/38C or higher); feeling feverish (chills, sweating) 
    • Refer to the complete list Symptoms of COVID-19 | CDC
  • Have had close contact (within 6 feet for at least 15 minutes or more over a 24 hour period of time) with someone who is COVID-19 positive
  • Are waiting for results of a COVID-19 test 
  • Have been recently diagnosed with COVID-19 and not yet cleared to discontinue isolation

Examples of screening methods include: 

  • Before arrival to the program, families:
    • Check for illness symptoms of COVID-19 at home
    • Take their child’s temperature at home and report the temperature upon arrival 
    • Confirm child does not have symptoms of COVID-19 
  • Upon arrival to the program, staff performs the daily health check:
    • Use a no-contact thermometer while wearing disposable gloves. If no physical contact with the child, there is no need to change gloves before the next screening.
    • Complete a visual check of the child for any symptoms of illness
    • Keep child interactions as brief as possible.
  • Refer to COVID-19 modifications for Standard Thermometers for Taking Human Temperatures.
  • Staff documents a record of the child health check and if temperature screening is done.

Child screening and health checks are not a replacement for other protective measures, such as the use of a well-fitted mask, consistent small groups, and physical distancing.

Programs should offer COVID-19 screening testing at least once a week. COVID-19 Screening Testing identifies people with COVID-19, including those with or without symptoms who are likely to be contagious, so steps can be taken to prevent further spread of illness. In ECE programs, screening testing can help identify and isolate cases, quarantine those who may have been exposed to COVID-19 and are not fully vaccinated, and identify clusters to reduce the risk to in-person care and education. Decisions regarding screening testing may be made at the state or local level.

Programs that conduct daily health screenings should do so safely, respectfully, and confidentially, in accordance with the American with Disabilities Act and the Family Educational Rights and Privacy Act (FERPA).

There is overlap between COVID-19 symptoms and other common infectious childhood illnesses. Therefore, follow the program illness exclusion guidelines and refer to COVID-19 modification for Standard Inclusion/Exclusion/Dismissal of Children.


Daily health checks seek to identify potential concerns about a child’s health including recent illness or injury in the child and the family. Health checks may serve to reduce the transmission of infectious diseases in child care settings by identifying children who should be excluded, and enable the caregivers/teachers to plan for necessary care while the child is in care at the facility. 


The daily health check should be performed in a relaxed and comfortable manner that respects the family’s culture as well as the child’s body and feelings. The child care health consultant should train the caregiver/teacher(s) in conducting a health check. The items in the standard can serve as a checklist to guide learning the procedure until it becomes routine. 

The obtaining of information from the parent/guardian should take place at the time of transfer of care from the parent/guardian to the staff of the child care facility. If this exchange of information happens outside the facility (e.g., when the child is put on a bus), the facility should use an alternative means to accurately convey important information. Handwritten notes, electronic communications, health checklists, and/or daily logs are examples of how parents/guardians and staff can exchange information when face-to-face is not possible.


Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

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